Free-Breathing High-Resolution, Swap-Free, and Motion-Corrected Water/Fat Separation in Pediatric Abdominal MRI

Objectives The T1-weighted GRE (gradient recalled echo) sequence with the Dixon technique for water/fat separation is an essential component of abdominal MRI (magnetic resonance imaging), useful in detecting tumors and characterizing hemorrhage/fat content. Unfortunately, the current implementation of this sequence suffers from several problems: (1) low resolution to maintain high pixel bandwidth and minimize chemical shift; (2) image blurring due to respiratory motion; (3) water/fat swapping due to the natural ambiguity between fat and water peaks; and (4) off-resonance fat blurring due to the multipeak nature of the fat spectrum. The goal of this study was to evaluate the image quality of water/fat separation using a high-resolution 3-point Dixon golden angle radial acquisition with retrospective motion compensation and multipeak fat modeling in children undergoing abdominal MRI. Materials and Methods Twenty-two pediatric patients (4.2 ± 2.3 years) underwent abdominal MRI on a 3 T scanner with routine abdominal protocol and with a 3-point Dixon radial-VIBE (volumetric interpolated breath-hold examination) sequence. Field maps were calculated using 3D graph-cut optimization followed by fat and water calculation from k-space data by iteratively solving an optimization problem. A 6-peak fat model was used to model chemical shifts in k-space. Residual respiratory motion was corrected through soft-gating by weighting each projection based on the estimated respiratory motion from the center of the k-space. Reconstructed images were reviewed by 3 pediatric radiologists on a PACS (picture archiving and communication systems) workstation. Subjective image quality and water/fat swapping artifact were scored by each pediatric radiologist using a 5-point Likert scale. The VoL (variance of Laplacian) of the reconstructed images was used to objectively quantify image sharpness. Results Based on the overall Likert scores, the images generated using the described method were significantly superior to those reconstructed by the conventional 2-point Dixon technique ( P < 0.05). Water/fat swapping artifact was observed in 14 of 22 patients using 2-point Dixon, and this artifact was not present when using the proposed method. Image sharpness was significantly improved using the proposed framework. Conclusions In smaller patients, a high-quality water/fat separation with sharp visualization of fine details is critical for diagnostic accuracy. High-resolution golden angle radial-VIBE 3-point Dixon acquisition with 6-peak fat model and soft-gated motion correction offers improved image quality at the expense of an additional ~1-minute acquisition time. Thus, this technique offers the potential to replace the conventional 2-point Dixon technique.