Journal Of Magnetic Resonance Imaging[JOURNAL]
Sun
200 papers
Sex, Gender, and the Search for Analytic Truth.
Starekova J, Schweitzer ME
J Magn Reson Imaging · 2026 Jun · PMID 42287138 · Publisher ↗
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Editorial for "Prognostic Value of a Cardiac Magnetic Resonance-Derived Left Atrioventricular Coupling Index From Routine Cine Images in Dilated Cardiomyopathy: A Multicenter Study".
Lange T, Schulz A
J Magn Reson Imaging · 2026 Jun · PMID 42281465 · Publisher ↗
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B1+rms for Implants: A Review of Intended Use.
Steckner M, Al-Dayeh L
J Magn Reson Imaging · 2026 Jun · PMID 42281234 · Publisher ↗
The B1+rms metric, requested by Active Implantable Medical Device (AIMD) manufacturers, characterizes MR equipment radiofrequency (RF) electromagnetic field outputs. Specific Absorption Rate (SAR) is the physiologically...
The B1+rms metric, requested by Active Implantable Medical Device (AIMD) manufacturers, characterizes MR equipment radiofrequency (RF) electromagnetic field outputs. Specific Absorption Rate (SAR) is the physiologically appropriate power deposition metric for patient heating considerations, but B1+rms is better suited for implant purposes because it more directly assesses AIMD/RF exposure interactions in conductive implants. The formal SAR definitions only specify limits, not how to compute SAR, thus each MR equipment make, model and software version may compute SAR differently via proprietary algorithms. Since a wide range of SAR occurs for a given B1+ exposure condition, SAR estimates are larger than the actual exposure. Consequently, the SAR safety margin size that fulfills limit requirements is unknown to AIMD manufacturers and MR equipment users. By design, the B1+rms metric has no limit or safety margin, but is precisely defined to enable transparency to all B1+rms users. Because B1+rms enables a more precise assessment of AIMD/RF exposure interactions, more RF performance becomes available for MR Conditional AIMD purposes. The AIMD manufacturer is responsible to assess all relevant uncertainties, set appropriate safety margins, and provide device-specific limits. These tasks are simplified with B1+rms. Additionally, since MR image quality requires control of B1+ outputs, the clinical workflow of AIMD scanning can be improved with B1+rms labelling whereas the SAR variability between patients undergoing the same B1+ exposure may require unique sequence adjustments to comply with MR Conditional SAR constraints, impacting image quality. However, confusion remains regarding B1+rms computation, application, and why it is an independently sufficient and superior metric for MR Conditional labeling purposes. This review compares the SAR and B1+rms metrics, their suitability for AIMD labeling, describes how AIMD manufacturers use B1+rms, and clarifies various B1+rms concerns. Reasons why B1+rms is a superior RF measure for MR Conditional labeling purposes are identified. EVIDENCE LEVEL: 5. TECHNICAL EFFICACY: Stage 1.
MR Imaging-Based Biomarkers for Strength Prediction: A Statistical Shape and Architecture Modeling of Quadriceps Muscles.
Bin Ghouth S, Cigdem O, Mazzoli V
J Magn Reson Imaging · 2026 Jun · PMID 42277391 · Publisher ↗
BACKGROUND: Muscle mass decline, associated with strength decline, is a hallmark of aging. Yet, strength decline greatly exceeds mass decline. This indicates that aspects of muscle quality and architecture-not reflected...
BACKGROUND: Muscle mass decline, associated with strength decline, is a hallmark of aging. Yet, strength decline greatly exceeds mass decline. This indicates that aspects of muscle quality and architecture-not reflected by mass-also influence force generating capacity. Additionally, shape modeling enables analysis of the shape variations of muscles beyond size. PURPOSE: To predict muscle strength using muscle features beyond muscle quantity. STUDY TYPE: Retrospective cross-sectional study. POPULATION: Twenty-four healthy subjects normally distributed over an age range between 30 and 79 years old with a balanced sex distribution (12 female). FIELD STRENGTH/SEQUENCE: 3 T MRI using multi-echo Dixon and Stejskal-Tanner DTI. ASSESSMENT: Shape-only and shape + architecture models were generated using water-only and DTI images of the quadriceps. Multiple linear mixed-effects models were produced using (1) volume, (2) shape-only, and (3) shape + architecture. Volume was not added to the shape-only and shape + architecture models. Features reaching statistical significance within the models were retained for further analysis. Models' performance was evaluated using leave-one-subject-out (LOSO) cross-validation (CV). STATISTICAL TESTS: Pairwise, subject-level bootstrapping comparison was conducted and ∆R and ∆RMSE with 95% confidence interval (CI) were calculated. The improvement was considered statistically significant when both ∆R and ∆RMSE are positive and the 95% CI did not contain zero. Positive ∆R and ∆RMSE indicate an increase in R and a decrease in RMSE values. RESULTS: Shape-only features demonstrated an improvement in the model performance compared to muscle volume. Models were significantly improved for the vastus lateralis to predict eccentric torque-∆R = 0.16 (0.01-0.29), ∆RMSE = 5.0 (0.4-9.7); and for the vastus intermedius predicting isometric torque-∆R = 0.19 (0.02-0.36), ∆RMSE = 6.5 (0.7-12.0). Shape + architecture features did not significantly improve the performance (all p ≥ 0.131). DATA CONCLUSION: Shape-only models are promising to quantify variations of muscle shape related to force production, and have the potential to develop imaging-based biomarkers for muscle strength in diseases. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 2.
Prognostic Value of MRI-Based Left Ventricular Trabecular Complexity for Sudden Cardiac Death in Hypertrophic Cardiomyopathy.
Zhang J, Yu M, Pu L … +8 more , Xu R, Li Y, Guo J, Xu Y, Wan K, Han Y, Wang J, Chen Y
J Magn Reson Imaging · 2026 Jun · PMID 42276847 · Publisher ↗
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a leading cause of sudden cardiac death (SCD). Early identification of high-risk patients is important for guiding preventive measures. PURPOSE: To validate left ventricul...
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a leading cause of sudden cardiac death (SCD). Early identification of high-risk patients is important for guiding preventive measures. PURPOSE: To validate left ventricular (LV) myocardial trabecular complexity using fractal dimension (FD) for SCD prediction in a larger cohort and investigate its relationship with sarcomere variants. STUDY TYPE: Prospective. POPULATION: 835 HCM patients (506 men; 50.7 ± 14.4 years). FIELD STRENGTH/SEQUENCE: Steady-state free precession (SSFP) cine sequence at 3 T. ASSESSMENT: Two cardiologists, blinded to clinical outcomes, independently analyzed assigned cardiac MRI cases. Biventricular function, late gadolinium enhancement, and LV FD were measured with fracAnalyse. The endpoint was SCD or aborted SCD. Sarcomere variants were classified by the American College of Medical Genetics and Genomics criteria, and their associations with FD were assessed. STATISTICAL TESTS: Cox regression assessed associations with SCD. Kaplan-Meier analysis and log-rank test were used to compare SCD incidence. Harrell's C-index assessed model discrimination. Welch's t-test compared FD between variant groups. Two-sided p < 0.05 indicated significance. RESULTS: Global FD (hazard ratio [HR] per 0.01 increase, 1.07, 95% CI: 1.01-1.15) and maximal apical FD (HR, 1.08, 95% CI: 1.02-1.14) independently predicted SCD after adjustment for European Society of Cardiology and American Heart Association risk predictors. High global FD (≥ 1.256) or maximal apical FD (≥ 1.352) improved model discrimination (C-index: 0.779-0.803, 0.77-0.791). MYBPC3 carriers had significantly higher maximal apical FD (1.35 ± 0.05 vs. 1.33 ± 0.07), maximal basal FD (1.35 ± 0.05 vs. 1.32 ± 0.06), and mean basal FD (1.28 ± 0.06 vs. 1.25 ± 0.07) than other sarcomere variant carriers. DATA CONCLUSION: LV global and apical FDs provide independent and incremental prognostic value for predicting SCD. MYBPC3 variant carriers exhibited elevated FD values, linking trabecular complexity with genetic variants in HCM. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 3.
Association Between HIV Infection Duration and Left Ventricular Concentric Remodeling and Myocardial Fibrosis: A Cross-Sectional Study Using Cardiac MRI.
Deng C, Sun W, Gao T … +3 more , Chen H, Liu L, Li R
J Magn Reson Imaging · 2026 Jun · PMID 42276843 · Publisher ↗
BACKGROUND: Antiretroviral therapy has transformed HIV into a chronic condition, yet cardiac injury remains a major issue. PURPOSE: To assess the ability of cardiac MR imaging markers to predict cardiac injury and diseas...
BACKGROUND: Antiretroviral therapy has transformed HIV into a chronic condition, yet cardiac injury remains a major issue. PURPOSE: To assess the ability of cardiac MR imaging markers to predict cardiac injury and disease progression in HIV-infected individuals. STUDY TYPE: Prospective. SUBJECTS: Eighty-three HIV-infected participants (short-duration infection < 5 years, n = 43; long-duration ≥ 5 years, n = 40) and 34 matched HIV-negative controls. FIELD STRENGTH/SEQUENCE: 1.5 T; SSFP cine and MOLLI sequences. ASSESSMENT: Left ventricular (LV) end diastolic volume indexed to body surface area (LVEDVi), ejection fraction (LVEF), mass (LVM), myocardial mass-to-volume ratio (MVR), and global strains were determined from SSFP cine data. Extracellular volume (ECV) and myocardial extracellular matrix volume index (ECMVi) were determined from pre- and post-contrast myocardial T1 values. STATISTICAL TESTS: ANOVA, Kruskal-Wallis, post hoc tests, correlation, and multivariable logistic regression; p < 0.05 indicated statistical significance. RESULTS: Both the HIV groups showed significantly elevated ECV (short: median 28.02 [25.40-31.86]%; long: median 28.18 [24.40-37.99]% vs. 25.07% ± 5.61%) and myocardial native T1 (1863.35 ± 300.29 ms; median 1963.00 [1807.00, 2072.25] ms vs. median 1734 [1309.75-1981.50] ms) compared to controls. The long-duration group exhibited significantly higher ECMVi (14.73 ± 4.59 mL/m vs. controls: 10.52 ± 2.82 mL/m and short: 12.32 ± 2.83 mL/m) and MVR (0.78 ± 0.16 vs. 0.61 ± 0.11 g/mL and median 0.63 [0.55-0.69] g/mL), significantly reduced LVEDVi (65.44 ± 13.21 vs. 73.42 ± 10.99 and 72.08 ± 10.62 mL/m) and significantly diminished global radial strain (29.82% ± 6.28% vs. controls: 36.18% ± 6.39% and short: median 33.16 [28.44-37.52]%).HIV duration correlated positively with ECMVi and MVR (r = 0.277 and 0.474, respectively), and significantly negatively correlated with global radial strain (r = -0.244). Two robust MRI models were validated: ECV/native T1/fasting blood glucose (FBG) for early HIV (AUC = 0.852) and LVEDVi/ECMVi/FBG for duration stratification (AUC = 0.844), with stable performance through bootstrapping and calibration. CONCLUSION: ECV, myocardial native T1, and FBG can predict short-duration HIV infection, while a multimodal model (LVEDVi, ECMVi, and FBG)stratifies duration. However, prospective validation is necessary. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 3.
Effects of Acute Aerobic Exercise and Task Repetition on the Neural Correlates of Executive Function in Young and Older Adults: A Crossover fMRI Study.
Asahara R, Fukuie M, Hoshi D … +4 more , Won J, Zhang R, Sugawara J, Tarumi T
J Magn Reson Imaging · 2026 Jun · PMID 42272048 · Publisher ↗
BACKGROUND: Acute aerobic exercise may alter neural recruitment supporting executive function; however, age-related differences and task repetition effects remain unclear. PURPOSE: To investigate the effects of acute aer...
BACKGROUND: Acute aerobic exercise may alter neural recruitment supporting executive function; however, age-related differences and task repetition effects remain unclear. PURPOSE: To investigate the effects of acute aerobic exercise and task repetition on brain activity during task switching in young and older adults. STUDY TYPE: Prospective randomized crossover study. POPULATION: Seventeen young and nineteen older healthy adults (18 females). FIELD STRENGTH/SEQUENCE: 3.0 T, BOLD fMRI. ASSESSMENT: fMRI was conducted during a task-switching paradigm before and at 15 and 45 min following 30 min of moderate-intensity walking or sitting on separate days. Neural and behavioral switch costs were computed as differences in BOLD activation, reaction time, and error rates between switch and nonswitch trials. STATISTICAL TESTS: Linear mixed-effects model examined BOLD signals and behavioral performance. Repeated measures correlation examined within-subject associations. p < 0.05 was considered statistically significant. RESULTS: Older adults exhibited significantly greater task-related BOLD activation in the bilateral superior frontal and middle temporal gyri, right angular gyrus, and left precuneus than young adults, despite slightly lower performance (p ≤ 0.002). Task repetition significantly reduced activation in the left middle occipital and middle frontal gyri and right cerebellar cortex in both groups, whereas reaction time significantly improved only in older adults. Following walking, activation in the right dorsolateral prefrontal cortex remained stable in older adults but significantly decreased in young adults, without corresponding behavioral changes (p ≥ 0.365). Regardless of age, activation in the right postcentral gyrus and bilateral superior parietal lobules remained stable after walking but significantly decreased after sitting. Reduced activation with task repetition was significantly associated with faster reaction time, particularly in older adults. DATA CONCLUSION: Acute aerobic exercise may preserve regional brain activation without measurable behavioral benefits, whereas task repetition reduces brain activation across age groups, suggesting modest neural effects of acute aerobic exercise on executive function. TECHNICAL EFFICACY STAGE: 2.
Editorial for "The Use of Non-Contrast Abbreviated MRI for the Detection of Recurrent Hepatocellular Carcinoma in Postoperative Surveillance".
Kahraman AS, Kahraman B
J Magn Reson Imaging · 2026 Jun · PMID 42247412 · Publisher ↗
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Infant Brain Age Estimation With T1w/T2w Ratio MRI: A Myelination-Aware Deep Learning Approach.
Park H, Choi YH, Gho SM
J Magn Reson Imaging · 2026 Jun · PMID 42247370 · Publisher ↗
BACKGROUND: Brain age estimation provides a noninvasive MRI biomarker of neurodevelopment. In infancy, rapid regionally ordered myelination reflects brain maturation, yet early-life brain age estimation remains underexpl...
BACKGROUND: Brain age estimation provides a noninvasive MRI biomarker of neurodevelopment. In infancy, rapid regionally ordered myelination reflects brain maturation, yet early-life brain age estimation remains underexplored, particularly with myelination-sensitive MRI and biologically informed modeling. PURPOSE: To develop and evaluate a biologically informed deep learning framework for infant brain age estimation using T1w/T2w ratio MRI. STUDY TYPE: Retrospective. POPULATION: Internal cohort: 629 infants aged 0-24 months (626 with age-appropriate myelination, train/validation/test = 376/125/125), 3 with myelin-related developmental abnormalities for qualitative review. External cohort: 10 healthy infants aged 0-15 months (5 females, 5 males). FIELD STRENGTH/SEQUENCE: Internal: 3T; 3D gradient-echo or 2D spin-echo T1w, and 2D turbo spin-echo T2w. External: 3T; 3D gradient-echo T1w and 2D turbo spin-echo T2w. ASSESSMENT: 3D convolutional neural networks were trained with T1w, T2w, and T1w/T2w ratio inputs using manually defined biological age labels from visual myelination assessment. The model incorporated multi-task learning for age regression, white matter segmentation, and image reconstruction. STATISTICAL TESTS: Performance was evaluated using five-fold cross-validation with repeated random splits. Metrics included mean absolute error, root mean squared error, , and Pearson and Spearman correlations. Modality differences were tested using one-way ANOVA, -tests, and Mann-Whitney , with Cohen's and 95% confidence intervals. In the external cohort, absolute prediction errors were compared using the Wilcoxon signed-rank test. Statistical significance was defined as . RESULTS: T1w/T2w ratio models achieved the best overall performance (MAE: 1.489 0.302 months; = 0.966 0.012), compared with T1w (2.055 0.944; 0.933 0.061), T2w (1.794 0.434; 0.947 0.023), T1w+T2w (1.546 0.291; 0.960 0.013), and T1w+T2w+RI (1.498 0.313; 0.963 0.012). Modality effects were significant for MAE, RMSE, , , but not for ( ). Auxiliary-task and multi-scale modeling numerically improved performance (MAE, 1.203 months; = 0.979). External validation showed the lowest error for the RI-based model (MAE, 1.16 months), and Grad-CAM highlighted myelination-relevant white matter. DATA CONCLUSION: T1w/T2w ratio MRI combined with biologically informed deep learning enabled accurate and interpretable infant brain age estimation. This framework showed promising cross-scanner performance and may support MRI-based assessment of early brain maturation. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: 2.
Editorial for "Mapping Neurodegenerative Changes in Clinically Uncertain Parkinsonian Syndrome Patients Using Fast Magnetic Resonance Spin TomogrAphy in Time-Domain (MR-STAT) Relaxometry at 3 T".
Artiges A, Malik S
J Magn Reson Imaging · 2026 Jun · PMID 42247339 · Publisher ↗
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A Data-Driven Normalization Framework for Subject-Specific Cerebrovascular Reactivity Assessment in Cerebrovascular Disease.
Zhu Y, Dogra S, Wang X … +2 more , Polimeni JR, Dehkharghani S
J Magn Reson Imaging · 2026 Jun · PMID 42233513 · Publisher ↗
BACKGROUND: Assessment of cerebrovascular reactivity (CVR) has been reported using acetazolamide-augmented blood oxygenation level-dependent (BOLD) MRI; however, wide intersubject baseline variability can complicate inte...
BACKGROUND: Assessment of cerebrovascular reactivity (CVR) has been reported using acetazolamide-augmented blood oxygenation level-dependent (BOLD) MRI; however, wide intersubject baseline variability can complicate interpretation. PURPOSE: To develop an integrated normalization framework combining machine learning-guided identification of healthy voxels for subject-specific baseline rescaling with atlas-based assessment. STUDY TYPE: Retrospective. POPULATION: 26 subjects (age 51 ± 13 at first scan, 50% women, 34 exams) with unilateral steno-occlusive disease (SOD) and 9 subjects with bilateral disease (age 55 ± 12, 4/9 women) underwent acetazolamide-augmented BOLD-MRI. FIELD STRENGTH/SEQUENCE: T1-weighted MPRAGE (1 mm isotropic) and gradient-echo EPI at 3 T. ASSESSMENT: Machine learning models (random forest, XGBoost, LightGBM, and neural networks) were trained to identify healthy candidate voxels using a previously reported pipeline based on baseline resting-state BOLD temporal shift features derived from 32 arterial territories. A healthy reference CVR atlas was constructed from unaffected hemispheres. Individual CVR maps were rescaled using predicted healthy voxels and converted to Z-scores and risk index maps using the reference atlas. STATISTICAL TESTS: Coefficient of variation (CV) within normal hemispheres, lesion contrast-to-noise ratio (CNR), Lesion ROC AUC, asymmetry index (AI) in unilateral patients, and chi-square distance between thresholded normal and abnormal CVR distributions across all patients were compared between atlas-based group normalization alone and the proposed integrated normalization using paired t-tests. (cutoff p = 0.05). RESULTS: CV within normal hemispheres significantly decreased (1.07 ± 0.15 vs. 0.45 ± 0.09), indicating improved inter-subject stability. Lesion CNR and ROC AUC improved across all impairment thresholds (CNR: 0.73-1.12 vs. 0.79-1.19; AUC: 0.76-0.89 vs. 0.81-0.90). AI increased significantly at higher risk thresholds (≥ 0.78), with no significant difference at the lowest threshold (p = 0.181). Chi-square analysis demonstrated significantly increased separation between CVR distributions at intermediate thresholds. DATA CONCLUSION: The proposed integrated normalization improves the stability, discriminability, and interpretability of acetazolamide-augmented BOLD-CVR for detection of cerebrovascular impairment. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 2.
The Use of Non-Contrast Abbreviated MRI for the Detection of Recurrent Hepatocellular Carcinoma in Postoperative Surveillance.
Chen J, Zhu Y, Zheng D … +4 more , Wen L, Wu J, Yue Q, Fang Z
J Magn Reson Imaging · 2026 May · PMID 42214033 · Publisher ↗
BACKGROUND: MRI is sensitive for detecting hepatocellular carcinoma (HCC), but its routine use is hindered by low accessibility. PURPOSE: To evaluate the performance of non-contrast abbreviated MRI (NC-AMRI) alone and in...
BACKGROUND: MRI is sensitive for detecting hepatocellular carcinoma (HCC), but its routine use is hindered by low accessibility. PURPOSE: To evaluate the performance of non-contrast abbreviated MRI (NC-AMRI) alone and in combination with alpha-fetoprotein (AFP) and protein induced by vitamin K absence II (PIVKA-II) compared to a complete MRI protocol for intrahepatic recurrent HCC detection. STUDY TYPE: Retrospective. POPULATION: 190 patients (male = 167, mean age 56.7 ± 11.2 years) undergoing post-hepatectomy MRI surveillance, including 88 with recurrent HCCs. FIELD STRENGTH/SEQUENCE: T2-weighted fast spin echo (conventional and PROPELLER), diffusion-weighted imaging (DWI), and dynamic T1-weighted gradient echo sequences at 1.5 T and 3.0 T. ASSESSMENT: The NC-AMRI set consisted of T2WI and DWI data and was extracted from the complete MRI study. Three radiologists independently evaluated the presence of recurrent HCC in two separate reading sessions (NC-AMRI and complete MRI). Pairwise comparisons were then made among three strategies: a combination of NC-AMRI, AFP, and PIVKA-II; NC-AMRI alone; and complete MRI. STATISTICAL TESTS: The diagnostic performance of the three strategies was compared using a marginal logistic regression with generalized estimating equations and McNemar test. Significance level was p < 0.05. RESULTS: The sensitivity of NC-AMRI was not significantly different to that of complete MRI for detecting recurrent HCC (Reviewer 1: 94.3% vs. 95.5%, p = 0.655; Reviewer 2: 96.6% vs. 96.6%, p > 0.999; Reviewer 3: 95.5% vs. 94.3%, p = 0.655), including small and medium size HCCs (p > 0.999 for all comparisons). Adding tumor markers to NC-AMRI did not significantly improve HCC detection compared to NC-AMRI alone or complete MRI. DATA CONCLUSION: NC-AMRI demonstrated no significant difference in diagnostic performance compared to that of complete MRI in detecting intrahepatic recurrent HCCs, including small-sized lesions. Additionally, the incorporation of AFP and PIVKA-II did not significantly improve the diagnostic sensitivity of NC-AMRI. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 2.
Longitudinal H and Xe Lung MRI in Patients With Post-COVID Residual Lung Abnormalities.
Saunders LC, Collier GJ, Smith LJ … +39 more , Chan HF, Hughes PJC, Strickland S, Gustafsson L, Newman T, Plowright M, Gabriel Z, Pearce LM, Grist JT, Ng KL, Harrison A, Bolton CE, Bray J, Marshall H, Norquay G, Biancardi AM, Ball JE, Stewart NJ, Johnson KM, Swift AJ, Rajaram S, Blaikley J, Stanel S, Collini PJ, Mills GH, Lawson R, Brooke J, Goodwin AT, Stewart ID, Ho LP, Jacob J, Meersmann T, Pavlovskaya GE, Gleeson F, Hall IP, Jenkins G, Wild JM, Thompson AAR, UK‐ILD consortium
J Magn Reson Imaging · 2026 May · PMID 42210667 · Publisher ↗
BACKGROUND: It is unclear how lung function may recover in patients with residual lung abnormalities (RLAs) following COVID-19 pneumonia. PURPOSE: To evaluate lung function trends over time in patients with RLAs followin...
BACKGROUND: It is unclear how lung function may recover in patients with residual lung abnormalities (RLAs) following COVID-19 pneumonia. PURPOSE: To evaluate lung function trends over time in patients with RLAs following hospitalization due to COVID-19. STUDY TYPE: Prospective, multicenter longitudinal cohort study. POPULATION: Twenty-four participants hospitalized due to COVID-19 with RLAs identified on CT ≥ 3 months postdischarge (median [IQR] age 69 (15) years; 3 female) underwent at least one MRI at 6 months (n = 16), 1 year (n = 19), or 2 years (n = 14). FIELD STRENGTH/SEQUENCE: 1.5 T. Dynamic contrast enhanced (DCE) 3D spoiled gradient echo, Xe steady state free precession (ventilation), Xe 3D spoiled gradient echo multiple b-value (diffusion-weighted), Xe 4-echo flyback 3D radial (dissolved phase). ASSESSMENT: Pulmonary blood flow, volume, and mean transit time (MTT) were calculated from DCE MRI. The fraction of Xe signal in the red blood cells to membrane (RBC:M) was calculated from the dissolved phase Xe acquisition. Ventilation defect percentage (VDP) was calculated from the Xe ventilation acquisition. Mean diffusive length scale (Lm) was calculated from the Xe diffusion-weighted acquisition. STATISTICAL TESTS: Changes in metrics with time and associations between metrics were assessed using mixed-effect linear regression. Correlations were tested using Spearman's correlation coefficient. Regional differences were assessed using a Friedman's test with a Bonferroni adjustment. p < 0.05 was considered significant. RESULTS: Pulmonary blood flow and MTT improved significantly over time (MTT: 6 months, 15.3 (IQR, 2.0); 1 year, 15.6 (1.4); 2 years, 15.0 (5.3); pulmonary blood flow: 6 months, 75.4 (IQR, 22.0); 1 year, 83.2 (47.4); 2 years, 107.3 (51.1)). RBC:M z-score was low at all three visits (6 months, -2.85 (0.98); 1 year, -2.44 (1.34); 2 years, -2.60 (1.39)), with no improvement with time (p = 0.993). VDP and Lm did not significantly change with time (VDP: p = 0.100; Lm: p = 0.166). DATA CONCLUSION: Improvements in lung perfusion were measured; however, there was no corresponding enhancement in RBC:M. EVIDENCE LEVEL: Level 2. TECHNICAL EFFICACY: Stage 3.
Cerebral Blood Transit in Sickle Cell Anemia.
Richerson WT, Aumann MA, Song AK … +8 more , Davis S, Milner L, Garza M, Martin D, Davis LT, Pruthi S, Jordan LC, Donahue MJ
J Magn Reson Imaging · 2026 May · PMID 42210666 · Publisher ↗
BACKGROUND: Sickle cell anemia (SCA) patients upregulate cerebral blood flow to compensate for decreased arterial oxygen content. Such hyperemic conditions can manifest as venous hyperintense signal on arterial spin labe...
BACKGROUND: Sickle cell anemia (SCA) patients upregulate cerebral blood flow to compensate for decreased arterial oxygen content. Such hyperemic conditions can manifest as venous hyperintense signal on arterial spin labeling (ASL) MRI, which may reflect faster capillary blood transit, altered oxygen extraction fraction (OEF), and infarct risk. PURPOSE: To implement multi-delay ASL to quantify cerebral arterial arrival time (AAT), arterial transit time (ATT) to tissue, and venous arrival time (VAT) and to test whether reductions in these parameters are present in SCA and relate to condition severity. STUDY TYPE: Prospective, cross-sectional. SUBJECTS: Adults with SCA (n = 40; age = 28.1 ± 7.1 years; sex = 47.5% female) and nonanemic controls (n = 24; age = 30.6 ± 6.6 years; sex = 37.5% male). FIELD STRENGTH/SEQUENCE: 3 T 3D T-weighted, 3D T-FLuid-Attenuated-Inversion-Recovery, 2D T-relaxation-under-spin-tagging (TRUST), 3D pseudo-Continuous ASL (pCASL) Gradient-And-Spin-Echo, and 2D multi-delay (delay range = 200-3200 ms) Pulsed ASL (PASL). ASSESSMENT: Multi-delay PASL was used to quantify AAT, gray matter ATT, VAT, and labeled venous blood volume. Venous hyperintensities and OEF were quantified from 3D pCASL and TRUST, respectively. Infarcts and vasculopathy were assessed from radiological review. STATISTICAL TESTS: AAT, gray matter ATT, VAT, and labeled venous blood volume were evaluated using a Wilcoxon rank-sum test; ANOVA assessed relationships with venous hyperintense signal. Continuous variable relationships were assessed using Spearman rank-correlation (significance: two-sided p < 0.05). RESULTS: Venous labeled blood volume was significantly increased in SCA (median = 0.015 mL; IQR = 0.0087-0.023 mL) versus control (median = 0.0047 mL; IQR = 0.0032-0.0092 mL) participants, whereas VAT was significantly reduced in SCA (median = 2.53 s; IQR = 2.23-2.72 s) versus control (median = 2.75 s; IQR = 2.63-2.80 s) participants. AAT, gray matter ATT, and VAT values were not significantly related to OEF (AAT: p = 0.38; gray matter ATT: p = 0.24; VAT: p = 0.48) or prior infarct (AAT: p = 0.99; gray matter ATT: p = 0.88; VAT: p = 0.98). AAT and gray matter ATT, but not VAT (p = 0.153), were directly related to hemoglobin. CONCLUSION: SCA patients had elevated labeled venous blood volume and shorter VAT. Differential relationships between blood transit and hemoglobin across vascular compartments provides support for venous blood kinetics not representing a simple sequela of anemia severity. EVIDENCE LEVEL: 2. TECHNICAL STAGE OF DEVELOPMENT: 2.
Prognostic Value of a Cardiac Magnetic Resonance-Derived Left Atrioventricular Coupling Index From Routine Cine Images in Dilated Cardiomyopathy: A Multicenter Study.
Jiang YJ, Hou XC, Tao J … +5 more , Guo ZT, Chao P, Xie WH, Yang YN, Wu LM
J Magn Reson Imaging · 2026 May · PMID 42204922 · Publisher ↗
BACKGROUND: Accurate risk stratification in dilated cardiomyopathy (DCM) is challenging. Conventional markers like left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE) fail to fully capture the...
BACKGROUND: Accurate risk stratification in dilated cardiomyopathy (DCM) is challenging. Conventional markers like left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE) fail to fully capture the pathophysiological interplay between left atrial (LA) and left ventricular (LV) remodeling. PURPOSE: To determine the prognostic value of a cardiac MRI-derived left atrioventricular coupling index (LACI) to predict adverse outcomes in DCM and assess its incremental utility beyond conventional markers. STUDY TYPE: Retrospective. POPULATION: 403 patients with DCM from two centers, randomly split into a training set (n = 282, 70%) for model development and an internal validation set (n = 121, 30%). FIELD STRENGTH/SEQUENCE: Balanced steady-state free precession cine and inversion-recovery prepared fast gradient-echo (LGE) sequences at 1.5T and 3.0T. ASSESSMENT: LACI was quantified as (LA minimal volume/LV end-diastolic volume) × 100% from routine cine images. LA/LV volumes, function, LGE, and global longitudinal strain (GLS) were assessed by blinded radiologists. The primary endpoint was a composite of all-cause mortality or heart failure hospitalization. STATISTICAL TESTS: Student's t-test, Mann-Whitney U test, chi-square test, Spearman's correlation, Cox regression, Kaplan-Meier analysis with log-rank test, receiver operating characteristic analysis, C-index, net reclassification improvement (NRI). A two-sided p value < 0.05 was significant. RESULTS: Over a median 43.6-month follow-up, 97 patients (24.1%) reached the primary endpoint. In the training set, elevated LACI (≥ 45.75%) was the strongest independent predictor (adjusted hazard ratio [HR] = 3.485, 95% CI 1.821-6.667). The LACI-enhanced model (including NYHA class, LGE, GLS) achieved a C-index of 0.804 (95% CI 0.774-0.835) in the training set, which remained robust in the validation set (C-index = 0.824, 95% CI 0.751-0.897). Adding LACI to the baseline model significantly improved reclassification (continuous NRI = 0.102, 95% CI 0.043-0.161). DATA CONCLUSION: LACI derived from routine cine images is strongly and independently associated with adverse outcomes in DCM and provides significant incremental prognostic value beyond established markers, supporting its potential as a practical risk stratification tool. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 5.
Comparison of Retrospective Motion Compensation Techniques for Pulmonary Dynamic Ultrashort Time to Echo MRI in Suspected Idiopathic Pulmonary Fibrosis.
Kizhakke Puliyakote AS, Torres LA, AlAtoum A … +7 more , AlArab N, Johnson KM, Bello RM, O'Sullivan-Murphy B, Mammarappallil JG, Hahn AD, Fain SB
J Magn Reson Imaging · 2026 May · PMID 42175722 · Publisher ↗
BACKGROUND: Motion can degrade image quality during Ultrashort Time-to-Echo (UTE) pulmonary MRI and is particularly prevalent in patients with lung disease. Comprehensive assessment of the impact of motion compensation t...
BACKGROUND: Motion can degrade image quality during Ultrashort Time-to-Echo (UTE) pulmonary MRI and is particularly prevalent in patients with lung disease. Comprehensive assessment of the impact of motion compensation techniques on image quality and clinical interpretation is needed. PURPOSE/HYPOTHESIS: To compare the impact of retrospective motion compensation schemes on image quality and clinical interpretation of pulmonary UTE MRI in idiopathic pulmonary fibrosis (IPF). STUDY TYPE: Prospective. POPULATION: 21 (male = 18; mean age, 69.9 ± 8.1 years) participants with suspected IPF. FIELD STRENGTH/SEQUENCE: 1.5 T/3 T, 3D center-out radial (gradient-echo) UTE sequence with 2× radial oversampling, while free-breathing. ASSESSMENT: Images were reconstructed to 1.25 mm isotropic resolution using five retrospective schemes: no gating, hard-gating, soft-gating, motion-resolved (XD-GRASP), and an iterative approach (iMoCo). Signal-to-noise ratios (SNR) were estimated within the lung parenchyma, airways, aorta, muscles, and liver. Contrast-to-noise ratios (CNR) were estimated using the mean airway signal as reference. Image sharpness was estimated using the maximum derivative of a line profile across the diaphragm and a wavelet-based autofocus measure. Three radiologists evaluated image quality, motion artifacts on a 5-point Likert scale, and diagnostic classification of usual interstitial pneumonia (UIP). STATISTICAL TESTS: The Kruskal-Wallis non-parametric test was used for qualitative reader scores and one-way ANOVA for the quantitative metrics, with p < 0.05 as the threshold for significance. RESULTS: CNR was highest using the iMoCo reconstructions (lung parenchyma: 1.64 ± 1.41 vs. 0.88 ± 0.81 via XD-GRASP). Image sharpness was significantly improved using compressed sensing (CS)-based techniques (XD-GRASP and iMoCo), compared to the other methods, using both diaphragm profile (CS: 6.28 ± 3.70 vs. non-CS: 3.73 ± 2.06) and wavelet metrics (CS: 2.33 ± 0.42 vs. non-CS: 2.05 ± 0.35). CS methods also demonstrated greatest image quality based on reader scores. CONCLUSION: Motion compensation using compressed sensing methods can improve image quality and clinical utility of UTE-MRI in the identification and diagnostic classification of typical parenchymal fibrotic patterns. EVIDENCE LEVEL: Level 2-Prospective study, with a reference standard determined during the course of the study (CT imaging). TECHNICAL EFFICACY: Stage 1.
A Study on Predicting Split Renal Function Using Renal Blood Flow Weighted Estimated Glomerular Filtration Rate From Arterial Spin Labeling MRI.
Lin Z, Li Y, Wang R … +5 more , Li W, Zhu J, Kuehn B, Qiu J, Li J
J Magn Reson Imaging · 2026 May · PMID 42165271 · Publisher ↗
BACKGROUND: Traditional methods for evaluating split renal function, including contrast-enhanced CT and radionuclide imaging, have limitations related to ionizing radiation or potentially nephrotoxic contrast agents. PUR...
BACKGROUND: Traditional methods for evaluating split renal function, including contrast-enhanced CT and radionuclide imaging, have limitations related to ionizing radiation or potentially nephrotoxic contrast agents. PURPOSE: To investigate the value of renal blood flow (RBF)-weighted estimated glomerular filtration rate (eGFR) derived from arterial spin labeling (ASL)-MRI in predicting split renal function in patients with suspected renal artery stenosis (RAS). STUDY TYPE: Retrospective. POPULATION: Fifty-three consecutive patients (21 females; mean age, 61.28 ± 13.50 years) with suspected RAS and renal insufficiency underwent renal ASL-MRI. FIELD STRENGTH/SEQUENCE: 1.5T; 3D pseudo-continuous ASL technique. ASSESSMENT: RBF and regions of interest (ROI) areas of the renal cortex and entire kidney were measured on oblique coronal ASL-MRI perfusion maps. The RBF-weighted eGFR (RBFw eGFR) for each kidney was derived by normalizing the RBF-area product to the bilateral total eGFR. The radionuclide GFR (rGFR) obtained from renal dynamic radionuclide imaging was used as the reference standard. STATISTICAL TEST: Paired t-tests, one-way repeated-measures ANOVA, Bonferroni test, Pearson's correlation analysis, and receiver operating characteristic (ROC) curves were used. Statistical significance was set at p = 0.05. RESULTS: The cortical and entire RBFw eGFR showed strong significant correlations with rGFR (r: 0.799 vs. 0.800). The cortical and entire RBFw eGFR had high diagnostic efficiency for differentiating severe, moderate, and mild renal insufficiency (AUC: 0.934 vs. 0.936, 0.927 vs. 0.928, and 0.873 vs. 0.865). DATA CONCLUSIONS: The RBFw eGFR derived from ASL-MRI demonstrated a significant correlation with rGFR and high diagnostic performance for differentiating split renal dysfunction grades, suggesting potential for split renal function assessment in patients with RAS. EVIDENCE LEVEL: 3 (Nonconsecutive cohort studies, usually retrospective with an imperfectly applied reference standard). TECHNICAL EFFICACY: 2 (diagnostic accuracy/clinical efficacy).
Cross-Vendor Validation of Proton Density Fat Fraction and T Mapping Using a Combined Proton Density Fat Fraction-T1 Phantom.
Starekova J, Weingärtner S, Rutkowski DR … +11 more , Fullerton GC, Bae WC, Do HP, Madhuranthakam AJ, Malis V, Lin SQ, Serai SD, Yokoo T, Reeder SB, Brittain JH, Hernando D
J Magn Reson Imaging · 2026 May · PMID 42159302 · Publisher ↗
BACKGROUND: In chronic liver disease, fat and fibroinflammatory changes often coexist. However, their biomarkers, proton density fat fraction (PDFF) and T, are typically assessed separately. Their reproducibility under m...
BACKGROUND: In chronic liver disease, fat and fibroinflammatory changes often coexist. However, their biomarkers, proton density fat fraction (PDFF) and T, are typically assessed separately. Their reproducibility under mutual confounding remains unclear. PURPOSE: To assess multicenter, multi-vendor reproducibility of confounder-corrected chemical shift-encoded (CSE)-MRI-based PDFF mapping and MOLLI-based T mapping using a combined PDFF-T phantom. STUDY TYPE: Prospective phantom study. PHANTOM: Commercial PDFF-T Phantom (Model 725) with varying PDFF (0%-30%) and T (200-1400 ms) values. FIELD STRENGTH/SEQUENCE: 1.5 T and 3 T multi-echo, three-dimensional spoiled-gradient-echo (SGRE) sequence for PDFF mapping, and MOLLI sequence (5(3)3 acquisition scheme) using two-dimensional SGRE readouts for T mapping across four centers and vendors. ASSESSMENT: PDFF and T maps were acquired using standardized protocols. PDFF maps were reconstructed locally, while T maps were generated using a centralized algorithm. All maps were quantitatively analyzed by a single radiologist using standardized region-of-interest placement. Phantom temporal stability was assessed at one center across five sessions over 9 months (baseline, retest, 1 week, 6 and 9 months). STATISTICAL TESTS: Intraclass correlation coefficients (ICC), reproducibility coefficients (RDC), and linear regression analysis were used. A p value < 0.05 was considered statistically significant. RESULTS: PDFF showed overall excellent reproducibility (ICC = 0.987, RDC = 3.7%), with increased variability at higher T values (RDC up to 7.9% at T = 1400 ms). T mapping showed good reproducibility in the absence of fat (RDC 16-161 ms at PDFF = 0%), but moderate to poor reproducibility in the presence of fat, with RDC increasing up to 1553 ms at PDFF 30%. Temporal stability was excellent ICC ≥ 0.998 for both PDFF and T, and RDC of 1.1%-1.3% for PDFF and 52-57 ms for T. DATA CONCLUSION: This phantom study demonstrated high reproducibility of PDFF, whereas T reproducibility deteriorated at higher fat and T levels, underscoring the need for fat-corrected T mapping for reliable assessment of fibroinflammatory changes. EVIDENCE LEVEL: N/A. TECHNICAL EFFICACY: Stage 1.
Editorial for "MRI Habitat Analysis for Preoperative Prediction of Perineural Invasion and Prognostic Stratification in Rectal Cancer".
Mytsyk Y, Kobilnyk Y, Kucheruk O
J Magn Reson Imaging · 2026 May · PMID 42138822 · Publisher ↗
Abstract loading — click title to view on PubMed.
MRI Habitat Analysis for Preoperative Prediction of Perineural Invasion and Prognostic Stratification in Rectal Cancer.
Ao W, Huang Y, Wu S … +4 more , Wang W, Mao G, Ding J, Deng S
J Magn Reson Imaging · 2026 May · PMID 42138820 · Publisher ↗
BACKGROUND: Accurate preoperative assessment of perineural invasion (PNI) remains challenging in rectal cancer. PURPOSE: To develop assessment models based on preoperative multiparametric MRI (mpMRI) habitat analysis for...
BACKGROUND: Accurate preoperative assessment of perineural invasion (PNI) remains challenging in rectal cancer. PURPOSE: To develop assessment models based on preoperative multiparametric MRI (mpMRI) habitat analysis for evaluating PNI status and to explore their prognostic value. STUDY TYPE: Retrospective. POPULATION: Six hundred and twenty-one rectal cancer patients were enrolled from two centers, divided into a training set (n = 330; 65.8 ± 11.22 years; 215 males), an internal validation set (in-vad, n = 152; 67.85 ± 12.43 years; 105 males), and an external validation set (ex-vad, n = 139; 62.82 ± 11.79 years; 96 males). FIELD STRENGTH/SEQUENCE: 1.5T, 3T, T2-weighted imaging using turbo spin-echo sequence, diffusion-weighted imaging using echo planar imaging, and contrast-enhanced T1-weighted imaging using 3D spoiled gradient echo sequence. ASSESSMENT: Tumor voxels were partitioned into subregions using k-means clustering, and habitat-based submodels were developed with deep learning. The Boruta algorithm combined with univariate and multivariate analyses identified key variables. STATISTICAL TESTS: Student's t test, Mann-Whitney U test, chi-square test, Boruta analysis, and DeLong's test. Significance was defined as p < 0.05. A clinical model was constructed from selected significant variables, and a nomogram integrating the clinical model with habitat-based submodels was subsequently developed. RESULTS: Tumors were divided into three imaging-derived subregions, generating three habitat submodels. Habitat 1, 2, 3, mrN, and mrEMVI were independent PNI variables. The nomogram exhibited the highest performance, with area under the curve (AUC) values of 0.967 (95% confidence interval [CI], 0.950-0.983), 0.965 (0.941-0.990), and 0.977 (0.949-1.000) in the training, in-vad, and ex-vad sets, respectively. Kaplan-Meier analysis further confirmed its effective stratification of 3-year disease-free survival. CONCLUSION: The MRI-based habitat analysis model and the derived nomogram demonstrate high predictive value for preoperative assessment of PNI in rectal cancer. The nomogram also shows promising capability for prognostic risk stratification. TECHNICAL EFFICACY STAGE: 3.
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