Comparison of Cartesian and Non-Cartesian Real-Time MRI Sequences at 1.5T to Assess Velar Motion and Velopharyngeal Closure during Speech

<div><p>Dynamic imaging of the vocal tract using real-time MRI has been an active and growing area of research, having demonstrated great potential to become routinely performed in the clinical evaluation of speech and swallowing disorders. Although many technical advances have been made in regards to acquisition and reconstruction methodologies, there is still no consensus in best practice protocols. This study aims to compare Cartesian and non-Cartesian real-time MRI sequences, regarding image quality and temporal resolution trade-off, for dynamic speech imaging. Five subjects were imaged at 1.5T, while performing normal phonation, in order to assess velar motion and velopharyngeal closure. Data was acquired using both Cartesian and non-Cartesian (spiral and radial) real-time sequences at five different spatial-temporal resolution sets, between 10 fps (1.7×1.7×10 mm³) and 25 fps (1.5×1.5×10 mm³). Only standard scanning resources provided by the MRI scanner manufacturer were used to ensure easy applicability to clinical evaluation and reproducibility. Data sets were evaluated by comparing measurements of the velar structure, dynamic contrast-to-noise ratio and image quality visual scoring. Results showed that for all proposed sequences, FLASH spiral acquisitions provided higher contrast-to-noise ratio, up to a 170.34% increase at 20 fps, than equivalent bSSFP Cartesian acquisitions for the same spatial-temporal resolution. At higher frame rates (22 and 25 fps), spiral protocols were optimal and provided higher CNR and visual scoring than equivalent radial protocols. Comparison of dynamic imaging at 10 and 22 fps for radial and spiral acquisitions revealed no significant difference in CNR performance, thus indicating that temporal resolution can be doubled without compromising spatial resolution (1.9×1.9 mm²) or CNR. In summary, this study suggests that the use of FLASH spiral protocols should be preferred over bSSFP Cartesian for the dynamic imaging of velopharyngeal closure, as it allows for an improvement in CNR and overall image quality without compromising spatial-temporal resolution.</p>