NMR in Biomedicine

Tumor pseudo-progression (PsP) refers to an initial increase in tumor size or the appearance of new lesions. These pseudo-progressive lesions are predominantly composed of infiltrative inflammatory cells, such as macrophages. This phenomenon commonly occurs in patients undergoing radiation therapy or immunotherapy and typically indicates a positive treatment response. However, it often leads to premature treatment cessation due to misinterpretation as disease progression. Non-invasive imaging biomarkers capable of distinguishing pseudo-progression from true progression would greatly aid in treatment decision-making. In our preliminary study, we explored the potential of gadoterate meglumine (Gd-DOTA, a macrocyclic Gd-contrast) in combination with amine chemical-exchange saturation transfer (amine-CEST) imaging to differentiate tumor from radiation necrosis by assessing Gd-DOTA uptake by infiltrating immune cells, such as macrophages. To evaluate whether amine-CEST, in combination with Gd-DOTA, can differentiate macrophages from cancer cells, we incubated them with Gd-DOTA for 30 minutes. Subsequently, the cells were processed, and amine-CEST imaging was performed on a 9.4 Tesla preclinical scanner. Upon treatment with Gd-DOTA, we did not observe a significant change in amine-CEST contrast in F98 cells compared with untreated cells, whereas treated macrophages exhibited a marked decrease (~40%) in amine-CEST signal compared with untreated macrophages. This reduction in signal was attributed to the uptake of Gd-DOTA by macrophages, which notably shortened water T1 relaxation, thereby quenching the amine-CEST signal. Conversely, cancer cells showed no appreciable change in the amine-CEST signal, indicating no Gd-DOTA uptake. Furthermore, to validate that T1 shortening influences amine-CEST signal, cancer cells were also treated with manganese chloride (MnCl2) for 30 minutes. The uptake of MnCl2 by cancer cells similarly induced T1 shortening, as observed in macrophages, resulting in a decrease in the amine-CEST signal from these cells. Next, we performed the amin-CEST imaging on F98 tumor-bearing rats and radiation necrotic rats. Post-injection with Gd-DOTA showed no appreciable change in the amine-CEST contrast in the tumor-bearing rat, whereas a significant decrease in contrast was observed in the radiation necrotic rat. This further demonstrates that no change in the amine-CEST contrast in tumor-bearing rats is due to cancer cells failing to take up Gd-DOTA. The decrease in amine-CEST contrast in radiation-treated rats reflects the uptake of Gd-DOTA by macrophages infiltrating the radiation-necrotic regions. This straightforward imaging approach holds promise for clinical translation. It offers a novel method for characterizing pseudo-progressive lesions and monitoring diverse treatment responses in cancer patients using standard clinical scanners.

PurposeTo present a first-of-its-kind artificial intelligence (AI-)integrated MR pulse sequence that detects out-of-voxel (OOV) artifacts in real-time (within-TR) and responds prospectively by updating the crusher gradient scheme. MethodsPer Excitation Real-time Execution & Guided Responses with Integrated Neural-network Evaluation (PEREGRINE), developed for deployment of deep learning models and sequence updates, operated time-domain (TD) and frequency-domain (FD) convolutional autoencoders that detect OOV artifacts. Scans without (AI-off) and with (AI-on) updates were collected from the prefrontal cortex of healthy volunteers using edited MRS. The degree of OOV contamination (OOV score) was quantified per transient based upon the prevalence of OOV signals in the TD and FD data. OOV scores above a user-defined threshold triggered an update of the gradient scheme, iterating through 48 permutations (6 axis transpositions x 8 polarity flips). ResultsWithin each 2-second TR, PEREGRINE successfully provided single-transient OOV scores and updated gradients accordingly. No difference was observed between the OOV scores from the full ("Full" condition) AI-on and AI-off sessions due to the AI-on scan cycling over better and worse gradient permutations relative to the AI-off scan. However, the AI-on scan had significantly lower OOV scores than the AI-off scan when selecting the transients where PEREGRINE persisted ("Dwell" condition) on a given gradient permutation. Ultimately, Fit Quality Number (FQN), from linear combination modeling, improved significantly for the AI-on compared to the AI-off scan. ConclusionPEREGRINE enabled an AI-integrated sequence allowing for real-time evaluation and reduction of OOV artifacts, identifying gradient modifications that produced less OOV contamination.

Background and Aims: Steatotic liver disease (SLD) has high clinical and public health relevance. Robust population estimates of SLD and its subcategories are challenging due to the limitations of ultrasound measurements or non-invasive scores, particularly for low-grade steatosis. We aimed to quantify SLD prevalence using magnetic resonance imaging (MRI) in the population-based German National Cohort (NAKO). Methods: Hepatic multi-echo Dixon MRI was performed at 5 dedicated study sites with identical setup across Germany. Liver fat (proton density fat fraction, PDFF), R2* as proxy for liver iron, and liver volume were assessed. The resulting data of N = 29'842 individuals (age range 20-72 years) were weighted by survey weights for regional representativeness, resulting in a sample of 50% women and a mean age of 45.6 years. SLD was defined as PDFF [&ge;] 5.75%, and sex-specific prevalence according to age, BMI, socioeconomic status and geographic region was calculated. Results: Overall, SLD prevalence was 21.3% in women and 35.7% in men, and the majority were metabolic dysfunction-associated (MASLD, 89.3% of all SLD cases). Prevalence increased with age in a sex-specific pattern, suggesting potential menopausal effects in women. There was a relevant prevalence of SLD in individuals with normal weight (5.3% in women, 13.2% in men) and the age group <25 years (7.5% in women, 11.9% in women). Differences in prevalence between low and high socioeconomic status were more pronounced in women (37% vs 15.8%) compared to men (45.5% vs 30.3%). Conclusions: Data underscore the high public health relevance of SLD and its subcategory MASLD. The considerable prevalence in groups historically considered low-risk, such as younger or lean individuals, emphasizes the need for raising awareness early.

Aceruloplasminemia (ACP) is a rare neurodegenerative disorder characterized by extreme cerebral iron overload and a shift towards larger iron aggregates, providing a unique possibility to study how iron aggregation shapes MRI contrast in vivo. We introduce a clinically feasible, multi-parametric quantitative MRI (qMRI) framework that combines quantitative susceptibility mapping (QSM), [Formula], and R2 to disentangle changes in total iron concentration from alterations in iron aggregation and its spatial organization at the cellular scale. Our biophysical model links the microstructure sensitive [Formula] ratio and the slope of the susceptibility-relaxation relationship (iron) to iron aggregation size and distribution. In a 3T qMRI study of three patients with ACP and three matched controls, we observe a marked increase in [Formula] and a pronounced increase of the [Formula]-QSM slope (iron: controls 154.09 {+/-} 52.89 s-1ppm-1; patients 296.68 {+/-} 57.18 s-1ppm-1; p = 0.016), consistent with enhanced iron aggregation and altered spatial organization. Model-based decomposition of transverse relaxation indicates that up to approximately 40% of the observed R2* elevation in ACP is attributable to changes in iron distribution beyond increased iron concentration alone. These findings establish a robust, translational qMRI approach for quantitative in vivo assessment of iron aggregation, revealing microstructural drivers of iron-related neurodegeneration that extend beyond bulk iron load.

BackgroundDynamic contrast-enhanced (DCE) MRI has the potential to be a useful tool for non-invasively assessing renal haemodynamics and function, however insufficient standardisation and difficulties in post-processing remain barriers to clinical translation. PurposeTo develop expert consensus-based technical recommendations for performing renal DCE-MRI in humans, relating to aspects of patient preparation, MRI hardware and acquisition parameters, and data analysis. Study TypeSystematic consensus process using an approximation to the two-step modified Delphi method. PopulationNot applicable. Field Strength / Sequence1.5 T and 3 T / Renal gradient echo-based 3D DCE-MRI. AssessmentAn international panel of experts were recruited and surveyed following a modified Delphi method to create consensus-based technical recommendations. Key areas for consensus were initially identified through a mixture of online and in-person discussions, and an initial survey round consisting of open- and close-ended questions. Consensus statements were formulated and iteratively refined to create the final recommendations. Statistical TestsConsensus was defined as [&ge;] 75% agreement in response (excluding abstentions), and clear preference was defined as [60-74]% agreement among the experts. Statements with [&ge;]40% abstentions were either excluded from subsequent survey rounds or recirculated as a modified statement. Results22 experts initially participated in the Delphi panel, of which 16 responded to the first survey. 15 panellists responded to all subsequent surveys. Out of 46 statements, 37 reached consensus and one showed clear preference. [&ge;]40% abstention was found in seven statements which were excluded from the final set of recommendations. Data conclusionThese recommendations provide a starting point for MRI centres worldwide wishing to perform renal DCE-MRI, contributing to the harmonisation of DCE-MRI scan protocols and facilitating clinical translation. These recommendations provide a practical minimum technical dataset for renal DCE-MRI acquisition and analysis to improve cross-site comparability and support responsible clinical translation.

IntroductionPostmortem human brain magnetic resonance imaging (MRI) offers a unique opportunity to study finer neuroanatomical details and enables direct correlations with gold standard histological and immunohistochemical assessments. However, to prevent tissue decay, postmortem brains are preserved in fixative solutions which can alter tissue properties and exert substantial impacts on the MRI signals. The present study investigates the impact of formalin fixation, the most commonly used solution for postmortem human brain preservation, on different quantitative MRI contrasts. Methods142 intact human brain hemispheres immersed in 10% formalin for a range of fixation durations (between 0 days and 20 years) were imaged in a 3T MRI scanner. A subset of 10 brains were further scanned repeatedly at days 0, 3, 10, 20, 30, 60, 90, and 120 to allow for better characterization of the initial transient effects of fixation. Voxel-wise T1 and T2* relaxation, T1/T2 ratio, and myelin water fraction (MWF) maps were generated for each specimen and timepoint, and linear and nonlinear models were used to examine the spatiotemporal changes associated with progressive fixation. ResultsAll investigated metrics were significantly impacted by formalin fixation, albeit at different rates and with differing regional patterns. T1 and T2* relaxation time decreased as a result of progressive fixation, whereas T1/T2 ratio and MWF measures increased. T1 relaxation and T1/T2 ratio showed nonlinear patterns with initially accelerated changes that decelerate in the first few months, whereas T2* relaxation and MWF changes followed a more linear trend. ConclusionFormaldehyde fixation exerts systematic changes on quantitative MRI signals that can be modeled and adjusted for to allow for harmonized comparisons of MRI metrics across brains fixed for differing durations. The distinct temporal trajectories observed across metrics highlight the need to account for fixation duration in study design and downstream analyses, particularly when integrating datasets acquired under heterogeneous conditions. Our findings provide a quantitative framework for correcting fixation-induced biases, thereby improving the interpretability and reproducibility of postmortem MRI studies.

PurposeTo develop a data-efficient deep learning framework for rapid reconstruction of highly accelerated 4D arterial spin labeling (ASL) magnetic resonance angiography (MRA) with robust generalization using extremely limited acquired data, addressing the challenges of prolonged acquisition and reconstruction time. MethodsA simulation-driven, few-shot transfer learning approach was adopted by leveraging publicly available 3D time-of-flight (TOF)-MRA data to generate realistic multi-coil complex-valued pseudo-ASL k-space datasets for large-scale pre-training. A 3D unrolled reconstruction network was trained on this simulated data using a histogram-weighted loss and subsequently extended to 4D using lightweight temporal fusion modules. Fine-tuning was performed using only two experimentally acquired 4D ASL-MRA datasets. The method was evaluated on retrospectively and prospectively undersampled Cartesian 4D ASL-MRA data acquired at 3T and compared with compressed sensing (CS) and locally low-rank (LLR) reconstructions. ResultsThe proposed method achieved superior reconstruction quality compared with CS and LLR, with improved vessel depiction, particularly in distal branches, and enhanced temporal fidelity. Quantitative evaluation demonstrated higher vessel-masked peak signal-to-noise ratio and structural similarity index measure, along with increased error entropy, indicating reduced noise and structured artifacts. The initial pre-trained model already outperformed conventional methods, while additional 4D fine-tuning further improved performance. Robust reconstruction was demonstrated in prospectively undersampled data and multi-slab acquisitions, enabling large-coverage, time-resolved angiography within clinically feasible scan times (4-6 min). ConclusionsSimulation-driven pre-training combined with few-shot fine-tuning enables accurate and rapid reconstruction of highly accelerated 4D ASL-MRA in data-limited settings. The proposed framework provides a practical pathway toward clinically feasible, non-contrast dynamic cerebrovascular imaging.

Diffusion MRI simulations based on realistic tissue microstructure provide a means to validate biophysical models and optimize acquisition protocols, but their computational cost restricts most studies to domains far smaller than a clinical voxel. The objective of this study was to develop an automated and scalable framework that converts whole-slide histology into diffusion MRI simulations at clinically relevant spatial scales while remaining feasible on standard workstation hardware. We present an end-to-end pipeline integrating two-dimensional whole-slide cell segmentation, mesh generation, and finite element Bloch-Torrey simulation. To enable simulations at large spatial scales without prohibitive memory growth, we introduce a subdomain tiling strategy in which the tissue domain is partitioned into extended subdomains simulated independently under no-flux boundary conditions. Signals are aggregated only from the central regions of each subdomain to minimize boundary artifacts. For an 800 {micro}m x 800 {micro}m histology-based domain, the aggregated signal differed by 0.07% from the corresponding full-domain finite element simulation while reducing wall-clock time from several days to hours and maintaining bounded memory usage independent of global domain size. When applied to a 2016 {micro}m x 2016 {micro}m heterogeneous region approximating the in-plane dimensions of a clinical voxel, the apparent diffusion coefficient obtained from the full domain differed from values computed in smaller dense and sparse subregions, demonstrating the influence of structural heterogeneity at clinically relevant scales on derived diffusion metrics. The proposed framework establishes an automated and memory-stable approach for generating diffusion MRI simulations directly from routine histology.

BackgroundMagnetic resonance imaging (MRI) is critical for acute stroke triage, but time-consuming, and often requires contrast injection for perfusion imaging. This study aimed to synthesize T-map perfusion maps from routinely available, non-contrast DWI and FLAIR using deep generative models. We hypothesized that relevant perfusion information could be inferred from these modalities to streamline imaging and reduce reliance on dynamic susceptibility contrast perfusion. MethodsAcute MRI data from 355 patients with anterior circulation stroke, including dynamic susceptibility contrast perfusion, were retrospectively collected from two European centers (Heidelberg: 2010-2018; Bordeaux: 2021-2022). Six versions of a denoising diffusion probabilistic model (DDPM) and a GAN architecture were trained to generate synthetic T-max perfusion maps from DWI, FLAIR, and infarct core mask as inputs. Performance was assessed by comparing synthetic and ground truth T-max maps using image similarity metrics. Regions with T-max >6s were compared using Dice coefficients, and mismatch volume distributions were analyzed. An ablation study quantified the contribution of each input. ResultsThe best performance was achieved by a DDPM with a 2.5D architecture using DWI, FLAIR, infarct core mask, and a perfusion-weighted loss function. It produced synthetic perfusion T-max maps with high similarity to ground truth under 110 seconds. The model showed strong spatial overlap for T-max >6s regions in internal validation (average Dice = 0.82, SD = 0.08), and external validation average (Dice 0.59, SD = 0.13), respectively. Synthetic maps closely matched ground-truth mismatch distributions, capturing key perfusion patterns. The infarct core mask played a critical role in model performance, alongside DWI and FLAIR inputs. ConclusionsWe propose a non-invasive, scalable framework to generate synthetic T-max perfusion maps from non-contrast MRI. This approach could expand access to perfusion data in acute stroke, shorten imaging protocols, and accelerate treatment decisions by eliminating the need for contrast-enhanced acquisition. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=200 SRC="FIGDIR/small/684079v2_ufig1.gif" ALT="Figure 1"> View larger version (94K): org.highwire.dtl.DTLVardef@164235forg.highwire.dtl.DTLVardef@14e5489org.highwire.dtl.DTLVardef@190214eorg.highwire.dtl.DTLVardef@17a9e3a_HPS_FORMAT_FIGEXP M_FIG C_FIG

Objective:This study aims to compare the advantages and disadvantages of DLIR and adaptive statistical iterative reconstruction-V (ASIR-V) in thin-slice (2.5 mm) CT images of hepatic lesions characterized by high and low contrast. Additionally, the study seeks to determine the optimal DLIR strength for the evaluation of liver lesions. Methods:A retrospective analysis was performed on 90 patients who underwent abdominal contrast-enhanced CT scans. Group A comprised 48 patients with low-contrast lesions, while Group B included 42 patients with high-contrast lesions. The acquired images were reconstructed using post-processing DLIR at low (DLIR-L), medium (DLIR-M), and high (DLIR-H) strengths, all with a slice thickness of 2.5 mm (subgroups A1-A3, B1-B3). Furthermore, images were reconstructed with ASIR-V at 50% strength at slice thicknesses of 2.5 mm and 5 mm (subgroups A4/B4 and A5/B5, respectively). CT values and standard deviations (SD) of the liver and lesions were measured, and the corresponding signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The edge rise slope (ERS) was determined using ImageJ software by measuring CT values along a line from the liver parenchyma to the lesion. Objective metrics were compared using one-way ANOVA, with independent samples t-tests applied for inter-group differences. Subjective scoring, which encompassed noise level, diagnostic confidence, and lesion margin delineation, was conducted by two radiologists, with differences analyzed using the Kappa test. Results: Objective evaluation revealed a progressive decrease in lesion SD and a progressive increase in SNR and CNR from subgroups A1/B1 to A3/B3. The SD of Group A2 decreased by 57.4% compared to A4, while the SNR and CNR of A2 icreased by 19.3% and 24.6% compared to A4. Although subgroup B2 had a lower SNR than B5, the difference was not statistically significant. SNR and CNR in B2 increased by 24.1% and 11.9%, respectively, compared to B4. ERS gradually decreased from A1/B1 to A3/B3. ERS values in A2 and B2 increased by 27.0% and 39.4%, respectively, relative to A5 and B5. Although A3 had a lower ERS than A1 and A2, all DLIR subgroups exhibited higher ERS than A5; similar trends were observed in Group B. Subjective evaluation indicated good inter-reader agreement (Kappa > 0.61, p < 0.05). As DLIR strength increased, noise scores rose progressively in both groups. However, noise in A2 and B2 was lower than in A4/A5 and B4/B5. Diagnostic confidence and lesion margin delineation scores were highest in A2 and B2, while all subjective scores were lowest in A5 and B5. Discussion: Most prior studies evaluated the liver, vessels, or confirmed that image quality can be guaranteed at low doses. However, there are few studies on specific individual lesions. Therefore, this study aims to investigate specific individual lesions. The details and detection rate were analyzed separately to confirm the clinical acceptability of 2.5-mm DLIR image in different contrast lesions. Conclusion: For both high- and low-contrast hepatic lesions, DLIR provides superior image quality compared to ASIR-V, with the 2.5mm DLIR-M setting being optimal. DLIR-M reduces image noise, improves spatial resolution, and produces images more suitable for diagnostic purposes.

Objectives To evaluate whether class-conditional conformal prediction (CP) can provide reliable uncertainty quantification (UQ) under severe class imbalance and distribution shift, using multiple sclerosis (MS) diagnosis from magnetic resonance imaging (MRI) as a clinical exemplar. Methods We evaluated marginal and class-conditional CP using 720 T2-weighted MRI scans (142 MS, 578 controls). A convolutional neural network trained on 3 T data was evaluated under distribution shift (1.5 T acquisitions and synthetic image degradations). Through 100 Monte Carlo experiments, we assessed coverage guarantees, class-specific performance, and relationships between calibration set size, coverage variance, and uncertainty. Results Marginal CP severely under-covered the minority MS class (16.9% mean coverage at 1.5 T vs. 95.2% for controls) despite valid population-level guarantees. Class-conditional CP dramatically improved MS coverage to 77.5% at 1.5 T and 85.8% at 3 T, significantly reducing severe undercoverage (<80%) frequency while maintaining >89% control coverage. Minority class coverage variance increased due to limited calibration samples, matching theoretical Beta-binomial predictions. CP maintained validity under distribution shift; prediction set sizes scaled monotonically with shift severity, yielding clinically interpretable UQ. Conclusions Class-conditional CP successfully mitigates systematic undercoverage of minority disease classes while maintaining validity under distribution shift. The approach offers a practical, model-agnostic solution for uncertainty quantification applicable across clinical AI systems, though increased coverage variance for less represented conditions reflects fundamental statistical constraints. By characterizing these variance trade-offs, this framework enables more reliable deployment of diagnostic AI in heterogeneous clinical environments across diverse medical domains where minority disease class detection is critical.

Purpose: To develop and evaluate a flexible, software-defined radar platform for contactless, vendor-independent motion detection and correction in MRI. Methods: A continuous-wave (CW) Doppler radar was implemented using a software-defined radio and the open-source GNU Radio framework. The system was deployed inside a 1.5T MRI scanner and synchronized with MRI acquisitions. We evaluated the performance in a custom-developed internal motion phantom and in healthy volunteers to track respiration and bulk motion. The radar-derived signal was validated against cine MRI and used to demonstrate both retrospective and prospective motion management techniques in phantom and in healthy volunteers. Results: The radar provided robust motion signals that correlated strongly with image-based ground truth signals in both phantom and volunteer experiments. Signal characteristics were found to be frequency-dependent, enabling optimization for different motion regimes. Retrospective correction of free-breathing abdominal data using the radar signal effectively suppressed respiratory artifacts, achieving image quality comparable to a self-gating approach. Prospective triggering successfully reduced motion artifacts in the phantom study. The system also reliably detected sporadic events such as swallowing during neck imaging. Conclusion: Software-defined radar was demonstrated to be an effective platform for both prospective and retrospective motion correction. Its independence from the MRI system, ultra-wide band capabilities, and body-region versatility enable the adaptation of the technique for a wide range of imaging applications and protocols.

Background: Cardiovascular magnetic resonance (CMR) quantification of the left ventricular (LV) volumes and ejection fraction (EF) typically involves manual segmentation of many short axis (SAx) and long axis (LAx) slices of the left ventricle. The scan time and the number of breath holds is proportional to the number of slices. We aimed to evaluate a geometric model of the left ventricle that could enable planimetry from a reduced number of slices. We sought to determine whether acceptable accuracy was retained for evaluating the End Diastolic Volume (EDV), End Systolic Volume (ESV), Stroke Volume (SV), and EF to provide a rapid and reliable clinical alternative. Methods: A cohort of 342 patients, median age: 54 (40 - 65) years, with full-stack CMR examinations was used. Nine geometrical combinations were evaluated: 3, 4 or 5 short axis slices and one of three LAx orientations (2-chamber, 3-chamber or 4-chamber) by retrospectively decimating the full-stack acquisition. LV volumes were calculated as a sum of trapezoidal approximations for apical and mid-cavity slices and a generalized prismoidal model at the base. The accuracy of the volume calculations was quantified against the full-stack reference for the EDV, ESV, SV, and EF using concordance correlation coefficient (CCC), two-way repeated measures ANOVA, pairwise tests, and Bayes factor log10(BF10) analysis. Results: The choice of the long axis (LAx) view was the most influential driver of accuracy (g2 = 0.104, for EDV), approximately 50 times more impactful than the number of SAx slices (g2 = 0.002, for EDV). Volumes calculated using the combination of 2-chamber LAx view and 5 SAx slices had the highest concordance with the full stack (CCC>0.90). While the estimated absolute volumes displayed a systematic negative bias, EF and SV remained highly robust due to bias cancellation. For a 2ch + 5 SAx protocol, EF bias was just 0.83% (LoA: -6.18 to 7.84%), with a minimum detectable change (MDC) of 7.01%, compared to 8.7% reported for expert human readers, suggesting strong concordance. Bayesian paired-samples t-tests yielded log10(BF10) = 6.42 in favor of 5 SAx over 3 SAx, constituting decisive evidence on the Jeffreys scale. The bias and limits of agreement (LoA) for stroke volume and ejection fraction were found to be lower than scan-rescan reproducibility in literature. Conclusion: This reduced-slice geometric model allows for reduced number of breath holds compared to a conventional full-stack CMR acquisition and provides an acceptable accuracy with bias less than scan-rescan variability.

Hypoxia-targeted BOLD MRI is a novel technique, which probes oxygenation physiology in response to a controlled transient hypoxia stimulus. In glioblastoma, the signal response is spatially and temporally heterogeneous. We developed a voxel-wise temporal decomposition framework for hypoxia-targeted BOLD MRI that separates the arrival of responses, transition phases, and steady state during controlled isocapnic hypoxia. Twenty healthy controls underwent 3-T BOLD MRI during a double hypoxic step challenge to establish a normative reference. Three patients with newly diagnosed glioblastoma were included as proof-of-concept cases. For each voxel, we estimated response arrival delay (Delaycorr), delay to plateau, delay to return and an O2-normalized steady-state response (HypoxiaSS). Healthy-control maps were used to construct a voxel-wise normative atlas and, for HypoxiaSS, a global-response-adjusted model for patient deviation mapping. In healthy controls, HypoxiaSS showed lower supratentorial between-subject variabilitythan both whole-stimulus comparators (coefficient of variation: 1.77 versus 2.36 for Hypoxiaavg) and higher voxel-level step-to-step agreement (ICC(2,1): median 0.951 versus 0.792 for Hypoxiaavg). Whole-stimulus averaging exhibited a systematic step-2 signal amplification present in 19 of 20 subjects, which was absent from HypoxiaSS. Asingle global response scalar explained a median 72.5% of voxel-wise between-subject variance in HypoxiaSS. In proof-of-concept patient analyses, G-adjusted HypoxiaSS deviation maps and timing maps identified spatially coherentabnormalities that were partly complementary and extended beyond conventional MRI-defined lesion margins.Temporal decomposition improves the stability and interpretability of hypoxia-targeted BOLD MRI and provides a practical framework for population-referenced physiological mapping and atlas-based deviation mapping in glioblastoma.

PurposeHigh-density RF receive arrays are required to realize the inherently available SNR and parallel imaging advantages at ultrahigh field strengths, which are essential for high-resolution functional and anatomical brain MRI. This study aims to systematically assess the impacts of often-overlooked parasitic losses associated with various RF coil components, as these losses can degrade the realized SNR and cause significant deviation from the ultimate intrinsic SNR (uiSNR; the theoretical upper bound of available SNR). In addition, we seek to detail engineering solutions to each of these loss mechanisms in pursuit of achieving a higher fraction of the uiSNR limit. MethodsA 16-channel loop-folded dipole transceiver array was developed for 10.5T human head applications and paired with a fully-updated 64-channel receive-only loop array. The optimization of the receive array considered several factors, including (but not limited to) coil dimensions to accommodate a larger population, the size and number of loops to enhance SNR and parallel imaging performance, and circuit design strategies to minimize parasitic losses. The SNR and parallel imaging performance of the receive array were quantitatively assessed by comparison with the uiSNR, as well as existing high-channel-count receive arrays at 7T and 10.5T. Finally, the complete 16-channel transmit, 80-channel receive coil array was safety validated for human use and employed for high-resolution functional and anatomical MRI at 10.5T. ResultsInitial results show that the 80-channel array, featuring larger loops in an overlapped layout with optimized circuitry, significantly improves the SNR and approaches the uiSNR limit in a large fraction of the head, while maintaining or enhancing the parallel imaging performance compared to previously used non-overlap layout. ConclusionThis study suggests that, although the traditionally used high-channel-count loop receive array technology can approach the uiSNR limit in the >10T regime, meticulous design optimization--including systematic assessment and minimization of parasitic losses--has become increasingly critical for achieving this goal in this new field-strength territory.

BackgroundDiffusion-weighted MRI is central to prostate cancer detection, but apparent diffusion coefficient (ADC) has limited reproducibility across scanners and sites. Restriction Spectrum Imaging restriction score maximum value (RSIrs-max) may provide a more reproducible biomarker. PurposeTo evaluate cross-session reproducibility of within-lesion mean ADC and RSIrs-max on prostate MRI, including same-vendor and cross-vendor comparisons, and in unfavorable-histology prostate cancer (uhPC) and different interpolation settings. Materials and MethodsIn this prospective study, participants with suspected or known prostate cancer enrolled from August 2022 to January 2026 underwent two MRI examinations including an RSI protocol. MRI-visible lesions were contoured on T2-weighted MRI; in participants with multiple lesions, the index lesion was selected. Mean ADC and RSIrs-max were measured within MRI-visible lesions. Analyses included all visible lesions, same-vendor and cross-vendor subgroups, participants with uhPC, and 20 participants with scans reconstructed with and without zero-filled interpolation (a setting with different defaults across vendors). Pearson correlation coefficients with 10,000 bootstrap resamples were used to estimate 95% confidence intervals. ResultsSixty-one male participants (median age, 69 years [IQR, 63-74]) were evaluated; 58 of 61 (95%) had MRI-visible lesions, and 26 of 58 (45%) had uhPC. For all MRI-visible lesions, correlations were 0.55 (95% CI: 0.23-0.76) for mean ADC and 0.83 (95% CI: 0.72-0.90) for RSIrs-max. In same-vendor scans, correlations were 0.76 (95% CI: 0.27-0.95) and 0.88 (95% CI: 0.72-0.96); in cross-vendor scans, they were 0.31 (95% CI: -0.07-0.62) and 0.79 (95% CI: 0.65-0.89), respectively. In uhPC, correlations were 0.42 (95% CI: -0.02-0.83) for mean ADC and 0.90 (95% CI: 0.77-0.96) for RSIrs-max. With inconsistent versus consistent interpolation, RSIrs-max correlation increased from 0.73 (95% CI: 0.48-0.89) to 0.89 (95% CI: 0.78-0.96). ConclusionADC showed limited reproducibility, particularly across vendors. RSIrs-max has stronger between-session reproducibility across same-vendor, cross-vendor, uhPC, and interpolation analyses.

Background: Traditional bone scintigraphy for detecting malignant bone metastases is limited by suboptimal accuracy and radiation exposure. Whole-body magnetic resonance imaging (WB-MRI), while an alternative, requires lengthy scan times and high patient compliance. Purpose: To develop a novel, rapid whole body bone screening (WB-RBS) MRI protocol and evaluate its diagnostic performance for bone metastasis detection. Materials and Methods: Patients with pathologically confirmed malignancies and healthy controls were prospectively enrolled. All participants underwent WB-RBS (acquisition time: about 10 min); patients additionally underwent WB-MRI (about 70 min). Three radiologists, blinded to clinical data, independently evaluated the images for bone metastases. A consensus expert diagnosis served as the reference standard to calculate the diagnostic performance of WB-RBS. Specificity was further assessed in the healthy control group. Results: Seventy patients and 19 healthy controls were included. WB-RBS demonstrated excellent inter-reader agreement at the patient level. Compared with the reference standard, WB-RBS achieved an accuracy of 77.1%-91.4% at the patient level and a slightly lower accuracy (70.6%-82.5%) at the lesion level. At diagnostic confidence thresholds 1-3, the correlations between WB-RBS ratings and the reference standard were statistically significant for both patient- and lesion-level analyses. Conclusion: WB-RBS showed favorable inter-reader agreement and high accuracy for bone metastasis screening at the patient level, while substantially reducing scan time and cost. Its rapid, radiation-free nature and high accessibility offer distinct clinical advantages, supporting its potential as an alternative screening tool to conventional bone scintigraphy.

Objectives: AI-based reconstructions can reduce MRI acquisition times and/or improve image quality. Guidelines recommend clinical evaluations and post-deployment monitoring of these novel methods, however, there has been little investigation of the clinical resources required for such assessments. The aim of this study was to evaluate the healthcare resource utilisation and potential savings associated with AI-based reconstructions in rectal MRI. Methods: A retrospective economic costing analysis was conducted from the NHS healthcare perspective. Resource utilisation data were extracted from the Electronic Patient Records for 9 healthy volunteer scans and 104 rectal MRI examinations evaluating an AI-based reconstruction. The resource profile included the MRI scan and the staff time required for data acquisition and analysis. Results: The clinical evaluation of the AI-based reconstruction cost {pound}15,023. Deployment of the AI-based reconstruction reduced the length of an MRI rectum scan by 22 minutes, theoretically saving approximately {pound}3,437 per month. Addition of post-deployment quality control scans reduced this monthly saving to {pound}2,636. If the quality control scans were evaluated using radiologists rather than image quality metrics, monthly savings would be approximately {pound}2,541. With ongoing quality control, the clinical evaluation cost would be recouped between 5.8 and 6 months, compared with 4.4 months without ongoing quality control. Conclusions: Deploying AI-based reconstructions can yield cost savings through reduced scanning times. Quality control tests using image quality metrics would save radiological burden and reduce costs compared with conducting repeated image scoring by radiologists.

PurposeTo present the design and validation of a lowcost, microcontrollerbased gas delivery system that automates fixed inspired respiratory stimuli for MRI experiments. MethodsThe system uses three solenoid valves controlled by an Arduinobased circuit to switch between premixed medical gas cylinders according to predefined timing protocols. By using the MRI scanner external timing signal, gas delivery can be synchronised with image acquisition. Both a permanently installed configuration and a portable enclosure were constructed using commercially available components, with a total material cost of approximately {pound}650. The system was integrated with a singleuse breathing circuit and evaluated using hypercapnic and hyperoxic stimulus paradigms. Endtidal oxygen and carbon dioxide were measured using a respiratory gas analyser and physiological responses were assessed using BOLD MRI at 3 T. ResultsThe system delivered reliable, repeatable gas transitions during MRItriggered protocols. During hypercapnia (n{square}={square}15), the mean increase in endtidal carbon dioxide was 8.7{square}{+/-}{square}1.8{square}mmHg from a baseline of 32.2{square}{+/-}{square}3.1{square}mmHg, producing a mean grey matter BOLD signal increase of 3.2{+/-}1.7%. During hyperoxia (n{square}={square}15), the mean increase in endtidal oxygen was 292.3{square}{+/-}{square}59.0{square}mmHg from a baseline of 114.5{square}{+/-}{square}10.7{square}mmHg, with an associated BOLD signal change of 1.2{+/-}1.7%. Across both protocols respiratory and BOLD responses were consistent across participants. ConclusionThis microcontrollerbased system provides an inexpensive and reliable method for administering fixed inspired respiratory stimuli with automated MRI synchronisation. It offers an intermediate option between simple manual systems and higher cost commercial gas blenders, making it well suited for technical and methodological studies in cerebrovascular reactivity, hyperoxiaBOLD and related applications.

PurposeTo demonstrate the feasibility of prostate MRI at low-field and provide an optimised low-field prostate MRI protocol. MethodsWe acquired bi-parametric prostate MRI in 15 healthy male volunteers (mean age 62 years, 95% CI 57-67.5), including tri-planar T2-weighted imaging (WI) and axial diffusion weighted imaging (DWI), with parameters adhering to PI-RADS guidelines. Deep learning reconstruction (DLR) was used to enhance image quality. SNR and CNR were measured in the prostate peripheral zone (PZ) and transitional zone (TZ). SNR was compared between T2-WI with and without DLR, between DWI data acquired with different b-values, and between different calculated b-value images. Radiologists assigned PI-QUAL qualitative image scores. ResultsThe acquisition time (minutes:seconds) was 4:02 for axial T2-WI and 6:32 for DWI. Axial T2-WI had a median (IQR) SNR of 8.72 (7.27-9.67) in the TZ and 12.84 (12.00-15.87) in the PZ. CNR between the PZ and TZ was 5.84 (4.06-6.82). DLR substantially improved T2-WI quality (p<0.05). The optimised DWI protocol had b-values of 50 and 800 s mm-2, with a calculated b-value image at 1500 s mm-2. Median apparent diffusion coefficient (ADC) values were 1.70 and 1.44x10-3 mm2 s-1 in the PZ and TZ, respectively. All participants had at least acceptable diagnostic quality (PI-QUAL score[&ge;]2/3), of which ten (67%) had optimal diagnostic quality (PI-QUAL score=3/3). ConclusionProstate MRI is feasible at low-field, providing clinically acceptable acquisition times and diagnostic quality images.