In current clinical systems, magnetic resonance imaging scans for disease diagnosis and prognosis are dominated by qualitative contrast-weighted imaging. These qualitative MR images reveal regional differences in signal intensities between tissues with focal structural or functional abnormalities and tissues that are supposedly in healthy states, facilitating subjective determination for disease diagnosis. The administration of gadolinium-based contrast agents is prevalent in clinical MRI exams, which alternates the relaxation time of neighboring water protons and creates enhanced signal intensities from damaged tissues with high vascular density and thin vessel wall for better visualization. Nowadays, nearly 50% of the MRI studies were conducted with contrast agents. However, patients with renal insufficiency are at risk of developing nephrogenic system fibrosis if exposed to gadolinium-based contrast agents, and chronic toxic effects of possible gadolinium retention have been reported. In the meantime, qualitative contrast-weighted images have limited sensitivity to subtle alteration in tissue states, lack of biological specificity and multi-center reproducibility, and limited predictive values. One promising alternative is quantitative multiparametric MRI, which contains various methods to quantify multiple parameters with interpretable physical units that are intrinsic to tissue properties. Most of these quantitative approaches do not involve the administration of contrast agents, therefore ensuring the safety of the application to a wide range of patients and reducing the costs of MRI. These quantitative parameters are highly reproducible, sensitive to subtle physiological tissue changes, and specific for disease pathologies. More importantly, each of these parameters reveal tissue properties in different aspects, having the potential to offer complementary information for comprehensive tissue characterization, and acting as biomarkers that are directly associated with diseases states. Despite the benefits to clinical studies, quantitative multiparametric MRI has yet to be widely adopted in routine clinical practices because of several major technical limitations including (i) long scan times that compromises image resolution and/or spatial coverage, (ii) motion artifacts, (iii) misaligned parametric maps due to separate acquisitions, and (iv) complicated clinical workflow. This dissertation aims to address some of these challenges by proposing a simultaneous quantitative multiparametric MRI approach with Magnetic Resonance Multitasking and focus on the quantification of T1, T2, T1 , and ADC, which serves as the start of the ultimate goal to provide a clinically translatable, multiparametric whole-body quantitative tissue characterization technique. A novel approach to simultaneously quantifying T1, T2, and ADC in the brain was first developed using MR Multitasking in conjunction with a time-resolved phase correction strategy to compensate for the inter-shot phase inconsistencies introduced by physiological motion. It was implemented as a push-button, continuous acquisition that simplified the workflow. This technique was initially demonstrated in healthy subjects to efficiently produce distortion-free, co-registered T1, T2, and ADC maps with 3D brain coverage (100mm) in 9.3min. The resulting T1, T2, and ADC measurements in the brain were comparable to reference quantitative approaches. Abrupt motion was manually identified and removed to yield T1, T2, and ADC maps that were free from motion artifacts and with accurate quantitative measurements. Clinical feasibility was demonstrated on post-surgery glioblastoma patients. A motion-resolved, simultaneous T1, T2, and T1 quantification technique was then developed using MR Multitasking in a push-button 9min acquisition. Rigid intra-scan head motion was captured and simultaneously resolved along with the relaxation processes. This technique was first validated in healthy subjects to produce high quality, whole-brain (140mm) T1, T2, and T1 maps and repeatable T1, T2, and T1 measurements that were in excellent agreement with gold standard methods. Motion-resolved, artifact-free maps were generated under either in-plane or through-plane motion, which provided a novel avenue for handling rigid motion in brain MRI. Synthetic contrast-weighted qualitative images comparable to clinical images were generated using the parameter maps, demonstrating the significant potential to replace conventional MRI scans with a single Multitasking scan for clinical purposes. This technique was applied in a pilot clinical setting to perform tissue characterization in relapsing-remitting multiple sclerosis patients. The combination of T1, T2, and T1 significantly improved the accuracy of the differentiation of multiple sclerosis patients from healthy controls, compared to either single parameter alone, indicating the clinical utility of T1, T2, and T1 as quantitative biomarkers. Lastly, the above two quantitative techniques were extended to other body organs for a preliminary demonstration of potential applications, where we 1) simultaneously quantified T1, T2, and ADC in the breast with whole-breast coverage (160mm) in 8min, incorporating a B1+-compensated multiparametric fitting approach to address the notable B1+ inhomogeneity across the bilateral breast FOV, and to provide distortion-free, co-registered whole-breast T1, T2, and ADC maps with good in vivo repeatability; and 2) simultaneously quantified myocardial T1 and T1 in a single non-ECG, free-breathing acquisition, where cardiac motion and respiratory motion were retrospectively identified and simultaneously resolved to produce dynamic myocardial T1 and T1 maps of 20 cardiac phases with high temporal resolution (15ms) in a single, continuous acquisition of 1.5min per slice. Multitasking T1 and T1 measurements in the heart were comparable with gold standard techniques.

The significantly updated second edition of this important work provides an up-to-date and comprehensive overview of cardiovascular magnetic resonance imaging (CMR), a rapidly evolving tool for diagnosis and intervention of cardiovascular disease. New and updated chapters focus on recent applications of CMR such as electrophysiological ablative treatment of arrhythmias, targeted molecular MRI, and T1 mapping methods. The book presents a state-of-the-art compilation of expert contributions to the field, each examining normal and pathologic anatomy of the cardiovascular system as assessed by magnetic resonance imaging. Functional techniques such as myocardial perfusion imaging and assessment of flow velocity are emphasized, along with the exciting areas of artherosclerosis plaque imaging and targeted MRI. This cutting-edge volume represents a multi-disciplinary approach to the field, with contributions from experts in cardiology, radiology, physics, engineering, physiology and biochemistry, and offers new directions in noninvasive imaging. The Second Edition of Cardiovascular Magnetic Resonance Imaging is an essential resource for cardiologists and radiologists striving to lead the way into the future of this important field.

Cardiac Magnetic Resonance (CMR) is a rapidly evolving imaging technology and is now increasingly utilized in patient care. Its advantages are noninvasiveness, superb image resolutions, and body tissue characterization. CMR is now an essential part of both cardiology and radiology training and has become part of the examination for Board certification. This book provides a condensed but comprehensive and reader friendly educational tool for cardiology fellows and radiology residents. It contains multiple choice questions similar to board examinations with concise comment and explanation about the correct answer.

In recent years there have been major advances in the fields of cardiovascular nuclear medicine and cardiac magnetic resonance imaging. In nuclear cardiology more adequate tomographic systems have been designed for routine cardiac use, as well as new or improved quantitative analytic software packages both for planar and tomographic studies implemented on modern state-of-the-art workstations. In addition, artificial intelligence techniques are being applied to these images in attempts to interpret the nuclear studies in a more objective and reproducible manner. Various new radiotracers have been developed, such as antimyosin, labeled isonitriles, metabolic compounds, etc. Furthermore, alternative stress testing with dipyridamole and dobutamine has received much attention in clinical cardiac practice. Magnetic resonance imaging is a relative newcomer in cardiology and has already shown its merits, not only for anatomical information but increasingly for the functional aspects of cardiac performance. This book covers almost every aspect of quantitative cardiovascular nuclear medicine and magnetic resonance imaging. It will assist the nuclear medicine physician, the radiologist, the physicist/image processing specialist and the clinical cardiologist in understanding the nuclear medicine techniques used in cardiovascular medicine, and in increasing our knowledge of cardiac magnetic resonance imaging.

Cardiovascular Magnetic Resonance provides you with up-to-date clinical applications of cardiovascular MRI for the broad spectrum of cardiovascular diseases, including ischemic, myopathic, valvular, and congenital heart diseases, as well as great vessel and peripheral vascular disease. Editors Warren J. Manning and Dudley J. Pennell and their team of international contributors cover everything from basic MR physics to sequence design, flow quantification and spectroscopy to structural anatomy and pathology. Learn the appropriate role for CMR in a variety of clinical settings with reference to other modalities, practical limitations, and costs. With the latest information on contrast agents, MR angiography, MR spectroscopy, imaging protocols, and more, this book is essential for both the beginner and expert CMR practitioner. Covers both the technical and clinical aspects of CMR to serve as a comprehensive reference. Demonstrates the full spectrum of the application of cardiac MR from ischemic heart disease to valvular, myopathic, pericardial, aortic, and congenital heart disease. Includes coverage of normal anatomy, orientation, and function to provide you with baseline values. Discusses advanced techniques, such as interventional MR, to include essential information relevant to the specialist. Features appendices with acronyms and CMR terminology used by equipment vendors that serve as an introduction to the field. Uses consistent terminology and abbreviations throughout the text for clarity and easy reference. Covers both the technical and clinical aspects of CMR to serve as a comprehensive reference. Demonstrates the full spectrum of the application of cardiac MR from ischemic heart disease to valvular, myopathic, pericardial, aortic, and congenital heart disease. Includes coverage of normal anatomy, orientation, and function to provide you with baseline values. Discusses advanced techniques, such as interventional MR, to include essential information relevant to the specialist. Features appendices with acronyms and CMR terminology used by equipment vendors that serve as an introduction to the field. Uses consistent terminology and abbreviations throughout the text for clarity and easy reference.