Fast field echo resembling a CT using restricted echo-spacing (FRACTURE): a novel MRI technique with superior bone contr
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TECHNICAL REPORT
Fast field echo resembling a CT using restricted echo-spacing (FRACTURE): a novel MRI technique with superior bone contrast Brian Johnson 1 & Hamza Alizai 2
&
Molly Dempsey 2
Received: 16 July 2020 / Revised: 23 October 2020 / Accepted: 25 October 2020 # ISS 2020
Abstract Objective Computerized tomography (CT) is the modality of choice for imaging bone; however, it utilizes ionizing radiation and suffers from poor soft-tissue contrast. Unlike CT, magnetic resonance imaging (MRI) provides excellent soft-tissue contrast but is limited in its ability to image bone. The objective of this study is to describe a new technical innovation which provides superior cortical and trabecular bone contrast on MRI. Methods FRACTURE (fast field echo resembling a CT using restricted echo-spacing), a 3D gradient echo pulse sequence with restricted echo-spacing combined with an automated post-processing, is described. Results Cases demonstrating the application and utility of this technique in diagnostic MRI performed for traumatic, inflammatory, neoplastic, and developmental conditions in pediatric patients are presented. Conclusion The cortical and trabecular bone contrast generated by FRACTURE yields clinically relevant information for diagnosis and management of a subset of patients in whom it may potentially obviate the need for a preoperative CT scan. Keywords MRI . Bone . Contrast . Pediatric
Introduction Computerized tomography (CT) is the modality of choice for imaging osseous structures [1]. Despite its availability, rapid acquisition times, and high spatial resolution, CT suffers from poor soft-tissue contrast and utilizes ionizing radiation [1]. The lack of ionizing radiation and unparalleled soft-tissue contrast makes magnetic resonance imaging (MRI) an attractive alternative to CT, especially for pediatric imaging [2]. However, conventional MRI is fundamentally limited in its ability to image bone due to the organized structure, low proton density, and very short T2/T2* decay times of bone, particularly cortical and trabecular bones [1, 3]. Improving the ability of MRI to image bone has been a focus for musculoskeletal imaging research and techniques including ultrashort echo time (UTE) and zero echo time (ZTE), and “black bone”
* Hamza Alizai [email protected] 1
Advanced Clinical Solutions, Philips Healthcare, Dallas, TX, USA
2
Department of Radiology, Scottish Rite Hospital for Children, 2222 Welborn St, Dallas, TX 75219, USA
techniques have been studied [4]. Improved, clinically relevant bone MRI has the potential to simplify and reduce the cost of surgical planning in procedures where both an MRI and CT are currently required [5]. Despite their ability to record signal from cortical and trabecular bones to produce CT-like images, UTE and ZTE applications are still handicapped by certain limitations that complicate widespread clinical adoption [3, 6]. Hardware and software requirements for UTE and ZTE acquisitions include fast transmit–receive switching, precise radiofrequency waveform
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