Fast and High‐Resolution T2 Mapping Based on Echo Merging Plus k‐t Undersampling with Reduced Refocusing Flip Angles (TEMPURA) as Methods for Human Renal MRI

Abstract Purpose To develop a highly accelerated multi‐echo spin‐echo method, TEMPURA, for reducing the acquisition time and/or increasing spatial resolution for kidney T 2 mapping. Methods TEMPURA merges several adjacent echoes into one k ‐space by either combining independent echoes or sharing one echo between k ‐spaces. The combined k ‐space is reconstructed based on compressed sensing theory. Reduced flip angles are used for the refocusing pulses, and the extended phase graph algorithm is used to correct the effects of indirect echoes. Two sequences were developed: a fast breath‐hold sequence; and a high‐resolution sequence. The performance was evaluated prospectively on a phantom, 16 healthy subjects, and two patients with different types of renal tumors. Results The fast TEMPURA method reduced the acquisition time from 3–5 min to one breath‐hold (18 s). Phantom measurements showed that fast TEMPURA had a mean absolute percentage error (MAPE) of 8.2%, which was comparable to a standardized respiratory‐triggered sequence (7.4%), but much lower than a sequence accelerated by purely k ‐t undersampling (21.8%). High‐resolution TEMPURA reduced the in‐plane voxel size from 3 × 3 to 1 × 1 mm 2 , resulting in improved visualization of the detailed anatomical structure. In vivo T 2 measurements demonstrated good agreement (fast: MAPE = 1.3%–2.5%; high‐resolution: MAPE = 2.8%–3.3%) and high correlation coefficients (fast: R = 0.85–0.98; high‐resolution: 0.82–0.96) with the standardized method, outperforming k ‐t undersampling alone (MAPE = 3.3–4.5%, R = 0.57–0.59). Conclusion TEMPURA provides fast and high‐resolution renal T 2 measurements. It has the potential to improve clinical throughput and delineate intratumoral heterogeneity and tissue habitats at unprecedented spatial resolution.