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NEW SEQUENCES LAVA Liver Acquisition with Volume Acceleration Slide 2 Abdominal Imaging Challenges: 1 in 10 abdominal MR exams is rendered inconclusive from motion artifacts or inadequate resolution LAVA-HD (Liver Acquisition with Volume Acceleration) combines contrast-enhanced, multi-phasic imaging with superb fat suppression for MR liver imaging as simple as CT. LAVA Slide 3 With LAVA-HD You Can: Produce excellent abdominal image quality on patients who have difficulty holding their breath Scan the entire liver of a large patient in a single breath-hold every time Achieve 25% more resolution with 25% more coverage at a speed unmatched by standard MR. LAVA Slide 4 Improved coverage Improved Fat suppression Improved Spatial resolution 8 Channel Body Array SNR ASSET performance Improved Sequence Shorter TR/TE Partial K space Segmented SPECIAL LAVA Slide 5 Clinical Examples Slide 6 Clinical case FRFSE Fat Sat SSFSE Metastasis of a colonic cancer Images courtesy of Pr Regent, CHU Brabois Nancy LAVA Slide 7 LAVA + PURE/ Contrast Enhancement PURE SCIC Images courtesy of Pr Regent, CHU Brabois Nancy Slide 8 Liver MRI with LAVA Clinical Examples T2 In PhaseOut of Phase Diffuse infiltation of the liver with Fat containing small nodules Large heterogeneous nodule of the left lobe Slide 9 Liver MRI with LAVA Clinical examples Arterial PortalDelayed Coronal Art MIP Coronal Port MIP adenoma HCC polyadenomatosis Slide 10 VIBRANT Volume Image Breast AssesmeNT Slide 11 VIBRANT lets you perform a bilateral breast exam in both the sagittal and the axial planes with the same resolution and scan time as a single-breast MR study. It delivers true slice dimension resolution. And HD VIBRANTs unique multi-technology approach eliminates fat with absolute reliability and confidence, to enhance lesion conspicuity. VIBRANT Slide 12 VIBRANT is the first technique that combines both high morphological & lesions enhancement kinetics information Slide 13 VIBRANT (Volume Image Breast AssesmeNT) is a true simultaneous acquisition of high resolution sagittal images from both left and right breasts. ASSET Simultaneous bilateral breast imaging in the sagittal plane What is VIBRANT? ASSET is applied in the slice dimension Slide 14 VIBRANT: How works Asset with Breast examination? Phase differentiation in the R/L direction only! R L ASSET The number of sampled lines in k-space (slice encodings) is reduced The prescribed slab is reduced to a slab thickness equal to half of the bilateral volume ALIASINgALIASINg ALIASINgALIASINg VOLUME ALIASINgALIASINg ALIASINgALIASINg Slide 15 Images and Spectra courtesy of Memorial Sloan-Kettering Cancer Center Variability in Breast composition Bilateral shiming: the right and left breasts are pre-scanned separately to calculate shim values and center frequency over a large FOV Optimized spectral inversion to suppress fat signal Automated image subtraction VIBRANT: New Fat suppression approach Slide 16 SPECIAL vs EXTRA SPECIAL The spectrally selective inversion pulse is optimized regarding the inversion time (TI) and the Excitation Flip Angle selected by the operator. The Inversion Flip Angle is applied every N times, N corresponding to the number of slices. The spectrally selective inversion pulse uses a inversion Flip Angle of 180 and is applied prior to the application of a train of excitation pulses. The number of kz lines collected per spectral inversion pulse is optimized for the Excitation Flip Angle, TR, and number of slices selected by the operator. SPECIAL EXTRA SPECIAL Slide 17 VIBRANT Clinical Examples Slide 18 VIBRANT RLRL Axial acquisition (MIP)) VIBRANT (MIP)) R L Fat Sat FSPGR T1 + C Max Slope of Increase RR Slide 19 TRICKS Time Resolved Imaging of Contrast KineticS Slide 20 Angiographic Imaging Challenges: Over half of diabetic patients have inadequate characterization of lower-leg vasculature. Many vascular studies are sub-optimal because of miscalculation of the contrast bolus arrival. Many arterio-venous malformations (AVMs) are difficult to characterize with conventional angiography. TRICKS Slide 21 TRICKS-HD (Time Resolved Imaging of Contrast KineticS), a GE-exclusive Signa HD imaging technique, eliminates the trade-off between spatial and temporal resolution thats typical of conventional MR angiography. TRICKS Slide 22 With TRICKS-HD you can: Simplify difficult contrast-enhanced MRA of the lower extremities. Achieve high-resolution detail into the critical vessels of the foot. Eliminate inaccurate contrast bolus timing simplify inject and scan with complete separation of arterial and venous phases. Obtain dynamic information as well as the static arterial phase. Compensate for differences in a patients flow dynamics to capture the complete flow pattern including high-resolution peak arterial phase in each leg in every case. Slide 23 TRICKS Clinical Examples Slide 24 TRICKS: Asymmetric flow Bolus chasing MRA TRICKS Heavy smoker Limited walking distance: 20 m causing pain in the lower legs Motion of the right leg & bilateral early venous return