Quantitative T1 and T2 mapping by magnetic resonance fingerprinting (MRF) of the placenta before and after maternal hyperoxia

Jeffrey N Stout, Congyu Liao, Borjan Gagoski, Esra Abaci Turk, Henry A Feldman, Carolina Bibbo, William H Barth Jr, Scott A Shainker, Lawrence L Wald, P Ellen Grant, Elfar Adalsteinsson, Jeffrey N Stout, Congyu Liao, Borjan Gagoski, Esra Abaci Turk, Henry A Feldman, Carolina Bibbo, William H Barth Jr, Scott A Shainker, Lawrence L Wald, P Ellen Grant, Elfar Adalsteinsson

Abstract

Introduction: MR relaxometry has been used to assess placental exchange function, but methods to date are not sufficiently fast to be robust to placental motion. Magnetic resonance fingerprinting (MRF) permits rapid, voxel-wise, intrinsically co-registered T1 and T2 mapping. After characterizing measurement error, we scanned pregnant women during air and oxygen breathing to demonstrate MRF's ability to detect placental oxygenation changes.

Methods: The accuracy of FISP-based, sliding-window reconstructed MRF was tested on phantoms. MRF scans in 9-s breath holds were acquired at 3T in 31 pregnant women during air and oxygen breathing. A mixed effects model was used to test for changes in placenta relaxation times between physiological states, to assess the dependency on gestational age (GA), and the impact of placental motion.

Results: MRF estimates of known phantom relaxation times resulted in mean absolute errors for T1 of 92 ms (4.8%), but T2 was less accurate at 16 ms (13.6%). During normoxia, placental T1 = 1825 ± 141 ms (avg ± standard deviation) and T2 = 60 ± 16 ms (gestational age range 24.3-36.7, median 32.6 weeks). In the statistical model, placental T2 rose and T1 remained contant after hyperoxia, and no GA dependency was observed for T1 or T2.

Discussion: Well-characterized, motion-robust MRF was used to acquire T1 and T2 maps of the placenta. Changes with hyperoxia are consistent with a net increase in oxygen saturation. Toward the goal of whole-placenta quantitative oxygenation imaging over time, we aim to implement 3D MRF with integrated motion correction to improve T2 accuracy.

Keywords: Magnetic resonance fingerprinting; Placenta; Pregnancy; Relaxometry; T(1); T(2).

Conflict of interest statement

Declaration of competing interest All authors declare that they have seen and approved the final version. They have no conflicts of interest to declare.

Copyright © 2021 Elsevier Ltd. All rights reserved.

Figures

Figure 1.
Figure 1.
Bland-Altman analysis of relaxation times of the T1- and T2-arrays of the NIST phantom. MRF values have been corrected for B1+ and slice profile effects, and the median value from within the manual ROI is shown here. NIST relaxation times are published reference values [26].
Figure 2.
Figure 2.
T1 (A, C) and T2 (B, D) maps from the 22 week phantom determined by reference techniques (A, B) and by MRF (C, D). T2 versus T1 values for NIST and 22-week phantom (E). The symbol marks the median parameter value and the error bars show IQR of the voxels within the hand-drawn ROI. The ROIs are represented by color and shown in the inset: NIST phantom T2-array (black), abdomen (blue), placenta (red), fetal body (green), and fetal brain (magenta). The measurement types are represented by symbols: reference or ground truth (x) and B1+ and slice profile corrected MRF (circle). The gray rectangle indicates the relaxation time range expected in fetal tissues.
Figure 3.
Figure 3.
Example T1 (A) and T2 (B) parameter maps for the placenta of subject 20 (34w). Acquisition was in the transverse plane while the subject was in the left lateral position.
Figure 4.
Figure 4.
Example T1 (A, C) and T2 (B, D) parameter maps during normoxia (A, B) and hyperoxia (C, D) for the placenta of subject 31 (31w4d). Acquisition was in the transverse plane while the subject was in the left lateral position. The imaging plane shifted due to maternal and fetal motion between normoxia and hyperoxia.
Figure 5.
Figure 5.
Scatter plots of median T1 (A) or T2 (B) across the placental ROI versus GA for all motion free scans during normoxia. Error bars indicate same-subject standard deviation for multiple measurements, which is possibly zero for subjects with only one measurement. Both linear regression lines are statistically insignificant (T1: R2 = 0.04, P = 0.16; T2: R2 = 0.04, P = 0.15).

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