Accurate separation of the simultaneously acquired slices is one of the bigger limitations of the SMS-EPI method, compared to the processing used for conventional multislice EPI. The default SMS reconstruction, as used in my two introductory posts on the SMS sequences from CMRR (MB-EPI) and MGH (Blipped CAIPI), is a slice dimension adaptation of the GeneRalized Autocalibrating Partial PArallel (GRAPPA) method that was originally applied in-plane to acceleration of the phase encoding direction. It's not essential to understand the GRAPPA method applied in-plane for the purposes of understanding this post or for SMS reconstruction more generally. But if you're curious I wrote a brief introduction to in-plane GRAPPA in 2011. That post was specifically concerned with motion sensitivity of (in-plane) GRAPPA. I'll be looking in more detail at the motion sensitivity of SMS in a future post. In this post I want to compare the standard SMS reconstruction - what is generally termed Slice GRAPPA - with an alternative known as Split Slice GRAPPA. The latter option is termed "Leak Block" in the CMRR pulse sequence, MB-EPI.
What's the concern?
CMRR's parameter nomenclature offers a strong clue to the problem. In conventional EPI reconstruction we use a 2D Fourier transform (FT) which produces some amount of ringing. We also use slices that have some degree of cross-talk to neighboring slices, arising out of the limitations of frequency selectivity. So, while we think of voxels as perfect little rectangles or cubes, in reality they are blurry beasts that spread their signal into adjoining voxels because of a non-rectangular point-spread function (PSF). The dimensions we assign a voxel are entirely nominal.
With SMS we have a broader spatial problem than just non-cubic PSF. Separation of the simultaneous slices can leave signal in an incorrect position that is quite some distance from where it is supposed to be. It's a longer length scale error than the simple PSF of a voxel. Let's suppose we acquire four 2 mm slices simultaneously, 84 total slices. In one SMS acquisition we will have four slices separated by one quarter of the total slice dimension extent of 168 mm, or about 42 mm (assuming no additional inter-slice gap). Do a quick thought experiment. Imagine that in the first slice there is a very strong activation and nothing in the other three. If there is a large residual spatial error arising from poor SMS separation then we might start seeing this activation projected 4.2, 8.4 or even 12.6 cm from where it should be! And how would we know that the distant activation sites were erroneous?
This slice leakage, as it's usually called in the literature, may be strongest for simultaneously acquired neighbors but may extend throughout the slice dimension, between simultaneously acquired slices that might be quite far apart in anatomical space. And, as the thought experiment illustrates, one might assume that distant leakage would be harder to spot than the conventional cross-talk between successively acquired slices in conventional multislice EPI, or errors arising from the PSF more generally. The PSF can usually be interpreted as a local phenomenon, with errors decreasing monotonically from a voxel. Not so with SMS slice separation, meaning there is more risk of interpreting a false positive remote from the true activation site.
At this point we can recognize that reducing leakage is a noble, perhaps essential, goal. As usual with MRI, however, there's a catch. Reducing leakage using the Split Slice GRAPPA reconstruction may come at the cost of increasing in-plane artifacts. The overall (total) artifact level might be higher, too. I'll go into these issues in some detail below. The goal of this post is to perform a rudimentary assessment of the artifacts and determine the circumstances when Split Slice GRAPPA might be preferred over the conventional Slice GRAPPA reconstruction. For the CMRR sequence this amounts to whether or not to enable the Leak Block option.