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STrategically Acquired Gradient Echo (STAGE) imaging, part III: Technical advances and clinical applications of a rapid multi-contrast multi-parametric brain imaging method.
Magn Reson Imaging 2019; 65:15-26MR

Abstract

One major thrust in radiology today is image standardization with a focus on rapidly acquired quantitative multi-contrast information. This is critical for multi-center trials, for the collection of big data and for the use of artificial intelligence in evaluating the data. Strategically acquired gradient echo (STAGE) imaging is one such method that can provide 8 qualitative and 7 quantitative pieces of information in 5 min or less at 3 T. STAGE provides qualitative images in the form of proton density weighted images, T1 weighted images, T2* weighted images and simulated double inversion recovery (DIR) images. STAGE also provides quantitative data in the form of proton spin density, T1, T2* and susceptibility maps as well as segmentation of white matter, gray matter and cerebrospinal fluid. STAGE uses vendors' product gradient echo sequences. It can be applied from 0.35 T to 7 T across all manufacturers producing similar results in contrast and quantification of the data. In this paper, we discuss the strengths and weaknesses of STAGE, demonstrate its contrast-to-noise (CNR) behavior relative to a large clinical data set and introduce a few new image contrasts derived from STAGE, including DIR images and a new concept referred to as true susceptibility weighted imaging (tSWI) linked to fluid attenuated inversion recovery (FLAIR) or tSWI-FLAIR for the evaluation of multiple sclerosis lesions. The robustness of STAGE T1 mapping was tested using the NIST/NIH phantom, while the reproducibility was tested by scanning a given individual ten times in one session and the same subject scanned once a week over a 12-week period. Assessment of the CNR for the enhanced T1W image (T1WE) showed a significantly better contrast between gray matter and white matter than conventional T1W images in both patients with Parkinson's disease and healthy controls. We also present some clinical cases using STAGE imaging in patients with stroke, metastasis, multiple sclerosis and a fetus with ventriculomegaly. Overall, STAGE is a comprehensive protocol that provides the clinician with numerous qualitative and quantitative images.

Authors+Show Affiliations

Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA; The MRI Institute for Biomedical Research, Bingham Farms, MI, USA; Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA. Electronic address: nmrimaging@aol.com.Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA.The MRI Institute for Biomedical Research, Bingham Farms, MI, USA; Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA.Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA.Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China; Neusoft Medical Systems Co., Ltd., Shanghai, China.Department of Radiology, Tianjin First Central Hospital, Tianjin, China.Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milano, Italy.Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.Departments of Radiology and Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA.The MRI Institute for Biomedical Research, Bingham Farms, MI, USA.Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA.Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China.Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA; The MRI Institute for Biomedical Research, Bingham Farms, MI, USA; Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA.Neusoft Medical Systems Co., Ltd., Shanghai, China.Department of Radiology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA.Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA.Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China. Electronic address: mywang@ha.edu.cn.Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31629075

Citation

Haacke, E Mark, et al. "STrategically Acquired Gradient Echo (STAGE) Imaging, Part III: Technical Advances and Clinical Applications of a Rapid Multi-contrast Multi-parametric Brain Imaging Method." Magnetic Resonance Imaging, vol. 65, 2019, pp. 15-26.
Haacke EM, Chen Y, Utriainen D, et al. STrategically Acquired Gradient Echo (STAGE) imaging, part III: Technical advances and clinical applications of a rapid multi-contrast multi-parametric brain imaging method. Magn Reson Imaging. 2019;65:15-26.
Haacke, E. M., Chen, Y., Utriainen, D., Wu, B., Wang, Y., Xia, S., ... Yan, F. (2019). STrategically Acquired Gradient Echo (STAGE) imaging, part III: Technical advances and clinical applications of a rapid multi-contrast multi-parametric brain imaging method. Magnetic Resonance Imaging, 65, pp. 15-26. doi:10.1016/j.mri.2019.09.006.
Haacke EM, et al. STrategically Acquired Gradient Echo (STAGE) Imaging, Part III: Technical Advances and Clinical Applications of a Rapid Multi-contrast Multi-parametric Brain Imaging Method. Magn Reson Imaging. 2019 Oct 16;65:15-26. PubMed PMID: 31629075.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - STrategically Acquired Gradient Echo (STAGE) imaging, part III: Technical advances and clinical applications of a rapid multi-contrast multi-parametric brain imaging method. AU - Haacke,E Mark, AU - Chen,Yongsheng, AU - Utriainen,David, AU - Wu,Bo, AU - Wang,Yu, AU - Xia,Shuang, AU - He,Naying, AU - Zhang,Chunyan, AU - Wang,Xiao, AU - Lagana,M Marcella, AU - Luo,Yu, AU - Fatemi,Ali, AU - Liu,Saifeng, AU - Gharabaghi,Sara, AU - Wu,Dongmei, AU - Sethi,Sean K, AU - Huang,Feng, AU - Sun,Taotao, AU - Qu,Feifei, AU - Yadav,Brijesh K, AU - Ma,Xiaoyue, AU - Bai,Yan, AU - Wang,Meiyun, AU - Cheng,Jingliang, AU - Yan,Fuhua, Y1 - 2019/10/16/ PY - 2019/06/16/received PY - 2019/09/11/revised PY - 2019/09/15/accepted PY - 2019/10/20/pubmed PY - 2019/10/20/medline PY - 2019/10/20/entrez KW - Multi-parametric magnetic resonance imaging KW - Quantitative magnetic resonance imaging KW - Quantitative susceptibility mapping KW - Strategically acquired gradient echo KW - Susceptibility weighted imaging KW - T1 mapping SP - 15 EP - 26 JF - Magnetic resonance imaging JO - Magn Reson Imaging VL - 65 N2 - One major thrust in radiology today is image standardization with a focus on rapidly acquired quantitative multi-contrast information. This is critical for multi-center trials, for the collection of big data and for the use of artificial intelligence in evaluating the data. Strategically acquired gradient echo (STAGE) imaging is one such method that can provide 8 qualitative and 7 quantitative pieces of information in 5 min or less at 3 T. STAGE provides qualitative images in the form of proton density weighted images, T1 weighted images, T2* weighted images and simulated double inversion recovery (DIR) images. STAGE also provides quantitative data in the form of proton spin density, T1, T2* and susceptibility maps as well as segmentation of white matter, gray matter and cerebrospinal fluid. STAGE uses vendors' product gradient echo sequences. It can be applied from 0.35 T to 7 T across all manufacturers producing similar results in contrast and quantification of the data. In this paper, we discuss the strengths and weaknesses of STAGE, demonstrate its contrast-to-noise (CNR) behavior relative to a large clinical data set and introduce a few new image contrasts derived from STAGE, including DIR images and a new concept referred to as true susceptibility weighted imaging (tSWI) linked to fluid attenuated inversion recovery (FLAIR) or tSWI-FLAIR for the evaluation of multiple sclerosis lesions. The robustness of STAGE T1 mapping was tested using the NIST/NIH phantom, while the reproducibility was tested by scanning a given individual ten times in one session and the same subject scanned once a week over a 12-week period. Assessment of the CNR for the enhanced T1W image (T1WE) showed a significantly better contrast between gray matter and white matter than conventional T1W images in both patients with Parkinson's disease and healthy controls. We also present some clinical cases using STAGE imaging in patients with stroke, metastasis, multiple sclerosis and a fetus with ventriculomegaly. Overall, STAGE is a comprehensive protocol that provides the clinician with numerous qualitative and quantitative images. SN - 1873-5894 UR - https://www.unboundmedicine.com/medline/citation/31629075/Strategically_acquired_gradient_echo_(STAGE)_imaging,_part_III:_Technical_advances_and_clinical_applications_of_a_rapid_multi-contrast_multi-parametric_brain_imaging_method L2 - https://linkinghub.elsevier.com/retrieve/pii/S0730-725X(19)30382-0 DB - PRIME DP - Unbound Medicine ER -