Keywords: Head & Neck/ENT, Cancer, Head and Neck Cancer, T1rho mapping, T2 mapping, Radiotherapy, Treatment responses

Motivation: Early assessment of response to radiotherapy may be useful to crucial for effectively managing head and neck cancer (HNC).

Goal(s): To evaluate the response to radiotherapy in HNC using quantitative 3D T1rho and T2 mapping. 

Approach: T1rho and T2 mapping was performed on a healthy volunteer and three HNC patients, one of whom was scanned before, during, and after radiotherapy.

Results: Significant decrease in T1rho and T2 values of the tumor were observed two weeks after starting and completing radiotherapy. However, the values in other tissues, such as muscles, remained relatively stable across the three scans.  

Impact: This study evaluates the feasibility of using quantitative T1rho and T2 mapping to assess the treatment response to radiotherapy for head and neck cancer. This information could be valuable in tailoring individualized treatments for patients with head and neck cancer. 

Keywords: Head & Neck/ENT, Fat, Pulsatile tinnitus. Sigmoid sinus dehiscence. Intracranial hypertension. Cerebrospinal fluid dynamics. Cerebrospinal fluid volume.

Motivation: The mechanism of sigmoid sinus dehiscence (SSWD) in pulsatile tinnitus (PT) patients remains unclear.

Goal(s): To assess the cerebrospinal fluid (CSF) dynamics and volume of SSWD-PT with intracranial hypertension by phase-contrast magnetic resonance imaging (PC-MRI).

Approach: Thirty-five PT patients with SSWD and intracranial hypertension identified on dual-phase contrast-enhanced CT (DP-CECT) and brain magnetic resonance venogram (MRV), respectively. And 35 age-, gender-, and handiness-matched healthy volunteers. All participants underwent T1-weighted volumetric and PC-MRI.

Results: The body mass index, regurgitant fraction and CSF volume were significantly higher and the mean velocity, peak velocity and mean flux were significantly slower in SSWD-PT.

Impact: We found the CSF dynamics and volume changes in SSWD-PT with intracranial hypertension, which may be related to blood flow dynamics changes in sigmoid sinus and presence of PT. These results suggest treatment for SSWD-PT should be more comprehensive.

Keywords: Head & Neck/ENT, Multimodal, Multiparameter Quantitative MRI

Motivation: Dysthyroid optic neuropathy (DON) is a rare yet highly significant complication of thyroid associated orbitopathy (TAO), which requires urgent treatment. However, diagnosing this condition is a formidable challenge due to the absence of well-defined criteria for its identification.

Goal(s): The aim of this study was to use multiparameter MRI for diagnosing DON.

Approach: Fifty-five patients were enrolled, who underwent MRI, including conventional imaging, T1 mapping, T2 mapping, and mDIXON Quant sequences for providing quantitative parameters.

Results: The quantitative parameters could offer reliable evidence for the differentiation of DON from TAO, especially T1 values of extraocular muscles and water fraction of orbital fat.

Impact: The native T1 values of extraocular muscles combined with water fraction of orbital fat provided more accurate diagnostic ability of DON in TAO patients. Moreover, the pathological presentation of fibrosis of extraocular muscles associated with DON may occur.

Keywords: Head & Neck/ENT, Nerves

Motivation: Trigeminal neuralgia is characterized by vascular compression of the trigeminal nerve, while neurogenic hypertension results from vascular compression in the medulla oblongata.

Goal(s): To investigate the pathogenesis of TN in conjunction with hypertension and identify the vessels responsible,

Approach: we conducted a retrospective population-based study including 457 TN patients,

Results: and found a significant link between neurovascular conflict and hypertension. Specifically, arteries near the root entry zone, such as the anterior inferior cerebellar artery, vertebrobasilar artery, and superior cerebellar artery, were more associated with hypertension, especially when pain localized in the V2,3 area. Conversely, the posterior inferior cerebellar artery displayed an opposing trend.

Impact: Patients with TN combined with neurogenic hypertension are recommended to take microvascular decompression (MVD) operation, who have these conditions in our study, will show potential improvements in their hypertension.

Keywords: Head & Neck/ENT, Head & Neck/ENT, Cochlear Implant Artifacts

Motivation: A cochlear implant (CI) contains an implanted magnet placed under the scalp. Newer rotating magnet designs facilitate safe and comfortable scanning up to and including 3 T. However, MRI of the head is still confounded by image distortion.

Goal(s): To characterise CI artefacts at 3 T.

Approach: T2DRIVE and T1-weighted mDIXON images were acquired in CI users, normally-hearing participants, and a phantom.

Results: Visibility of bilateral internal auditory canals and cochleae varied across three CI users. Pre-surgical assessment will be beneficial on an individual basis to maximise the chances of successful post-operative MR acquisition.

Impact: Bilateral internal auditory canals can be visualised despite the presence of a cochlear implant (CI): an assessment of the effect of a CI on the usability of clinical MR images in CI users, normally-hearing individuals, and a phantom.

Keywords: Head & Neck/ENT, Head & Neck/ENT

Motivation: HYDROS is useful method for detection of endolymphatic hydrops in patients with Meniere’s disease, but it has a potential risk for motion of patients during the acquisition because of its long scan time, resulting in misalignments of subtraction images.

Goal(s): To develop a new sequence, called interleaved HYDROPS, which acquires PPI and PEI images with an interleaved manner in one single scan.

Approach: We developed the interleaved 3D IR-prepared TSE with variable inversion delays. Interleaved HYDROPS were compared with conventional HYDROPS for image quality, particularly in the motion simulated situation.

Results: Initial findings indicated good feasibility of interleaved HYDROPS, encouraging further clinical evaluation.

Impact: Interleaved HYDROPS could provide PPI and PEI images with minimized motion effects during scan, compared with conventional separately acquired sequence. It holds promise for increasing robustness for motion-induced subtraction errors, but further studies are warranted to confirm its full potential.

Keywords: Head & Neck/ENT, Cancer, Nasopharyngeal Carcinoma

Motivation: Complications from radiotherapy in nasopharyngeal carcinoma impact patient quality of life, necessitating methods to determine the optimal radiation dose for patients. 

Goal(s): To evaluate Synthetic MRI's ability to monitor clival invasion and its changes during treatment in nasopharyngeal carcinoma patients. 

Approach: T1, T2 and PD values of clivus were acquired before treatment, at radiation doses of 6420cGy and 7062cGy, and were compared with each other.

Results: Prior to treatment, the clival T1 values in clival invasion patients were higher than those without clival invasion. No difference was found in Quantitative values between the radiation dose reached 6420cGy and 7062cGy. 

Impact: Synthetic MRI can assess clival invasion in nasopharyngeal carcinoma and its changes during radiation treatment, potentially enabling the evaluation of the optimal radiation dose for patient.

Keywords: Head & Neck/ENT, Quantitative Imaging

Motivation: The objective of this study was to examine the potential impact of chemotherapy on the brain in patients with nasopharyngeal carcinoma (NPC) using Multiplex (MTP) MR imaging sequence, which generate multiple contrasts with one-time scan.

Goal(s): We aimed to investigate the altered MTP parameters and their correlation with clinical cognitive scores before and after chemotherapy.

Approach: All patients underwent MTP imaging, and the data were analyzed using BrainTool software.

Results: The findings revealed that patients who underwent chemotherapy exhibited reduced brain volume and elongated T2Star in some brain regions, although no significant correlation was observed with clinical cognitive scores.

Impact: The newly MTP MR sequence can evaluate brain alterations in NPC patients following chemotherapy. The observed decrease in volume values and increase in T2Star properties within brain regions may suggest neuron and myelin sheath damages in NPC patients after chemotherapy.

Keywords: Head & Neck/ENT, Tumor

Motivation: Malignancies originating from the mucosa of the oral cavity and oropharynx are considered as one of the most prevalent types of malignancies.

Goal(s): We intended to evaluate the diagnostic performance of MAGIC in distinguishing between benign and malignant pathologies in the oral cavity and oropharynx regions.

Approach: This study enrolled 45 patients with malignancies and 19 patients with benign pathologies. The quantitative values were measured and histogram features were extracted from lesion regions. ROC curves were constructed to evaluate the diagnostic efficiency.

Results: The quantitative mappings showed similar diagnostic performance as morphological images. The diagnostic efficacy was further improved with all images combined.     

Impact: Considering the routine diagnosis of malignancies mainly based on morphologic and contrast-enhanced images, the present study validated the clinical value of MAGIC to acquire both of the morphological and quantitative images during a single scan without contast.

Keywords: Head & Neck/ENT, Neuro, facial morphology, craniofacial atlas

Motivation: Current research lacks an understanding of the relationship between the craniofacial structure and the brain, and this connection is of significant importance for pre-diagnosis and neuroscience research.

Goal(s): Develop a MRI-based craniofacial atlas to support clinical-neuroscience research, particularly in understanding the relationship between the brain and craniofacial structure.

Approach: Gathered and processed MRI scans from 148 subjects, employing specialized algorithms for detailed craniofacial and skull mapping, aiding neuroscience research.

Results: The study revealed variations in skull thickness, particularly in the occipital bones, and a significant negative correlation between cortical and skull thickness in specific regions. A comprehensive facial atlas was also successfully developed.

Impact: Our research provides a clear research framework and atlas that can be used to explore the relationship between neurological disorders and craniofacial morphological changes in future studies. Additionally, it offers a potential approach for non-invasive and rapid preclinical diagnosis.

Keywords: Head & Neck/ENT, Head & Neck/ENT, Normative Modeling; Meige syndrome; Facial Paralysis; Machine Learning

Motivation: This study delves into the variations in gray matter volume among patients with Meige Syndrome (MS), facial paralysis (FP), and healthy controls. 

Goal(s): It aims to unveil the neurological mechanisms underlying these conditions. With a sample of 53 FP patients, 31 MS patients, and 102 healthy controls, the research assesses disease severity and conducts high-resolution MRI imaging. 

Approach: Normative modeling and machine learning algorithms are employed to identify differences in specific brain regions. 

Results: Results reveal significant variations in gray matter volume, particularly in the anterior cingulate region, shedding light on the importance of this area in understanding these conditions.

Impact: This study's outcomes could transform clinical practice and research in Ménière's Syndrome and facial paralysis. Enhanced diagnostic and treatment methods may significantly improve patients' quality of life, fostering exploration of innovative therapies and a deeper understanding of these conditions.

Keywords: Head & Neck/ENT, Spectroscopy, Precision and accuracy, brain, tinnitus

Motivation: The measurement of GABA+ using in vivo proton magnetic resonance spectroscopy requires adequate reproducibility and reliability for its use in clinical research and as a potential biomarker. 

Goal(s): We aimed to determine the within-session test-retest reproducibility and reliability of GABA+ in the auditory cortex of individuals with tinnitus. 

Approach: A MEGA-sLASER sequence for GABA+ measurement using two consecutive within-session blocks was performed on 38 participants over 2 scanning days.

Results: GABA+ quantification in the auditory cortex demonstrated similar reproducibility and reliability when using either a total creatine (tCr) or water reference (GABA+/tCr: CV=5.6%, ICC=0.69, 95% CI [0.52-0.80]; GABA+/water: CV=5.6%; ICC=0.73, 95% CI [0.58-0.83]). 

Impact: Auditory cortex GABA+ quantification with MEGA-sLASER in a clinical population with GABA+ abnormalities in the region of interest can be achieved with reproducibility and reliability that is comparable to what has been reported in other brain regions of healthy controls. 

Keywords: Head & Neck/ENT, Head & Neck/ENT, Graves’ ophthalmopathy; T2 mapping

Motivation: T2 relaxation time (T2RT) of extraocular muscle (EOM) derived from T2 mapping has been reported to be useful for staging patients with Graves’ ophthalmopathy (GO). However, due to the particularity of orbital anatomy, various region of interest (ROI) selection methods have been used in the process of T2RT measurements in GO.

Goal(s): This study aimed to evaluate the performance of T2 mapping based on different ROIs for staging GO.

Approach: T2RT-mean and T2RT-max values of EOM on coronal T2 mapping  were measured and analyzed.

Results: Taking reproducibility and diagnostic performance into consideration, T2RT-mean was found to be an ideal biomarker for staging GO.

Impact: Taking reproducibility and diagnostic performance into consideration, T2RT-mean of EOM derived from T2 mapping was found to be an ideal biomarker for staging GO compared to T2RT-max.

Keywords: Head & Neck/ENT, Head & Neck/ENT, Nasopharyngeal carcinoma; Depth of Invasion; Synthetic MRI

Motivation: Deeply infiltrating tumors have a poor prognosis and need close follow-up. Whether the depth of invasion could serve as a quantitative prognostic indicator in NPC. The prognostic assessment value of synthetic MRI (SyMRI) needs further analysis.

Goal(s): To explore the value of two quantitative methods in prognostic assessment in NPC, including depth of invasion and SyMRI.

Approach: This study prospectively included NPC patients, and utilized multiple statistical methods to construct and validate two methods.

Results: Depth of invasion and SyMRI are important quantitative methods.

Impact: Tumor invasion depth is an unignorable metric, and combining it with SyMRI may provide a quantitative and objective approach for clinical treatment.

Keywords: Head & Neck/ENT, CEST & MT, Synthetic imaging, Sinonasal Lesions, APT

Motivation: Distinguishing between benign and malignant sinonasal lesions is crucial for determining the appropriate treatment regimen and predicting patient outcomes. 

Goal(s): To evaluate the performance of synthetic MRI (SyMRI), combined with amide proton transfer (APT)-weighted MRI (APTw) in differentiating between malignant and benign sinonasal lesions. 

Approach: Eighty patients with sinonasal lesions were underwent the SyMRI and ATPw scan and the quantitative parameters were analyzed.

Results: T1, T2, PD and APT values were significant between the benign and malignant groups. Combined SyMRI and APTw had the best diagnostic efficiency.

Impact: Combined the SyMRI with APTw would function as a quantitative and contrast-free approach, significantly enhancing the differentiation of benign and malignant sinonasal lesions. This method also helps overcome the limitations associated with the superficial nature of nasal endoscopic sampling.

Keywords: Head & Neck/ENT, Image Reconstruction, deep learning, reconstruction, magnetic resonance imaging, eye, image quality

Motivation: Extraocular rectus muscles (ERMs) are essential for precise eye movement control, and their assessment is vital for diagnosing eye conditions. Magnetic Resonance Imaging (MRI) is preferred due to its superior soft-tissue resolution, but it has limitations.

Goal(s): To determine whether Deep Learning Reconstruction (DLR) can enhance eye image quality and diagnosis.

Approach: A study with 28 patients used DLR on ocular MRI. Two readers evaluated the images independently, and statistical analyses were conducted.

Results: DLR significantly improved ERM depiction and overall image quality compared to conventional MRI. Interobserver agreement was good, especially for structural depiction. DLR produced clear, detailed images, enhancing diagnostic potential.

Impact:  This study demonstrates that DLR improves MRI image quality for assessing eye conditions, potentially leading to more accurate diagnoses, reduced repeat examinations, and enhanced patient care.