Pulmonary Structural MRI using Free-Breathing, Self-Gated Ultra-short Echo Time Imaging

Summary

A protocol is described for generating high-resolution structural images of the lungs using ultra-short-echo time (UTE) Magnetic Resonance Imaging (MRI). This protocol allows for images to be acquired using a simple MRI pulse sequence during free-breathing.

Abstract

High quality MRI of the lungs is challenged by low tissue density, fast MRI signal relaxation, and respiratory and cardiac motion. For these reasons, structural imaging of the lungs is performed almost exclusively using Computed Tomography (CT). However, CT imaging delivers ionizing radiation, and thus is less well suited for certain vulnerable populations (e.g., pediatrics) or for research applications. As an alternative, MRI using ultra-short echo times (UTE) is attracting interest. This technique can be performed during free-breathing over the course of a ~5-10 min scan. Respiratory motion information is encoded alongside images; this information can be used to "self-gate" images. Self-gating thus removes the requirement of advanced MRI pulse sequence programming or the use of respiratory bellows, which simplifies image acquisition. In this protocol, simple, robust, and computationally efficient acquisition and reconstruction methods for acquiring high quality UTE MRI of the lungs are presented. This protocol was developed for use on a 3T MRI scanner, but the same principles can be implemented at lower magnetic field strength. The protocol includes recommended parameter settings for 3D radial UTE image acquisition as well as directions for self-gated image reconstruction to generate images at distinct respiratory phases. Through the implementation of this protocol, users can generate high-resolution UTE images of the lungs with minimal to minimal-to-no motion artifacts. These images can be used to evaluate pulmonary structure, which can be implemented for research use in a variety of pulmonary conditions.

Introduction

High-resolution imaging of the pulmonary structure is an essential part of diagnostic work-ups for many pulmonary conditions. Typically, this is performed using Computed Tomography (CT) imaging, which is ideally suited to generate high-resolution images of the lungs¹. However, CT imaging delivers a non-trivial dose of ionizing radiation, making it ill-suited for regular repeat imaging, imaging at multiple different respiratory phases, or imaging certain populations (e.g., pediatrics). Magnetic resonance imaging (MRI) does not carry the same risk of ionizing radiation, and thus is amenable to such imaging tasks. However, it is challenging to ima....

Protocol

All human subject imaging was performed with approval from the KUMC IRB. Written informed consent was obtained from all participants. Images in this study were obtained under a generic technical development protocol, and the inclusion/exclusion criteria were deliberately broad. Inclusion Criteria: Age ≥ 18. Exclusion Criteria: MRI contraindicated based on responses to the MRI screening questionnaire, and pregnancy. The accessories and the equipment used for this study are listed in the Table of Materials

Discussion

When performing UTE imaging of the lungs, many variations of both acquisition and reconstruction can be used to generate images of the lungs. This protocol focuses on ease of implementation and computational efficiency. Imaging using 3D radial UTE is relatively simple, with imaging sequences generally available from the major MRI vendors. MATLAB-based tools are provided for data handling and self-gating. Because most academic institutions have access to MATLAB licenses, this code should be broadly useable and easily impl.......

Materials

Name	Company	Catalog Number	Comments
Chest MRI Coil	Siemens, GE, Philips,, Other Clinical MRI Imaging Coil Vendor	N/A	A 26 - 32 channel Chest coil should be used
High Performance Workstation	HP, Apple, or other Computer Hardware company	N/A	A computer with a minimum of 64 GB of Memory is needed for image reconstruction
Matlab	Mathworks	R2016A or newer	A Matlab license is needed to run the provided computer code
MRI Phantom	Siemens, GE, Philips, or Other MRI Phantom Vendor	N/A	Any Phantom can be used to test the MRI sequence prior to its use in human subjects.
MRI Scanner	Siemens, GE, Philips, or Other Clinical MRI Scanner Vendor	N/A	The protocol was developed on a 3T scanner, but 1.5T or 0.55T would also work with minimal adaptation