Biomedical subjects

Andrew C Larson

Publications and source records attributed to Andrew C Larson.

18 recordsLinked to original sources

PubMed2006

Comparison between intravenous and intraarterial contrast injections for dynamic 3D MRI of liver tumors in the VX2 rabbit model.

PURPOSE: To test the hypothesis that catheter-directed intraarterial (IA) contrast agent injection increases tumor enhancement and conspicuity compared to intravenous (IV) injection. MATERIALS AND METHODS: Eight VX2 liver tumors were grown in five rabbits. After positioning a catheter in the hepatic artery, we performed 3D inversion recovery GRE MRI after IA and IV gadopentetate-dimeglumine contrast injections at doses of 0.04 and 0.1 mmol/kg, respectively. Peak enhancement (signal-to-noise ratio (SNR)) and conspicuity (contrast-to-noise ratio (CNR)) were measured for each acquisition. RESULTS: The peak SNR and CNR were 21.7 +/- 5.8 and 17.0 +/- 4.8 (mean +/- SD) after IA injection, and 16.9 +/- 10.2 and 6.2 +/- 2.6 after IV injection. The IA CNR was significantly greater than the IV CNR (P < 0.05), with a >60% increase in CNR for each tumor. For six of the eight tumors the IA SNR was greater than the IV SNR, but statistical significance was not achieved due to the small sample size of the study (P = 0.07). CONCLUSION: We demonstrated the feasibility of using IA injection techniques to improve tumor conspicuity. This strategy could be employed to enhance the detection of small liver tumors or to conserve contrast agent in future MRI-guided transcatheter liver therapies.

Animals↗

PubMed2006

In vivo diffusion-weighted imaging of liver tumor necrosis in the VX2 rabbit model at 1.5 Tesla.

OBJECTIVES: We sought to demonstrate the feasibility of using single-shot spin-echo echo-planar imaging for imaging liver tumor necrosis in the in vivo VX2 rabbit model at 1.5 T. MATERIALS AND METHODS: VX2 liver tumors were grown in 4 rabbits. Diffusion-weighted images (DWIs) were acquired during breath-hold using twice refocused SE-EPI (b = 0, 700, 1400 seconds/mm). Anatomic images for tumor size measurements were acquired using T2W TSE. Rabbits were euthanized for subsequent necropsy. Viable and necrotic tumor tissue ADC measurements were performed with reference to hematoxylin and eosin pathology. RESULTS: A total of 8 tumors were grown with diameters ranging from 1.2 to 5.3 cm. Viable and necrotic tumor compartments were clearly differentiated. Apparent diffusion coefficient in necrotic tumor cores, 1.26 +/- 0.11 x 10 mm/s, were significantly greater than those in surrounding viable tumor tissues, 0.74 +/- 0.06 x 10 mm/s (mean +/- SD, P < 0.05). CONCLUSIONS: In vivo DWI of liver tumor necrosis in the VX2 rabbit model is feasible using a 1.5 T clinical magnetic resonance imaging scanner. DWI may permit longitudinal assessment of liver tumor therapies in both preclinical and clinical studies.

Animals↗

PubMed2006

Multishot diffusion-weighted PROPELLER magnetic resonance imaging of the abdomen.

OBJECTIVE: The objective of this study was to evaluate the feasibility of using multishot PROPELLER for diffusion-weighted imaging (DWI) of the abdomen. MATERIALS AND METHODS: Diffusion-weighted abdominal imaging was performed in 9 healthy volunteers and 3 patients using both single-shot DW-SE-EPI and multishot DW-PROPELLER (BLADE sequence). We compared ADC measurements in phantoms, liver and pancreatic tissues and performed qualitative comparisons of the diffusion-weighted images and ADC maps provided by these 2 techniques. RESULTS: DW-PROPELLER significantly improved image quality (P < 0.05) with reduced geometric distortion and artifact. The ADC values of phantoms and abdominal organs measured by DW-PROPELLER were generally greater than those measured by single-shot DW-SE-EPI. The ADC values measured by both DWI techniques were significantly different for liver tissues but not for pancreatic tissues (P < 0.05). Preliminary patient studies demonstrated clearly distinguished lesion areas from surrounding normal liver tissues in the DW-PROPELLER images. DW-PROPELLER offers the potential for high-resolution DWI of the abdomen. CONCLUSIONS: The multishot DW-PROPELLER sequence is a promising technique for DWI of abdominal organs. Future clinical studies will evaluate the use of DW-PROPELLER technique for abdominal oncologic imaging applications.

Abdomen↗

PubMed2006

Diffusion-weighted MR imaging for determination of hepatocellular carcinoma response to yttrium-90 radioembolization.

Early detection of the response of hepatocellular carcinoma (HCC) to yttrium-90 radioembolization therapy may be important to permit repeat radioembolization or alternative treatment options. Water-mobility measurements with use of diffusion-weighted (DW) magnetic resonance (MR) imaging are useful for noninvasive interrogation of microstructural tissue properties. Findings of DW MR imaging may serve as an early biomarker of HCC response. This study tested the hypothesis that DW MR imaging can detect changes in tumor tissue water diffusion in response to (90)Y therapy. In each of six patients with HCC included in the study, tumor water diffusion increased significantly after therapy. DW MR imaging is a promising technique for noninvasive assessment of tumor response to (90)Y radioembolization.

Adult↗

PubMed2006

Comparison of intraarterial MR angiography at 3.0 T with X-ray digital subtraction angiography for detection of renal artery stenosis in swine.

PURPOSE: To compare the accuracy of catheter-directed intraarterial (IA) magnetic resonance (MR) angiography at 3.0 T with that of x-ray digital subtraction angiography (DSA) for the measurement of renal artery stenosis (RAS) in swine. MATERIALS AND METHODS: Unilateral hemodynamically significant RAS (>50%) was induced surgically in six pigs with use of reverse cable ties. One to two weeks after surgery, each pig underwent x-ray DSA and MR angiography before and after percutaneous transluminal balloon angioplasty (PTA). X-ray DSA was performed before and after PTA of RAS by injection of iodinated contrast agent through a 5-F multiple-side hole angiographic catheter placed in the abdominal aorta under fluoroscopic guidance. MR angiography of RAS was performed before and after PTA of RAS on a 3.0-T clinical MR imager with use of gadolinium-based contrast agent. MR angiography and DSA images were analyzed with the full width at half maximum method. Percent stenosis measurements between x-ray DSA and MR angiography were compared with a paired t test and were correlated with linear regression and Bland Altman analysis (alpha = 0.05). RESULTS: Six cases of RAS were induced and imaged successfully with DSA and MR angiography techniques before and after PTA. On x-ray DSA, median stenoses was 64% (95% CI 57%-80%) before PTA and 20% (95% CI 5%-32%) after PTA. Corresponding MR angiography median stenosis measurement was 69% (95% CI 58%-80%) before PTA and 26% (95% CI 16%-36%) after PTA. A paired t test comparison did not show a difference between DSA and MR angiography (P = .16). RAS measurements on MR angiography correlated closely (P < .01) with DSA measurements (r(2) = 0.92). CONCLUSION: In swine, the accuracy of catheter-directed IA MR angiography with use of a clinical 3.0-T MR imaging unit for the measurement of RAS was similar to that of conventional x-ray DSA.

Angiography, Digital Subtraction↗

PubMed2006

MR imaging- versus conventional X-ray fluoroscopy-guided renal angioplasty in swine: prospective randomized comparison.

PURPOSE: To test the hypothesis that the technical success rates, complication rates, and procedural times for magnetic resonance (MR) imaging-guided percutaneous transluminal angioplasty (PTA) and conventional (x-ray) fluoroscopy-guided PTA for treatment of renal artery stenosis are similar. MATERIALS AND METHODS: The study was animal care and use committee approved. After surgically inducing bilateral renal artery stenosis in 11 swine, the authors performed baseline digital subtraction angiography. They transferred each animal to a 1.5-T MR imaging unit and randomly decided which artery would be treated with MR-guided PTA. With MR imaging guidance, angioplastic devices were tracked by using active and passive techniques. Vascular depiction was achieved by using catheter-directed MR angiography. Stenotic vessels were dilated by using 5-6-mm-diameter balloon catheters. PTA was then performed in the contralateral artery by using conventional fluoroscopy-guided techniques. With the intention to treat, the authors compared the technical success (residual stenosis < 50%) rates, complication rates, and procedural times for each guidance method. They compared technical successes and complications by using the McNemar test and procedural times by using a paired t test, with P < .05 indicating a significant difference. RESULTS: The authors successfully dilated nine (82%) of 11 renal arteries with MR guidance and all 11 arteries (100%) with conventional fluoroscopic guidance. The difference was not significant (P = .5). Complications occurred in three (27%) arteries with MR guidance and in one (9%) artery with fluoroscopic guidance, with no significant differences (P = .5). The mean MR-guided PTA procedural time was 46 minutes longer than the fluoroscopy-guided PTA procedural time; this difference was significant (P = .01). CONCLUSION: In a small cohort of swine, the authors did not observe a significant difference between MR imaging- and conventional fluoroscopy-guided renal artery PTA in terms of success and complication rates. However, no evidence of similarity between the techniques should be assumed. Procedural times differed significantly.

Angioplasty↗

PubMed2005

Preliminary investigation of respiratory self-gating for free-breathing segmented cine MRI.

Segmented cine MRI generally requires breath-holding, which can be problematic for many patients. Navigator echo techniques, particularly successful for free-breathing coronary MRA, are incompatible with the acquisition strategies and SSFP pulse sequences commonly used for cine MRI. The purpose of this work is to introduce a new self-gating technique deriving respiratory gating information directly from the raw imaging data acquired for segmented cine MRI. The respiratory self-gating technique uses interleaved radial k-space sampling to provide low-resolution images in real time during the free-breathing acquisition that are compared to target expiration images. Only the raw data-producing images with high correlation to the target images are included in the final high-resolution reconstruction. The self-gating technique produced cine series with no significant differences in quantitative image sharpness to series produced using comparable breath-held techniques. Because of the difficulties associated with breath-holding, the respiratory self-gating technique represents an important practical advance for cardiac MRI. , Inc.

Algorithms↗

PubMed2005

Motion-corrected free-breathing delayed enhancement imaging of myocardial infarction.

Following administration of Gd-DTPA, infarcted myocardium exhibits delayed enhancement and can be imaged using an inversion-recovery sequence. A conventional segmented acquisition requires a number of breath-holds to image the heart. Single-shot phase-sensitive inversion-recovery (PSIR) true-FISP may be combined with parallel imaging using SENSE to achieve high spatial resolution. SNR may be improved by averaging multiple motion-corrected images acquired during free breathing. PSIR techniques have demonstrated a number of benefits including consistent contrast and appearance over a relatively wide range of inversion recovery times (TI), improved contrast-to-noise ratio, and consistent size of the enhanced region. Comparison between images acquired using segmented breath-held turbo-FLASH and averaged, motion-corrected, free-breathing true-FISP show excellent agreement of measured CNR and infarct size. In this study, motion correction was implemented using image registration postprocessing rather than navigator correction of individual frames. Navigator techniques may be incorporated as well.

Algorithms↗

PubMed2005

Contrast-enhanced 4D radial coronary artery imaging at 3.0 T within a single breath-hold.

Coronary magnetic resonance angiography data are usually acquired during mid-diastole of each heartbeat to minimize cardiac motion related artifacts. The proper trigger delay time, which may vary widely among subjects, must be determined individually for each subject before data acquisition to achieve optimal image quality. These complications could be resolved by acquiring contiguous cardiac phase images through the cardiac cycle. In this study, we used a radial sampling technique to acquire 3D cine coronary artery images at 3 T within a single breath-hold. An extravascular, paramagnetic contrast agent was i.v. administered to improve the blood signal intensity. Relatively high temporal resolution and spatial resolution were achieved simultaneously with radial sampling, parallel data acquisition, and interleaved sliding window image reconstruction. Volunteer studies demonstrate the feasibility of this technique in acquiring 4D coronary artery images and the flexibility in postprocessing of 3D image sets.

Contrast Media↗

PubMed2005

4D radial coronary artery imaging within a single breath-hold: cine angiography with phase-sensitive fat suppression (CAPS).

Coronary artery data acquisition with steady-state free precession (SSFP) is typically performed in a single frame in mid-diastole with a spectrally selective pulse to suppress epicardial fat signal. Data are acquired while the signal approaches steady state, which may lead to artifacts from the SSFP transient response. To avoid sensitivity to cardiac motion, an accurate trigger delay and data acquisition window must be determined. Cine data acquisition is an alternative approach for resolving these limitations. However, it is challenging to use conventional fat saturation with cine imaging because it interrupts the steady-state condition. The purpose of this study was to develop a 4D coronary artery imaging technique, termed "cine angiography with phase-sensitive fat suppression" (CAPS), that would result in high temporal and spatial resolution simultaneously. A 3D radial stacked k-space was acquired over the entire cardiac cycle and then interleaved with a sliding window. Sensitivity-encoded (SENSE) reconstruction with rescaling was developed to reduce streak artifact and noise. Phase-sensitive SSFP was employed for fat suppression using phase detection. Experimental studies were performed on volunteers. The proposed technique provides high-resolution coronary artery imaging for all cardiac phases, and allows multiple images at mid-diastole to be averaged, thus enhancing the signal-to-noise ratio (SNR) and vessel delineation.

Adipose Tissue↗

PubMed2005

High-resolution steady-state free precession coronary magnetic resonance angiography within a breath-hold: parallel imaging with extended cardiac data acquisition.

Coronary artery imaging data are conventionally acquired in a single imaging frame during mid-diastole. The data acquisition window must be sufficiently short to avoid cardiac motion artifacts. A short data acquisition window results in decreased imaging efficiency and limited spatial resolution. Parallel imaging may lessen these limitations, but requires highly accurate coil sensitivity. The purpose of this work was to increase the imaging efficiency and spatial resolution in coronary artery imaging using parallel imaging with an extended acquisition window. External coil calibration data were acquired before and after a short mid-diastolic period of accelerated imaging data acquisition. It was assumed that residual cardiac motion in the extended acquisition window would not impede accurate estimation of coil sensitivity since only low spatial frequency signals were acquired for coil calibration. Experimental studies were performed in five healthy volunteers at 3 T using steady-state free precession sequence. Statistical comparison was made between the proposed method and conventional data acquisition for visual quality of image and vessel sharpness. The proposed technique demonstrated higher visual grading and improved vessel sharpness. The proposed method is a new approach to enhance the imaging efficiency and spatial resolution in coronary artery imaging.

Artifacts↗

PubMed2005

Determination of optimal gadolinium concentration using SSFP for catheter-directed contrast-enhanced coronary MR angiography.

RATIONALE AND OBJECTIVES: To determine the optimal gadolinium concentration for catheter-directed coronary magnetic resonance angiography (MRA) using magnetization-prepared steady-state free-precession (SSFP) in swine. MATERIALS AND METHODS: In six pigs, we performed real-time MR imaging-guided coronary artery catheterization using a 1.5 T MR scanner. For catheter-directed coronary MRA, we injected 3-4 mL of dilute Gd at 1 mL/second for each tested concentration (4%, 8%, 10%, and 12% Gd). Eleven images per concentration were acquired using electrocardiographic-triggered, magnetization-prepared two-dimensional (2D) projection SSFP. We compared mean relative signal-to-noise ratio (SNR) values for each concentration using two-way analysis of variance. RESULTS: The targeted coronary artery was catheterized under real-time MR guidance in all pigs. Magnetization-prepared 2D projection SSFP successfully depicted the coronary arteries in all 44 injections. Mean relative SNR (+/- standard error) was 7.2 +/- 0.49 for 4%, 8.8 +/- 0.47 for 8%, 9.5 +/- 0.38 for 10%, and 8.8 +/- 0.41 for 12%. Injections of 4% dilute gadolinium yielded significantly less relative SNR than the other tested concentrations (P < .05). There were no statistically significant differences between the remaining concentrations. CONCLUSION: For catheter-directed contrast-enhanced coronary MRA, the ideal gadolinium concentration should maximize relative SNR and limit the total gadolinium dose. Using these criteria, of those concentrations we tested in the swine model, 8% injected gadolinium was superior for catheter-directed SSFP coronary MRA.

Analysis of Variance↗

PubMed2005

Real-time MRI monitoring of transcatheter hepatic artery contrast agent delivery in rabbits.

RATIONALE AND OBJECTIVES: We sought to test the hypothesis that transcatheter hepatic artery delivery of dilute gadolinium (Gd) in rabbits can be monitored in real-time using magnetic resonance imaging (MRI). MATERIALS AND METHODS: Catheters (2F) were inserted via a femoral access into the hepatic arteries of six New Zealand White rabbits under radiographic guidance. After transfer to a 1.5-T MRI scanner, 26 separate hepatic artery injections of 2 mL of 4% Gd and 14 sham injections were performed. Real-time imaging of all injections was acquired using two-dimensional projection inversion recovery-gradient echo. Films of these 40 injections, as well as 10 random repeats, were independently reviewed in a randomized, blinded fashion by two Certificate of Added Qualification-certified interventional radiologists. Observers reported (i) if Gd injection occurred and (ii) if so, the location of delivery. For each observer, we compared sensitivity/specificity for real-time visualization of contrast injection and accuracy of injection localization. Interobserver and intraobserver variability was assessed using the kappa statistic. X-ray digital subtraction angiography was the gold standard for all MRI studies. RESULTS: Both observers had a sensitivity of 100% and a specificity of 93%. Accuracy for intrahepatic contrast delivery was 77% for both observers. Accuracy for extrahepatic delivery was 92% and 96%, respectively. Both interobserver and intraobserver agreement was outstanding. CONCLUSIONS: In rabbits, MRI allows for accurate real-time monitoring of transcatheter hepatic artery delivery of contrast agent. Localization accuracy is higher outside the liver than within the liver. These results can be used as a baseline reference for comparing the accuracy of delivery of Gd-tagged therapies in the future.

Animals↗

PubMed2005

The effect of catheter-directed CT angiography on yttrium-90 radioembolization treatment of hepatocellular carcinoma.

PURPOSE: Yttrium 90 radioembolization is a transcatheter therapy for unresectable hepatocellular carcinoma (HCC) that delivers internal radiation to tumors. In contrast to the usual method of lobar regional delivery, catheter-directed computed tomographic (CT) angiography was investigated as a potentially useful technique to evaluate the administration of segmental 90Y tumor radiation doses superselectively without significantly altering liver function or Child-Pugh classification. MATERIALS AND METHODS: Fourteen patients underwent 90Y therapy for unresectable HCC. After standard angiographic placement of a 3-F microcatheter in a segmental hepatic artery supplying the tumor, each patient underwent CT angiography with use of segmental hepatic artery injection of iodinated contrast agent to confirm segmental perfusion and delineate segmental liver volume. 90Y was later injected into the same segmental artery. Target dose was calculated according to infused 90Y activity and targeted hepatic volume with standard lobar volume (before CT angiography) versus segmental liver volume (after CT angiography). The Wilcoxon signed-rank test (alpha = 0.05) was used to compare the estimated 90Y dose before CT angiography with the actual 90Y dose after CT angiography, as well as changes in serum bilirubin level and Child-Pugh classification as a result of treatment. RESULTS: The mean estimated tumor dose before CT angiography (SD) was 100 Gy +/- 43 (range, 35-169 Gy). The mean actual tumor dose after CT angiography was 348 Gy +/- 204 (range, 105-857 Gy), which was significantly greater (P < .001). The mean bilirubin level before treatment was 1.0 mg/dL +/- 0.97 (range, 0.2-4.0 mg/dL), whereas the mean bilirubin level after treatment was 1.3 mg/dL +/- 0.85 (range, 0.5-3.8 mg/dL). This difference, although statistically significant (P = .03), was not clinically important. Thirteen of 14 patients had no change in Child-Pugh class. CONCLUSION: CT angiography can be used to delineate the blood supply and volume to a targeted hepatic segment, allowing superselective 90Y radioembolization. This approach significantly increases effective 90Y tumor radiation dose without clinically altering liver function or Child-Pugh class.

Adult↗

PubMed2005

Feasibility of blood oxygenation level-dependent MR imaging to monitor hepatic transcatheter arterial embolization in rabbits.

Blood oxygenation level-dependent (BOLD) magnetic resonance (MR) imaging is a noninvasive method to assess changes in oxygen delivery to tissues. It was hypothesized that BOLD MR imaging can detect changes in rabbit VX2 liver tumor oxygenation after hepatic artery embolization with polyvinyl alcohol particles. In four discrete VX2 liver tumors, a statistically significant mean reduction in apparent transverse relaxation time was shown, from 55 milliseconds before embolization to 41 milliseconds after embolization (P < .01). This reduction corresponded to a decrease in hepatic tumor oxygenation. The use of BOLD MR imaging to monitor changes in hepatic tumor oxygenation after embolization is feasible. These functional MR imaging measurements of hypoxia may be targeted as an endpoint for therapy in future studies.

Angiography, Digital Subtraction↗

PubMed2004

Self-gated cardiac cine MRI.

The need for ECG gating presents many difficulties in cardiac magnetic resonance imaging (CMRI). Real-time imaging techniques eliminate the need for ECG gating in cine CMRI, but they cannot offer the spatial and temporal resolution provided by segmented acquisition techniques. Previous MR signal-based techniques have demonstrated an ability to provide cardiac gating information; however, these techniques result in decreased imaging efficiency. The purpose of this work was to develop a new "self-gated" (SG) acquisition technique that eliminates these efficiency deficits by extracting the motion synchronization signal directly from the same MR signals used for image reconstruction. Three separate strategies are proposed for deriving the SG signal from data acquired using radial k-space sampling: echo peak magnitude, kymogram, and 2D correlation. The SG techniques were performed on seven normal volunteers. A comparison of the results showed that they provided cine image series with no significant differences in image quality compared to that obtained with conventional ECG gating techniques. SG techniques represent an important practical advance in clinical MRI because they enable the acquisition of high temporal and spatial resolution cardiac cine images without the need for ECG gating and with no loss in imaging efficiency.

Algorithms↗

PubMed2004

Automated rectilinear self-gated cardiac cine imaging.

ECG-based gating in cardiac MR imaging requires additional patient preparation time, is susceptible to RF and magnetic interference, and is ineffective in a significant percentage of patients. "Wireless" or "self-gating" techniques have been described using either interleaved central k-space lines or projection reconstruction to obtain MR signals synchronous with the cardiac cycle. However, the interleaved, central line method results in a doubling of the acquisition time, while radial streak artifacts are encountered with the projection reconstruction method. In this work, a new self-gating technique is presented to overcome these limitations. A retrospectively gated TrueFISP cine sequence was modified to acquire a short second echo after the readout and phase gradients are rewound. The information obtained from this second echo was used to derive a gating signal. This technique was compared to ECG-based gating in 10 healthy volunteers and shown to have no significant difference in image quality. The results indicate that this method could serve as an alternative gating strategy without the need for external physiological signal detection.

Electrocardiography↗

PubMed2002

Coronary MRA with 3D undersampled projection reconstruction TrueFISP.

Undersampled projection reconstruction (PR) offers improved imaging efficiency allowing a relative tradeoff between signal-to-noise ratio (SNR) or streak artifact and the number of acquired k-space views rather than the tradeoff between resolution or aliasing artifact and the number of acquired k-space lines inherent to Fourier imaging techniques. TrueFISP (true fast imaging with steady state precession) is ideally suited for undersampled PR imaging because of its inherently high SNR. The purpose of this work was to investigate the feasibility of using undersampled three-dimensional (3D) PR TrueFISP for breathhold coronary artery imaging. Phantom studies and a preliminary in vivo comparison demonstrated the improved spatial resolution of PR over Fourier TrueFISP with the same imaging time. In a 24-heartbeat coronary imaging scheme, segmented 3D PR TrueFISP provided a 1.0 x 1.0 mm(2) isotropic in-plane voxel size while acquiring between 93 and 153 views per partition. Streak artifacts were present in some images but were not found to impede coronary artery delineation. In conclusion, 3D undersampled PR TrueFISP provides isotropic in-plane voxel size within a single breathhold and is a promising technique for coronary artery imaging.

Arteries↗