Quantifying the Financial Savings of Motion Correction in Brain MRI: A Model‐Based Estimate of the Costs Arising From Patient Head Motion and Potential Savings From Implementation of Motion Correction

Accelerated motion correction with deep generative diffusion models

PURPOSE

The aim of this work is to develop a method to solve the ill-posed inverse problem of accelerated image reconstruction while correcting forward model imperfections in the context of subject motion during MRI examinations.

METHODS

The proposed solution uses a Bayesian framework based on deep generative diffusion models to jointly estimate a motion-free image and rigid motion estimates from subsampled and motion-corrupt two-dimensional (2D) k-space data.

RESULTS

We demonstrate the ability to reconstruct motion-free images from accelerated two-dimensional (2D) Cartesian and non-Cartesian scans without any external reference signal. We show that our method improves over existing correction techniques on both simulated and prospectively accelerated data.

CONCLUSION

We propose a flexible framework for retrospective motion correction of accelerated MRI based on deep generative diffusion models, with potential application to other forward model corruptions.

Preliminary Experience with Three Alternative Motion Sensors for 0.55 Tesla MR Imaging

Due to limitations in current motion tracking technologies and increasing interest in alternative sensors for motion tracking both inside and outside the MRI system, in this study we share our preliminary experience with three alternative sensors utilizing diverse technologies and interactions with tissue to monitor motion of the body surface, respiratory-related motion of major organs, and non-respiratory motion of deep-seated organs. These consist of (1) a Pilot-Tone RF transmitter combined with deep learning algorithms for tracking liver motion, (2) a single-channel ultrasound transducer with deep learning for monitoring bladder motion, and (3) a 3D Time-of-Flight camera for observing the motion of the anterior torso surface. Additionally, we demonstrate the capability of these sensors to simultaneously capture motion data outside the MRI environment, which is particularly relevant for procedures like radiation therapy, where motion status could be related to previously characterized cyclical anatomical data. Our findings indicate that the ultrasound sensor can track motion in deep-seated organs (bladder) as well as respiratory-related motion. The Time-of-Flight camera offers ease of interpretation and performs well in detecting surface motion (respiration). The Pilot-Tone demonstrates efficacy in tracking bulk respiratory motion and motion of major organs (liver). Simultaneous use of all three sensors could provide complementary motion information outside the MRI bore, providing potential value for motion tracking during position-sensitive treatments such as radiation therapy.

Unsupervised MRI motion artifact disentanglement: introducing MAUDGAN

Objective.This study developed an unsupervised motion artifact reduction method for magnetic resonance imaging (MRI) images of patients with brain tumors. The proposed novel design uses multi-parametric multicenter contrast-enhanced T1W (ceT1W) and T2-FLAIR MRI images.Approach.The proposed framework included two generators, two discriminators, and two feature extractor networks. A 3-fold cross-validation was used to train and fine-tune the hyperparameters of the proposed model using 230 brain MRI images with tumors, which were then tested on 148 patients'in-vivodatasets. An ablation was performed to evaluate the model's compartments. Our model was compared with Pix2pix and CycleGAN. Six evaluation metrics were reported, including normalized mean squared error (NMSE), structural similarity index (SSIM), multi-scale-SSIM (MS-SSIM), peak signal-to-noise ratio (PSNR), visual information fidelity (VIF), and multi-scale gradient magnitude similarity deviation (MS-GMSD). Artifact reduction and consistency of tumor regions, image contrast, and sharpness were evaluated by three evaluators using Likert scales and compared with ANOVA and Tukey's HSD tests.Main results.On average, our method outperforms comparative models to remove heavy motion artifacts with the lowest NMSE (18.34±5.07%) and MS-GMSD (0.07 ± 0.03) for heavy motion artifact level. Additionally, our method creates motion-free images with the highest SSIM (0.93 ± 0.04), PSNR (30.63 ± 4.96), and VIF (0.45 ± 0.05) values, along with comparable MS-SSIM (0.96 ± 0.31). Similarly, our method outperformed comparative models in removingin-vivomotion artifacts for different distortion levels except for MS- SSIM and VIF, which have comparable performance with CycleGAN. Moreover, our method had a consistent performance for different artifact levels. For the heavy level of motion artifacts, our method got the highest Likert scores of 2.82 ± 0.52, 1.88 ± 0.71, and 1.02 ± 0.14 (p-values≪0.0001) for our method, CycleGAN, and Pix2pix respectively. Similar trends were also found for other motion artifact levels.Significance.Our proposed unsupervised method was demonstrated to reduce motion artifacts from the ceT1W brain images under a multi-parametric framework.

Servo navigators: Linear regression and feedback control for rigid-body motion correction

PURPOSE

Navigator-based correction of rigid-body motion reconciling high precision with minimal acquisition, minimal calibration and simple, fast processing.

METHODS

A short orbital navigator (2.3 ms) is inserted in a three-dimensional (3D) gradient echo sequence for human head imaging. Head rotation and translation are determined by linear regression based on a complex-valued model built either from three reference navigators or in a reference-less fashion, from the first actual navigator. Optionally, the model is expanded by global phase and field offset. Run-time scan correction on this basis establishes servo control that maintains validity of the linear picture by keeping its expansion point stable in the head frame of reference. The technique is assessed in a phantom and demonstrated by motion-corrected imaging in vivo.

RESULTS

The proposed approach is found to establish stable motion control both with and without reference acquisition. In a phantom, it is shown to accurately detect motion mimicked by rotation of scan geometry as well as change in global B0 . It is demonstrated to converge to accurate motion estimates after perturbation well beyond the linear signal range. In vivo, servo navigation achieved motion detection with precision in the single-digit range of micrometers and millidegrees. Involuntary and intentional motion in the range of several millimeters were successfully corrected, achieving excellent image quality.

CONCLUSION

The combination of linear regression and feedback control enables prospective motion correction for head imaging with high precision and accuracy, short navigator readouts, fast run-time computation, and minimal demand for reference data.

MRI motion artifact reduction using a conditional diffusion probabilistic model (MAR-CDPM)

BACKGROUND

High-resolution magnetic resonance imaging (MRI) with excellent soft-tissue contrast is a valuable tool utilized for diagnosis and prognosis. However, MRI sequences with long acquisition time are susceptible to motion artifacts, which can adversely affect the accuracy of post-processing algorithms.

PURPOSE

This study proposes a novel retrospective motion correction method named "motion artifact reduction using conditional diffusion probabilistic model" (MAR-CDPM). The MAR-CDPM aimed to remove motion artifacts from multicenter three-dimensional contrast-enhanced T1 magnetization-prepared rapid acquisition gradient echo (3D ceT1 MPRAGE) brain dataset with different brain tumor types.

MATERIALS AND METHODS

This study employed two publicly accessible MRI datasets: one containing 3D ceT1 MPRAGE and 2D T2-fluid attenuated inversion recovery (FLAIR) images from 230 patients with diverse brain tumors, and the other comprising 3D T1-weighted (T1W) MRI images of 148 healthy volunteers, which included real motion artifacts. The former was used to train and evaluate the model using the in silico data, and the latter was used to evaluate the model performance to remove real motion artifacts. A motion simulation was performed in k-space domain to generate an in silico dataset with minor, moderate, and heavy distortion levels. The diffusion process of the MAR-CDPM was then implemented in k-space to convert structure data into Gaussian noise by gradually increasing motion artifact levels. A conditional network with a Unet backbone was trained to reverse the diffusion process to convert the distorted images to structured data. The MAR-CDPM was trained in two scenarios: one conditioning on the time step t $t$ of the diffusion process, and the other conditioning on both t $t$ and T2-FLAIR images. The MAR-CDPM was quantitatively and qualitatively compared with supervised Unet, Unet conditioned on T2-FLAIR, CycleGAN, Pix2pix, and Pix2pix conditioned on T2-FLAIR models. To quantify the spatial distortions and the level of remaining motion artifacts after applying the models, quantitative metrics were reported including normalized mean squared error (NMSE), structural similarity index (SSIM), multiscale structural similarity index (MS-SSIM), peak signal-to-noise ratio (PSNR), visual information fidelity (VIF), and multiscale gradient magnitude similarity deviation (MS-GMSD). Tukey's Honestly Significant Difference multiple comparison test was employed to quantify the difference between the models where p-value < 0.05 $ < 0.05$ was considered statistically significant.

RESULTS

Qualitatively, MAR-CDPM outperformed these methods in preserving soft-tissue contrast and different brain regions. It also successfully preserved tumor boundaries for heavy motion artifacts, like the supervised method. Our MAR-CDPM recovered motion-free in silico images with the highest PSNR and VIF for all distortion levels where the differences were statistically significant (p-values< 0.05 $< 0.05$ ). In addition, our method conditioned on t and T2-FLAIR outperformed (p-values< 0.05 $< 0.05$ ) other methods to remove motion artifacts from the in silico dataset in terms of NMSE, MS-SSIM, SSIM, and MS-GMSD. Moreover, our method conditioned on only t outperformed generative models (p-values< 0.05 $< 0.05$ ) and had comparable performances compared with the supervised model (p-values> 0.05 $> 0.05$ ) to remove real motion artifacts.

CONCLUSIONS

The MAR-CDPM could successfully remove motion artifacts from 3D ceT1 MPRAGE. It is particularly beneficial for elderly who may experience involuntary movements during high-resolution MRI imaging with long acquisition times.

Prospective motion correction for brain MRI using spherical navigators

PURPOSE

To demonstrate for the first time the feasibility of performing prospective motion correction using spherical navigators (SNAVs).

METHODS

SNAVs were interleaved in a 3D FLASH sequence with an additional short baseline scan (6.8 s) for fast rotation estimation. Assessment of SNAV-based prospective motion correction was performed in six volunteers. Participant motion was guided using randomly generated stepwise prompts as well as prompts derived from real motion cases. Experiments were performed on a 3 T MRI scanner using a 32-channel head coil.

RESULTS

When optimized for real-time application, SNAV-based motion estimates were computed in 25.8 ± 1.3 ms. Phantom-based quantification of rotation and translation accuracy indicated mean absolute errors of 0.10 ± 0.09° and 0.25 ± 0.14 mm, respectively. Implementing SNAV-based motion estimates for prospective motion correction led to a clear improvement in image quality with minimal increase in scan time (<5%).

CONCLUSION

Optimization of SNAV processing for real-time application enables prospective motion correction with low latency and minimal scan time requirements.

Rapid motion estimation and correction using self-encoded FID navigators in 3D radial MRI

PURPOSE

To develop a self-navigated motion compensation strategy for 3D radial MRI that can compensate for continuous head motion by measuring rigid body motion parameters with high temporal resolution from the central k-space acquisition point (self-encoded FID navigator) in each radial spoke.

METHODS

A forward model was created from low-resolution calibration data to simulate the effect of relative motion between the coil sensitivity profiles and the underlying object on the self-encoded FID navigator signal. Trajectory deviations were included in the model as low spatial-order field variations. Three volunteers were imaged at 3 T using a modified 3D gradient-echo sequence acquired with a Kooshball trajectory while performing abrupt and continuous head motion. Rigid body-motion parameters were estimated from the central k-space signal of each spoke using a least-squares fitting algorithm. The accuracy of self-navigated motion parameters was assessed relative to an established external tracking system. Quantitative image quality metrics were computed for images with and without retrospective correction using external and self-navigated motion measurements.

RESULTS

Self-encoded FID navigators achieved mean absolute errors of 0.69 ± 0.82 mm and 0.73 ± 0.87° relative to external tracking for maximum motion amplitudes of 12 mm and 10°. Retrospective correction of the 3D radial data resulted in substantially improved image quality for both abrupt and continuous motion paradigms, comparable to external tracking results.

CONCLUSIONS

Accurate rigid body motion parameters can be rapidly obtained from self-encoded FID navigator signals in 3D radial MRI to continuously correct for head movements. This approach is suitable for robust neuroanatomical imaging in subjects that exhibit patterns of large and frequent motion.

Correcting synthetic MRI contrast-weighted images using deep learning

Synthetic magnetic resonance imaging (MRI) offers a scanning paradigm where a fast multi-contrast sequence can be used to estimate underlying quantitative tissue parameter maps, which are then used to synthesize any desirable clinical contrast by retrospectively changing scan parameters in silico. Two benefits of this approach are the reduced exam time and the ability to generate arbitrary contrasts offline. However, synthetically generated contrasts are known to deviate from the contrast of experimental scans. The reason for contrast mismatch is the necessary exclusion of some unmodeled physical effects such as partial voluming, diffusion, flow, susceptibility, magnetization transfer, and more. The inclusion of these effects in signal encoding would improve the synthetic images, but would make the quantitative imaging protocol impractical due to long scan times. Therefore, in this work, we propose a novel deep learning approach that generates a multiplicative correction term to capture unmodeled effects and correct the synthetic contrast images to better match experimental contrasts for arbitrary scan parameters. The physics inspired deep learning model implicitly accounts for some unmodeled physical effects occurring during the scan. As a proof of principle, we validate our approach on synthesizing arbitrary inversion recovery fast spin-echo scans using a commercially available 2D multi-contrast sequence. We observe that the proposed correction visually and numerically reduces the mismatch with experimentally collected contrasts compared to conventional synthetic MRI. Finally, we show results of a preliminary reader study and find that the proposed method statistically significantly improves in contrast and SNR as compared to synthetic MR images.

Robust retrospective motion correction of head motion using navigator-based and markerless motion tracking techniques

PURPOSE

This study investigated the artifacts arising from different types of head motion in brain MR images and how well these artifacts can be compensated using retrospective correction based on two different motion-tracking techniques.

METHODS

MPRAGE images were acquired using a 3 T MR scanner on a cohort of nine healthy participants. Subjects moved their head to generate circular motion (4 or 6 cycles/min), stepwise motion (small and large) and "simulated realistic" motion (nodding and slow diagonal motion), based on visual instructions. One MPRAGE scan without deliberate motion was always acquired as a "no motion" reference. Three dimensional fat-navigator (FatNavs) and a Tracoline markerless device (TracInnovations) were used to obtain motion estimates and images were separately reconstructed retrospectively from the raw data based on these different motion estimates.

RESULTS

Image quality was recovered from both motion tracking techniques in our stepwise and slow diagonal motion scenarios in almost all cases, with the apparent visual image quality comparable to the no-motion case. FatNav-based motion correction was further improved in the case of stepwise motion using a skull masking procedure to exclude non-rigid motion of the neck from the co-registration step. In the case of circular motion, both methods struggled to correct for all motion artifacts.

CONCLUSION

High image quality could be recovered in cases of stepwise and slow diagonal motion using both motion estimation techniques. The circular motion scenario led to more severe image artifacts that could not be fully compensated by the retrospective motion correction techniques used.

Quantifying MR Head Motion in the Rhineland Study - A Robust Method for Population Cohorts

Head motion during MR acquisition reduces image quality and has been shown to bias neuromorphometric analysis. The quantification of head motion, therefore, has both neuroscientific as well as clinical applications, for example, to control for motion in statistical analyses of brain morphology, or as a variable of interest in neurological studies. The accuracy of markerless optical head tracking, however, is largely unexplored. Furthermore, no quantitative analysis of head motion in a general, mostly healthy population cohort exists thus far. In this work, we present a robust registration method for the alignment of depth camera data that sensitively estimates even small head movements of compliant participants. Our method outperforms the vendor-supplied method in three validation experiments: 1. similarity to fMRI motion traces as a low-frequency reference, 2. recovery of the independently acquired breathing signal as a high-frequency reference, and 3. correlation with image-based quality metrics in structural T1-weighted MRI. In addition to the core algorithm, we establish an analysis pipeline that computes average motion scores per time interval or per sequence for inclusion in downstream analyses. We apply the pipeline in the Rhineland Study, a large population cohort study, where we replicate age and body mass index (BMI) as motion correlates and show that head motion significantly increases over the duration of the scan session. We observe weak, yet significant interactions between this within-session increase and age, BMI, and sex. High correlations between fMRI and camera-based motion scores of proceeding sequences further suggest that fMRI motion estimates can be used as a surrogate score in the absence of better measures to control for motion in statistical analyses.

External Hardware and Sensors, for Improved MRI

Complex engineered systems are often equipped with suites of sensors and ancillary devices that monitor their performance and maintenance needs. MRI scanners are no different in this regard. Some of the ancillary devices available to support MRI equipment, the ones of particular interest here, have the distinction of actually participating in the image acquisition process itself. Most commonly, such devices are used to monitor physiological motion or variations in the scanner's imaging fields, allowing the imaging and/or reconstruction process to adapt as imaging conditions change. "Classic" examples include electrocardiography (ECG) leads and respiratory bellows to monitor cardiac and respiratory motion, which have been standard equipment in scan rooms since the early days of MRI. Since then, many additional sensors and devices have been proposed to support MRI acquisitions. The main physical properties that they measure may be primarily "mechanical" (eg acceleration, speed, and torque), "acoustic" (sound and ultrasound), "optical" (light and infrared), or "electromagnetic" in nature. A review of these ancillary devices, as currently available in clinical and research settings, is presented here. In our opinion, these devices are not in competition with each other: as long as they provide useful and unique information, do not interfere with each other and are not prohibitively cumbersome to use, they might find their proper place in future suites of sensors. In time, MRI acquisitions will likely include a plurality of complementary signals. A little like the microbiome that provides genetic diversity to organisms, these devices can provide signal diversity to MRI acquisitions and enrich measurements. Machine-learning (ML) algorithms are well suited at combining diverse input signals toward coherent outputs, and they could make use of all such information toward improved MRI capabilities. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 1.

Evaluation of the Aggregated Time Savings in Adopting Fast Brain MRI Techniques for Outpatient Brain MRI

INTRODUCTION

Clinical validation studies have demonstrated the ability of accelerated MRI sequences to decrease acquisition time and motion artifact while preserving image quality. The operational benefits, however, have been less explored. Here, we report our initial clinical experience in implementing fast MRI techniques for outpatient brain imaging during the COVID-19 pandemic.

METHODS

Aggregate acquisition times were extracted from the medical record on consecutive imaging examinations performed during matched pre-implementation (7/1/2019-12/31/2019) and post-implementation periods (7/1/2020-12/31/2020). Expected acquisition time reduction for each MRI protocol was calculated through manual collection of acquisition times for the conventional and accelerated sequences performed during the pre- and post-implementation periods. Aggregate and expected acquisition times were compared for the five most frequently performed brain MRI protocols: brain without contrast (BR-), brain with and without contrast (BR+), multiple sclerosis (MS), memory loss (MML), and epilepsy (EPL).

RESULTS

The expected time reductions for BR-, BR+, MS, MML, and EPL protocols were 6.6 min, 11.9 min, 14 min, 10.8 min, and 14.1 min, respectively. The overall median aggregate acquisition time was 31 [25, 36] min for the pre-implementation period and 18 [15, 22] min for the post-implementation period, with a difference of 13 min (42%). The median acquisition time was reduced by 4 min (25%) for BR-, 14.0 min (44%) for BR+, 14 min (38%) for MS, 11 min (52%) for MML, and 16 min (35%) for EPL.

CONCLUSION

The implementation of fast brain MRI sequences significantly reduced the acquisition times for the most commonly performed outpatient brain MRI protocols.

Deep learning-based motion quantification from k-space for fast model-based magnetic resonance imaging motion correction

BACKGROUND

Intra-scan rigid-body motion is a costly and ubiquitous problem in clinical magnetic resonance imaging (MRI) of the head.

PURPOSE

State-of-the-art methods for retrospective motion correction in MRI are often computationally expensive or in the case of image-to-image deep learning (DL) based methods can be prone to undesired alterations of the image (hallucinations'). In this work we introduce a novel rigid-body motion correction method which combines the advantages of classical model-driven and data-consistency (DC) preserving approaches with a novel DL algorithm, to provide fast and robust retrospective motion correction.

METHODS

The proposed Motion Parameter Estimating Densenet (MoPED) retrospectively estimates subject head motion during MRI acquisitions using a DL network with DenseBlocks and multitask learning. It quantifies the 2D rigid in-plane motion parameters slice-wise for each echo train (ET) of a Cartesian T2-weighted 2D Turbo-Spin-Echo sequence. The network receives a center patch of the motion corrupted k-space as well as an additional motion-free low-resolution reference scan to provide the ground truth orientation. The supervised training utilizes motion simulations based on 28 acquisitions with subject-wise training, validation, and test data splits of 70%, 23%, and 7%. During inference, MoPED is embedded in an iterative DC-driven motion correction algorithm which alternatingly updates estimates of the motion parameters and motion-corrected low-resolution k-space data. The estimated motion parameters are then used to reconstruct the final motion corrected image. The mean absolute/squared error and the Pearson correlation coefficient were used to analyze the motion parameter estimation quality on in-silico data in a quantitative evaluation. Structural similarity (SSIM), DC error and root mean squared error (RMSE) were used as metrics of image quality improvement. Furthermore, the generalization capability of the network was analyzed on two in-vivo motion volumes with 28 slices each and on one simulated T1-weighted volume.

RESULTS

The motion estimation achieves a Pearson correlation of 0.968 to the simulated ground-truth of the 2433 test data slices used. In-silico results indicate that MoPED decreases the time for the optimization by a factor of around 27 compared to a conventional method and is able to reduce the RMSE of the reconstructions and average DC error by more than a factor of two compared to uncorrected images. In-vivo experiments show a decrease in computation time by a factor of around 20, a RMSE decrease from 0.055 to 0.033 and an SSIM increase from 0.795 to 0.862. Furthermore, contrast independence is demonstrated as MoPED is also able to correct T1-weighted images in simulations without retraining. Due to the model-based correction, no hallucinations were observed.

CONCLUSIONS

Incorporating DL in a model-based motion correction algorithm shows great benefit on the optimization and computation time. The k-space-based estimation also allows a data consistent correction and therefore avoids the risk of hallucinations of image-to-image approaches.

Accuracy investigations for volumetric head-motion navigators with and without EPI at 7 T

Purpose

Accuracy investigation of volumetric navigators for motion correction, with emphasis on geometric EPI distortions at ultrahigh field.

Methods

High‐resolution Dixon images were collected in different head positions and reconstructed to water, fat, T₂*, and B₀ maps. Resolution reduction was performed, and the T₂* and B₀ maps were used to apply effects of TE and EPI distortions to simulate various volumetric water and fat navigators. Registrations of the simulated navigators were compared with registrations of the original high‐resolution images.

Results

Increased accuracy was observed with increased spatial resolution for non‐EPI navigators. When using EPI, the distortions had a negative effect on registration accuracy, which was most noticeable for high‐resolution navigators. Parallel imaging helped to alleviate those caveats to a certain extent, and 5‐fold acceleration gave close to similar accuracy to non‐EPI in most cases. Shortening the TE by partial Fourier sampling was shown to be mostly beneficial, except for water navigators with long readout durations. The EPI blip direction had an influence on navigator accuracy, and positive blip gradient polarities (yielding mostly image stretching frontally) typically gave the best accuracy for water navigators, whereas no clear recommendation could be made for fat navigators. Generally, fat EPI navigators had lower accuracy than water EPI navigators with otherwise similar parameters.

Conclusions

Echo planar imaging has been widely used for MRI navigators, but the induced distortions reduce navigator accuracy at ultrahigh field. This study can help protocol optimization and guide the complex tradeoff between resolution and EPI acceleration in navigator parameter setup.

Motion corrected silent ZTE neuroimaging

Purpose

To develop self‐navigated motion correction for 3D silent zero echo time (ZTE) based neuroimaging and characterize its performance for different types of head motion.

Methods

The proposed method termed MERLIN (Motion Estimation & Retrospective correction Leveraging Interleaved Navigators) achieves self‐navigation by using interleaved 3D phyllotaxis k‐space sampling. Low resolution navigator images are reconstructed continuously throughout the ZTE acquisition using a sliding window and co‐registered in image space relative to a fixed reference position. Rigid body motion corrections are then applied retrospectively to the k‐space trajectory and raw data and reconstructed into a final, high‐resolution ZTE image.

Results

MERLIN demonstrated successful and consistent motion correction for magnetization prepared ZTE images for a range of different instructed motion paradigms. The acoustic noise response of the self‐navigated phyllotaxis trajectory was found to be only slightly above ambient noise levels (<4 dBA).

Conclusion

Silent ZTE imaging combined with MERLIN addresses two major challenges intrinsic to MRI (i.e., subject motion and acoustic noise) in a synergistic and integrated manner without increase in scan time and thereby forms a versatile and powerful framework for clinical and research MR neuroimaging applications.

Comparison of prospective and retrospective motion correction in 3D-encoded neuroanatomical MRI

PURPOSE

To compare prospective motion correction (PMC) and retrospective motion correction (RMC) in Cartesian 3D-encoded MPRAGE scans and to investigate the effects of correction frequency and parallel imaging on the performance of RMC.

METHODS

Head motion was estimated using a markerless tracking system and sent to a modified MPRAGE sequence, which can continuously update the imaging FOV to perform PMC. The prospective correction was applied either before each echo train (before-ET) or at every sixth readout within the ET (within-ET). RMC was applied during image reconstruction by adjusting k-space trajectories according to the measured motion. The motion correction frequency was retrospectively increased with RMC or decreased with reverse RMC. Phantom and in vivo experiments were used to compare PMC and RMC, as well as to compare within-ET and before-ET correction frequency during continuous motion. The correction quality was quantitatively evaluated using the structural similarity index measure with a reference image without motion correction and without intentional motion.

RESULTS

PMC resulted in superior image quality compared to RMC both visually and quantitatively. Increasing the correction frequency from before-ET to within-ET reduced the motion artifacts in RMC. A hybrid PMC and RMC correction, that is, retrospectively increasing the correction frequency of before-ET PMC to within-ET, also reduced motion artifacts. Inferior performance of RMC compared to PMC was shown with GRAPPA calibration data without intentional motion and without any GRAPPA acceleration.

CONCLUSION

Reductions in local Nyquist violations with PMC resulted in superior image quality compared to RMC. Increasing the motion correction frequency to within-ET reduced the motion artifacts in both RMC and PMC.

Characterisation of Children's Head Motion for Magnetic Resonance Imaging With and Without General Anaesthesia

Head motion is one of the major reasons for artefacts in Magnetic Resonance Imaging (MRI), which is especially challenging for children who are often intimidated by the dimensions of the MR scanner. In order to optimise the MRI acquisition for children in the clinical setting, insights into children's motion patterns are essential. In this work, we analyse motion data from 61 paediatric patients. We compare structural MRI data of children imaged with and without general anaesthesia (GA), all scanned using the same hybrid PET/MR scanner. We analyse several metrics of motion based on the displacement relative to a reference, decompose the transformation matrix into translation and rotation, as well as investigate whether different regions in the brain are affected differently by the children's motion. Head motion for children without GA was significantly higher, with a median of the mean displacements of 2.19 ± 0.93 mm (median ± standard deviation) during 41.7±7.5 min scans; however, even anaesthetised children showed residual head motion (mean displacement of 1.12±0.35 mm). For both patient groups translation along the z-axis (along the scanner bore) was significantly larger in absolute terms (GA / no GA: 0.87±0.29/0.92 ± 0.49 mm) compared to the other directions. Considering directionality, both patient groups were moving in negative z-direction and thus, out of the scanner. The awake children additionally showed significantly more nodding rotation (0.33±0.20°). In future studies as well as in the clinical setting, these predominant types of motion need to be taken into consideration to limit artefacts and reduce re-scans due to poor image quality.

Combining prospective and retrospective motion correction based on a model for fast continuous motion

PURPOSE

Prospective motion correction (PMC) and retrospective motion correction (RMC) have different advantages and limitations. The present work aims to combine the advantages of both for rigid body motion, aiming at correcting for faster motions than was previously achievable. Additionally, it provides insights into the effects of motion on pulse sequences and MR signals with a goal of further improving motion correction in the future.

METHODS

The effective encoding trajectory and a global phase offset in a moving object are calculated based on complete gradient waveforms of an arbitrary sequence and a continuous motion model. These data are used to feed the forward signal model, which is then used in iterative image reconstruction to suppress the artifacts still present after the PMC.

RESULTS

Verification experiments with a rotation phantom and in vivo were performed. Predictions of simulated motion artifacts for PMC based on sequence waveforms are very accurate. The performance at combined PMC+RMC is limited by Nyquist violations in the sampled k-space and can be compensated by oversampling.

CONCLUSION

The combined correction results in better images than pure PMC in the presence of fast motion. The predictions of artifacts are very accurate, allowing for comparing sequences or protocols in simulations. The observed artifacts due to Nyquist violations are expected to be corrected by utilizing parallel imaging.

Free induction decay navigator motion metrics for prediction of diagnostic image quality in pediatric MRI

Purpose

To investigate the ability of free induction decay navigator (FIDnav)‐based motion monitoring to predict diagnostic utility and reduce the time and cost associated with acquiring diagnostically useful images in a pediatric patient cohort.

Methods

A study was carried out in 102 pediatric patients (aged 0‐18 years) at 3T using a 32‐channel head coil array. Subjects were scanned with an FID‐navigated MPRAGE sequence and images were graded by two radiologists using a five‐point scale to evaluate the impact of motion artifacts on diagnostic image quality. The correlation between image quality and four integrated FIDnav motion metrics was investigated, as well as the sensitivity and specificity of each FIDnav‐based metric to detect different levels of motion corruption in the images. Potential time and cost savings were also assessed by retrospectively applying an optimal detection threshold to FIDnav motion scores.

Results

A total of 12% of images were rated as non‐diagnostic, while a further 12% had compromised diagnostic value due to motion artifacts. FID‐navigated metrics exhibited a moderately strong correlation with image grade (Spearman's rho ≥ 0.56). Integrating the cross‐correlation between FIDnav signal vectors achieved the highest sensitivity and specificity for detecting non‐diagnostic images, yielding total time savings of 7% across all scans. This corresponded to a financial benefit of $2080 in this study.

Conclusions

Our results indicate that integrated motion metrics from FIDnavs embedded in structural MRI are a useful predictor of diagnostic image quality, which translates to substantial time and cost savings when applied to pediatric MRI examinations.

Prospective motion correction for diffusion weighted EPI of the brain using an optical markerless tracker

PURPOSE

To enable motion-robust diffusion weighted imaging of the brain using well-established imaging techniques.

METHODS

An optical markerless tracking system was used to estimate and correct for rigid body motion of the head in real time during scanning. The imaging coordinate system was updated before each excitation pulse in a single-shot EPI sequence accelerated by GRAPPA with motion-robust calibration. Full Fourier imaging was used to reduce effects of motion during diffusion encoding. Subjects were imaged while performing prescribed motion patterns, each repeated with prospective motion correction on and off.

RESULTS

Prospective motion correction with dynamic ghost correction enabled high quality DWI in the presence of fast and continuous motion within a 10° range. Images acquired without motion were not degraded by the prospective correction. Calculated diffusion tensors tolerated the motion well, but ADC values were slightly increased.

CONCLUSIONS

Prospective correction by markerless optical tracking minimizes patient interaction and appears to be well suited for EPI-based DWI of patient groups unable to remain still including those who are not compliant with markers.

Prevalence and Financial Impact of Claustrophobia, Anxiety, Patient Motion, and Other Patient Events in Magnetic Resonance Imaging

Claustrophobia, other anxiety reactions, excessive motion, and other unanticipated patient events in magnetic resonance imaging (MRI) not only delay or preclude diagnostic-quality imaging but can also negatively affect the patient experience. In addition, by impeding MRI workflow, they may affect the finances of an imaging practice. This review article offers an overview of the various types of patient-related unanticipated events that occur in MRI, along with estimates of their frequency of occurrence as documented in the available literature. In addition, the financial implications of these events are discussed from a microeconomic perspective, primarily from the point of view of a radiology practice or hospital, although associated limitations and other economic viewpoints are also included. Efforts to minimize these unanticipated patient events can potentially improve not only patient satisfaction and comfort but also an imaging practice's operational efficiency and diagnostic capabilities.