REVIEW ARTICLE

Magnetic Resonance Fingerprinting Part 1:

Potential Uses, Current Challenges,
and Recommendations
Megan E. Poorman, PhD,1,2 Michele N. Martin, PhD,2 Dan Ma, PhD,3
Debra F. McGivney, PhD,3 Vikas Gulani, MD, PhD,3 Mark A. Griswold, PhD,3 and
Kathryn E. Keenan, PhD2*

Magnetic resonance fingerprinting (MRF) is a powerful quantitative MRI technique capable of acquiring multiple property
maps simultaneously in a short timeframe. The MRF framework has been adapted to a wide variety of clinical applications,
but faces challenges in technical development, and to date has only demonstrated repeatability and reproducibility in
small studies. In this review, we discuss the current implementations of MRF and their use in a clinical setting. Based on
this analysis, we highlight areas of need that must be addressed before MRF can be fully adopted into the clinic and make
recommendations to the MRF community on standardization and validation strategies of MRF techniques.
Level of Evidence: 2
Technical Efficacy: Stage 2
J. MAGN. RESON. IMAGING 2020;51:675–692.

and dictionary matching.2,3 In this review we summarize recently

Q UANTITATIVE MAGNETIC RESONANCE IMAG-
ING (MRI) has the potential to impact patient care by
providing functional information about biomarkers, such as
metabolites and tissue composition, coregistered to the anatomy.
However, quantitative MRI has yet to be widely accepted in the
clinic, in part due to the long acquisition times required to obtain
a full-volume property map. Acquiring more than one property
map extends the acquisition time, limiting its practical use. Mag-
netic resonance fingerprinting (MRF) has the potential to over-
come this barrier by providing an accelerated acquisition scheme
that quantifies multiple properties at once. This technique can
deliver multiple, inherently spatially-registered property maps in
the time it would take to acquire just one map using conventional
methods, eliminating errors due to motion or temporal delays.
Since it was first introduced by Ma et al,1 advances have
adapted this technique for use in many clinical applications, as well
as to improve the speed and efficiency of acquisition, reconstruction,
published efforts to advance MRF with a focus on adoption in clini-
cal practice. We highlight efforts to overcome technical challenges,
such as field inhomogeneities and volume coverage, and point out
technical gaps in the literature that must be addressed. We aim not
only to point out challenges that need to be overcome, but also sug-
gest recommendations to ensure the continued growth of MRF.
These recommendations include guidelines for standardized
reporting and best-practices to enhance the validation, repeatability,
and reproducibility of MRF techniques. This article serves as Part
1 of a pair of reviews, the second of which4 addresses recent technical
advances including pulse sequence design, optimization, dictionary
generation, pattern matching algorithms, and machine learning.
Overview of MR Fingerprinting
MRF is an image generation framework that can be used to
acquire multiple quantitative property maps simultaneously.

View this article online at wileyonlinelibrary.com. DOI: 10.1002/jmri.26836

Received Mar 30, 2019, Accepted for publication May 31, 2019.

*Address reprint requests to: K.E.K., National Institute of Standards and Technology, 325 Broadway, MC 686-08, Boulder, CO 80305.
E-mail: kathryn.keenan@nist.gov
Contract grant sponsor: National Institute of Standards and Technology and University of Colorado.

From the 1Department of Physics, University of Colorado Boulder, Boulder, Colorado, USA; 2Physical Measurement Laboratory, National Institute of Standards
and Technology, Boulder, Colorado, USA; and 3Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA
Additional supporting information may be found in the online version of this article

© 2019 International Society for Magnetic Resonance in Medicine 675

Journal of Magnetic Resonance Imaging

FIGURE 1: An overview of the MRF framework. (a) Through-time signals are acquired with a highly undersampled pulse sequence
where the parameters vary every repetition. This sequence (Ref. 1) varied the FA and TR every repetition according to the displayed
plots. Every voxel generates a unique through-time signal. (b) A dictionary of all possible signals is simulated from combinations of
the properties of interest. In this sequence, the dictionary values were: T1 from 100 to 5000 msec, T2 from 20 to 1900 msec, and B0
from –50 to 50 Hz. (c) The signal acquired using the pulse sequence in (a) is matched to the dictionary from (b). For each voxel, the
dictionary entry that has the highest correlation to the acquired signal is considered the match and used to assign property values to
that voxel. These values are used to generate the property maps.

It is based on the assumption that each tissue or material of
interest can generate a unique MRI signal evolution given the
appropriate pulse sequence implementation. It consists of
three parts: the signal acquisition, dictionary creation, and
pattern matching for data visualization. Instead of acquiring
full-resolution images like conventional MRI, MRF relies on
a simulated library of signal evolutions, based on prior knowl-
edge of how a particular tissue behaves in a magnetic field.
Parameters are varied every repetition time (TR), generating a
unique through-time signal evolution per voxel. This signal
"fingerprint" is matched to a dictionary of known, simulated
signals generated over all combinations of the properties of
interest. From this matching, the underlying properties of the
tissue can be inferred and mapped. This matching process is
tolerant to errors, allowing a highly undersampled pulse
sequence to be used. An overview of the MRF framework can
be seen in Fig. 1.
Signal Acquisition
The goal of an MRF pulse sequence is to sensitize the MRI
magnetization to different tissue properties (ie, T1, T2, etc.)
such that each combination of sequence parameters yields a
unique signal evolution through time. This gives MRF an
inherent flexibility; any pulse sequence can be used with
MRF, as long as it provides sufficient signal-to-noise ratio
(SNR) and sensitivity to the properties of interest. To gener-
ate an MRF pattern, parameters such as the flip angle
(FA) and TR of the prescribed pulse sequence are varied every
repetition, yielding a temporally incoherent signal (Fig. 1a).
The original MRF sequence used a balanced steady-state free
precession (bSSFP) sequence.1,5 This sequence can also be
referred to as a TrueFISP, FIESTA, or Balanced-FFE,
depending on the vendor. The spin behavior provided by
this sequence is well understood and described by the Bloch
equations, making its signal evolution straightforward to
simulate.6,7 To accelerate the acquisition, a variable density
spiral was applied at every readout, yielding a highly under-
sampled image with undersampling artifacts (Fig. 1a). These
errors are able to be eliminated in the matching process due
to their temporal incoherence with the expected signal.
Other methods have successfully demonstrated MRF with
Cartesian,8 echo planar imaging (EPI),9 and radial trajecto-
ries.10 Undersampling in MRF offers a key advantage over
conventional methods, a fully sampled, high-resolution
image is not required to generate a usable signal evolution.
Once acquired, each voxel’s signal evolution is matched to
the dictionary of simulated signals and used to generate
artifact-free property maps. The data were acquired in
12.3 seconds, and maps were generated in 3 minutes on a
standard desktop computer, which is a marked time

676 Volume 51, No. 3


improvement over the 5–10 minutes each required for con-
ventional T1 and T2 mapping.11
One potential drawback to the bSSFP-MRF method is
the possibility that off-resonance banding artifacts obscure
important anatomy. This issue can be overcome through the
use of an unbalanced SSFP MRF sequence,12 also referred to as
FISP, GRASS, or FFE. The SSFP sequence is robust to B0
inhomogeneities, at the cost of reduced SNR compared with
the bSSFP sequence, and is unable to map B0 with MRF unless
FIGURE 2: Chart of validation methods used with MRF
techniques, as compiled from published articles. The star
indicates repeatability experiments that explicitly mention a
test–retest procedure where the subject was removed from the
scanner prior to reimaging. It should be noted that Jiang et al99
performed this type of test–retest experiment on the SSFP-MRF
implementation, which is not listed in this chart.
March 2020
Poorman et al.: MR Fingerprinting Review Part 1
echo time (TE) is also modulated. Another approach to over-
come B0 inhomogeneities proposes a pseudo-SSFP sequence,13
which reduces the complexity of the MRF sequence design
problem, but it is also unable to perform B0 mapping.
Sensitizing the sequence to new forms of contrast
beyond T1 and T2 mapping necessitated development of
novel pulse sequences within the MRF framework. Descrip-
tions of many of these and their technical implementations
can be found in the review by Mehta et al,2 and their valida-
tion approaches can be seen in Figs. 2 and 3.
Dictionary Generation
The acquired signal must be matched to a library, termed "dictio-
nary," of known signal evolutions to create property maps. Dic-
tionary signals are simulated given the FA and TR pattern and
combinations of properties such as T1, T2, and B0. The original
MRF implementation used the Bloch equation6; however other
approaches used the extended phase graph (EPG)14 formalism,
which can improve computation efficiency. The dictionary of sig-
nals and an associated look-up table are stored to relate the simu-
lated signals to the property combinations used to create them. In
most MRF applications, the dictionary need only be generated
once prior to imaging and can then be used in multiple subjects.
FIGURE 3: Chart of validation approaches used in clinical studies
with MRF, as reported in published articles. Note that Refs.
25,28,39 also appear in Fig. 2, because they contain both
methods development and preliminary clinical data. The asterisk
indicates repeatability experiments that explicitly mention a
test–retest procedure where the subject was removed from the
scanner prior to reimaging.
677
Journal of Magnetic Resonance Imaging
Depending on the range and step size of each property
value and number of parameters and properties, dictionaries can
become large and unwieldy, requiring storage space and long
computation times. Overcoming these limitations is an active
area of research and is discussed further in Part 2 of this review.4
Pattern Matching
Once the dictionary is generated and signals are acquired, the
through-time signal evolution from each voxel must be matched
to a signal within the dictionary. This can be achieved through
template matching,15 where the dictionary is multiplied by the
acquired signal. The multiplication generates a signal vector; the
entry with the highest correlation between acquired signal and
dictionary is considered the match, and the associated properties
from the look-up table are assigned to the given voxel. This is
repeated for every voxel in the image, generating multiple,
artifact-free property maps from one acquisition, despite image
artifacts from the highly undersampled acquired signal. Addi-
tionally, each map is inherently coregistered to the others, elimi-
nating the need for post-acquisition image registration. Many
nonlinear pattern matching approaches have been explored to
accelerate the matching processes, the details of which can be
found in Part 2.4
Potential Clinical Uses
One of the unique aspects of MRF is the ability to adapt the
framework to a wide variety of applications. An overview of
clinical areas where the framework was applied can be seen in
Table 1. Properties measured in various tissues with MRF com-
pared with those found in the literature can be found in the
supporting information (Supporting Information Table 1).
Cardiovascular
T1 and T2 mapping of the myocardium can provide informa-
tion about fibrosis, edema, and injury16; however, clinical
implementation is challenging due to cardiac motion and the
long acquisition times of quantitative methods. MRF could
overcome these constraints by rapidly acquiring multiple
maps in the heart simultaneously. While the original MRF
method was shown to be robust to some types of motion,1
the time scale of cardiac motion would lead to large errors in
MRF maps if left unaccounted for. To address this, Hamilton
et al17 modified the MRF framework to account for cardiac
and respiratory motion. The SSFP sequence acquisition was
triggered to EKG waveforms from a breath-held patient and
employed a T2 preparation pulse to improve sensitivity of the
T2 measurement.
In a subsequent study, Hamilton et al18 investigated the
effect of confounding factors on the accuracy of the T1 and
T2 maps. Errors due to non-ideal slice profiles, inefficient
preparation pulses, and B1+ inhomogeneities were included in
the dictionary, improving accuracy and precision of cardiac
MRF. This increased the dictionary size, requiring a high-
678
performance computing cluster to generate the dictionary.
The authors performed brute force optimization and found
that a smoothly varying sinusoidal flip angle patterns yielded
robust metrics, while the TR pattern had little effect on the
results. However, they noted that more rigorous optimization
could be useful and is currently being explored.
The first studies with cardiac MRF in a clinical popula-
tion are studying patients with nonischemic cardiomyopathy.16
A second study is monitoring cardiac graft rejection in heart
transplant patients. Preliminary results were presented by Cor-
istine et al19 in a small patient cohort, where quantitative differ-
ences between healthy patients and transplant recipients were
observed. Thus far, cardiac MRF results are comparable to
those obtained with conventional methods and can be obtained
with reduced scan time without image registration.
Head Imaging
Relaxometry measurements in the brain are useful for track-
ing changes related to age,20,21 distinguishing between
healthy and cancerous tissues,22 and diagnosing diseases such
as epilepsy23,24 and multiple sclerosis (MS).25
Imaging in the pediatric population is limited to short
scan times or requires sedation to avoid motion errors, which
limits the use of quantitative imaging. Acquisition of patient-
specific values could better inform myelin fraction models,
which typically use average T1 and T2 from adults that may
not translate to children. Badve et al20 demonstrated that
MRF can generate comparable results in a large cohort of
healthy volunteers, and observed changes with age; a small
increase in T1 and T2 of some brain regions and a decrease in
T1 and T2 in other regions. Chen et al21 applied SSFP-MRF
successfully in a clinical pediatric setting to patients in the
first 5 years of life and explored changes in T1, T2, and mye-
lin content. This was achieved using two dictionaries, one for
T1 and T2, and the other for myelin fraction, and employed
an inversion recovery preparation module26 to avoid B1+
inhomogeneities. The study successfully imaged 28 patients
between ages 2 months and 60 months and observed age-
related differences, particularly in myelination. T1 and T2
decreased logarithmically with age and were consistent with
literature values. These two studies demonstrate using MRF-
derived quantitative maps to study changes with age and the
potential to explore abnormalities and disease states.
Early identification of malignant tumors is important
for prompt and successful medical treatment, and MRF has
been used to explore disease states. Badve et al22 used an
SSFP-MRF method to rapidly and effectively differentiate
between common types of brain tumors in a study of
31 patients. The acquired T1 and T2 maps were used to suc-
cessfully differentiate low-grade gliomas from metastases and
from peritumoral regions of glioblastomas, suggesting that
MRF could be used for quantifiable diagnosis, provided that
the results are verified in large patient trials.
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 TABLE 1. Overview of Clinical Applications to Which MRF Has Been Applied

Application Method Used Performance Considerations

March 2020
20 1
Brain (Normal bSSFP-MRF Identified age-related changes. Differentiated low grade gliomas No statistical significance in grading solid neuronal
and Tumors22) from metastases and healthy tissue. tumors. Limited volume coverage.
Breast37,38 3D MRF74 Obtained volumetric maps over entire breast. Differences between Small study makes determining significance
diseased and healthy tissue. difficult. Repeatable and reproducible across
scanners.38
Cardiac16,19 cMRF17,18 based Performed in single breath hold. Adapts to patient-specific heart Optimization of sequence needed to account for
on SSFP-MRF12 rate variation. confounding factors.
Cartilage10 Based on PnP-MRF39 Acquired high-resolution maps of many slices in a short scan time. Dictionary spacing may need optimization to range
of expected cartilage values.
Eye31 Cartesian MRF8 Achieved Cartesian MRF at 7T. Needs only a single receive coil. Needs optimization for accuracy of mapping long
T1 in the eye.
Epilepsy23,24 3D MRF74 or Sliding Better able to identify lesions in less time than existing methods. Nature of disease could require higher resolution.
Window76 SSFP-
MRF12
Liver Lesions35 SSFP-MRF12 with Overcomes abdominal B1+ inhomogeneities. In small patient study, Current implementation lacks volume coverage.
Bloch-Siegert B1+ noted property differences between benign and malignant tissue. Requires breath hold to avoid motion.
mapping36
Moyamoya28 ASL bSFFP MRF Joint hemodynamic and relaxation maps, allowing for improved Requires further sequence optimization for
1,32
model fit. Observed differences between healthy and improved fitting. Sensitive to choice of model.
diseased tissue.
Near Metal PnP-MRF39 Anatomy near implant visible. Maps obtained of the area. Proton-density map lacks tissue contrast. Slice
Implants39 profile can be influenced by field fluctuations.
Pediatric Brain SSFP-MRF12 and T2 Performed without sedation. Changes in tissue properties and Limited volume coverage. Validation of myelin
Development21 prep modules17 myelin water fraction with growth. water fraction needed.
Prostate32–34 SSFP-MRF12 with Aids classfication of tumor severity. Coupled measurement with Resolution too low for lesion detection.
conventional ADC conventional diffusion mapping. Misalignment between diffusion and MRF maps.

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Poorman et al.: MR Fingerprinting Review Part 1
Journal of Magnetic Resonance Imaging
Epilepsy diagnosis is particularly challenging, because it
requires full-volume, high-resolution images.23 Liao et al24
demonstrated that 2D MRF can be used to circumvent this
issue. Using MRF, only one out of 33 patients was misdi-
agnosed, while 10 were misdiagnosed with conventional MRI.
Ma et al23 used a 3D MRF sequence to acquire full brain maps
(see Enhanced Volume Coverage) in 13.5 minutes, while con-
ventional methods required over 30 minutes. MRF and con-
ventional MRI methods identified epileptic lesions in 11 out of
15 patients, while MRF enabled the detection of lesions in the
remaining 4 patients. However, 3D MRF still faces potential
challenges from motion.
Proton density (PD) images can be useful in imaging of
MS plaques.27 However, direct mapping of proton density
requires corrections for B1+ and other forms of contrast.
Rieger et al25 used MRF to account for these factors and
image MS plaques in a proof-of-concept study. MS plaques
were distinguishable from healthy tissue on T1, T2*, and PD
maps acquired with EPI-MRF (also discussed in Enhanced
Volume Coverage).
Arterial spin labeling (ASL) is often used to noninva-
sively monitor hemodynamics in the brain, without the use
of contrast agents. Conventional MRI ASL techniques are
limited by low SNR, require assumptions about the timing of
a labeled bolus’ entry into tissue, and use simplified signal
models that may not be accurate in abnormal tissues.
Su et al28 first demonstrated a combined ASL-MRF
approach to quantify hemodynamic properties simultaneously
using a two-compartment model. Using a conventional ASL
sequence29 acquisition, parameters were pseudorandomly var-
ied and the postlabeling delay was eliminated, avoiding
wasted time during the sequence. This technique generated
maps of seven unique hemodynamic properties in addition to
T1 and B1+. Relaxometry performed well in reproducibility
experiments (>95% cross-correlation); however, the cerebral
blood flow and bolus arrival time measures were not as reli-
able, suggesting that optimization of the method against vali-
dated standards is needed. The method was used in small
trials of hypercapnia and Moyamoya disease. In both cases
the ASL-MRF method measured differences in perfusion
between the control and experimental groups, without the
use of contrast agent. Wright et al30 also implemented an
ASL-MRF method, using a modified pseudocontinuous ASL
sequence to explore sources of error in the ASL-MRF
sequence. They found that the T1 map and FA used were
larger contributors to the overall ASL signal than the hemo-
dynamic properties. Based on these results, the authors
suggested that the acquisition scheme should be optimized to
increase sensitivity to the hemodynamic properties of interest.
In addition to brain imaging, efficient acquisition times
are important in eye imaging to reduce motion effects from
blinking. Koolstra et al31 used undersampled Cartesian MRF
to reduce the scan time to 1:16 minutes from 7:02 minutes
680
required for conventional MR relaxometry. Matrix comple-
tion reconstruction was used to achieve sufficient image reso-
lution despite the high undersampling factors, which proved
to be computationally efficient and required only a single
receive coil. Relaxation times in healthy patients were compa-
rable to the literature and image reconstruction was compara-
ble to a fully-sampled scan. Differences between healthy
tissues and a uveal melanoma were observed.
Body Imaging
Quantitative measurements such as T1, T2, T2*, and the
apparent diffusion coefficient (ADC) can be used for many
body applications.
Early MRF methodologies have been implemented in
the clinic to study cancer in the prostate32–34 and liver.35 Yu
et al used SSFP-MRF to simultaneously assess T1 and T2
(7.5 min), paired with a conventional ADC sequence
(4.5 min) to acquire three quantitative maps of the prostate
in 12 minutes for lesion characterization.32 This reduced the
scan time, compared with the clinical standard sequences, by
9 minutes, while acquiring quantitative maps rather than
weighted images. T1, T2, and ADC were significant predic-
tors in a multivariate logistic model that differentiated
between prostate cancer and normal peripheral zone cancer
(by comparison with histologically confirmed cancer). Panda
et al conducted two similar studies using 2D SSFP-MRF to
measure T1 and T2, and combined information from those
maps with quantitative ADC.33,34 In both the peripheral zone
and transition zone regions, the quantitative map information
was useful in differentiating cancers from noncancers. The
protocol combining MRF and diffusion may obviate the need
for lesion characterization with contrast and reduce the overall
scan time compared with clinical standard of care.
Chen et al35 acquired 2D SSFP-MRF and a Bloch–Siegert
36
shift B1+ map. The B1+ measurement was incorporated in the
pattern-matching step, and the method rapidly acquired T1 and
T2 values in the abdomen of healthy subjects that agreed with
literature values. B1+ correction improved the accuracy of the T2
and PD measurements, as demonstrated with a phantom. The
T1 and T2 values obtained in metastatic adenocarcinoma were
significantly different from the surrounding liver parenchyma
relaxation times (six patients with 20 focal liver lesions) and
those in hepatic parenchyma in eight healthy volunteers. While
the results using MRF to characterize cancerous tissue are prom-
ising, the utility of these methods could be improved with 1)
faster acquisitions times of the entire volume, 2) the inclusion of
ADC in the MRF sequence, 3) fat suppression or water/fat sepa-
ration, and 4) the inclusion of B1+, rather than using a Bloch–
Siegert B1+ map correction.
More recently, 3D MRF with Bloch–Siegert B1+ map
correction and fat suppression was used to acquire full-volume,
T1 and T2 maps in the breast at a spatial resolution of 1.6 ×
1.6 × 3 mm3 in ~6 minutes.37 Panda et al conducted both
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repeatability and reproducibility studies in healthy subjects.38 In
the work by Chen et al,37 MRF maps were useful in character-
izing the breast lesions: T1 and T2 relaxation times measured in
healthy subjects agreed with previous literature, and the T2
relaxation time was significantly higher in invasive ductal carci-
noma than in healthy tissue.37
Musculoskeletal
Musculoskeletal imaging could also benefit from MRF tech-
niques, both for the acquisition of T1 and T2 in a reasonable
scan time and the ability to image near metal. An MRF-based
methodology was introduced to acquire PD, T1, and T2 relaxa-
tion time maps along radial sections of the hip10 based on the
plug-n-play (PnP-MRF) method.39 This method’s resolution
was within the range of resolutions presented in previous hip
mapping methods,40,41 with an overall faster scan time.
The PnP-MRF method can image near metal implants,39
which is a challenge in musculoskeletal MRI previously
addressed by methods such as SEMAC42 and MAVRIC.43
Orthopedic implants create an inhomogeneous B1+ field that
rapidly decays the signal, leading to voids in the image. PnP-
MRF recovers the lost signal by mapping the heterogeneous B1+
field as part of the MRF sequence, rather than using a separate
calculation, generating both anatomical and quantitative maps
near the implant. With such techniques, the case of pain or
improper function at the site of the implant could be explored
and understood with imaging before turning to surgery.
Technique Development for Clinical
Applications
An overview of techniques that have been combined with
MRF can be seen in Table 2.
Blood Flow
Measurement of blood flow velocity can inform cardiac out-
put and vasculature health. The effect of blood flow on an
MRI signal is complex and determined by a multitude of
factors,44 and thus cannot be used directly to quantify veloc-
ity. Existing methods require long acquisition times and
encode flow in only one direction at once. Incorporating such
techniques with MRF would enable simultaneous quantifica-
tion of flow in multiple directions, yielding a velocity vector,
while also generating T1 and T2 mapping of the surrounding
tissue.
To accomplish this, Flassbeck et al45 incorporated
motion encoding gradients into an SSFP-MRF sequence,
varying the FA and strength of the x, y, and z gradients each
TR. Unlike the conventional MRF methods, TR was kept
constant. The first five TRs were discarded prior to recon-
struction to avoid the effects of noninverted blood inflow
caused by the inversion pulse. The acquisition used patient-
specific EKG signals to separate cardiac phases in the recon-
struction. The sequence measured velocities comparable to
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Poorman et al.: MR Fingerprinting Review Part 1
conventional methods and accurate T1 and T2 metrics of
static tissue, confirmed with literature values. However, the
sequence was unable to quantify flow in static voxels or rel-
axometry in flowing voxels due to phase effects from the
inversion pulse. This effect also limits the velocities that can
be encoded, limiting the method’s application to blood vessels
and static organs.
Chemical Exchange Saturation Transfer and
Magnetization Transfer
Chemical exchange saturation transfer (CEST) methods can
measure tissue physiological properties and detect biomole-
cules with water-exchangeable protons. However, there is no
consensus-standard method to measure CEST, nor is there a
standard phantom with which to test proposed CEST and
magnetization transfer (MT) methodologies. Given those
considerations, we attempt to compare and contrast three
recently proposed methods to measure CEST via MRF-based
methods for amide46,47 and creatine protons.48
MRF typically matches acquired signals to a
precalculated dictionary, which can be generated using the
Bloch–McConnell equation for CEST.46,48 However, con-
ventional CEST is already at risk of overfitting errors due to
the incorporation of additional properties in multiple pool
models,47 and inclusion of all these properties in MRF would
result in prohibitively large dictionaries and computation
times. Each of the CEST-MRF methods approaches these
challenges in different ways.
Zhou et al48 adapted MRF to quantify exchange rates
of creatine. The saturation power and duration were varied
while keeping TR fixed. Signals were pattern-matched with a
label dictionary at the solute proton resonance frequency and
a reference dictionary at the opposite resonant frequency.
Then the CEST signals were calculated by subtracting the
label signal from the reference signal49 and matching to the
corresponding CEST dictionary. The exchange rates mea-
sured with CEST-MRF had higher agreement with the
exchange rates measured by water-exchange spectroscopy than
the pulsed quantitative CEST method. The method was
designed to also measure the effect of MT on CEST-MRF;
however, the MT effects were not large because the saturation
times used were shorter than those used by pulsed quantita-
tive CEST. The lack of susceptibility to MT is an advantage
of this CEST-MRF method.
Cohen et al46 developed a dictionary-based CEST
method using a two-pool model for phantom measurements
and a three-pool model for mouse measurements. Similar to
Zhou et al,48 saturation pulse power was varied; however, the
saturation pulse duration remained unchanged. Dictionary
size and uniqueness of the signals were a concern, especially
when extending to the three-pool model. To maintain a rea-
sonable dictionary size and avoid overfitting, T1 and T2 of
the three pools (water, amide, and semisolid) were set from
681
682
TABLE 2. Overview of Techniques That Have Been Developed With MRF

Feature Benefits Limitations

Arterial Spin Avoids model assumptions. Need to time entry of labeled bolus. Requires large dictionary. Dependent on choice of flow model.
Labeling28,30
B1+ Improves T2 estimation in particular. For Ref. 39, does not Validation of B1+ map is challenging.
Mapping39,69,71,73 require homogeneous B1+ :
Cardiac17,18 Robust to heart rate variability and confounds (e.g., slice profile Limited volume coverage. Long computation times. Susceptible to gradient
and pulse efficiency). non-linearities.
CESTand MT46–48 Dramatically reduces scan time compared to conventional Model assumptions are required to reduce dictionary size. Partial volume
Journal of Magnetic Resonance Imaging

methods. effects. Lacks ground truth for validation.

Contrast Detect multiple contrast agents simultaneously. Acquire Blood flow can confound T2 measurement. High spatial resolution
Enhancement26,50 colocalized maps faster than conventional methods. requirements limit undersampling.
Diffusion Improves accuracy of T2 measurements Allows for simultaneous Increases size of dictionary. Sequence sensitivity to diffusion could be
Mapping51 diffusion mapping. improved.
Flow Mapping45 Quantifies all velocity components simultaneously. Confounded by motion unrelated to blood flow.
85–89
Motion MRF inherently robust to some motion types. Data processing Cannot account for through-plane motion in 2D. Error severity depends on
pipeline can account for in-plane errors. when in the sequence motion occurs.
Patient Comfort55 Calm patient and make MRI more comfortable. Acquisition pattern limited to specific order.
Spectroscopy56,57 Subject-specific T1 and T2 improves model quantification of Confounded by multiple tissues in a voxel and low SNR. Requires
metabolites. large dictionaries.
T*2 Contrast9,59–61 T*2 enables use of MRF for iron detection in heart, liver diseases. Lose some accuracy of T2 in vivo. Needs pulse sequence optimization.
Volume Coverage Acquire full volume at once. Increase in SNR over 2D method Sliding window reduces temporal sensitivity for Ref. 75. Needs correction
(3D)74,75,78 allows finer resolution. for B1+ .
Volume Coverage Up to 3x acceleration of image acquisition. Fast algorithm Noise amplification and signal leakage between slices. Requires training data.
(SMS)34,80,83 training time. Requires multiple coils for high multiband factors.
Volume Coverage Slice interleaving allows spacing slices over area of interest. Up to Needs slice profile estimation to improve precision. Currently does not
(EPI)25 4x acceleration factor. account for T2.
Water-Fat Provides accurate fat fraction and property maps. Methods vary in accuracy, particularly at very small and very large fat
Separation39,62,63 fractions. Fixed fat model could lead to errors.

Volume 51, No. 3


experimentally-measured values. Finally, based on a Monte
Carlo sensitivity analysis, the worst error in the amide
exchange rate was 27%, with the greatest contribution to this
error from the measured water T1.
Heo et al47 developed a dictionary-free method to quan-
tify CEST with a reduced dataset using the simplifying assump-
tion of subgrouping proton exchange models (MRF-SPEM).
Similar to the other CEST-MRF methods,46,48 two-pool and
three-pool models were studied using variable saturation pulse
power. Differing from other methods, MRF-SPEM consists of
two distinct datasets: magnetization transfer contrast far off-
resonance frequency offsets, which were fit to the two-pool
model, and amide proton transfer weighted data acquired at
near off-resonance frequency offsets, which were fit with a
three-pool exchange model. The two-pool properties were
incorporated in the three-pool model as known information,
reducing the number of parameters and fitting uncertainty.
One limitation of this work is the observed partial volume
effect—in vivo studies found MT contrast in the ventricles,
where it is known not to be present. To overcome these limi-
tations, the authors suggested additional MT contrast acquisi-
tion with varied RF saturation parameters may be required or
introduction of interpulse delay times to increase the specific-
ity of affected proton exchange rates.
CEST is currently limited in clinical application because
scan and processing times are lengthy. CEST-MRF methods
resulted in reduced scan times: CEST fingerprinting decreased
the scan time to 10 minutes from 50 minutes48; single-slice
CEST-MRF acquisition was ~2 minutes, although T1, T2, and
T2* maps are also required46; and MRF-SPEM including B0
and B1+ mapping was ~3 minutes compared with ~11 minutes
for extrapolated a semisolid MT reference method.47 MRF-based
methods could move CEST to clinical possibility, especially if
the methods can be validated by an agreed-upon methodology
and phantom, and if the processing times decrease.
Contrast Enhancement
Contrast agents can be used to sensitize MRI signal to static and
dynamic pathological processes in the body. Dynamic contrast
enhancement (DCE) methods either rapidly acquire T1-weighted
images with high spatial resolution or acquire T1 maps with low
temporal resolution. MRF can acquire quantitative maps with suffi-
ciently high spatial and temporal resolution to use advanced kinetic
models that better characterize tissue. Gu et al50 assessed DCE-
based MRF (both SSFP and bSSFP implementations) at 7T. The
phantom was used to validate data undersampling up to a factor of
eight without loss of accuracy, which enabled 2-minute temporal
resolution in mouse brains. However, optimization is needed to
sensitize the MRF method to short T2 species, especially when
using a T2 contrast agent (eg, dysprosium) that further shortens T2.
The simultaneous T1 and T2 mapping by MRF could
broaden applications of contrast agent imaging. Anderson
et al26 created the dual contrast MRF (DC-MRF) sequence
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that simultaneously maps contributions from two contrast
agents, based on their different relaxivities (r1, r2), which is
the change in relaxation rate as a function of concentration.
DC-MRF allowed the use of multiple contrast agents to be
used to observe more than one, possibly related, pathological
process at a time. For example, both a T1 and T2 contrast
agent could be used to track with one agent the delivery of a
pharmacological treatment and with the second agent the
resulting tumor cell death.
Diffusion Mapping
Additional tissue properties, such as diffusion, can be important
for tissue characterization. However, the repeatability of this
approach is limited because of the challenge of registering images
from distinct methods.32 Additionally, diffusion effects influence
the accuracy of MRF sequences, particularly when spoiling gradi-
ents are applied, as in SSFP-MRF.51 Kobayashi and Terada deter-
mined that including ADC in the dictionary could counteract
this effect and improve T2 measurements.51 The authors used the
extended phase graph formalism to generate the dictionary. Incor-
porating these approaches can improve the accuracy of rel-
axometry and provide information about the diffusion properties
of a tissue. However, as with many MRF methods, incorporation
of additional factors such as diffusion can prohibitively increase
the dictionary size and processing time. Additionally, using a dif-
fusion MRF approach with a sequence that is not optimized for
diffusion can limit the sensitivity. Research is ongoing to formu-
late an isotropic diffusion Bloch simulator for the problem52,53
and to optimize the sequence for sensitivity to diffusion.54
Patient Comfort
In an effort to improve patient comfort, Ma et al55 developed a
technique to replace unpleasant clanging that results from gradi-
ent switching during traditional MRI with music. Instead of
the repetitive gradient switching scheme used in traditional
MRI, a gradient switching scheme is created to generate sounds
at frequencies that mimic a tune. An audio file is compressed,
filtered to remove frequencies over 4 kHz, intensity matched to
the gradient amplitude, and then implemented in a bSSFP-
MRF sequence. Volunteers were found to be more comfortable
during the MRF-MUSIC scans than during the other conven-
tional methods. The method was performed using both 2D
and 3D MRF, and the 3D scheme had better spatial resolution,
higher through-plane resolution, and better sound quality.55
Such techniques could be particularly useful in a pediatric pop-
ulation to keep patients calm and avoid sedation.
Spectroscopy
MR spectroscopy can be used to measure metabolics and
chemical signatures of tissues within the body, such as dis-
tinguishing benign from malignant tumors. Quantitative
approaches to spectroscopy use the T1 and T2 of a given tissue
to build mathematical models that allow direct computation
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Journal of Magnetic Resonance Imaging
of analyte concentrations. However, due to acquisition time
constraints, the models use population-level tabulated values
of T1 and T2, leading to errors. Combining spectroscopy with
MRF could allow patient-specific T1 and T2 values to be used.
Wang et al56 developed a bSSFP-MRF sequence for 31P
measurement of creatine kinase reactions, evaluated in simula-
tions and in vivo in rat limbs. Acquisition time and reproduc-
ibility of creatine kinase rate quantification improved compared
with conventional methods. However, the authors noted that
certain properties, such as the T1 and T2 of some chemical spe-
cies and B1+ effects, were held constant to avoid large dictionar-
ies and reduce computation requirements. This constraint was
found to introduce up to 30% error into the final measure-
ment, depending on pathophysiological conditions.
Kulpanovich and Tal57 extended MRF spectroscopy to
1
H, which is more commonly used in MRI, to map T1, T2,
and B1+ and simultaneously quantify metabolite concentra-
tion. The study confirmed that using patient-specific T1 and
T2 values offered the highest sensitivity and specificity,
whereas using a population average offered little improvement
over excluding T1 and T2 entirely. The authors explored the
effect of acquisition scheme optimization58 on bias and vari-
ance introduced into the final estimation.
T2 *
T2* measurement is useful for understanding disease processes
that involve iron accumulation in the body. Each of the MRF
methods to determine T2* presents a unique solution with
advantages and disadvantages, and similar to CEST, there is no
consensus-standard method nor standard phantom.
One method to sensitize MRF to T2* is to substantially
modulate TE, in contrast to the original MRF method, where
TE was constant and as short as possible to maximize SNR
and minimize phase contributions.1 Rieger et al9 presented an
echo-planar imaging (EPI) MRF method for simultaneous
assessment of T1, T2*, and PD, accelerated by a factor of four
using an interleaved slice acquisition pattern.25 However, the
long TEs necessitated by EPI may make the method insensi-
tive to short T2* species when SNR is below five,9 which was
not fully explored by the authors. The dictionary spans T2
10–300 msec; however, the phantom does not test the lower
bound of the dictionary, since the shortest reported T2 for
the phantom is ~40 msec. Alternatively, Wyatt et al59 used
SSFP-MRF and modulated TE to sensitize signals to T2* in
magnitude and B0 in phase, allowing the fit of T1, T2, T2*,
and δf, the resonant frequency offset. Due to the broad range
of δf field variations, a two-step dictionary method was used.
The MRF estimates of T1, T2, T2*, and δf were compared
with their conventionally measured counterparts in a phan-
tom and in vivo.
Another approach is to create a hybrid MRF sequence
using multiple MRF base sequences that modulate the signal
to be sensitized to T2*. Wang et al60 incorporated bSSFP-
684
MRF with quadratic RF (qRF) to create high T2* sensitivity.
The signal model was modified to include an irreversible signal
decay time constant based on a Lorentzian distribution, Γ, to
account for nonrefocused transverse magnetization. The com-
plete model also included background off-resonance (δf), simi-
lar to Wyatt et al.59 Unlike Wyatt et al, δf was included in the
dictionary, along with T1, T2, and Γ. Then the relationship
between T2 and Γ was used to compute T2*. The authors
noted that optimization is needed to determine the appropriate
number of bSSFP and qRF blocks to obtain sensitivity to all
relaxation properties. Hong et al61 also used a hybrid MRF
sequence, alternating SSFP and SPGR MRF schemes to sensi-
tize to T2 and T2*, and compensated background field inho-
mogeneity with z-shim gradients. The gradient compensation
is unique to this method and restored T2 and T2* measure-
ment signal by removing macroscopic field inhomogeneity
induced by hardware imperfections or naturally occurring
inhomogeneities, such as at the air–tissue boundaries.
Water/Fat Separation
Water/fat separation is important for quantifying fat concentra-
tion, as well as reducing biases in property estimation that can
result if fat is not considered. To date, three approaches to wat-
er/fat separation using MRF have been published,39,62,63 each
approaching the problem differently with varied success.
Cencini et al62 developed a dictionary-based water/fat
separation MRF method (DBWF-MRF) to determine fat
fraction, water T1, fat T1, B0, and B1+ maps. To reduce the
size of the dictionary, the authors used RF spoiling to
decrease T2 sensitivity and thus omitted T2 relaxation time
from the dictionary. The authors compared their results to
both an MRF-Dixon based method64 and IDEAL.65 In
phantoms and in vivo, DBWF-MRF had comparable separa-
tion results to IDEAL, with an improved image acquisition
time. However, the method has definite limitations, including
that it fails with large field inhomogeneities, and there are
challenges at the water/fat boundaries due to blurring. The
measured water and fat T1 values are accurate and reliable
only within the bounds of 25–75% fat, as shown with a
Cramér–Rao lower bound analysis.
In the supplementary material of Cloos et al,39 they
report a method to estimate fat fraction using two PnP-MRF
acquisitions using two echo times. This dual echo method was
tested in a single, healthy subject, and the T1 and T2 values of
the water and fat agreed with the literature,66 although the fat
fraction was overestimated compared with IDEAL.65
Ostenson et al63 demonstrated that a k-space-based wat-
er/fat separation technique67 can be adapted to MRF, using a
variable TE and static TR to encode the chemical shift. The
method was used to quantify T1, T2, B0, and the fat fraction,
and demonstrated accurate quantification in fat fractions from
0% to 90% in phantoms, when water/fat separation was
applied, and up to 100% in simulation. The method was
Volume 51, No. 3

compared with conventional water/fat separation68 and
shown to be less biased than MRF without water/fat separa-
tion. The authors note that variations in the measured prop-
erty maps arise from residual undersampling aliasing and
suggest that this could be improved with alternative recon-
struction approaches beyond dictionary matching.
Current Sequence Challenges
B1+ Mapping
Field inhomogeneities must be accounted for in MRF to
avoid errors in property maps resulting from poor dictionary
matches. B1+ and B0 field inhomogeneities are especially
problematic at high field strengths (>3T) and large fields of
view (FOVs), such as abdominal imaging.35 Several
approaches were developed to correct MRF for these inhomo-
geneities, either by acquiring a separate B1+ map for correc-
tion35 or incorporating B1+ sensitivity into the MRF
sequence and dictionary.39,69–71 An example of such artifacts
and their correction can be seen in Fig. 4.
Chen et al35 used the Bloch–Siegert shift to map B1+
outside of the MRF acquisition, incorporating the measure-
ment into the pattern matching step. Accurate T1 and T2
maps were obtained with 12-fold acceleration, despite inho-
mogeneous fields in the abdomen (previously in Body Imag-
ing). When using this correction approach, noise propagation
from the B1+ mapping technique is a potential issue, eg, in
variable FA T1 mapping, noise in the B1+ map increases noise
in the T1 map.72 Thus, it is preferable to incorporate B1+
simulation into the dictionary to account for these errors.73
FIGURE 4: Example of B1+-induced MRI artifacts in the leg near an orthopedic implant. Conventional, spin echo images have large
signal voids near the implant and in the contralateral leg. PnP-MRF is able to account for the inhomogeneities to reconstruct high-
quality, quantitative PD, T1, T2, and B1+ maps. Figure adapted with permission from Ref. 39.
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Poorman et al.: MR Fingerprinting Review Part 1
Buonincontri and Sawiak69 created sensitivity to B1+ by
modifying a 3D SSFP-MRF sequence with abrupt FA
changes between 0 and 90 at the end of the sequence to cap-
ture the signal’s oscillatory behavior. This approach was also
applied at 7T, where T1, T2, and B1+ were successfully
corrected in vivo.70
Cloos et al39 noted that direct incorporation of B1+ into
the dictionary could fail in areas where B1+ distortions are
large enough to cause complete signal loss. To overcome this,
they created the PnP-MRF sequence that leveraged parallel
transmission to allow acquisition even in areas of nulled sig-
nal. This was accomplished by using multiple coil modes and
multiple echo types to incorporate B1+ in the dictionary. This
method was demonstrated near metal and in the presence of
adipose tissue. Recently, Körzdörfer et al71 proposed to mod-
ify a conventional bSSFP-MRF framework for B1+ quantifica-
tion, by combining it with a fast low angle shot (FLASH,
SPGR, T1-FFE) and SSFP sequence. Additionally, in vivo
measurements showed a greater standard deviation using the
proposed technique than values acquired with a separate B1+
correction. It should be noted that with these three methods,
each added dimension requires exponentially more finger-
prints to be simulated in the dictionary, requiring greater
computational power.71
While traditionally a challenge in conventional MR
studies, these results indicate that inhomogeneities in MRF
can be advantageous. Field maps not only improve T1 and T2
measurements, they also can be used to image near metal,39
estimate tissue susceptibility,71 and map electrical properties.39
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Journal of Magnetic Resonance Imaging
Enhanced Volume Coverage
Quantitative MRI is often neglected in clinical protocols
because of the long acquisition times required to obtain high-
resolution, quantitative maps. Efforts have been made to accel-
erate MRF acquisition to enable enhanced volume coverage in
a clinically-usable timeframe. The methods can be classified as
3D, simultaneous multislice (SMS), or slice interleaving.
Ma et al74 extended MRF to a 3D acquisition such that var-
iable density spirals were acquired in the kx-y plane for every step
in kz in a stack of spirals strategy. This enabled a full-volume
MRF acquisition in less than 5 minutes, preceded by a 3D
Bloch–Siegert B1+ map that required 1.6 minutes. Liao et al75 fur-
ther accelerated the stack of spirals 3D acquisition by combining a
sliding window reconstruction76 with generalized autocalibrating
partially parallel acquisitions (GRAPPA).77 This combination
allowed reconstruction of artifact-free images for dictionary
matching and reduced the number of repetitions required for pat-
tern matching. Full-volume T1, T2, and PD brain maps were
acquired in 7.5 minutes. However, these modifications resulted in
a reconstruction time of 20 hours with multiple computing cores
running in parallel.75 Cao et al78 enabled further acceleration by
undersampling in all dimensions using multiaxis spiral projection
imaging,79 with an acquisition time of 5 minutes.
Ye et al80 proposed simultaneous multislice acquisition
combined with bSSFP-MRF to increase volume coverage by
accelerating 2D acquisitions. This method used a gradient-
blipped CAIPIRINHA acquisition to encode unique phases into
each slice81 and a SENSE reconstruction.82 It was shown to be
accurate in simulations and in vivo against conventional MRI
methods, requiring only 5 s/slice, but struggled at multiband fac-
tors greater than two. The method was later supplemented with
GRAPPA to allow a multiband factor of three with an acquisition
time of 3.8 s/slice, but was prone to noise amplification at higher
factors.83 To avoid the need for parallel arrays required by these
methods, Jiang et al84 modulated the applied FA pattern of an
SSFP-MRF sequence to encode slice phases with RF instead of
gradients. The work was validated against conventional methods
in a phantom and between single-slice and SMS-MRF in vivo,
and required 18 seconds to acquire two slices. A multiband factor
of two was achieved with a single coil, suggesting that higher fac-
tors could be achieved when more coils are present.
Rieger et al9 combined MRF with EPI to accelerate
Cartesian acquisitions and acquire T1, T2*, and PD (see
T2*). MRF-EPI achieved accuracy in a phantom and in vivo
comparable to conventional scans, in less time than a fully-
sampled acquisition. The authors note that this EPI method
was slower than the typical spiral readout. However, it was
extended to cover a full volume using a slice interleaved
acquisition and acquired 32 slices in 3:36 minutes in vivo.25
Motion Compensation
Motion is a challenge in MRI, as it results in blurring and arti-
facts. If left unaccounted, errors can result from nonperiodic,
686
bulk motion as well as periodic cardiac and respiratory motion.
Flow in areas such as the cerebrospinal fluid and blood vessels
can cause artifacts in MRF due to unbalanced gradients and
through-plane magnetization, causing these voxels to be mis-
classified. An example of motion errors and a correction
method can be seen in Fig. 5.
Ma et al1 demonstrated that MRF is insensitive to non-
periodic motion at the end of a scan, because the motion-
corrupted data were filtered out by the pattern matching
algorithm. Building on this work, Yu et al85 confirmed that T1
measured using MRF with a nonselective inversion pulse was
relatively insensitive to in-plane motion but was sensitive to
through-plane motion in the middle of a scan, where larger flip
angles were used. Mehta et al86 developed in-plane motion cor-
rection that occurs during any part of the acquisition. The
method, MOtion insensitive MRF (MORF), identified and
corrected motion-compromised data by iterating between pat-
tern matching,1 identification of motion corrupted frames, and
motion estimation. MORF allowed motion correction during
the entirety of the acquisition; however, it required longer and
more intense computations. MORF also generated a map of
displacements, which could be beneficial to other applications
such as cardiac and abdominal imaging.86
Anderson et al87 addressed the need for respiratory and pul-
satile motion correction in Cartesian MRF. The proposed RIPE-
MRF method linearly incremented the phase-encoding line in
k-space to add temporal incoherence to the motion. RIPE-MRF
reduced the artifact-to-noise ratio without increasing the acquisi-
tion time.87 The authors noted that additional work is needed in
regions of high frequency pulsatility and rapid motion.87
Cruz et al88 proposed a method for 2D in-plane motion
correction during reconstruction. The method (MC-MRF)
used a sliding window reconstruction76 to estimate rigid body
motion, corrected the k-space data, and performed low rank
reconstruction. Errors due to in-plane motion were reduced,
although through-plane motion remained a challenge, particu-
larly for small structures in T2 maps. Xu et al89 developed a
similar method comprised of motion recognition and correc-
tion in k-space prior to reconstruction. The proposed method
suppressed errors from in-plane motion artifacts in a phantom
and in vivo, but it did not substantially improve through-plane
motion errors. The authors suggest that using a 3D acquisition
could aid through-plane correction.
Barriers to Clinical Adaptation and
Recommendations for Progress
As summarized in this review, MRF has many possible uses for
diagnostics, and there is ongoing work to address challenges such
as incorporation of B1+ compensation,35,39,69–71 enhancing vol-
ume coverage,9,25,75,80,83 and motion compensation.85–89 A key
advantage of MRF is that it can acquire data in a rapid fashion,
although the overall time between patient positioning and image
Volume 51, No. 3
 Poorman et al.: MR Fingerprinting Review Part 1

FIGURE 5: MRF results from motion-corrupted data using a noncorrected method (IMS) and correction algorithm (MORF).
Conventional MRF is prone to errors in the presence of motion, which can be corrected using an MRF motion-correction algorithm.
Motion artifacts obscure the brain in conventional weighted imaging, but parameter maps from motion-corrected MRF can be used
to synthesize an artifact-free weighted image. Figure adapted with permission from Ref. 86.

viewing by the radiologist may not be fast enough in some cases
due to postprocessing time.
Optimization of the MRF sequence can enable
reduced scan times and/or improve the quality of acquired
data.58,71,90,91 However, the postprocessing computational
power needed for generating dictionaries and pattern-
matching is still a limitation. For example, the cardiac MRF
methodology proposed patient-specific dictionaries, but
required a high-performance computing cluster to achieve
reasonable dictionary generation times.18 It is preferred for maps
to be generated near instantaneously, but current MRF methods
take on the order of 3 minutes to reconstruct per 2D section35
and in the case of 3D acquisitions, more than 2 hours23 or as
long as 20 hours.75 Sequence optimization, algorithm perfor-
mance metrics, and these computational limitations are an ongo-
ing area of development and will be addressed in more detail in
Part 2 of this review.4
Beyond the technological hurdles, there are certain steps
to be taken such that the proposed methods and resulting
maps can be compared across clinical centers and over time.
Here we discuss recommendations for validation, repeatability
and reproducibility studies, and standardized reporting.
Validation, Repeatability, and Reproducibility
Validation is required of any new technique using digital phan-
toms and simulations, using phantoms with ground truth mea-
surements, through comparison of measured in vivo values to
standard method measurements in the same subjects, or
through comparison of measured in vivo values to the
literature. Phantoms can be used to test the sequence on MRI
hardware, but MRF measures multiple properties, which
requires a phantom that represents multiple properties. This
necessitates construction of custom phantoms, such as that
used by Kobayashi and Terada.51 Standardized and well-
characterized phantoms are widely available, including
ADNI,92 ACR,93 and ISMRM/NIST94 phantoms. Yet many
of these do not replicate the T1/T2 ratios found in most tis-
sues. Finally, a challenge that was emphasized in the discussion
of CEST is the lack of gold standard methodology and phan-
toms, which can inhibit the ability to present a singular valida-
tion method.47
We summarize the validation approaches used in various
implementations of MRF applications (Fig. 2) and initial clini-
cal studies (Fig. 3), as well as comparisons of MRF values to
quantitative MRI measures from the literature (Supporting
Information Table 1). In this review, 16 clinical studies and
36 applications development studies were presented. The
majority of MRF applications presented to date validated the
method by comparison of their measured in vivo values to
standard method measurements in the same subjects, and most
validated by either numerical simulation or the use of a custom
phantom (Fig. 2). In the literature, there can be discrepancies
between the MRF-measured value and those by other tech-
niques, which is possibly due to the challenge of implementing
quantitative MR in vivo. The spin-echo methods to measure
T1 and T2 are time-consuming to acquire in the clinic, so
abbreviated protocols are used. These abbreviated protocols
can be confounded themselves by B1 effects and slice profile

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Journal of Magnetic Resonance Imaging
effects, stimulated echoes, and magnetization transfer. As a
result, we are not surprised that there are discrepancies between
MRF and literature measurements. MRF is typically used as a
research tool in a clinical setting, often with a comparison to a
standard method (Fig. 3) to demonstrate the utility of the tech-
nique. The growing variety of clinical applications in the litera-
ture could lead to more routine adaptation in the future.
However, repeatability and reproducibility studies on MRF
methods are lacking.
Repeatability and reproducibility studies are highly rec-
ommended to demonstrate the robustness of the technique
and readiness for clinical use. The Radiological Society of
North America – Quantitative Imaging Biomarkers Alliance
(RSNA-QIBA) carefully developed recommendations for
repeatability and reproducibility studies95 and the statistical
analysis of results.96–98 Repeatability and reproducibility stud-
ies can be completed using phantoms or in vivo and should be
the next step following validation. In a phantom, when ground
truth values are available, the bias of that method from the gro-
und truth values should be presented, as shown in Fig. 6 using
data from Ma et al.23 Ideally, the phantom is used not for a sin-
gle validation, but repeatedly removed and then positioned in
the scanner and imaged to generate repeatability data, as done
in one day by Anderson et al,26 over multiple days on one sys-
tem by Jiang et al,99 and reproducibility data, as done across
three MRI systems by Cloos et al.10 Repeatability and repro-
ducibility data are also needed in vivo, and some studies were
recently completed.10,23,28,38,74 Cloos et al10 presented results
from a small study using three healthy controls, with two mea-
surements across three systems. Using the high-resolution 3D
MRF method, Ma et al74 performed repeatability studies using
the ISMRM/NIST system phantom, and test–retest studies
were completed in healthy volunteers.23 Panda et al conducted
a b
FIGURE 6: Results from a test–retest study using 3D MRF with the ISMRM/NIST phantom94 for T1 (a) and T2 (b). This sort of study
can be used to assess bias in the measurement technique. Data for this figure were reproduced with permission from Ref. 23.
688
repeatability and reproducibility studies in the breast of healthy
subjects, and they determined the coefficient of repeatability
for T1 to be 290 msec and for T2 to be 14 msec.38 Thus, if an
observed change was greater than the coefficient of repeatabil-
ity (eg, ΔT1 >290 msec or ΔT2 >14 msec), it can be consid-
ered notable. From the reproducibility study across two
models of the same vendor, there was no difference in mea-
sured values. In vivo studies of MRF repeatability and clinical
application have been limited to small patient cohorts, which
limits the clinical impact of MRF. To date, reproducibility
studies compared different platforms within the same vendor,
but methods must also be compared across vendors. Additional
work is needed, and several studies are under way.100–102
Without repeatability and reproducibility studies to
demonstrate consistency, accuracy, and precision of MRF
across time, location, operator, etc., the method cannot be
implemented in the clinic. Beyond the demonstration of con-
sistency, accuracy, and precision, protocols need to exist to
ensure the quality of MRF data, which may exceed the qual-
ity assurance (QA) protocols currently in place. Geethanath
et al103 presented a short QA protocol for use prior to clinical
studies using MRF using the ACR and ADNI phantoms.
Alternatively, we suggest using a phantom that represents
multiple properties; for example, the T1, T2, and ADC or
T2* of various tissues. Then use of this phantom could be
incorporated into the regular QA protocol, ideally weekly or
even daily to quickly identify errors in the measurements of
any of the multiple properties, which can go unnoticed by
the human eye and the existing SNR and contrast-based QA.
Standardized Reporting
Standardized reporting, when possible, will allow the field to
more easily compare and contrast methodologies. We
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FIGURE 7: An example layout for reporting the pulse sequence diagram, relevant parameters, and k-space pattern. We also
recommend labeling the parameters of interest (FA and TR for this particular sequence) in the pulse sequence diagram. This figure is
reproduced with permission from Ref. 12.
recommend including a pulse sequence diagram with labels
on each varied acquisition parameter, plots of all parameters
that are varied, and details of the sampling pattern in every
publication. One example of a figure layout containing this
information can be seen in Fig. 7, which originally appeared in
Jiang et al.12 However, the pulse sequence diagram should
include labels of the variables of interest: in this example, repe-
tition time and flip angle. An example of such labeling can be
found in Fig. 1 of Ma et al,1 where each parameter was labeled
from repetition 1 to N. To aid reproducibility and comparison
of algorithms, the variation patterns should be specified in a
text file in supplementary information. It should be acknowl-
edged that this exact figure format may not be conducive to
every MRF implementation, eg, CEST MRF implementations
do not vary TR. In these cases, plots of the parameters being
varied should be displayed instead of FA and TR. Efforts
should be made to include these parameters in a pulse sequence
diagram with corresponding labels, such as in Fig. 1 of Zhou
et al.48 Finally, when possible, sharing repositories of code is
extremely helpful to allow others to reproduce results. Exam-
ples of such resources can be found in Refs. 1,39,63,76,104.
Standardized reporting extends beyond pulse sequence
specifications to reporting of results. Metrics of the methodol-
ogy need to be included, such as computation times and
memory requirements of the dictionary (including computer
specifications). Computation times and specifications should
be included for the reconstruction of property maps. Metrics
for this analysis are still under development and will be dis-
cussed in Part 2.4 When, at last, quantitative maps are
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Poorman et al.: MR Fingerprinting Review Part 1
created, it is easier to compare data using the same color
schemes for each property map. We recommend using per-
ceptually uniform color maps, such as those recommended by
Griswold et al,105 including a color bar next to each map and
the units of the map property.
Conclusion
Magnetic resonance fingerprinting is a powerful new
approach to quantitative MRI. With a flexible framework that
can be adapted to many applications, this technique has yet
to explore its full potential. MRF offers the ability to acquire
multiple property maps simultaneously in just a few minutes,
without the need for image registration, allowing quantitative
MRI to be used in the clinic. One can imagine many future
possibilities for MRF beyond what is presented here. For
example, the ability to quantify multiple properties simulta-
neously with MRF could allow synthetic MRI to be used to
generate conventional, weighted MR images with any form of
tissue contrast, as well as quantitative maps.106 Using CEST-
MRF, the fast acquisition time and sensitivity to chemical
effects could enable real-time assessment of MRI biomarkers
in vivo to monitor disease progression and treatment efficacy,
allowing MRI to be used as a screening tool for disease, rather
than reserved for use only in high-risk cases.
MRF has already enabled some interesting findings, and
we are excited about the future possibilities. In spectroscopy,
for example, MRF enabled accurate quantification of absolute
metabolite concentrations.57 This had not previously been
689
Journal of Magnetic Resonance Imaging
accomplished, because patient-specific T1 and T2 could
not be acquired in a realistic timeframe, and as a result
population-average values were used in models.57 Patient-
specific modeling of cancer progression, including multiple
MR-measured properties, is an active area of research,107
which could become clinically feasible with the application of
MRF for fast, quantitative mapping. Another area of interest
is defining normal ranges of MRI biomarkers. Studies such as
Badve et al20 and Chen et al21 demonstrated the sensitivity of
MRF techniques to normal tissue variations with age. Larger
studies are needed to define a baseline for quantitative mea-
surement that could fully allow quantitative MR biomarkers
to be used in diagnosis and screening.
Much work in MRF was devoted to the development of
methods for clinical applications, including relaxometry and
functional metrics in cardiovascular, body, and head applica-
tions. However, current methods face challenges in vivo from
B1+ inhomogeneities, motion, and volume coverage, which
are active areas of research. Technical considerations such as
pulse sequence optimization, computational power, and met-
rics for error analysis are also barriers to the widespread use of
MRF. Additionally, the field needs more studies on repeat-
ability, reproducibility, and validation of this technique before
it can become a reliable clinical tool. We call on the MRF
community to adopt standardized methods of reporting to
increase the reproducibility of methods.
Conflict of Interest
Contribution of the National Institute of Standards and
Technology: not subject to copyright in the United States.
Certain commercial instruments and software are identified
to specify the experimental study adequately. This does not
imply endorsement by the National Institute of Standards
and Technology nor that the instruments and software are
the best available for the purpose. Authors D.M., D.F.M.,
V.G., and M.A.G. receive research support from Siemens.
References
1. Ma D, Gulani V, Seiberlich N, et al. Magnetic resonance fingerprint-
ing. Nature 2013;495:187–192.
2. Mehta BB, Coppo S, McGivney DF, et al. Magnetic resonance finger-
printing: A technical review. Magn Reson Med 2019;81:25–46.
3. Panda A, Mehta BB, Coppo S, et al. Magnetic resonance fingerprint-
ing — An overview. Curr Opin Biomed Eng 2017;3:56–66.
4. McGivney DF, Boyacioglu R, Jiang Y, et al. Magnetic resonance fin-
gerprinting Part 2: Technique and directions. J Magn Reson Imaging
2019 (Invited Review) [Epub ahead of print].
5. Carr HY. Steady-state free precession in nuclear magnetic resonance.
Phys Rev 1958;112:1693–1701.
6. Bloch F. Nuclear induction. Phys Rev 1946;70:460–474.
7. Scheffler K. On the transient phase of balanced SSFP sequences.
Magn Reson Med 2003;49:781–783.
690
8. Gao Y, Chen Y, Ma D, et al. Preclinical magnetic resonance finger-
printing (MRF) at 7 T: Effective quantitative imaging for rodent disease
models. NMR Biomed 2015;28:384–394.
9. Rieger B, Zimmer F, Zapp J, Weingärtner S, Schad LR. Magnetic reso-
nance fingerprinting using echo-planar imaging: Joint quantification
of T1 and T2* relaxation times. Magn Reson Med 2017;78:
1724–1733.
10. Cloos MA, Assländer J, Abbas B, et al. Rapid radial T1 and T2 map-
ping of the hip articular cartilage with magnetic resonance fingerprint-
ing. J Magn Reson Imaging 2018;1–6.
11. Deoni SCL, Rutt BK, Peters TM. Rapid combined T1 and T2 mapping
using gradient recalled acquisition in the steady state. Magn Reson
Med 2003;49:515–526.
12. Jiang Y, Seiberlich N, Gulani V, Griswold MA. MR fingerprinting using
fast imaging with steady state precession (FISP) with spiral readout.
Magn Reson Med 2015;74:1621–1631.
13. Assländer J, Glaser SJ, Hennig J. Pseudo steady-state free precession
for MR-fingerprinting. Magn Reson Med 2017;77:1151–1161.
14. Weigel M. Extended phase graphs: Dephasing, RF pulses, and
echoes — Pure and simple. J Magn Reson Imaging 2015;41:266–295.
15. Tropp JA, Gilbert AC. Signal recovery from random measurements via
orthogonal matching pursuit. IEEE Trans Inf Theory 2007;53:
4655–4666.
16. Liu Y, Hamilton J, Rajagopalan S, Seiberlich N. Cardiac magnetic reso-
nance fingerprinting: Technical overview and initial results. JACC
Cardiovasc Imaging 2018;11:1837–1853.
17. Hamilton JI, Jiang Y, Chen Y, et al. MR fingerprinting for rapid quanti-
fication of myocardial T1, T2, and proton spin density. Magn Reson
Med 2017;77:1446–1458.
18. Hamilton JI, Jiang Y, Ma D, et al. Investigating and reducing the
effects of confounding factors for robust T1 and T2 mapping with car-
diac MR fingerprinting. Magn Reson Imaging 2018;53:40–51.
19. Coristine AJ, Hamilton J, van Heeswijk RB, Hullin R, Seiberlich N. Cardiac
magnetic resonance fingerprinting in heart transplant recipients. In: Pro-
ceedings of the Joint Annual Meeting ISMRM-ESMRMB; 2018. p 675.
20. Badve C, Yu A, Rogers M, et al. Simultaneous T1 and T2 brain rel-
axometry in asymptomatic volunteers using magnetic resonance fin-
gerprinting. Tomography 2015;1(2).
21. Chen Y, Chen M-H, Baluyot KR, Potts TM, Jimenez J, Lin W. MR fin-
gerprinting enables quantitative measures of brain tissue relaxation
times and myelin water fraction in the first five years of life.
Neuroimage 2019;186:782–793.
22. Badve C, Yu A, Dastmalchian S, et al. MR fingerprinting of adult brain
tumors: Initial experience. Am J Neuroradiol 2017;38:492–499.
23. Ma D, Jones SE, Deshmane A, et al. Development of high-resolution
3D MR fingerprinting for detection and characterization of epileptic
lesions. J Magn Reson Imaging 2018;1–14.
24. Liao C, Wang K, Cao X, et al. Detection of lesions in mesial temporal
lobe epilepsy by using MR fingerprinting. Radiology 2018;288:
804–812.
25. Rieger B, Akçakaya M, Pariente JC, et al. Time efficient whole-brain
coverage with MR Fingerprinting using slice-interleaved echo-planar-
imaging. Sci Rep 2018;8:1–12.
26. Anderson CE, Donnola SB, Jiang Y, et al. Dual contrast — Magnetic
resonance fingerprinting (DC-MRF): A platform for simultaneous quan-
tification of multiple MRI contrast agents. Sci Rep 2017;7(8431).
27. Laule C, Vavasour IM, Moore GRW, et al. Water content and myelin
water fraction in multiple sclerosis. J Neurol 2004;251:284–293.
28. Su P, Mao D, Liu P, et al. Multiparametric estimation of brain hemody-
namics with MR fingerprinting ASL. Magn Reson Med 2017;778:
1812–1823.
29. Jahng G, Li K, Ostergaard L, Calamante F. Perfusion magnetic reso-
nance imaging: A comprehensive update on principles and tech-
niques. Korean J Radiol 2014;15:554–577.
Volume 51, No. 3

30. Wright KL, Jiang Y, Ma D, et al. Estimation of perfusion properties
with MR fingerprinting arterial spin labeling. Magn Reson Imaging
2018;50:68–77.
31. Koolstra K, Beenakker JWM, Koken P, Webb A, Börnert P. Cartesian MR
fingerprinting in the eye at 7T using compressed sensing and matrix
completion-based reconstructions. Magn Reson Med 2018;1–15.
32. Yu AC, Badve C, Ponsky LE, et al. Development of a combined MR
fingerprinting and diffusion examination for prostate cancer. Radiol-
ogy 2017;283(3).
33. Panda A, Obmann VC, Lo W-C, et al. MR Fingerprinting and ADC
Mapping for Characterization of Lesions in Transition Zone of the
Prostate Gland, in Press, Radiology 2019.
34. Panda A, O’Connor G, Lo W-C, et al. Targeted biopsy validation of
peripheral zone prostate cancer characterization with MR fingerprint-
ing and diffusion mapping. Invest Radiol 2019 [Epub ahead of print].
35. Chen Y, Jiang Y, Pahwa S, et al. MR fingerprinting for rapid quantita-
tive abdominal imaging. Radiology 2016;279:278–286.
36. Sacolick LI, Wiesinger F, Hancu I, Vogel MW. B1 mapping by Bloch-
Siegert shift. Magnetic Resonance in Medicine 2010;63:1315–1322.
37. Chen Y, Panda A, Pahwa S, et al. Three-dimensional MR fingerprinting
for quantitative breast imaging. Radiology 2019;290:33–40.
38. Panda A, Chen Y, Ropella-Panagis K, et al. Repeatability and Repro-
ducibility of 3D MR fingerprinting measurements in normal breast tis-
sue. J Magn Reson Imaging 2019 [Epub ahead of print].
39. Cloos MA, Block KT, Knoll F, et al. Multiparametric imaging with het-
erogeneous radiofrequency fields. Nat Commun 2016;7(12445).
40. Watanabe A, Boesch C, Siebenrock K, Obata T, Anderson SE. T2
mapping of hip articular cartilage in healthy volunteers at 3T: A
study of topographic variation. J Magn Reson Imaging 2007;26:
165–171.
41. Nemeth A, Di Marco L, Boutitie F, et al. Reproducibility of in vivo
magnetic resonance imaging T1 rho and T2 relaxation time measure-
ments of hip cartilage at 3.0T in healthy volunteers. J Magn Reson
Imaging 2018;47:1022–1033.
42. Lu W, Pauly KB, Gold GE, Pauly JM, Hargreaves BA. SEMAC: Slice
encoding for metal artifact correction in MRI. Magn Reson Med 2009;
62:66–76.
43. Koch KM, Hargreaves BA, Pauly KB, Chen W, Gold GE, King KF. Mag-
netic resonance imaging near metal implants. J Magn Reson Imaging
2010;32:773–787.
44. Axel L. Blood effects in magnetic resonance imaging. Am J Radiol
1984;143:1157–1166.
45. Flassbeck S, Schmidt S, Bachert P, Ladd ME, Schmitter S. Flow MR fin-
gerprinting. Magn Reson Med 2018;1–15.
46. Cohen O, Huang S, McMahon MT, Rosen MS, Farrar CT. Rapid and
quantitative chemical exchange saturation transfer (CEST) imaging
with magnetic resonance fingerprinting (MRF). Magn Reson Med
2018;80:2449–2463.
47. Heo H-Y, Han Z, Jiang S, Char M, van Zijl P, Zhou J. Quantifying
amide proton exchange rate and concentration in chemical exchange
saturation transfer image of the human brain. Neuroimage 2019;189:
202–213.
48. Zhou Z, Han P, Zhou B, et al. Chemical exchange saturation transfer
fingerprinting for exchange rate quantification. Magn Reson Med
2018;80:1352–1363.
49. Goerke S, Zaiss M, Bachert P. Characterization of creatine gua-
nidinium proton exchange by water-exchange (WEX) spectroscopy
for absolute-pH CEST imaging in vitro. NMR Biomed 2014;27:
507–518.
50. Gu Y, Wang CY, Anderson CE, et al. Fast magnetic resonance finger-
printing for dynamic contrast-enhanced studies in mice. Magn Reson
Med 2018;80:2681–2690.
51. Kobayashi Y, Terada Y. Diffusion-weighting caused by spoiler gradi-
ents in the fast imaging with steady-state precession sequence may
March 2020
Poorman et al.: MR Fingerprinting Review Part 1
lead to inaccurate T2 measurements in MR fingerprinting. Magn
Reson Med Sci 2019;18:96–104.
52. Honodo S, Jiang Y, Nallapareddy N, Gulani V, Griswold MA. Diffusion
propagator formalism in Bloch equation simulation of Magnetic Reso-
nance Fingerprinting. In: Proceedings of the Joint Annual Meeting
ISMRM-ESMRMB; 2018. p 4252.
53. Seroussi I, Sochen N, Ben-Eliezer N, Pasternak O. Bloch-Torrey simu-
lation to quantify diffusion effects on multi-parametric sequences with
application for MR fingerprinting. In: Proceedings of the Joint Annual
Meeting ISMRM-ESMRMB; 2018. p 4267.
54. Cohen O, Rosen MS. Simultaneous diffusion, PD, T1, and T2 mapping
with optimized MR Fingerprinting EPI. In: Proceedings of the Joint
Annual Meeting ISMRM-ESMRMB; 2018. p 4270.
55. Ma D, Pierre EY, Schluchter MD, Setsompop K, Gulani V,
Griswold MA. Music-based magnetic resonance fingerprinting to
improve patient comfort during MRI exams. Magn Reson Med 2016;
75:2303–2314.
56. Wang CY, Liu Y, Huang S, Griswold MA, Seiberlich N, Yu X. 31 P mag-
netic resonance fingerprinting for rapid quantification of creatine
kinase reaction rate in vivo. NMR Biomed 2017;30(e3786).
57. Kulpanovich A, Tal A. The application of magnetic resonance fingerprint-
ing to single voxel proton spectroscopy. NMR Biomed 2018;31:1–14.
58. Cohen O, Rosen MS. Algorithm comparison for schedule optimization
in MR fingerprinting. Magn Reson Imaging 2017;41:15–21.
59. Wyatt CR, Smith TB, Sammi MK, Rooney WD, Guimaraes AR. Multi-
parametric T2* magnetic resonance fingerprinting using variable echo
times. NMR Biomed 2018;31:1–12.
60. Wang CY, Coppo S, Mehta BB, Seiberlich N, Yu X, Griswold MA. Mag-
netic resonance fingerprinting with quadratic RF phase for measurement
of T2* simultaneously with δf, T1, and T2. Magn Reson Med 2018;1–14.
61. Hong T, Han D, Kim DH. Simultaneous estimation of PD, T1, T2, T2*,
and δB0 using magnetic resonance fingerprinting with background
gradient compensation. Magn Reson Med 2018;1–10.
62. Cencini M, Biagi L, Kaggie J, Schulte R, Tosetti M, Buonincontri G.
Musculoskeletal MR fingerprinting with dictionary-based fat and water
separation. Magn Reson Med 2018;1–14.
63. Ostenson J, Damon BM, Welch EB. MR fingerprinting with simulta-
neous T1, T2, and fat signal fraction estimation with integrated B0 cor-
rection reduces bias in water T1 and T2 estimates. Magn Reson
Imaging 2019;60:7–19.
64. Glover GH. Multipoint Dixon technique for water and fat proton and
susceptibility imaging. J Magn Reson Imaging 1991;1:521–530.
65. Reeder SB, Wen Z, Yu H, et al. Multicoil Dixon chemical species sepa-
ration with an iterative least-squares estimation method. Magn Reson
Med 2004;51:35–45.
66. Gold GE, Han E, Stainsby J, Wright G, Brittain J, Beaulieu C. Musculo-
skeletal MRI at 3.0 T: Relaxation times and image contrast. AJR
Am J Roentgenol 2004;183:343–351.
67. Brodsky EK, Holmes JH, Yu H, Reeder SB. Generalized k-space
decomposition with chemical shift correction for non-Cartesian water-
fat imaging. Magn Reson Med 2008;59:1151–1164.
68. Hernando D, Kellman P, Haldar JP, Liang ZP. Robust water/fat separa-
tion in the presence of large field inhomogeneities using a graph cut
algorithm. Magnetic 2010;63:79–90.
69. Buonincontri G, Sawiak SJ. MR fingerprinting with simultaneous B1
estimation. Magn Reson Med 2016;76:1127–1135.
70. Buonincontri G, Schulte RF, Cosottini M, Tosetti M. Spiral MR finger-
printing at 7 T with simultaneous B1 estimation. Magn Reson Imaging
2017;41:1–6.
71. Körzdörfer G, Jiang Y, Speier P, et al. Magnetic resonance field finger-
printing. Magn Reson Med 2019;81:2347–2359.
72. Lee Y, Callaghan MF, Nagy Z. Analysis of the precision of variable flip
angle T1 mapping with emphasis on the noise propagated from RF
transmit field maps. Front Neurosci 2017;11(106).
691
Journal of Magnetic Resonance Imaging
73. Ma D, Coppo S, Chen Y, et al. Slice profile and B1 corrections in 2D
magnetic resonance fingerprinting. Magn Reson Med 2017;78:
1781–1789.
74. Ma D, Jiang Y, Chen Y, et al. Fast 3D magnetic resonance fingerprinting
for a whole-brain coverage. Magn Reson Med 2018;79:2190–2197.
75. Liao C, Bilgic B, Manhard MK, et al. 3D MR fingerprinting with accel-
erated stack-of-spirals and hybrid sliding-window and GRAPPA recon-
struction. Neuroimage 2017;162:13–22.
76. Cao X, Liao C, Wang Z, et al. Robust sliding-window reconstruction
for accelerating the acquisition of MR fingerprinting. Magn Reson
Med 2017;78:1579–1588.
77. Griswold MA, Jakob PM, Heidemann RM, et al. Generalized
autocalibrating partially parallel acquisitions (GRAPPA). Magn Reson
Med 2002;47:1202–1210.
78. Cao X, Ye H, Liao C, Li Q, He H, Zhong J. Fast 3D brain MR finger-
printing based on multi-axis spiral projection trajectory. Magn Reson
Med 2019;:1–13.
79. Irarrazabal P, Nishimura DG. Fast three dimensional magnetic reso-
nance imaging. Magn Reson Med 1995;33:656–662.
80. Ye H, Ma D, Jiang Y, et al. Accelerating magnetic resonance finger-
printing (MRF) using t-blipped simultaneous multislice (SMS) acquisi-
tion. Magn Reson Med 2016;75:2078–2085.
81. Setsompop K, Gagoski B, Polimeni J, Witzel T, Wedeen VJ, Wald LL.
Blipped-controlled aliasing in parallel imaging (blipped-CAIPI) for
simultaneous multi-slice EPI with reduced g-factor penalty. Magn
Reson Med 2012;67:1210–1224.
82. Pruessmann KP, Weiger M, Scheidegger MB, Boesiger P. SENSE: Sen-
sitivity encoding for fast MRI. Magn Reson Med 1999;42:952–962.
83. Ye H, Cauley SF, Gagoski B, et al. Simultaneous Multi-Slice Magnetic
Resonance Fingerprinting (SMS-MRF) with Direct-spiral Slice-GRAPPA
(ds-SG) Reconstruction. Magn Reson Med 2017;77:1966–1974.
84. Jiang Y, Ma D, Bhat H, et al. Use of pattern recognition for unaliasing
simultaneously acquired slices in simultaneous multislice magnetic
resonance fingerprinting. Magn Reson Med 2017;78:1870–1876.
85. Yu Z, Zhao T, Assländer J, Lattanzi R, Sodickson DK, Cloos MA.
Exploring the sensitivity of magnetic resonance fingerprinting to
motion. Magn Reson Imaging 2018;54:241–248.
86. Mehta BB, Ma D, Pierre EY, Jiang Y, Coppo S, Griswold MA. Image
reconstruction algorithm for motion insensitive MR fingerprinting
(MRF): MORF. Magn Reson Med 2018;80:2485–2500.
87. Anderson CE, Wang CY, Gu Y, et al. Regularly incremented phase
encoding — MR fingerprinting (RIPE-MRF) for enhanced motion arti-
fact suppression in preclinical cartesian MR fingerprinting. Magn
Reson Med 2018;79:2176–2182.
88. Cruz G, Jaubert O, Schneider T, Botnar RM, Prieto C. Rigid motion-
corrected magnetic resonance fingerprinting. Magn Reson Med 2019;
81:947–961.
89. Xu Z, Ye H, Lyu M, He H, Zhong J, Mei Y, et al. Rigid motion correc-
tion for magnetic resonance fingerprinting with sliding-window recon-
struction and image registration. Magn Reson Imaging 2019;57:
303–312.
90. Kara D, Fan M, Hamilton J, Griswold M, Seiberlich N, Brown R. Param-
eter map error due to normal noise and aliasing artifacts in MR finger-
printing. Magn Reson Med 2019;1–16.
692
91. Zhao B, Haldar JP, Liao C, et al. Optimal experiment design for mag-
netic resonance fingerprinting: Cramer-Rao bound meets spin dynam-
ics. IEEE Trans Med Imaging 2018;1–18.
92. Gunter JL, Bernstein MA, Borowski BJ, et al. Measurement of MRI
scanner performance with the ADNI phantom. Med Phys 2009;36:
2193–2205.
93. Price AJ, Clarke G, Dennis M, et al. MRI quality control manual. Am
Coll Radiol 2015.
94. Keenan KE, Boss MA, Jackson EF, Kown S, Jennings D, Russek SE. NIST/-
ISMRM MRI system phantom T1 measurements on multiple MRI systems.
In: 21st Annual Meeting of the ISMRM Salt Lake City; 2013. p 4338.
95. Raunig DL, McShane LM, Pennello G, et al. Quantitative imaging bio-
markers: A review of statistical methods for technical performance
assessment. Stat Methods Med Res 2015;24:27–67.
96. Sullivan DC, Obuchowshki NA, Kessler LG, et al. Metrology standards
for quantitative imaging biomarkers. Radiology 2015;227:813–825.
97. Obuchowski NA, Reeves AP, Huang EP, et al. Quantitative imaging
biomarkers: A review of statistical methods for computer algorithm
comparisons. Stat Methods Med Res 2015;24:68–106.
98. Huang EP, Wang XF, Choudhury KR, et al. Meta-analysis of the techni-
cal performance of an imaging procedure: Guidelines and statistical
methodology. Stat Methods Med Res 2015;24:141–174.
99. Jiang Y, Ma D, Keenan KE, Stupic KF, Gulani V, Griswold MA. Repeat-
ability of magnetic resonance fingerprinting T1 and T2 estimates
assessed using the ISMRM/NIST MRI system phantom. Magn Reson
Med 2017;78:1452–1457.
100. Körzdörfer G, Kirsch R, Liu K, et al. Multicenter and multiscanner
reproducibility of Magnetic Resonance Fingerprinting relaxometry in
the brain. In: Proceedings of the Joint Annual Meeting ISMRM-
ESMRMB; 2018. p 798.
101. Pahwa S, Hamilton J, Adedigba J, et al. Myocardial T1 and T2 mapping
using MR fingerprinting: Comparison to clinical standards. In: Proceed-
ings of the Joint Annual Meeting ISMRM-ESMRMB; 2018. p 762.
102. Sridaran S, Panda A, Chen Y, et al. Normative T1 and T2 relaxation
times and measurement repeatability of abdomen organs at 3T using
2D MR fingerprinting. In: Proceedings of the Joint Annual Meeting
ISMRM-ESMRMB; 2018. p 4253.
103. Geethanath S, Jambawaliar S, Vanguri R, et al. Daily qualitative and
quantitative assessment of magnetic resonance fingerprinting using
the American College of Radiology and Alzheimer’s Disease Neuroim-
aging Initiative Phantoms. In: Radiological Society of North America
Annual Meeting; 2018.
104. Assländer J, Cloos MA, Knoll F, Sodickson DK, Hennig J, Lattanzi R.
Low rank alternating direction method of multipliers reconstruction for
MR fingerprinting. Magn Reson Med 2018;79:83–96.
105. Griswold M, Sunshine J, Seiberlich N, Gulani V. Towards unified colo-
rmaps for quantitative MRF data. In: International Society for Magnetic
Resonance in Medicine Workshop on Magnetic Resonance Finger-
printing; 2018.
106. Bobman SA, Riederer SJ, Lee JN, et al. Cerebral magnetic resonance
image synthesis. Am J Neuroradiol 1985;6:265–269.
107. Hormuth II D, Jarrett A, Lima E, McKenna M, Fuentes D, Yankeelov T.
Mechanism-based modeling of tumor growth and treatment response
constrained by multiparametric imaging data. J Clin Oncol Clin Can-
cer Inform 2019;:1–10.
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