IMPROVING THE ROBUSTNESS OF PERFUSION IMAGING WITH ARTERIAL SPIN LABELING MAGNETIC RESONANCE IMAGING BY HUAN TAN A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL OF ARTS AND SCIENCES in Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PHILOSOPHY Biomedical Engineering December 2010 Winston-Salem, North Carolina Approved By: Robert A. Kraft, Ph.D., Advisor, Chair James B. Daunais, Ph.D. Craig A. Hamilton, Ph.D. W. Scott Hoge, Ph.D. Robert J. Plemmons, Ph.D. ACKNOWLEDGEMENTS I would like to thank my advisor, Dr. Robert Kraft for his guidance and friendship. I am grateful for his time and patience working with me over the course of my graduate career, and his continuous support and encouragement in my endeavors outside of the world of MRI. I cherish the countless hours spent together at the scanner solving problems. I have grown as an independent engineer and researcher, and I owe a great deal of that progression to Dr. Kraft’s guidance and mentorship. I would like to thank Drs. James Daunais, Craig Hamilton, Scott Hoge, and Robert Plemmons for serving on my Ph.D. committee. I greatly appreciate the time and effort they have put in to improve the quality of my dissertation. I owe special thanks to Dr. Scott Hoge for his collaboration and expertise on parallel imaging that has helped me to overcome many research barriers. I would also like to give thanks to Dr. Craig Hamilton for insightful discussion and Dr. James Daunais for his continuous support on non-human primate studies. I have been fortunate to be a member of the best lab at Wake Forest University, Laboratory for Complex Brain Networks (LCBN). I cannot express in quantitative terms how much I have enjoyed working there. I must thank the director of LCBN, Dr. Paul Laurienti, for always being available to help and making such a relaxed and supportive research environment. I would like thank all current and previous members of LCBN, especially Dr. Jonathan Burdette, Dr. Satoru Hayasaka, Dr. Ann Peiffer, Debra Hege, and Ashley Morgan. ii My accomplishments would not be possible without the love and support of my family and friends. To my mother and father, I thank you both for your unconditional love, support, encouragement and sacrifice. You have been the main motivation during my pursuit of this degree. To Donna and Robert, thank you for your tireless love and support of my decisions and everything you have done for me in the last eleven years. You are my family here in the states. For all my wonderful friends, thank you for making those years so special and I will cherish the memories from good times for the rest of my life. iii TABLE OF CONTENTS ACKNOWLEDGEMENTS................................................................................................ ii LIST OF ABBREVIATIONS............................................................................................ vi LIST OF FIGURES ........................................................................................................... ix LIST OF TABLES............................................................................................................. xi ABSTRACT...................................................................................................................... xii Chapter I. NON-GADOLINIUM (ARTERIAL SPIN LABELING) TECHNIQUE ..................1 Accepted in Functional Neuroradiology: Principles and Clinical Applications, June 2010 II. A FAST, EFFECTIVE F METHOD FOR IMPROVING CLINICAL PULSED ARTERIAL SPIN LABELING MRI .......................................................................22 Published in Journal of Magnetic Resonance Imaging, April 2009 III. 3D GRASE PROPELLER: IMPROVED IMAGE ACQUISITION TECHNIQUE FOR ARTERIAL SPIN LABELING PERFUSION IMAGING..............................43 In Press in Magnetic Resonance in Medicine, December 2010 IV. ROBUST EPI NYQUIST GHOST ELIMINATION VIA SPATIAL AND TEMPORAL ENCODING (EPI-GESTE)................................................................65 Published in Magnetic Resonance in Medicine, December 2010 V. PSEUDO-CONTINOUSL ARTERIAL SPIN LABELING.....................................95 VI. PERFUSION PHANTOM VALIDATION USING ARTERIAL SPIN LABELING MRI ...................................................................................................113 iv VII. CONCLUSION.......................................................................................................128 SCHOLASTIC VITA ......................................................................................................152 v LIST OF ABBREVIATIONS ASL Arterial Spin Labeling MRI Magnetic Resonance Imaging CBF Cerebral Blood Flow CBV Cerebral Blood Volume MTT Mean Transit Time PLD Post Labeling Delay ETL Echo Train Length SNR Signal to Noise Ratio PASL Pulsed Arterial Spin Labeling CASL Continuous Arterial Spin Labeling VS-ASL Velocity Selective Arterial Spin Labeling RF Radio Frequency FAIR Flow-sensitive Alternating Inversion Recovery PICORE Proximal Inversion with Control for Off-Resonance Effects EPISTAR Echo Planar Imaging and Signal Targeting with Alternating Radio Frequency AHS Adiabatic Hyperbolic Secant FOCI Frequency Offset Correction Inversion QUIPSS QUantitative Imaging of Perfusion using a Single Subtraction Q2TIPS QUIPSS II with Thin-slice TI1 Periodic Saturation SAR Specific Absorption Rate MT Magnetic Transfer vi ASSIST Attenuating the Static Signal in Arterial Spin Tagging EPI Echo Planar Imaging TE Echo Time TI Inversion Time PWI Perfusion Weighted Image M0 Proton Density Weighted Image PACS Picture Archiving and Communication System μ Mean σ Standard Deviation GRASE Gradient Echo And Spin Echo PROPELLER Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction 3DGP 3D GRASE PROPELLER FOV Field Of View PLACE Phase Labeling for Additional Coordinate Encoding PAGE Phased Array Ghost Elimination SENSE Sensitivity Encoding PSF Point Spread Function GESTE Ghost Elimination via Spatial and Temporal Encoding SVD Singular Value Decomposition GSR Ghost to Signal Ratio DSC Dynamic Susceptibility Contrast PET Positron Emission Tomography vii NHP Non-Human Primate PCASL Pseudo-Continuous Arterial Spin Labeling VSS Very Selective Suppression TOF Time Of Flight ROI Region Of Interests RPP Relative Perfusion Proportion MP-PCASL Multi-Phase Pseudo-Continuous Arterial Spin Labeling WM White Matter BOLD Blood Oxygenation Level Dependent viii LIST OF FIGURES Page 1 Normal ASL CBF Map............................................................................................3 2 General Principle of ASL and Image Post-processing ............................................4 3 Perfusion Signal from a Single Control/Label Pair .................................................6 4 ASL Labeling Schemes............................................................................................7 5 PASL Filter Processing Steps ................................................................................30 6 Mean Coefficient of Variation for 200 Study Cases..............................................34 7 Clinical CBF Perfusion Cases Before and After ASL Filtering ............................36 8 Image Quality Assessment Scores.........................................................................37 9 3DGP Trajectory and Pulse Sequence ...................................................................49 10 3DGP Reconstruction Process Diagram ................................................................50 11 3DGP and 3D GRASE Invivo CBF Maps Comparison ........................................54 12 Reformatted Views of 3DGP and 3D GRASE Invivo CBF Maps ........................55 13 Diagram of EPI-GESTE Reconstruction Algorithm..............................................72 14 An Image Domain Comparison of the parallel MRI Calibration ..........................78 15 Estimated Line Shift Coefficient and Comparisons of GSR .................................80 16 Image Reconstruction Comparison for Nyquist Ghost Correction .......................82 17 Residual Artifact Comparison................................................................................84 18 Perfusion Weighted Image Comparison ................................................................86 19 Difference Image Comparison...............................................................................87 20 Phantom and Signal Variance Images ...................................................................88 21 Balanced PCASL Labeling Scheme and Pulse Diagram.......................................99 ix 22 PCASL and PASL Images from Human Subject One.........................................104 23 PCASL and PASL Images from Human Subject Two ........................................105 24 PCASL and PASL Images from NHP .................................................................106 25 Design and Actual Illustration of the Perfusion Phantom ...................................118 26 Locations of the Thermocouple on the Perfusion Tissue.....................................120 27 Video Screen Capture of the Red-Dye Experiment.............................................123 28 Estimated Relative Perfusion Proportion as a Function of Slice Thickness........125 29 Simulated Inversion Response Curve as a Function of Phase Offset ..................141 30 Illustration of MP-PCASL...................................................................................142 x LIST OF TABLES Page 1 Q2TIPS-FAIR Implementation Parameters...........................................................27