ObjectiveThis study aims to assess the statistical significance of training parameters in 240 dense UNets (DUNets) used for enhancing low Signal-to-Noise Ratio (SNR) and undersampled MRI in various... Show moreObjectiveThis study aims to assess the statistical significance of training parameters in 240 dense UNets (DUNets) used for enhancing low Signal-to-Noise Ratio (SNR) and undersampled MRI in various acquisition protocols. The objective is to determine the validity of differences between different DUNet configurations and their impact on image quality metrics.Materials and MethodsTo achieve this, we trained all DUNets using the same learning rate and number of epochs, with variations in 5 acquisition protocols, 24 loss function weightings, and 2 ground truths. We calculated evaluation metrics for two metric regions of interest (ROI). We employed both Analysis of Variance (ANOVA) and Mixed Effects Model (MEM) to assess the statistical significance of the independent parameters, aiming to compare their efficacy in revealing differences and interactions among fixed parameters.ResultsANOVA analysis showed that, except for the acquisition protocol, fixed variables were statistically insignificant. In contrast, MEM analysis revealed that all fixed parameters and their interactions held statistical significance. This emphasizes the need for advanced statistical analysis in comparative studies, where MEM can uncover finer distinctions often overlooked by ANOVA.DiscussionThese findings highlight the importance of utilizing appropriate statistical analysis when comparing different deep learning models. Additionally, the surprising effectiveness of the UNet architecture in enhancing various acquisition protocols underscores the potential for developing improved methods for characterizing and training deep learning models. This study serves as a stepping stone toward enhancing the transparency and comparability of deep learning techniques for medical imaging applications. Show less
PurposeConcomitant gradient fields have been extensively studied at clinical field strengths. However, their effects have not yet been modeled for low-field point-of-care (POC) systems. The purpose... Show morePurposeConcomitant gradient fields have been extensively studied at clinical field strengths. However, their effects have not yet been modeled for low-field point-of-care (POC) systems. The purpose of this work is to characterize the effects associated with concomitant fields for POC Halbach-array-based systems.MethodsThe concomitant fields associated with a cylindrical gradient coils designed for a transverse B0$$ {B}_0 $$ and a signal model including the tilting effect of the effective magnetic field are derived. The formalism is used to simulate and predict concomitant field related distortions. A 46-mT Halbach-array-based system with a maximum gradient strength of 15 mT/m is used to verify the model using two-dimensional spin-echo sequences.ResultsThe simulations and experimental results are in good agreement with the derived equations. The fundamental characteristics of the concomitant field equations are different to conventional MRI systems: Image distortions occur primarily in the transverse directions and a cross-term only exists when applying transverse gradient pulses simultaneously.ConclusionThe level of image warping in the frequency encoding direction is insignificant for the POC systems discussed here. However, when trying to achieve short echo-times by using strong phase encoding and readout-dephasing gradients, the combination can result in image warping and blurring which should be accounted for in image interpretation. Show less
In March 2022, the first ISMRM Workshop on Low-Field MRI was held virtually. The goals of this workshop were to discuss recent low field MRI technology including hardware and software developments,... Show moreIn March 2022, the first ISMRM Workshop on Low-Field MRI was held virtually. The goals of this workshop were to discuss recent low field MRI technology including hardware and software developments, novel methodology, new contrast mechanisms, as well as the clinical translation and dissemination of these systems. The virtual Workshop was attended by 368 registrants from 24 countries, and included 34 invited talks, 100 abstract presentations, 2 panel discussions, and 2 live scanner demonstrations. Here, we report on the scientific content of the Workshop and identify the key themes that emerged. The subject matter of the Workshop reflected the ongoing developments of low-field MRI as an accessible imaging modality that may expand the usage of MRI through cost reduction, portability, and ease of installation. Many talks in this Workshop addressed the use of computational power, efficient acquisitions, and contemporary hardware to overcome the SNR limitations associated with low field strength. Participants discussed the selection of appropriate clinical applications that leverage the unique capabilities of low-field MRI within traditional radiology practices, other point-of-care settings, and the broader community. The notion of "image quality" versus "information content" was also discussed, as images from low-field portable systems that are purpose-built for clinical decision-making may not replicate the current standard of clinical imaging. Speakers also described technical challenges and infrastructure challenges related to portability and widespread dissemination, and speculated about future directions for the field to improve the technology and establish clinical value. Show less
We have investigated an approach for obtaining H-1 NMR spectra of different alcohols on a large-bore (27 cm diameter), B (0) = 0.05 T (f (0) = 2 MHz) portable MRI scanner. We used a Carr-Purcell... Show moreWe have investigated an approach for obtaining H-1 NMR spectra of different alcohols on a large-bore (27 cm diameter), B (0) = 0.05 T (f (0) = 2 MHz) portable MRI scanner. We used a Carr-Purcell-Meiboom-Gill (CPMG) sequence to acquire multiecho data from solutions of different alcohols, focusing on ethanol, a molecule of relevance to many applications in the food and beverage industry. Our results show that the Fourier transformed J-spectra at different echo spacings fit well with simulations of the evolution of the echo train signal with excellent signal to noise ratio (SNR) for concentrations of similar to 10 % within a few minutes. Spectra were also obtained from intact bottles of whiskey and wine. Finally, we show that different alcohols with similar chemical structures can be differentiated using this approach. Show less
ObjectiveLow-cost low-field point-of-care MRI systems are used in many different applications. System design has correspondingly different requirements in terms of imaging field-of-view, spatial... Show moreObjectiveLow-cost low-field point-of-care MRI systems are used in many different applications. System design has correspondingly different requirements in terms of imaging field-of-view, spatial resolution and magnetic field strength. In this work an iterative framework has been created to design a cylindrical Halbach-based magnet along with integrated gradient and RF coils that most efficiently fulfil a set of user-specified imaging requirements.MethodsFor efficient integration, target field methods are used for each of the main hardware components. These have not been used previously in magnet design, and a new mathematical model was derived accordingly. These methods result in a framework which can design an entire low-field MRI system within minutes using standard computing hardware.ResultsTwo distinct point-of-care systems are designed using the described framework, one for neuroimaging and the other for extremity imaging. Input parameters are taken from literature and the resulting systems are discussed in detail.DiscussionThe framework allows the designer to optimize the different hardware components with respect to the desired imaging parameters taking into account the interdependencies between these components and thus give insight into the influence of the design choices. Show less
Purpose: Activated brown adipose tissue (BAT) enhances lipid catabolism and improves cardiometabolic health. Quantitative MRI of the fat fraction (FF) of supraclavicular BAT (scBAT) is a promising... Show morePurpose: Activated brown adipose tissue (BAT) enhances lipid catabolism and improves cardiometabolic health. Quantitative MRI of the fat fraction (FF) of supraclavicular BAT (scBAT) is a promising noninvasive measure to assess BAT activity but suffers from high scan variability. We aimed to test the effects of coregistration and mutual thresholding on the scan variability in a fast (1 min) time-resolution MRI protocol for assessing scBAT FF changes during cold exposure. Methods: Ten volunteers (age 24.8 +/- 3.0 years; body mass index 21.2 +/- 2.1 kg/m(2)) were scanned during thermoneutrality (32 degrees C; 10 min) and mild cold exposure (18 degrees C; 60 min) using a 12-point gradient-echo sequence (70 consecutive scans with breath-holds, 1.03 min per dynamic). Dynamics were coregistered to the first thermoneutral scan, which enabled drawing of single regions of interest in the scBAT depot. Voxel-wise FF changes were calculated at each time point and averaged across regions of interest. We applied mutual FF thresholding, in which voxels were included if their FF was greater than 30% FF in the reference scan and the registered dynamic. The efficacy of the coregistration was determined by using a moving average and comparing the mean squared error of residuals between registered and nonregistered data. Registered scBAT Delta FF was compared with single-scan thresholding using the moving average method. Results: Registered scBAT Delta FF had lower mean square error values than nonregistered data (0.07 +/- 0.05% vs. 0.16 +/- 0.14%; p<0.05), and mutual thresholding reduced the scBAT Delta FF variability by 30%. Conclusion: We demonstrate that coregistration and mutual thresholding improve stability of the data 2-fold, enabling assessment of small changes in FF following cold exposure. Show less
PurposeHigh permittivity dielectric pads are known to be effective for tailoring the RF field and improving image quality in high field MRI. Despite a number of studies reporting benign specific... Show morePurposeHigh permittivity dielectric pads are known to be effective for tailoring the RF field and improving image quality in high field MRI. Despite a number of studies reporting benign specific absorption rate (SAR) effects, their "universal" safety remains an open concern. In this work, we evaluate the impact of the insulation material in between the pad and the body, using both RF simulations as well as phantom experiments. MethodsA 3T configuration with high permittivity material was simulated and characterized experimentally in terms of B-1(+) fields and RF power absorption, both with and without electrical insulation in between the high permittivity material and the sample. Different insulation conditions were compared, and electromagnetic analyses on the induced current density were performed to elucidate the effect. ResultsIncreases in RF heating of up to 49% were observed experimentally in a tissue-mimicking phantom after removing the material insulation. The B-1(+) magnitude and RF transceive phase were not affected. Simulations indicated that an insulation thickness of 0.5-2 mm should be accounted for in numerical models in order to ensure reliable results. ConclusionA reliable RF safety assessment of high permittivity dielectric pads requires accounting for the insulating properties of the plastic encasing. Ignoring the electrical insulation can lead to erroneous results with substantial increases in local SAR at the interface. Conversely, the material insulation does not need to be modeled to predict the B-1(+) effects during the design of the pad geometry. Show less
Anazodo, U.C.; Ng, J.J.; Ehiogu, B.; Obungoloch, J.; Fatade, A.; Mutsaerts, H.J.M.M.; ... ; Consortium Advanced MRI Education Research in Africa (CAMERA) 2022
Magnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances,... Show moreMagnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances, MRI remains largely inaccessible to clinicians, patients, and researchers in low-resource areas, such as Africa. The rapidly growing burden of noncommunicable diseases in Africa underscores the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education and Research in Africa (CAMERA) is a network of African biomedical imaging experts and global partners, implementing novel strategies to advance MRI access and research in Africa. Upon its inception in 2019, CAMERA sets out to identify challenges to MRI usage and provide a framework for addressing MRI needs in the region. To this end, CAMERA conducted a needs assessment survey (NAS) and a series of symposia at international MRI society meetings over a 2-year period. The 68-question NAS was distributed to MRI users in Africa and was completed by 157 clinicians and scientists from across Sub-Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at less than one, of which 39% were obsolete low-field systems but still in use to meet daily clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher-field (1.5 T) MRI scanners in the region. However, these systems are underutilized, with only 8% of facilities reporting clinical scans of 15 or more patients per day, per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. The CAMERA NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up-to-date data on MRI density in Africa and offers a unique insight into Africa's MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high-value MRI access in SSA. Findings from the NAS and focused discussions at international MRI society meetings provided the basis for the framework presented here for advancing MRI capacity in SSA. While these findings pertain to SSA, the framework provides a model for advancing imaging needs in other low-resource settings. Show less
MR scans of low-gamma X-nuclei, low-concentration metabolites, or standard imaging at very low field entail a challenging tradeoff between resolution, signal-to-noise, and acquisition duration.... Show moreMR scans of low-gamma X-nuclei, low-concentration metabolites, or standard imaging at very low field entail a challenging tradeoff between resolution, signal-to-noise, and acquisition duration. Deep learning (DL) techniques, such as UNets, can potentially be used to improve such "low-quality" (LQ) images. We investigate three UNets for upscaling LQ MRI: dense (DUNet), robust (RUNet), and anisotropic (AUNet). These were evaluated for two acquisition scenarios. In the same-subject High-Quality Complementary Priors (HQCP) scenario, an LQ and a high quality (HQ) image are collected and both LQ and HQ were inputs to the UNets. In the No Complementary Priors (NoCP) scenario, only the LQ images are collected and used as the sole input to the UNets. To address the lack of same-subject LQ and HQ images, we added data from the OASIS-1 database. The UNets were tested in upscaling 1/8, 1/4, and 1/2 undersampled images for both scenarios. As manifested by non-statically significant differences of matrices, also supported by subjective observation, the three UNets upscaled images equally well. This was in contrast to mixed effects statistics that clearly illustrated significant differences. Observations suggest that the detailed architecture of these UNets may not play a critical role. As expected, HQCP substantially improves upscaling with any of the UNets. The outcomes support the notion that DL methods may have merit as an integral part of integrated holistic approaches in advancing special MRI acquisitions; however, primary attention should be paid to the foundational step of such approaches, i.e., the actual data collected. Show less
In a standard spin echo, the time evolution due to homonuclear couplings is not reversed, leading to echo time (TE)-dependent modulation of the signal amplitude and signal loss in the case of... Show moreIn a standard spin echo, the time evolution due to homonuclear couplings is not reversed, leading to echo time (TE)-dependent modulation of the signal amplitude and signal loss in the case of overlapping multiplet resonances. This has an adverse effect on quantification of several important metabolites such as glutamate and glutamine. Here, we propose a J-refocused variant of the sLASER sequence (J-sLASER) to improve quantification of J-coupled metabolites at ultrahigh field (UHF). The use of the sLASER sequence is particularly advantageous at UHF as it minimizes chemical shift displacement error and results in relatively homogenous refocusing. We simulated the MRS signal from brain metabolites over a broad range of TE values with sLASER and J-sLASER, and showed that the signal of J-coupled metabolites was increased with J-sLASER with TE values up to similar to 80 ms. We further simulated "brain-like" spectra with both sequences at the shortest TE available on our scanner. We showed that, despite the slightly longer TE, the J-sLASER sequence results in significantly lower Cramer-Rao lower bounds (CRLBs) for J-coupled metabolites compared with those obtained with sLASER. Following phantom validation, we acquired spectra from two brain regions in 10 healthy volunteers (age 38 +/- 15 years) using both sequences. We showed that using J-sLASER results in a decrease of CRLBs for J-coupled metabolites. In particular, we measured a robust similar to 38% decrease in the mean CRLB (glutamine) in parietal white matter and posterior cingulate cortex (PCC). We further showed, in 10 additional healthy volunteers (age 34 +/- 15 years), that metabolite quantification following two separate acquisitions with J-sLASER in the PCC was repeatable. The improvement in quantification of glutamine may in turn improve the independent quantification of glutamate, the main excitatory neurotransmitter in the brain, and will simultaneously help to track possible modulations of glutamine, which is a key player in the glutamatergic cycle in astrocytes. Show less
Purpose: Brown adipose tissue (BAT) increases metabolic heat production in response to cold exposure. Body size and composition are involved in the human cold response, yet the influence of BAT... Show morePurpose: Brown adipose tissue (BAT) increases metabolic heat production in response to cold exposure. Body size and composition are involved in the human cold response, yet the influence of BAT herein have not fully been explored. Here, we aimed to study the association of the cold-induced shivering threshold time with body composition, BAT, the perception of shivering and skin temperature in young adults. Methods: 110 young healthy adults (81 females; age = 21.7 +/- 2.1 years, BMI = 24.2 +/- 4.3 kg/m2) underwent 2 h of individualized cooling, followed by the quantification of BAT using a18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography-computed tomography (PET-CT) scan. Body mass index (BMI), lean mass, fat mass and body surface area (BSA) were also measured. Shivering threshold time was defined as the time until shivering occurred using an individualized cooling protocol. Results: The shivering threshold time was on average 116.1 min for males and 125.8 min for females, and was positively associated to BMI (beta = 3.106; R2 = 0.141; p = 0.001), lean mass (beta = 2.295; R2 = 0.128; p = 0.001) and fat mass (beta = 1.492; R2 = 0.121; p = 0.001) in females, but not in males (all p >= 0.409). The shivering threshold time was positively associated with BSA in males (p = 0.047) and females (p = 0.001), but it was not associated with BAT volume or [18F]FDG uptake nor with the perception of shivering and skin temperature perception in both sexes. Conclusion: The shivering threshold time is positively associated with whole-body adiposity and lean mass in females, but not in males. The shivering threshold time was positively associated with BSA, but no association was observed with BAT nor with the perception of shivering or skin temperature. Future research should consider the influence of body composition when applying cooling protocols among individuals with different phenotypical features. Show less
Microvascular function is an important component in the physiology of muscle. One of the major parameters, blood perfusion, can be measured noninvasively and quantitatively by arterial spin... Show moreMicrovascular function is an important component in the physiology of muscle. One of the major parameters, blood perfusion, can be measured noninvasively and quantitatively by arterial spin labeling (ASL) MRI. Most studies using ASL in muscle have only reported data from a single slice, thereby assuming that muscle perfusion is homogeneous within muscle, whereas recent literature has reported proximodistal differences in oxidative capacity and perfusion. Here, we acquired pulsed ASL data in 12 healthy volunteers after dorsiflexion exercise in two slices separated distally by 7 cm. We combined this with a Look-Locker scheme to acquire images at multiple postlabeling delays (PLDs) and with a multiecho readout to measure T-2*. This enabled the simultaneous evaluation of quantitative muscle blood flow (MBF), arterial transit time (ATT), and T-2* relaxation time in the tibialis anterior muscle during recovery. Using repeated measures analyses of variance we tested the effect of time, slice location, and their interaction on MBF, ATT, and T-2*. Our results showed a significant difference as a function of time postexercise for all three parameters (MBF: F = 34.0, p < .0001; T-2*: F = 73.7, p < .0001; ATT: F = 13.6, p < .001) and no average differences between slices over the total time postexercise were observed. The interaction effect between time postexercise and slice location was significant for MBF and T-2* (F = 5.5, p = 0.02, F = 6.1, p = 0.02, respectively), but not for ATT (F = 2.2, p = .16). The proximal slice showed a higher MBF and a lower ATT than the distal slice during the first 2 min of recovery, and T-2* showed a delayed response in the distal slice. These results imply a higher perfusion and faster microvascular response to exercise in the proximal slice, in line with previous literature. Moreover, the differences in ATT indicate that it is difficult to correctly determine perfusion based on a single PLD as is commonly performed in the muscle literature. Show less
Low-field MRI scanners are significantly less expensive than their high-field counterparts, which gives them the potential to make MRI technology more accessible all around the world. In general,... Show moreLow-field MRI scanners are significantly less expensive than their high-field counterparts, which gives them the potential to make MRI technology more accessible all around the world. In general, images acquired using low-field MRI scanners tend to be of a relatively low resolution, as signal-to-noise ratios are lower. The aim of this work is to improve the resolution of these images. To this end, we present a deep learning-based approach to transform low-resolution low-field MR images into high-resolution ones. A convolutional neural network was trained to carry out single image super-resolution reconstruction using pairs of noisy low-resolution images and their noise-free high-resolution counterparts, which were obtained from the publicly available NYU fastMRI database. This network was subsequently applied to noisy images acquired using a low-field MRI scanner. The trained convolutional network yielded sharp super-resolution images in which most of the high-frequency components were recovered. In conclusion, we showed that a deep learning-based approach has great potential when it comes to increasing the resolution of low-field MR images. Show less
Moussu, M.A.C.; Abdeddaim, R.; Dubois, M.; Georget, E.; Webb, A.G.; Nenasheva, E.; ... ; Enoch, S. 2022
Comments about the above article [1] were proposed. We thank and reply to the authors of the comments about our model of high-permittivity dielectric ring resonators used as microscopy magnetic... Show moreComments about the above article [1] were proposed. We thank and reply to the authors of the comments about our model of high-permittivity dielectric ring resonators used as microscopy magnetic resonance probes. In this prospect, we reply part by part to the comments. Show less
Purpose: Parallel RF transmission (PTx) is one of the key technologies enabling high quality imaging at ultra-high fields (>= 7T). Compliance with regulatory limits on the local specific... Show morePurpose: Parallel RF transmission (PTx) is one of the key technologies enabling high quality imaging at ultra-high fields (>= 7T). Compliance with regulatory limits on the local specific absorption rate (SAR) typically involves over-conservative safety margins to account for intersubject variability, which negatively affect the utilization of ultra-high field MR. In this work, we present a method to generate a subject-specific body model from a single T1-weighted dataset for personalized local SAR prediction in PTx neuroimaging at 7T. Methods: Multi-contrast data were acquired at 7T (N = 10) to establish ground truth segmentations in eight tissue types. A 2.5D convolutional neural network was trained using the T1-weighted data as input in a leave-one-out cross-validation study. The segmentation accuracy was evaluated through local SAR simulations in a quadrature birdcage as well as a PTx coil model. Results: The network-generated segmentations reached Dice coefficients of 86.7% +/- 6.7% (mean +/- SD) and showed to successfully address the severe intensity bias and contrast variations typical to 7T. Errors in peak local SAR obtained were below 3.0% in the quadrature birdcage. Results obtained in the PTx configuration indicated that a safety margin of 6.3% ensures conservative local SAR estimates in 95% of the random RF shims, compared to an average overestimation of 34% in the generic "one-size-fits-all" approach. Conclusion: A subject-specific body model can be automatically generated from a single T1-weighted dataset by means of deep learning, providing the necessary inputs for accurate and personalized local SAR predictions in PTx neuroimaging at 7T. Show less
In Becker muscular dystrophy (BMD), muscle weakness progresses relatively slowly, with a highly variable rate among patients. This complicates clinical trials, as clinically relevant changes are... Show moreIn Becker muscular dystrophy (BMD), muscle weakness progresses relatively slowly, with a highly variable rate among patients. This complicates clinical trials, as clinically relevant changes are difficult to capture within the typical duration of a trial. Therefore, predictors for disease progression are needed. We assessed if temporal increase of fat fraction (FF) in BMD follows a sigmoidal trajectory and whether fat fraction at baseline (FFbase) could therefore predict FF increase after 2 years (Delta FF). Thereafter, for two different MR-based parameters, we tested the additional predictive value to FFbase. We used 3-T Dixon data from the upper and lower leg, and multiecho spinecho MRI and 7-T P-31 MRS datasets from the lower leg, acquired in 24 BMD patients (age: 41.4 [SD 12.8] years). We assessed the pattern of increase in FF using mixed-effects modelling. Subsequently, we tested if indicators of muscle damage like standard deviation in water T-2 (stdT(2)) and the phosphodiester (PDE) over ATP ratio at baseline had additional value to FFbase for predicting Delta FF. The association between FFbase and Delta FF was described by the derivative of a sigmoid function and resulted in a peak Delta FF around 0.45 FFbase (fourth-order polynomial term: t = 3.7, p < .001). StdT(2) and PDE/ATP were not significantly associated with Delta FF if FFbase was included in the model. The relationship between FFbase and Delta FF suggests a sigmoidal trajectory of the increase in FF over time in BMD, similar to that described for Duchenne muscular dystrophy. Our results can be used to identify muscles (or patients) that are in the fast progressing stage of the disease, thereby facilitating the conduct of clinical trials. Show less
Study Design: This was a survey of the surgeon members of the Lumbar Spine Research Society (LSRS).Objective: The purpose of this study was to assess trends in surgical practice and patient... Show moreStudy Design: This was a survey of the surgeon members of the Lumbar Spine Research Society (LSRS).Objective: The purpose of this study was to assess trends in surgical practice and patient management involving elective and emergency surgery in the early months of the coronavirus pandemic.Summary of Background Data: The novel coronavirus has radically disrupted medical care in the first half of 2020. Little data exists regarding the exact nature of its effect on spine care.Methods: A 53-question survey was sent to the surgeon members of the LSRS. Respondents were contacted via email 3 times over a 2-week period in late April. Questions concentrated on surgical and clinical practice patterns before and after the pandemic. Other data included elective surgical schedules and volumes, as well as which emergency cases were being performed. Surgeons were asked about the status of coronavirus disease 2019 (COVID-19) virus testing. Circumstances for performing surgical intervention on patients with and without testing as well as patients testing positive were explored.Results: A total of 43 completed surveys were returned of 174 sent to active surgeons in the LSRS (25%). Elective lumbar spine procedures decreased by 90% in the first 2 months of the pandemic, but emergency procedures did not change. Patients with "stable" lumbar disease had surgeries deferred indefinitely, even beyond 8 weeks if necessary. In-person outpatient visits became increasingly rare events, as telemedicine consultations accounted for 67% of all outpatient spine appointments. In total, 91% surgeons were under some type of confinement. Only 11% of surgeons tested for the coronavirus on all surgical patients.Conclusions: Elective lumbar surgery was significantly decreased in the first few months of the coronavirus pandemic, and much of outpatient spine surgery was practiced via telemedicine. Despite these constraints, spine surgeons performed emergency surgery when indicated, even when the COVID-19 status of patients was unknown. Show less
Purpose Low-field (B-0 < 0.1 T) MRI has generated much interest as a means of increased accessibility via reduced cost and improved portability compared to conventional clinical systems (B-0 >... Show morePurpose Low-field (B-0 < 0.1 T) MRI has generated much interest as a means of increased accessibility via reduced cost and improved portability compared to conventional clinical systems (B-0 >= 1.5 Tesla). Here we measure MR relaxation times at 50 mT and compare results with commonly used models based on both in vivo and ex vivo measurements. Methods Using 3D turbo spin echo readouts, T-1 and T-2 maps of the human brain and lower leg were acquired on a custom-built 50 mT MRI scanner using inversion-recovery and multi-echo-based sequences, respectively. Image segmentation was performed based on a histogram analysis of the relaxation times. Results The average T-1 times of gray matter, white matter, and cerebrospinal fluid (CSF) were 327 +/- 10 ms, 275 +/- 5 ms, and 3695 +/- 287 ms, respectively. Corresponding values of T-2 were 102 +/- 6 ms, 102 +/- 6 ms, and 1584 +/- 124 ms. T-1 times in the calf muscle were measured to be 171 +/- 11 ms and were 130 +/- 5 ms in subcutaneous and bone marrow lipid. Corresponding T-2 times were 39 +/- 2 ms in muscle and 90 +/- 13 ms in lipid. Conclusions For tissues except for CSF, the measured T-1 times are much shorter than reported at higher fields and generally lie within the range of different models in the literature. As expected, T-2 times are similar to those seen at typical clinical field strengths. Analysis of the relaxation maps indicates that segmentation of white and gray matter based purely on T-1 or T-2 will be quite challenging at low field given the relatively small difference in relaxation times. Show less
Introduction/Aims Duchenne and Becker muscular dystrophies (DMD and BMD, respectively) are characterized by fat replacement of different skeletal muscles in a specific temporal order. Given the... Show moreIntroduction/Aims Duchenne and Becker muscular dystrophies (DMD and BMD, respectively) are characterized by fat replacement of different skeletal muscles in a specific temporal order. Given the structural role of dystrophin in skeletal muscle mechanics, muscle architecture could be important in the progressive pathophysiology of muscle degeneration. Therefore, the aim of this study was to assess the role of muscle architecture in the progression of fat replacement in DMD and BMD. Methods We assessed the association between literature-based leg muscle architectural characteristics and muscle fat fraction from 22 DMD and 24 BMD patients. Dixon-based magnetic resonance imaging estimates of fat fractions at baseline and 12 (only DMD) and 24 months were related to fiber length and physiological cross-sectional area (PCSA) using age-controlled linear mixed modeling. Results DMD and BMD muscles with long fibers and BMD muscles with large PCSAs were associated with increased fat fraction. The effect of fiber length was stronger in muscles with larger PCSA. Discussion Muscle architecture may explain the pathophysiology of muscle degeneration in dystrophinopathies, in which proximal muscles with a larger mass (fiber length x PCSA) are more susceptible, confirming the clinical observation of a temporal proximal-to-distal progression. These results give more insight into the mechanical role in the pathophysiology of muscular dystrophies. Ultimately, this new information can be used to help support the selection of current and the development of future therapies. Show less
The ability to control the electromagnetic near field with metasurfaces offers potential applications over the frequency range from radio frequency to optical domains. In this work, we show an... Show moreThe ability to control the electromagnetic near field with metasurfaces offers potential applications over the frequency range from radio frequency to optical domains. In this work, we show an essential feature of metasurfaces, subwavelength field confinement via excitation of a large number of eigenstates in a narrow frequency range, and demonstrate an innovative way of visualizing profiles of metasurface eigenmodes with the aid of a magnetic resonance imaging (MRI) system. We show that by tuning different eigenmodes of the metasurface to the Larmor frequency, we can passively tailor the near-field distribution to adjust the desired pattern of radio-frequency excitation in a MRI experiment. Our work demonstrates a practical nonperturbed rapid way of imaging metasurface eigenmodes. Show less
