<scp>1D</scp> Pre‐Acquisition Navigator Correcting Respiratory‐Induced Field Fluctuations in Multi‐Echo Gradient‐Echo Imaging of the Thoracic Spinal Cord

PURPOSE: In the spinal cord (SC), multi-echo gradient echo (ME-GRE) increases gray (GM) and white matter (WM) contrast and improves sensitivity to lesions in people with multiple sclerosis (pwMS). However, SC ME-GRE is susceptible to breathing-induced field fluctuations, causing ghosting artifacts and signal loss. Recent work introduced a 1D phase navigator following the last echo to measure field variations; however, susceptibility to phase wrapping increases at longer echo times. We propose a 1D phase navigator preceding the first echo, reducing phase accumulation and eliminating the need for respiratory monitoring. METHODS: ME-GRE data covering the lower (T9-T12 vertebrae) and upper (T4-T8 vertebrae) thoracic SC were acquired in 20 healthy volunteers and 3 pwMS at 3T. Standard and navigator-corrected images were acquired in the same acquisition. To evaluate image quality, WM and GM signal-to-noise ratio (SNR), WM/GM contrast-to-noise ratio (CNR), and background ghosting signals were measured and compared between the two reconstructions. Both were blindly assessed for artifacts, structural delineation, and diagnostic confidence in pwMS. RESULTS: Navigator correction significantly increased GM and WM SNR and CNR, reduced posterior ghosting across both thoracic regions, and significantly reduced artifacts while increasing structural delineation. Preliminary evaluation in three pwMS showed consistent improvements in artifact mitigation, structural delineation, and lesion conspicuity with navigator correction, providing proof-of-concept for potential clinical application. CONCLUSION: A 1D navigator prior to the first echo reduces ghosting and improves thoracic SC image quality without respiratory monitoring. This approach could improve the diagnostic value and enhance the reliability of thoracic SC ME-GRE.