The magnetic susceptibility of tissue can be determined in gradient echo MRI by deconvolving the local magnetic field with the magnetic field generated by a unit dipole. This Quantitative Susceptibility Mapping (QSM) problem is unfortunately ill-posed. By transforming the problem to the Fourier domain, the susceptibility appears to be undersampled only at points where the dipole kernel is zero, suggesting that a modest amount of additional information may be sufficient for uniquely resolving susceptibility. A Morphology Enabled Dipole Inversion (MEDI) approach is developed that exploits the structural consistency between the susceptibility map and the magnitude image reconstructed from the same gradient echo MRI. Specifically, voxels that are part of edges in the susceptibility map but not in the edges of the magnitude image are considered to be sparse. In this approach an L1 norm minimization is used to express this sparsity property. Numerical simulations and phantom experiments are performed to demonstrate the superiority of this L1 minimization approach over the previous L2 minimization method. Preliminary brain imaging results in healthy subjects and in patients with intracerebral hemorrhages illustrate that QSM is feasible in practice.

Magnetic susceptibility varies among brain structures and provides insights into the chemical and molecular composition of brain tissues. However, the determination of an arbitrary susceptibility distribution from the measured MR signal phase is a challenging, ill-conditioned inverse problem. Although a previous method named calculation of susceptibility through multiple orientation sampling (COSMOS) has solved this inverse problem both theoretically and experimentally using multiple angle acquisitions, it is often impractical to carry out on human subjects. Recently, the feasibility of calculating the brain susceptibility distribution from a singleangle acquisition was demonstrated using morphology enabled dipole inversion (MEDI). In this study, we further improved the original MEDI method by sparsifying the edges in the quantitative susceptibility map that do not have a corresponding edge in the magnitude image. Quantitative susceptibility maps generated by the improved MEDI were compared qualitatively and quantitatively with those generated by calculation of susceptibility through multiple orientation sampling. The results show a high degree of agreement between MEDI and calculation of susceptibility through multiple orientation sampling, and the practicality of MEDI allows many potential clinical applications. Magn Reson Med 66:777-783,

Purpose Within multiple sclerosis (MS) lesions iron is present in chronically activated microglia. Thus, iron detection with MRI might provide a biomarker for chronic inflammation within lesions. Here, we examine contributions of iron and myelin to magnetic susceptibility of lesions on quantitative susceptibility mapping (QSM). Methods Fixed MS brain tissue was assessed with MRI including gradient echo data, which was processed to generate field (phase), R2* and QSM. Five lesions were sectioned and evaluated by immunohistochemistry for presence of myelin, iron and microglia/macrophages. Two of the lesions had an elemental analysis for iron concentration mapping, and their phospholipid content was estimated from the difference in the iron and QSM data. Results Three of the five lesions had substantial iron deposition that was associated with microglia and positive susceptibility values. For the two lesions with elemental analysis, the QSM derived phospholipid content maps were consistent with myelin labeled histology. Conclusion Positive susceptibility values with respect to water indicate the presence of iron in MS lesions, though both demyelination and iron deposition contribute to QSM.

QSM with a minimal variation in ventricular CSF is viable to provide a consistent zero reference while improving image quality. Magn Reson Med 79:2795-2803, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Purpose To compare the utility of magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) in characterizing fibrosis and chronic hepatitis in patients with chronic liver diseases. MATERIALS AND METHODS Following IRB approval, 76 patients with chronic liver disease underwent abdominal MRI, MRE and DWI. Severities of liver fibrosis and chronic hepatitis were graded by histopathologic analysis according to standard disease-specific classification. The overall predictive ability of MRE and DWI in assessment of fibrosis was compared by constructing a receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC) based on histopathologic analysis. RESULTS Using ROC analysis, MRE showed greater capability than DWI in discriminating stage 2 or greater (≥F2), stage 3 or greater (≥F3), cirrhosis (≥F4) shown as significant differences in AUC (P=0.003, P=0.001, P=0.001, respectively). Higher sensitivity/specificity were demonstrated by MRE in predicting fibrosis scores ≥F2 (91%/97%), scores ≥F3 (92%/95%), and scores F4 (95%/87%) compared to DWI (84%/82%, 88%/76%, and 85%/68%). Although MRE had higher ability in identification of liver with fibrosis scores ≥F1 than DWI, a significant difference was not seen (P=0.398). Stiffness values on MRE increased in relation to increasing severity of fibrosis as confirmed by histopathology scores; however, a consistent relationship between apparent diffusion coefficient (ADC) values and stage of fibrosis was not demonstrated. In addition, liver tissue with chronic hepatitis preceding fibrosis may account for mild elevation of liver stiffness. CONCLUSIONS MRE had greater predictive ability in distinguishing the stages of liver fibrosis compared with DWI.

Purpose Venous blood oxygen saturation is an indicator of brain oxygen consumption and can be measured directly from quantitative susceptibility mapping (QSM) by deconvolving the MR phase signal. However, accurate estimation of the susceptibility of blood may be affected by flow induced phase in the presence of imaging gradient and the inhomogeneous susceptibility field gradient. The purpose of this study is to correct the flow induced error in QSM for improved venous oxygenation quantification. Methods Flow compensation is proposed for QSM by using a fully flow compensated multi-echo gradient echo sequence for data acquisition. A quadratic fit of the phase with respect to echo time is employed for the flow phase in the presence of inhomogeneity field gradients. Phantom and in vivo experiments were carried out to validate the proposed method. Results Phantom experiments demonstrated reduced error in the estimated field map and susceptibility map. Initial data in in vivo human imaging demonstrated improvements in the quantitative susceptibility map and in the estimated venous oxygen saturation values. Conclusion Flow compensated multi-echo acquisition and an adaptive-quadratic fit of the phase images improves the quantitative susceptibility map of blood flow. The improved vein susceptibility enables in vivo measurement of venous oxygen saturation throughout the brain.

Chronic active multiple sclerosis lesions, characterized by a hyperintense rim of iron-enriched, activated microglia and macrophages, have been linked to greater tissue damage. Post-mortem studies have determined that chronic active lesions are primarily related to the later stages of multiple sclerosis; however, the occurrence of these lesions, and their relationship to earlier disease stages may be greatly underestimated. Detection of chronic active lesions across the patient spectrum of multiple sclerosis requires a validated imaging tool to accurately identify lesions with persistent inflammation. Quantitative susceptibility mapping provides efficient in vivo quantification of susceptibility changes related to iron deposition and the potential to identify lesions harbouring iron-laden inflammatory cells. The PET tracer 11 C-PK11195 targets the translocator protein expressed by activated microglia and infiltrating macrophages. Accordingly, this study aimed to validate that lesions with a hyperintense rim on quantitative susceptibility mapping from both relapsing and progressive patients demonstrate a higher level of innate immune activation as measured on 11 C-PK11195 PET. Thirty patients were enrolled in this study, 24 patients had relapsing remitting multiple sclerosis, six had progressive multiple sclerosis, and all patients had concomitant MRI with a gradient echo sequence and PET with 11 C-PK11195. A total of 406 chronic lesions were detected, and 43 chronic lesions with a hyperintense rim on quantitative susceptibility mapping were identified as rim + lesions. Susceptibility (relative to CSF) was higher in rim + (2.42 AE 17.45 ppb) compared to rimÀ lesions (À14.6 AE 19.3 ppb, P 5 0.0001). Among rim + lesions, susceptibility within the rim (20.04 AE 14.28 ppb) was significantly higher compared to the core (À5.49 AE 14.44 ppb, P 5 0.0001), consistent with the presence of iron. In a mixed-effects model, 11 C-PK11195 uptake, representing activated microglia/macrophages, was higher in rim + lesions compared to rimÀ lesions (P = 0.015). Validating our in vivo imaging results, multiple sclerosis brain slabs were imaged with quantitative susceptibility mapping and processed for immunohistochemistry. These results showed a positive translocator protein signal throughout the expansive hyperintense border of rim + lesions, which co-localized with iron containing CD68 + microglia and macrophages. In conclusion, this study provides evidence that suggests that a hyperintense rim on quantitative susceptibility measure within a chronic lesion is a correlate for persistent inflammatory activity and that these lesions can be identified in the relapsing patients. Utilizing quantitative susceptibility measure to differentiate chronic multiple sclerosis lesion subtypes, especially chronic active lesions, would provide a method to assess the impact of these lesions on disease progression.

Purpose:To compare gradient-echo (GRE) phase magnetic resonance (MR) imaging and quantitative susceptibility mapping (QSM) in the detection of intracranial calcifications and hemorrhages. Materials and Methods:This retrospective study was approved by the institutional review board. Results:A total of 156 lesions were detected: 62 hemorrhages, 89 calcifications, and five mixed lesions containing both hemorrhage and calcification. Most of these lesions (146 of 151 lesions, 96.7%) had a dominant sign on QSM images suggestive of a specific diagnosis of hemorrhage or calcium, whereas half of these lesions (76 of 151, 50.3%) were heterogeneous on GRE phase images and thus were difficult to characterize. Averaged over the two independent observers for detecting hemorrhages, QSM achieved a sensitivity of 89.5% and a specificity of 94.5%, which were significantly higher than those at GRE phase imaging (71% and 80%, respectively; P , .05 for both readers). In the identification of calcifications, QSM achieved a sensitivity of 80.5%, which was marginally higher than that with GRE phase imaging (71%; P = .08 and .10 for the two readers), and a specificity of 93.5%, which was significantly higher than that with GRE phase imaging (76.5%; P , .05 for both readers). QSM achieved significantly better interobserver agreements than GRE phase imaging in the differentiation of hemorrhage from calcification (k: 0.91 vs 0.55, respectively; P , .05). Conclusion:QSM is superior to GRE phase imaging in the differentiation of intracranial calcifications from hemorrhages and with regard to the sensitivity and specificity of detecting hemorrhages and the specificity of detecting calcifications.q RSNA, 2013