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Matthew G. Birkbeck ^1,2,3, Linda Heskamp¹, Ian S. Schofield¹, Julie Hall⁴, Roger G. Whittaker¹, and Andrew M. Blamire^1
1Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom, ²NIHR Biomedical Research Centre, NIHR Biomedical Research Centre, Newcastle upon Tyne, United Kingdom, ³Northern Medical Physics and Clinical Engineering, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom, ⁴Department of Neuroradiology, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom

Keywords: Muscle, Aging

Functional changes to the muscle’s contractile and relaxation properties occur with age. Current techniques which measure twitch dynamics provide limited information about individual muscles. We used phase contrast motor unit MRI (PC-MUMRI) to non-invasively measure the contraction and relaxation times of lower leg muscles in a healthy ageing cohort, relating this to isometric maximum voluntary contraction (MVC). Contraction and relaxation times increased with ageing and were negatively correlated with MVC. PC-MUMRI offers a sensitive method to measure muscle twitch dynamics and could be combined with other MR techniques to characterise functional changes to muscle with ageing.

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Mary A Neal^1,2, Isobel K Townsend^1,2, Harry Wightman^1,2, and Peter E Thelwall^1,2
1Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, United Kingdom, ²Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom

Keywords: Muscle, Non-Proton, 23Na, Sodium

Atypical Na⁺ regulation following exercise can be indicative of skeletal muscle dysfunction. Dynamic ²³Na-MRI of signal recovery following exercise therefore holds potential to provide a sensitive, quantitative, and non-invasive tool for physiological monitoring of disease progression or response to interventions. ²³Na-MRI sequences with temporal resolutions ranging from 2-8 minutes were acquired in the lower leg before and repeatedly after strenuous isometric dorsiflexion. Our data characterised sodium dynamics during recovery from exercise, and demonstrated an initial increase in ²³Na signal intensity from baseline levels after exercise ceased. These findings may provide additional metrics for monitoring skeletal muscle dysfunction.

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Melissa T. Hooijmans^1,2,3, Carly Lockard², Crystal Coolbaugh¹, Mark George¹, Xingyu Zhou^1,2,4, and Bruce Damon^1,2,4
1Institute of Imaging Sciences, Vanderbilt University, Nashville, TN, United States, ²Carle Health, Stephens Family Clinical Research Institute, Urbana, IL, United States, ³Radiology and Nuclear Medicine, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam, Netherlands, ⁴Biomedical Engineering, Vanderbilt University, Nashville, TN, United States

Keywords: Muscle, Diffusion Tensor Imaging, Muscle architecture

In this study we explored if displacement fields, derived from registration of high-resolution anatomical images in different foot positions, could be used to transform muscle fiber architecture from plantar-flexed to dorsi-flexed foot position (passive shortening). Our data revealed that muscle fiber architecture from one foot position can be transformed in the other foot position and that the original and transformed fibers demonstrate similar architectural characteristics, i.e. fiber lengths, pennation angle, curvature, and physiological cross-sectional area. 

Pinzhen Chen¹, Zhiming Zhen², Ting Yin³, and Wei Chen^2
1The first affiliated hospital ofArmy Medical University, Chongqing, China, ²The first affiliated hospital, Army Medical University, Chongqing, China, ³MR Collaborations, Siemens Healthineers Ltd., Chengdu, China

Keywords: MSK, Nerves, 7T, DESS, peripheral nerves

This study investigated the feasibility of DESS sequence to assess the knee peripheral nerve structures in healthy subjects and patients. The results showed that the nerve imaging quality of DESS sequence was superior to PD sequence in healthy adults. Further, only the isotropic 3D-DESS protocol could clearly visualize the distal peroneal nerve branches and their anatomical course. In patient with peripheral nerves damages, combining the PD and DESS imaging could provide more pathological and anatomical information about the knee peripheral nerve. This suggests that DESS sequence can reliably image the knee peripheral nerves and effectively provide precise knowledge about it. 

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Vadim Malis¹, Won Bae^1,2, Diana Vucevic¹, Yoshimori Kassai³, and Mitsue Miyazaki^1
1Radiology, UC San Diego, San Diego, CA, United States, ²VA San Diego Healthcare System, San Diego, CA, United States, ³Canon Medical, Ōtawara-shi, Japan

Keywords: Tendon/Ligament, CEST & MT, UTE, Ultra-short TE

A δUTE sequence allows for collecting multiple echoes with short echo time intervals, without the restriction of in-phase TEs. This study utilizes data collected with δUTE for bi-exponential T₂^* mapping of cartilage, muscle and tendon tissues in a human foot. The same anatomies are also evaluated using Z-spectrum Analysis Protons (ZAP) and Chemical exchange saturation transfer (CEST). While ZAP imaging provides overall exchange proton quantification of free and restricted exchange protons in a wide range of frequencies, CEST focuses on specific hydroxy (-OH, at 1.0 ppm), amine (-NH₂, at 2 ppm), and amide (-NH, at 3.5 ppm) protons.

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Daehyun Yoon¹, Brian Hargreaves¹, and Amelie Lutz^1
1Radiology, Stanford University, Stanford, CA, United States

Keywords: Neurography, Diffusion Tensor Imaging, Multi-shot DW-EPI, repeatability, feasibility

DTI of peripheral nerves for detecting nerve damage has been very challenging due to limited resolution and imaging artifacts of the conventional single-shot diffusion-weighted echoplanar imaging (SS-DW-EPI). Here, we have evaluated the feasibility of improved DTI with multi-shot DW-EPI (MUSE) by comparing mean diffusivity (MD) and fractional anisotropy (FA) estimates of tibial and peroneal nerves with those from SS-DW-EPI in ten healthy subjects. MUSE showed lower within-subject coefficient of variation in diffusion estimates, indicating improved repeatability, while correlation analysis showed noticeable differences between FA estimates. Our results show the feasibility of MUSE for in vivo evaluation of peripheral nerves.

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Shaowei Bo^1,2, Chongxue Bie^1,3, Nirbhay N. Yadav^4,5, Peter C.M. van Zijl^4,5, Jiadi Xu^4,5, Chao Zou¹, Hairong Zheng¹, and Yang Zhou^1
1Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China, ²Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China, ³Department of Information Science and Technology, Northwest University, Xian, China, ⁴F.M Kirby Research Center, Kennedy Krieger Institute, Baltimore, MD, United States, ⁵Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Keywords: Muscle, CEST & MT

Pompe disease (PD) is a glycogen storage disease, characterized by progressive lysosomal glycogen accumulation and changes in energy metabolite levels. There is a lack of methods to noninvasively assess PD progression and treatment response. We demonstrate that saturation transfer MRI can detect changes in glycogen, total creatine (tCr), and phosphocreatine (PCr) in a mouse model of PD and show more than doubling of muscle glycogen levels and a gradual decrease of tCr and PCr levels with age. The simultaneous mapping of these energy metabolites with MRI has potential to assess PD and other diseases involving mitochondrial or energy metabolic disorders.

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Jiujun Lan¹, Wei Wang¹, Xiaocheng Wei², and Junrong Chen^1
1Sichuan Province Orthopedic Hospital, Chengdu, China, ²GE Healthcare China, Beijing, China

Keywords: Muscle, Fat, Quantitative imaging, Lumbar disc herniation

Previous study found that low back pain (LBP) and Modic changes were closely associated with fatty infiltration and cross-sectional area (CSA) of the paraspinal muscles. However, conflicting evidences were reported. This study investigated the association between intervertebral discs degeneration and lumbar paraspinal muscles CSA and fat infiltration, and explored the relationship between Modic change and intervertebral discs degeneration. Our results found that lumbar disc’s Pfirrmann grading was weakly correlated with CSA of multifidus, fat fraction of multifidus and erector spinae, and the incidence rate of Modic changes increased in higher Pfirrmann grading.

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Xin Mu¹, Huahui Xu², Jialin Wang³, Chang Ni¹, Meng Tian⁴, Xiaoli Gu², and Jeff L Zhang^1
1Vascular and Physiologic Imaging Research (VPIR) Lab, School of Biomedical Engineering, ShanghaiTech University, Shanghai, China, ²Department of Radiology, Shanghai Guanghua Hospital of Integrative Medicine, Shanghai, China, ³Central Research Institute, UIH Group, Central Research Institute, UIH Group, Shanghai, China, ⁴School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China

Keywords: Osteoarthritis, Aging

Fat content and clustering are linked to muscle function in various disorders and are of therapeutic importance because they reflect the physical activity. Thus, we studied the fat content and  clustering in three groups: hip-joint replacement surgery (HJRS) patients, ankylosing spondylitis (AS) patients who received medicine, and healthy controls. Although the intramuscular fat of unaffected side remained same in HJRS patients, Moran's index declined. Meanwhile, the Moran index of HJRS patients' affected side decreased significantly when fat content decreased. Besides, the drug treatment for AS patients resulted in a decrease in both fat content and Moran's index.

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Martijn Froeling^1
1Radiology, UMC Utrecht, Utrecht, Netherlands

Keywords: Muscle, Diffusion Tensor Imaging

In this study, the aim is to show the feasibility of generating a per-muscle architecture template using a combination of muscle shape and muscle tensor registration. Additionally, the use of a generalized muscle template to identify between-subject differences will be explored. The tensor-based registration does allow for better alignment of internal muscle structures which is not possible using registration based on distance maps alone. 

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Constantin von Deuster^1,2, Shila Pazahr³, Nikolai Pfender⁴, Armin Curt⁴, Reto Sutter³, and Daniel Nanz^2
1Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Zurich, Switzerland, ²Swiss Center of Musculoskeletal Imaging, Balgrist Campus AG, Zurich, Switzerland, ³Radiology, Balgrist University Hospital, Zurich, Switzerland, ⁴Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland

Keywords: MSK, Skeletal, Spine, Tagging

The reference standard for spinal-cord motion measurement is phase-contrast (PC) imaging. This approach, however, requires a dedicated phase correction during post processing, which renders clinical application very challenging. The objective of this work was to employ MR-tag imaging to directly visualize cervical spinal-cord motion in patients with spinal-canal stenosis and compare results with PC imaging. Among all patients, a good correlation between tag imaging and matched PC measurements was found (R² = 0.84). Hence, MR-tag imaging may well complement standard static imaging within clinical routine of patients with spinal-canal stenosis, reflecting dynamic spinal cord distress.

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L. Tugan Muftuler¹, Brendan Bych¹, Jeffrey A. King¹, and Jordan A. Gliedt^1
1Medical College of Wisconsin, Milwaukee, WI, United States

Keywords: Skeletal, Degenerative, intervertebral disc

Chronic low back pain is usually associated with degeneration of the intervertebral discs, although the disc itself may not be the source of pain. Unfortunately, there are no objective measures of the disc degeneration process. The gold standard relies on visual assessment of MRI scans, which may not capture complex physiological changes in degenerating discs. We used quantitative MRI metrics to study longitudinal changes disc degeneration over a period of 2 years. Although most subjects did not show visible changes in discs, there were significant losses in disc height and some discs also showed a reduction in ADC and T1ρ.

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L. Tugan Muftuler¹, Tomas Rokos², Srivishnu Appalaraju², Tyler Tran², Joshua Goldshteyn², Garin Jankowski², and John Bukowy^2
1Medical College of Wisconsin, Milwaukee, WI, United States, ²Milwaukee School of Engineering University, Milwaukee, WI, United States

Keywords: MSK, Quantitative Imaging, spine, lumbar, intervertebral disc degeneration

Intervertebral disc degeneration is the leading cause of chronic low back pain (CLBP). However, there are no objective measures of the disc degeneration process. The current gold standard for grading disc degeneration relies on visual assessment of discs using MRI, which may not adequately capture complex physiological changes in degenerating discs. We developed a deep convolutional neural network to automatically segment vertebral structures and calculate quantitative MRI metrics. Results show significant changes in ADC and normalized T2 values with disc volume loss.

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Mitchell J. Christiansen^1,2, Mark C. Preul³, Steven Marsh³, Jay D. Turner⁴, Juan Uribe⁴, Muhammad Nadeem², Elliott J. Mufson², Richard D. Dortch², John C. Gore⁵, and Ping Wang^2
1Creighton University School of Medicine, Phoenix, AZ, United States, ²Translational Neuroscience, Barrow Neurological Institute, Phoenix, AZ, United States, ³Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, United States, ⁴Sonntag Spine Center, Barrow Neurological Institute, Phoenix, AZ, United States, ⁵Radiology and Radiological Sciences, Vanderbilt Institute of Imaging Science, Nashville, TN, United States

Keywords: MSK, Degenerative, Intervertebral disc

T1rho imaging has been used to probe relatively slow macromolecular processes, making it a practical tool to gain information about water spin dynamics and interactions with endogenous macromolecules. We measured the dispersion of T1rho with different spin-lock fields in the intervertebral disc of swine spine specimens before and after the treatment to induce proteoglycan loss, a sign of early disc degeneration. Analysis revealed elevated T1rho values in all proteoglycan-depleted discs at each spin-lock field, and that post-treatment T1rho changes increase at a higher spin-lock field.  

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Jiyo S Athertya¹, James Lo^1,2, Alicia Ji¹, Charles Ding¹, Arya Suprana^1,2, Kiersten Red³, Yujia Ge³, Madeline Brown ³, Jiang Du^1,2,4, Eric Y Chang^1,4, Koichi Masuda ³, and Yajun Ma^1
1Radiology, UC San Diego, San Diego, CA, United States, ²Bioengineering, UC San Diego, San Diego, CA, United States, ³Orthopedic Surgery, UC San Diego, San Diego, CA, United States, ⁴Radiology, Veterans Affairs San Diego Healthcare System, San Diego, CA, United States

Keywords: MSK, Joints, Intervertebral disc

Intervertebral disc degeneration is a leading cause of disability. In this study, quantitative T2 and ultrashort echo time magnetization transfer ratio (UTE-MTR) measurement techniques are utilized to assess biochemical component changes for better understanding of the mechanism of disc degeneration using a rabbit spinal intervertebral disc degeneration model. Both T2 and UTE-MTR values of nucleus pulposus (NP) are significantly different between normal and degenerated discs, indicating water and/or proteoglycan content changes. 

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Thierno D. Diallo¹, Zeynep Berkarda¹, Simon Wiedemann¹, Caroline Wilpert¹, Ralph Strecker², Gregor Koerzdorfer³, Dominik Nickel³, Fabian Bamberg¹, Matthias Benndorf¹, and Jakob Weiß^1
1Radiology, University Medical Center Freiburg, Freiburg, Germany, ²EMEA Scientific Partnerships, Siemens Healthcare GmbH, Erlangen, Germany, ³MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany

Keywords: MSK, Machine Learning/Artificial Intelligence

Magnetic resonance imaging of the spine is considered one of the most commonly performed examinations in clinical routine. The raising demand for high quality imaging of the spine creates the need for tailored examination protocols, especially with regard to increasingly limited scanner capacities. Deep Learning based imaging reconstruction has emerged as promising novel technique to accelerate MR imaging while maintaining image quality. This study analyzed  a novel deep learning accelerated T2-weighted Dixon sequence of the spine in terms of diagnostic performance. The results suggest that the here presented sequence is feasible with a diagnostic performance comparable to standard imaging.

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Sang Won Jo¹, Eun Kyung Khil¹, Seun Ah Lee¹, Jihe Lim¹, Jae Hyeok Lee², and Yu Sung Yoon^3
1Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea, Republic of, ²Deepnoid, Seoul, Korea, Republic of, ³Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea, Republic of

Keywords: MSK, Machine Learning/Artificial Intelligence, thoracolumbar fracture

This study was aimed to develop a deep learning algorithm for automated detection and localization of posterior ligamentous complex (PLC) injury on magnetic resonance imaging and evaluate its diagnostic performance. The sensitivity, the specificity and AUC of inception-ResNet V2 architecture of second step were 88%, 82% and 0.928, for the internal test set and 86%, 74% and 0.916 for the external test set, respectively.  A deep learning algorithm detected PLC injury in patients with thoracolumbar fracture with a high diagnostic performance which was validated using external data set.

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Adiraju Karthik¹, Apoorwa Devappa², Aakaar Kapoor³, Dharmesh Singh⁴, and Dileep Kumar^4
1Department of Radiology, Sprint Diagnostics, Jubilee Hills, Hyderabad, India, ²Department of Radiology, Mahadevappa Rampure Medical College, Kalaburagi, India, ³Department of Radiology, City X-Rays Scan & Clinical Private Limited, New Delhi, India, ⁴Central Research Institute, Global Scientific Collaborations, United Imaging Healthcare, New Delhi, India

Keywords: Skeletal, Spinal Cord, Intervertebral lumbar disc patients , T2* mapping

The human lumbar spine is comprised of multiple tissue components that serve to offer structural stability as well as optimal nutrition. Traditional magnetic resonance (MR) imaging techniques have been beneficial in assessing intervertebral disc (IVD). Quantitative T2* mapping has recently been used to diagnose and characterize abnormalities associated with IVD, particularly water content variations. However, this approach remains in research settings, and its clinical application has not been thoroughly investigated. This study quantitatively evaluate the clinical value of T2* mapping of intervertebral lumbar disc patients with lower back pain using 3T magnetic resonance imaging (MRI).

Jian-Bang Zhang¹, Jin Liu¹, Jia-Xin Feng¹, Jianwei Liao¹, Wei Li¹, Xiao-Jun Chen¹, Long Qian², Ya-Jun Ma³, and Shao-Lin Li^1
1Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China, ²GE Healthcare, Beijing, China, ³Department of Radiology, University of California San Diego, San Diego, CA, United States

Keywords: Bone, Skeletal

Ultrashort echo time magnetization transfer (UTE-MT) technique can non-invasively quantify the macromolecular component changes. It has great potential to assess intervertebral disc degeneration (IVDD). In this study, we utilized the UTE-MT sequence to investigate the relationship between UTE-MT ratio (UTE-MTR) measurements of lumbar trabecular bone and IVDD. We found that the lumbar trabecular bone UTE-MTR negatively correlated with the IVDD grading. It demonstrates that the UTE-MTR of lumbar trabecular bone may serve as a useful biomarker to assess IVDD.

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Rolf Reiter^1,2, David Kaufmann³, Mehrgan Shahryari¹, Janosch Simon Jahn¹, Rebecca Strehle¹, Christian Bayerl¹, Bernd Hamm¹, Jürgen Braun⁴, Ingolf Sack¹, and Patrick Asbach^1
1Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany, ²BIH Biomedical Innovation Academy, BIH Charité Digital Clinician Scientist Program, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany, ³Radiology, Universitätsklinikum Augsburg, Augsburg, Germany, ⁴Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Germany

Keywords: Elastography, MSK

Despite the success in detecting intervertebral disc degeneration with high-resolution T2 sequences, conventional MRI is limited by large inter-reader variability as well as lacking stratification of clinical trials and their assessment of treatment responses. Several studies have shown the technical feasibility of MR elastography for the study of the intervertebral disc, but its clinical relevance remains unclear. This study shows an excellent diagnostic performance of high-resolution multifrequency MR elastography in the evaluation of lumbar spine intervertebral disc degeneration.