Quantitative susceptibility mapping (QSM) has enabled MRI of tissue magnetic susceptibility to advance from simple qualitative detection of hypointense blooming artifacts to precise quantitative measurement of spatial biodistributions. QSM technology may be regarded to be sufficiently developed and validated to warrant wide dissemination for clinical applications of imaging isotropic susceptibility, which is dominated by metals in tissue, including iron and calcium. These biometals are highly regulated as vital participants in normal cellular biochemistry, and their dysregulations are manifested in a variety of pathologic processes. Therefore, QSM can be used to assess important tissue functions and disease. To facilitate QSM clinical translation, this review aims to organize pertinent information for implementing a robust automated QSM technique in routine MRI practice and to summarize available knowledge on diseases for which QSM can be used to improve patient care. In brief, QSM can be generated with postprocessing whenever gradient echo MRI is performed. QSM can be useful for diseases that involve neurodegeneration, inflammation, hemorrhage, abnormal oxygen consumption, substantial alterations in highly paramagnetic cellular iron, bone mineralization, or pathologic calcification; and for all disorders in which MRI diagnosis or surveillance requires contrast agent injection. Clinicians may consider integrating QSM into their routine imaging practices by including gradient echo sequences in all relevant MRI protocols.

Quantitative susceptibility mapping (QSM) is a magnetic resonance imaging technique that reveals tissue magnetic susceptibility. It relies on having a high quality field map, typically acquired with a relatively long echo spacing and long final TE. Applications of QSM outside the brain require the removal of fat contributions to the total signal phase. However, current water/fat separation methods applied on typical data acquired for QSM suffer from three issues: inadequacy when using large echo spacing, over-smoothing of the field maps and high computational cost. In this paper, the general phase wrap and chemical shift problem is formulated using a single species fitting and is solved using graph cuts with conditional jump moves. This method is referred as simultaneous phase unwrapping and removal of chemical shift (SPURS). The result from SPURS is then used as the initial guess for a voxel-wise iterative decomposition of water and fat with echo asymmetric and least-squares estimation (IDEAL). The estimated 3-D field maps are used to compute QSM in body regions outside of the brain, such as the liver. Experimental results show substantial improvements in field map estimation, water/fat separation and reconstructed QSM compared to two existing water/fat separation methods on 1.5T and 3T magnetic resonance human data with long echo spacing and rapid field map variation.

Purpose: To develop quantitative susceptibility mapping (QSM) of bone using an ultrashort echo time (UTE) gradient echo (GRE) sequence for signal acquisition and a bonespecific effective transverse relaxation rate (R Ã 2 ) to model water-fat MR signals for field mapping. Methods: Three-dimensional radial UTE data (echo times ! 40 ms) was acquired on a 3 Tesla scanner and fitted with a bone-specific signal model to map the chemical species and susceptibility field. Experiments were performed ex vivo on a porcine hoof and in vivo on healthy human subjects (n ¼ 7). For water-fat separation, a bone-specific model assigning R Ã 2 decay mostly to water was compared with the standard models that assigned the same decay for both fat and water. In the ex vivo experiment, bone QSM was correlated with CT. Results: Compared with standard models, the bone-specific R Ã 2 method significantly reduced errors in the fat fraction within the cortical bone in all tested data sets, leading to reduced artifacts in QSM. Good correlation was found between bone CT and QSM values in the porcine hoof (R 2 ¼ 0.77). Bone QSM was successfully generated in all subjects. Conclusions: The QSM of bone is feasible using UTE with a conventional echo time GRE acquisition and a bone-specific R

Quantitative susceptibility mapping (QSM) is an MR technique that depicts and quantifies magnetic susceptibility sources. Mapping iron, the dominant susceptibility source in the brain, has many important clinical applications. Herein, we review QSM applications in the diagnosis, medical management, and surgical treatment of disease. To assist in early disease diagnosis, QSM can identify elevated iron levels in the motor cortex of amyotrophic lateral sclerosis patients, in the substantia nigra of Parkinson's disease (PD) patients, in the globus pallidus, putamen, and caudate of Huntington's disease patients, and in the basal ganglia of Wilson's disease patients. Additionally, QSM can distinguish between hemorrhage and calcification, which could prove useful in tumor subclassification, and can measure microbleeds in traumatic brain injury patients. In guiding medical management, QSM can be used to monitor iron chelation therapy in PD patients, to monitor smoldering inflammation of multiple sclerosis (MS) lesions after the blood-brain barrier (BBB) seals, to monitor active inflammation of MS lesions before the BBB seals without using gadolinium, and to monitor hematoma volume in intracerebral hemorrhage. QSM can also guide neurosurgical treatment. Neurosurgeons require accurate depiction of the subthalamic nucleus, a tiny deep gray matter nucleus, prior to inserting deep brain stimulation electrodes into the brains of PD patients. QSM is arguably the best imaging tool for depiction of the subthalamic nucleus. Finally, we discuss future directions, including bone QSM, cardiac QSM, and using QSM to map cerebral metabolic rate of oxygen. Copyright © 2016 John Wiley & Sons, Ltd.