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Research ArticleAdult Brain
Open Access

Clinical Evaluation of Scout Accelerated Motion Estimation and Reduction Technique for 3D MR Imaging in the Inpatient and Emergency Department Settings

M. Lang, A. Tabari, D. Polak, J. Ford, B. Clifford, W.-C. Lo, K. Manzoor, D.N. Splitthoff, L.L. Wald, O. Rapalino, P. Schaefer, J. Conklin, S. Cauley and S.Y. Huang
American Journal of Neuroradiology February 2023, 44 (2) 125-133; DOI: https://doi.org/10.3174/ajnr.A7777
M. Lang
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
bHarvard Medical School (M.L., A.T., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Boston, Massachusetts
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A. Tabari
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
bHarvard Medical School (M.L., A.T., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Boston, Massachusetts
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D. Polak
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
cSiemens Healthcare GmbH (D.P., D.N.S.), Erlangen, Germany
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J. Ford
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
bHarvard Medical School (M.L., A.T., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Boston, Massachusetts
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B. Clifford
dSiemens Medical Solutions (B.C., W.-C.L.), Boston, Massachusetts
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W.-C. Lo
dSiemens Medical Solutions (B.C., W.-C.L.), Boston, Massachusetts
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K. Manzoor
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
bHarvard Medical School (M.L., A.T., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Boston, Massachusetts
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D.N. Splitthoff
cSiemens Healthcare GmbH (D.P., D.N.S.), Erlangen, Germany
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L.L. Wald
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
bHarvard Medical School (M.L., A.T., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Boston, Massachusetts
eHarvard-MIT Health Sciences and Technology (L.L.W.), Massachusetts Institute of Technology, Cambridge, Massachusetts
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O. Rapalino
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
bHarvard Medical School (M.L., A.T., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Boston, Massachusetts
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P. Schaefer
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
bHarvard Medical School (M.L., A.T., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Boston, Massachusetts
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J. Conklin
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
bHarvard Medical School (M.L., A.T., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Boston, Massachusetts
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S. Cauley
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
bHarvard Medical School (M.L., A.T., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Boston, Massachusetts
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S.Y. Huang
aFrom the Department of Radiology (M.L., A.T., D.P., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
bHarvard Medical School (M.L., A.T., J.F., K.M., L.L.W., O.R., P.S., J.C., S.C., S.Y.H.), Boston, Massachusetts
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  • FIG 1.
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    FIG 1.

    Motion scale used for the clinical quantification of motion artifacts along with representative cases before motion correction. The arrows point to areas of image blurring due to motion artifacta.

  • FIG 2.
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    FIG 2.

    Sagittal T1 MPRAGE images illustrating examples of cases with motion artifacts (grades I–5) for which SAMER reconstruction improved motion by 1 grade. A, A 23-year-old woman with a normal brain. B, Postoperative findings from resection of a left parietal lobe tumor in a 59-year-old woman with a history of anaplastic oligodendroglioma. C, Diffuse parenchymal volume loss with disproportionate involvement of the frontal and parietal lobes and, to a lesser extent, the left temporal lobe in a 59-year-old man with history of cognitive impairment. D, An 83-year-old woman with history of chronic cerebral small-vessel disease. E, Expected postoperative changes and enhancement from left temporal parietal craniotomy (arrows) are demonstrated in a 63-year-old man with history of glioblastoma.

  • FIG 3.
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    FIG 3.

    Proportion of nondiagnostic and diagnostic examinations that demonstrated worsening, no change, and improvement of motion grade after SAMER correction. Motion grades 1 (no motion), 2 (minimal), and 3 (mild) are considered diagnostic in terms of motion artifacts, whereas motion grades 4 (moderate) and 5 (severe) are considered nondiagnostic in terms of motion artifacts.

  • FIG 4.
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    FIG 4.

    Axial MR images of 2 cases with severe motion artifacts (grade 5) in which SAMER motion correction restored diagnostic value (by reducing motion grade to 3). A, The extent of cortical/gyral enhancement (arrows) and edematous expansion of the left temporoparietal region with a mild rightward mass effect is better visualized on the motion-corrected image of a 67-year-old man with traumatic brain injury. B, Motion-corrected image shows better visualization of cortical laminar necrosis in the left occipital lobe (arrows) and better evaluation of left temporal lobe volume loss (arrows) in an 86-year-old woman with history of stroke.

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    FIG 5.

    Balloon plot showing the results of the head-to-head comparison of baseline MPRAGE and SAMER motion-corrected MPRAGE studies for pathology conspicuity, pathology sharpness, and evaluation of surrounding anatomy. A total 79 of 97 cases had pathology on imaging and were included in this assessment. The size of the circle correlates to the percentage of cases assigned a given score, and the percentage of cases receiving a given score is indicated below each circle. A zero score indicates equivalency, negative scores (left) favor baseline MPRAGE images, and positive scores (right) favor SAMER motion-corrected MPRAGE images.

  • FIG 6.
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    FIG 6.

    Boxplot charts demonstrating the distribution of CNR and SNR in the gray matter and white matter in MPRAGE without and with SAMER motion correction. CNRs and SNRs are significantly greater (P < .001) in the MPRAGE SAMER motion-corrected images compared with baseline MPRAGE images. Triple asterisks indicate P < .001.

Tables

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    Table 1:

    Clinical characteristics of the patients

    Value
    No. of subjects97
    Mean age (yr)60.2 (SD, 16)
    Sex (F/M)48:49
    Clinical indication for MR imaging (No.) (%)
     Tumor32 (33%)
     Stroke17 (17.5%)
     AMS15 (15.4%)
     Neurologic deficit11 (11.3%)
     Abscess3 (3%)
     Dementia2 (2%)
     Headache2 (2%)
     Seizure2 (2%)
     TBI2 (2%)
     TIA2 (2%)
     Other9 (9.2%)
    MR imaging protocol (No.) (%)
     SAMER MPRAGE without contrast34 (35%)
     Routine brain without contrast33 (34%)
     Memory loss without contrast1 (1%)
     SAMER MPRAGE with contrast63 (65%)
     Routine brain without and with contrast61 (63%)
     Memory loss without and with contrast2 (2%)
    • Note:—AMS indicates altered mental status; TBI, traumatic brain injury.

    • View popup
    Table 2:

    Overall change in motion grade after SAMER implementation

    Before Motion Correction, Motion Grade (No. of cases)After Motion, Correction Motion Grade (No. of cases)Change in Motion Grade (mean)
    Grade 1 (5)Grade 1 (5)0
    Grade 2 (46)Grade 1 (2)0.1 (SD, 0.7)
    Grade 2 (36)
    Grade 3 (8)
    Grade 3 (30)Grade 2 (11)–0.3 (SD, 0.5)
    Grade 3 (19)
    Grade 4 (8)Grade 2 (1)–1.1 (SD, 0.3)
    Grade 3 (7)
    Grade 5 (8)Grade 3 (3)–1.1 (SD, 0.8)
    Grade 4 (3)
    Grade 5 (2)
    Mean motion grade (2.7 [SD, 1.0])Mean motion grade (2.4 [SD, .08])Change in motion grade (–0.2 [SD, 0.7])
    • Note:—Grade 1 indicates no motion; grade 2, minimal motion; grade 3, mild motion; grade 4, moderate motion; grade 5, severe motion.

    • View popup
    Table 3:

    Change in motion grade after SAMER implementation for noncontrast examinations

    Before Motion Correction, Motion Grade (No. of Cases)After Motion Correction, Motion Grade (No. of Cases)Change in Motion Grade (mean)
    Grade 1 (3)Grade 1 (3)0
    Grade 2 (18)Grade 2 (16)0.1 (SD, 0.3)
    Grade 3 (2)
    Grade 3 (7)Grade 2 (5)–0.7 (SD, 0.4)
    Grade 3 (2)
    Grade 4 (2)Grade 2 (1)–1.5 (SD, 0.7)
    Grade 3 (1)
    Grade 5 (4)Grade 3 (3)–1.7 (SD, 0.5)
    Grade 4 (1)
    Mean motion grade (2.6 [SD, 1.1])Mean motion grade (2.2 [SD, 0.6])Change in motion grade (–0.4 [SD, 0.8])
    • View popup
    Table 4:

    Change in motion grade after SAMER implementation for contrast-enhanced examinations

    Before Motion Correction, Motion Grade (No. of Cases)After Motion Correction, Motion Grade (No. of Cases)Change in Motion Grade (mean)
    Grade 1 (2)Grade 1 (2)0
    Grade 2 (28)Grade 1 (2)0.1 (SD, 0.5)
    Grade 2 (20)
    Grade 3 (6)
    Grade 3 (23)Grade 2 (6)–0.2 (SD, 0.4)
    Grade 3 (17)
    Grade 4 (6)Grade 3 (6)–1 (SD, 0)
    Grade 5 (4)Grade 4 (2)–0.5 (SD, 0.5)
    Grade 5 (2)
    Mean motion grade (2.7 [SD, 0.9])Mean motion grade (2.6 [SD, 0.8])Change in motion grade (–0.2 [SD, 0.6])
    Mean motion grade (2.6 [SD, 1.1])Mean motion grade (2.2 [SD, 0.6])Change in motion grade (–0.4 [SD, 0.8])
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M. Lang, A. Tabari, D. Polak, J. Ford, B. Clifford, W.-C. Lo, K. Manzoor, D.N. Splitthoff, L.L. Wald, O. Rapalino, P. Schaefer, J. Conklin, S. Cauley, S.Y. Huang
Clinical Evaluation of Scout Accelerated Motion Estimation and Reduction Technique for 3D MR Imaging in the Inpatient and Emergency Department Settings
American Journal of Neuroradiology Feb 2023, 44 (2) 125-133; DOI: 10.3174/ajnr.A7777

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Scout Accelerated Motion Estimation in MR Imaging
M. Lang, A. Tabari, D. Polak, J. Ford, B. Clifford, W.-C. Lo, K. Manzoor, D.N. Splitthoff, L.L. Wald, O. Rapalino, P. Schaefer, J. Conklin, S. Cauley, S.Y. Huang
American Journal of Neuroradiology Feb 2023, 44 (2) 125-133; DOI: 10.3174/ajnr.A7777
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