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Xiang J, Lamy J, Qiu M, Galiana G, Peters DC. K-t PCA accelerated in-plane balanced steady-state free precession phase-contrast (PC-SSFP) for all-in-one diastolic function evaluation. Magn Reson Med 2024; 91:911-925. [PMID: 37927206 PMCID: PMC10803002 DOI: 10.1002/mrm.29897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE Diastolic function evaluation requires estimates of early and late diastolic mitral filling velocities (E and A) and of mitral annulus tissue velocity (e'). We aimed to develop an MRI method for simultaneous all-in-one diastolic function evaluation in a single scan by generating a 2D phase-contrast (PC) sequence with balanced steady-state free precession (bSSFP) contrast (PC-SSFP). E and A could then be measured with PC, and e' estimated by valve tracking on the magnitude images, using an established deep learning framework. METHODS Our PC-SSFP used in-plane flow-encoding, with zeroth and first moment nulling over each TR. For further acceleration, different k-t principal component analysis (PCA) methods were investigated with both retrospective and prospective undersampling. PC-SSFP was compared to separate balanced SSFP cine and PC-gradient echo acquisitions in phantoms and in 10 healthy subjects. RESULTS Phantom experiments showed that PC-SSFP measured accurate velocities compared to PC-gradient echo (r = 0.98 for a range of pixel-wise velocities -80 cm/s to 80 cm/s). In subjects, PC-SSFP generated high SNR and myocardium-blood contrast, and excellent agreement for E (limits of agreement [LOA] 0.8 ± 2.4 cm/s, r = 0.98), A (LOA 2.5 ± 4.1 cm/s, r = 0.97), and e' (LOA 0.3 ± 2.6 cm/s, r = 1.00), versus the standard methods. The best k-t PCA approach processed the complex difference data and substituted in raw k-space data. With prospective k-t PCA acceleration, higher frame rates were achieved (50 vs. 25 frames per second without k-t PCA), yielding a 13% higher e'. CONCLUSION The proposed PC-SSFP method achieved all-in-one diastolic function evaluation.
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Affiliation(s)
- Jie Xiang
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States
| | - Jerome Lamy
- Université de Paris, Cardiovascular Research Center, INSERM, 75015 Paris, France
| | - Maolin Qiu
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, United States
| | - Gigi Galiana
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, United States
| | - Dana C. Peters
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, United States
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Demirel OB, Yaman B, Shenoy C, Moeller S, Weingärtner S, Akçakaya M. Signal intensity informed multi-coil encoding operator for physics-guided deep learning reconstruction of highly accelerated myocardial perfusion CMR. Magn Reson Med 2023; 89:308-321. [PMID: 36128896 PMCID: PMC9617789 DOI: 10.1002/mrm.29453] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/21/2022] [Accepted: 08/21/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE To develop a physics-guided deep learning (PG-DL) reconstruction strategy based on a signal intensity informed multi-coil (SIIM) encoding operator for highly-accelerated simultaneous multislice (SMS) myocardial perfusion cardiac MRI (CMR). METHODS First-pass perfusion CMR acquires highly-accelerated images with dynamically varying signal intensity/SNR following the administration of a gadolinium-based contrast agent. Thus, using PG-DL reconstruction with a conventional multi-coil encoding operator leads to analogous signal intensity variations across different time-frames at the network output, creating difficulties in generalization for varying SNR levels. We propose to use a SIIM encoding operator to capture the signal intensity/SNR variations across time-frames in a reformulated encoding operator. This leads to a more uniform/flat contrast at the output of the PG-DL network, facilitating generalizability across time-frames. PG-DL reconstruction with the proposed SIIM encoding operator is compared to PG-DL with conventional encoding operator, split slice-GRAPPA, locally low-rank (LLR) regularized reconstruction, low-rank plus sparse (L + S) reconstruction, and regularized ROCK-SPIRiT. RESULTS Results on highly accelerated free-breathing first pass myocardial perfusion CMR at three-fold SMS and four-fold in-plane acceleration show that the proposed method improves upon the reconstruction methods use for comparison. Substantial noise reduction is achieved compared to split slice-GRAPPA, and aliasing artifacts reduction compared to LLR regularized reconstruction, L + S reconstruction and PG-DL with conventional encoding. Furthermore, a qualitative reader study indicated that proposed method outperformed all methods. CONCLUSION PG-DL reconstruction with the proposed SIIM encoding operator improves generalization across different time-frames /SNRs in highly accelerated perfusion CMR.
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Affiliation(s)
- Omer Burak Demirel
- Department of Electrical and Computer EngineeringUniversity of MinnesotaMinneapolisMinnesotaUSA,Center for Magnetic Resonance ResearchUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Burhaneddin Yaman
- Department of Electrical and Computer EngineeringUniversity of MinnesotaMinneapolisMinnesotaUSA,Center for Magnetic Resonance ResearchUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Chetan Shenoy
- Department of Medicine (Cardiology)University of MinnesotaMinneapolisMinnesotaUSA
| | - Steen Moeller
- Center for Magnetic Resonance ResearchUniversity of MinnesotaMinneapolisMinnesotaUSA
| | | | - Mehmet Akçakaya
- Department of Electrical and Computer EngineeringUniversity of MinnesotaMinneapolisMinnesotaUSA,Center for Magnetic Resonance ResearchUniversity of MinnesotaMinneapolisMinnesotaUSA
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3
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Károlyi M, Gotschy A, Polacin M, Plein S, Paetsch I, Jahnke C, Frick M, Gebker R, Alkadhi H, Kozerke S, Manka R. Diagnostic performance of 3D cardiac magnetic resonance perfusion in elderly patients for the detection of coronary artery disease as compared to fractional flow reserve. Eur Radiol 2022; 33:339-347. [PMID: 35984513 DOI: 10.1007/s00330-022-09040-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/09/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES In patients of advanced age, the feasibility of myocardial ischemia testing might be limited by age-related comorbidities and falling compliance abilities. Therefore, we aimed to test the accuracy of 3D cardiac magnetic resonance (CMR) stress perfusion in the elderly population as compared to reference standard fractional flow reserve (FFR). METHODS Fifty-six patients at age 75 years or older (mean age 79 ± 4 years, 35 male) underwent 3D CMR perfusion imaging and invasive coronary angiography with FFR in 5 centers using the same study protocol. The diagnostic accuracy of CMR was compared to a control group of 360 patients aged below 75 years (mean age 61 ± 9 years, 262 male). The percentage of myocardial ischemic burden (MIB) relative to myocardial scar burden was further analyzed using semi-automated software. RESULTS Sensitivity, specificity, and positive and negative predictive values of 3D perfusion CMR deemed similar for both age groups in the detection of hemodynamically relevant (FFR < 0.8) stenosis (≥ 75 years: 86%, 83%, 92%, and 75%; < 75 years: 87%, 80%, 82%, and 85%; p > 0.05 all). While MIB was larger in the elderly patients (15% ± 17% vs. 9% ± 13%), the diagnostic accuracy of 3D CMR perfusion was high in both elderly and non-elderly populations to predict pathological FFR (AUC: 0.906 and 0.866). CONCLUSIONS 3D CMR perfusion has excellent diagnostic accuracy for the detection of hemodynamically relevant coronary stenosis, independent of patient age. KEY POINTS • The increasing prevalence of coronary artery disease in elderly populations is accompanied with a larger ischemic burden of the myocardium as compared to younger individuals. • 3D cardiac magnetic resonance perfusion imaging predicts pathological fractional flow reserve in elderly patients aged ≥ 75 years with high diagnostic accuracy. • Ischemia testing with 3D CMR perfusion imaging has similarly high accuracy in the elderly as in younger patients and it might be particularly useful when other non-invasive techniques are limited by aging-related comorbidities and falling compliance abilities.
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Affiliation(s)
- Mihály Károlyi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Alexander Gotschy
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Malgorzata Polacin
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sven Plein
- Multidisciplinary Cardiovascular Research Centre & the Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Ingo Paetsch
- Department of Electrophysiology, HELIOS Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | - Cosima Jahnke
- Department of Electrophysiology, HELIOS Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | - Michael Frick
- Department of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | | | - Hatem Alkadhi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Robert Manka
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. .,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland. .,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.
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4
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Hoh T, Vishnevskiy V, Polacin M, Manka R, Fuetterer M, Kozerke S. Free-breathing motion-informed locally low-rank quantitative 3D myocardial perfusion imaging. Magn Reson Med 2022; 88:1575-1591. [PMID: 35713206 PMCID: PMC9544898 DOI: 10.1002/mrm.29295] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/30/2022] [Accepted: 04/19/2022] [Indexed: 12/30/2022]
Abstract
Purpose To propose respiratory motion‐informed locally low‐rank reconstruction (MI‐LLR) for robust free‐breathing single‐bolus quantitative 3D myocardial perfusion CMR imaging. Simulation and in‐vivo results are compared to locally low‐rank (LLR) and compressed sensing reconstructions (CS) for reference. Methods Data were acquired using a 3D Cartesian pseudo‐spiral in‐out k‐t undersampling scheme (R = 10) and reconstructed using MI‐LLR, which encompasses two stages. In the first stage, approximate displacement fields are derived from an initial LLR reconstruction to feed a motion‐compensated reference system to a second reconstruction stage, which reduces the rank of the inverse problem. For comparison, data were also reconstructed with LLR and frame‐by‐frame CS using wavelets as sparsifying transform (ℓ1‐wavelet). Reconstruction accuracy relative to ground truth was assessed using synthetic data for realistic ranges of breathing motion, heart rates, and SNRs. In‐vivo experiments were conducted in healthy subjects at rest and during adenosine stress. Myocardial blood flow (MBF) maps were derived using a Fermi model. Results Improved uniformity of MBF maps with reduced local variations was achieved with MI‐LLR. For rest and stress, intra‐volunteer variation of absolute and relative MBF was lower in MI‐LLR (±0.17 mL/g/min [26%] and ±1.07 mL/g/min [33%]) versus LLR (±0.19 mL/g/min [28%] and ±1.22 mL/g/min [36%]) and versus ℓ1‐wavelet (±1.17 mL/g/min [113%] and ±6.87 mL/g/min [115%]). At rest, intra‐subject MBF variation was reduced significantly with MI‐LLR. Conclusion The combination of pseudo‐spiral Cartesian undersampling and dual‐stage MI‐LLR reconstruction improves free‐breathing quantitative 3D myocardial perfusion CMR imaging under rest and stress condition. Click here for author‐reader discussions
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Affiliation(s)
- Tobias Hoh
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Valery Vishnevskiy
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Malgorzata Polacin
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Robert Manka
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Maximilian Fuetterer
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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5
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Tourais J, Scannell CM, Schneider T, Alskaf E, Crawley R, Bosio F, Sanchez-Gonzalez J, Doneva M, Schülke C, Meineke J, Keupp J, Smink J, Breeuwer M, Chiribiri A, Henningsson M, Correia T. High-Resolution Free-Breathing Quantitative First-Pass Perfusion Cardiac MR Using Dual-Echo Dixon With Spatio-Temporal Acceleration. Front Cardiovasc Med 2022; 9:884221. [PMID: 35571164 PMCID: PMC9099052 DOI: 10.3389/fcvm.2022.884221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/04/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction To develop and test the feasibility of free-breathing (FB), high-resolution quantitative first-pass perfusion cardiac MR (FPP-CMR) using dual-echo Dixon (FOSTERS; Fat-water separation for mOtion-corrected Spatio-TEmporally accelerated myocardial peRfuSion). Materials and Methods FOSTERS was performed in FB using a dual-saturation single-bolus acquisition with dual-echo Dixon and a dynamically variable Cartesian k-t undersampling (8-fold) approach, with low-rank and sparsity constrained reconstruction, to achieve high-resolution FPP-CMR images. FOSTERS also included automatic in-plane motion estimation and T2* correction to obtain quantitative myocardial blood flow (MBF) maps. High-resolution (1.6 x 1.6 mm2) FB FOSTERS was evaluated in eleven patients, during rest, against standard-resolution (2.6 x 2.6 mm2) 2-fold SENSE-accelerated breath-hold (BH) FPP-CMR. In addition, MBF was computed for FOSTERS and spatial wavelet-based compressed sensing (CS) reconstruction. Two cardiologists scored the image quality (IQ) of FOSTERS, CS, and standard BH FPP-CMR images using a 4-point scale (1–4, non-diagnostic – fully diagnostic). Results FOSTERS produced high-quality images without dark-rim and with reduced motion-related artifacts, using an 8x accelerated FB acquisition. FOSTERS and standard BH FPP-CMR exhibited excellent IQ with an average score of 3.5 ± 0.6 and 3.4 ± 0.6 (no statistical difference, p > 0.05), respectively. CS images exhibited severe artifacts and high levels of noise, resulting in an average IQ score of 2.9 ± 0.5. MBF values obtained with FOSTERS presented a lower variance than those obtained with CS. Discussion FOSTERS enabled high-resolution FB FPP-CMR with MBF quantification. Combining motion correction with a low-rank and sparsity-constrained reconstruction results in excellent image quality.
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Affiliation(s)
- Joao Tourais
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of MR R&D – Clinical Science, Philips Healthcare, Best, Netherlands
- Department of Imaging Physics, Magnetic Resonance Systems Lab, Delft University of Technology, Delft, Netherlands
| | - Cian M. Scannell
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | | | - Ebraham Alskaf
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Richard Crawley
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Filippo Bosio
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | | | | | | | | | | | - Jouke Smink
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Marcel Breeuwer
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of MR R&D – Clinical Science, Philips Healthcare, Best, Netherlands
| | - Amedeo Chiribiri
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Markus Henningsson
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linkoping University, Linkoping, Sweden
| | - Teresa Correia
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Centre for Marine Sciences (CCMAR), Faro, Portugal
- *Correspondence: Teresa Correia
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Liu J, Jin S, Li Q, Zhang K, Yu J, Mo Y, Bian Z, Gao Y, Zhang H. Motion compensation combining with local low rank regularization for low dose dynamic CT myocardial perfusion reconstruction. Phys Med Biol 2021; 66. [PMID: 34181588 DOI: 10.1088/1361-6560/ac0f2f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/28/2021] [Indexed: 11/11/2022]
Abstract
Dynamic CT myocardial perfusion imaging (DCT-MPI) is a reliable examination tool for the assessment of myocardium and vascular, while its special scan protocol may result in excessive radiation exposure to patients and inevitable inter-frame motion. Lowering the tube current is a simple way to reduce radiation exposure. However, low mAs will certainly cause severe image noise, thus may further impact the accuracy of functional hemodynamic parameters, which are used for the assessment of blood supply. In this work, we present a novel scheme applying motion compensation and local low rank regularization (MC-LLR) for obtaining high quality motion compensated DCT-MPI images. Specifically, motion compensation by using robust data decomposition registration (RDDR) was introduced. Robust principal component analysis coupled with optical flow-based registration algorithm were used in RDDR. Then, the local low rank constraint on the motion compensated time series images was applied for the DCT-MPI reconstruction. One healthy mini pig and two patient datasets were used to evaluate the proposed MC-LLR algorithm. Results show that the present method achieved satisfactory image quality with higher CNRs, smaller rRMSEs, and more accurate hemodynamic parameter maps.
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Affiliation(s)
- Jia Liu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, People's Republic of China
| | - Shuang Jin
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, People's Republic of China
| | - Qian Li
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, People's Republic of China
| | - Kunpeng Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, People's Republic of China
| | - Jiahong Yu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, People's Republic of China
| | - Ying Mo
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, People's Republic of China
| | - Zhaoying Bian
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, People's Republic of China
| | - Yang Gao
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, People's Republic of China
| | - Hua Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, People's Republic of China
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7
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Fair MJ, Gatehouse PD, Reyes E, Adluru G, Mendes J, Khan T, de Silva R, Wage R, DiBella EVR, Firmin DN. Initial investigation of free-breathing 3D whole-heart stress myocardial perfusion MRI. Glob Cardiol Sci Pract 2020; 2020:e202038. [PMID: 33598498 PMCID: PMC7868101 DOI: 10.21542/gcsp.2020.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Objective: Myocardial first-pass perfusion imaging with MRI is well-established clinically. However, it is potentially weakened by limited myocardial coverage compared to nuclear medicine. Clinical evaluations of whole-heart MRI perfusion by 3D methods, while promising, have to date had the limit of breathhold requirements at stress. This work aims to develop a new free-breathing 3D myocardial perfusion method, and to test its performance in a small patient population. Methods: This work required tolerance to respiratory motion for stress investigations, and therefore employed a “stack-of-stars” hybrid Cartesian-radial MRI acquisition method. The MRI sequence was highly optimised for rapid acquisition and combined with a compressed sensing reconstruction. Stress and rest datasets were acquired in four healthy volunteers, and in six patients with coronary artery disease (CAD), which were compared against clinical reference information. Results: This free-breathing method produced datasets that appeared consistent with clinical reference data in detecting moderate-to-strong induced perfusion abnormalities. However, the majority of the mild defects identified clinically were not detected by the method, potentially due to the presence of transient myocardial artefacts present in the images. Discussion: The feasibility of detecting CAD using this 3D first-pass perfusion sequence during free-breathing is demonstrated. Good agreement on typical moderate-to-strong CAD cases is promising, however, questions still remain on the sensitivity of the technique to milder cases.
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Affiliation(s)
- Merlin J Fair
- Cardiovascular Research Centre, Royal Brompton Hospital, London, UK.,National Heart & Lung Institute, Imperial College London, London, UK
| | - Peter D Gatehouse
- Cardiovascular Research Centre, Royal Brompton Hospital, London, UK.,National Heart & Lung Institute, Imperial College London, London, UK
| | - Eliana Reyes
- Cardiovascular Research Centre, Royal Brompton Hospital, London, UK
| | - Ganesh Adluru
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jason Mendes
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Tina Khan
- Cardiovascular Research Centre, Royal Brompton Hospital, London, UK
| | - Ranil de Silva
- Cardiovascular Research Centre, Royal Brompton Hospital, London, UK.,National Heart & Lung Institute, Imperial College London, London, UK
| | - Rick Wage
- Cardiovascular Research Centre, Royal Brompton Hospital, London, UK
| | - Edward V R DiBella
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - David N Firmin
- Cardiovascular Research Centre, Royal Brompton Hospital, London, UK.,National Heart & Lung Institute, Imperial College London, London, UK
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8
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Kwiatkowski G, Kozerke S. Accelerating CEST MRI in the mouse brain at 9.4 T by exploiting sparsity in the Z-spectrum domain. NMR IN BIOMEDICINE 2020; 33:e4360. [PMID: 32621367 DOI: 10.1002/nbm.4360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/20/2020] [Accepted: 06/05/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE Chemical exchange saturation transfer (CEST) is an MR contrast modality offering an enhanced sensitivity for the detection of dilute metabolites with exchangeable protons. Quantitative analysis requires the acquisition of a number of images (usually between 20 and 50 RF offsets) per Z-spectrum, leading to long acquisition times of the order of 5-40 min in practice. In this work, we explore the possibility of employing sparsity in the Z-spectrum domain (irradiation offset dimension) to provide an accelerated acquisition scheme without compromising the quality of reconstructed CEST spectra. METHOD AND THEORY Ex vivo and in vivo data were acquired on an experimental, small animal 9.4 T system. Three different reconstruction methods were tested: k-Z SPARSE, k-Z SLR and k-Z principal component analysis (PCA) using retrospective undersampling with net acceleration factors R = 2, 3, 5. The quality of the reconstructed data was compared with respect to CEST spectra and full magnetization transfer ratio (MTR) asymmetry maps. RESULTS In both phantom and in vivo data, CEST spectra and the resulting MTR asymmetry maps were reconstructed without significant deterioration in data quality. For a low acceleration factor (R = 2, 3) all applied methods resulted in similar data quality, while for high acceleration factor (R = 5) only k-Z PCA and k-Z SLR could be used. Loss in spatial resolution was observed in reconstruction with k-Z PCA for all acceleration factors. An example of prospective undersampling with acceleration factor R = 3 and k-Z PCA reconstruction demonstrates improved CEST maps when compared with fully sampled data acquisition with either three times longer scan duration or threefold prolonged acquisition window per frequency offset. CONCLUSION The acquisition time of CEST spectra can be significantly accelerated by exploiting the sparsity of the Z-domain. For prospective and retrospective analysis using k-Z PCA, an acceleration factor of up to R = 3 can be used without significant loss in data quality.
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Affiliation(s)
- Grzegorz Kwiatkowski
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
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9
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Fan L, Shen D, Haji-Valizadeh H, Naresh NK, Carr JC, Freed BH, Lee DC, Kim D. Rapid dealiasing of undersampled, non-Cartesian cardiac perfusion images using U-net. NMR IN BIOMEDICINE 2020; 33:e4239. [PMID: 31943431 PMCID: PMC7165063 DOI: 10.1002/nbm.4239] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 05/25/2023]
Abstract
Compressed sensing (CS) is a promising method for accelerating cardiac perfusion MRI to achieve clinically acceptable image quality with high spatial resolution (1.6 × 1.6 × 8 mm3 ) and extensive myocardial coverage (6-8 slices per heartbeat). A major disadvantage of CS is its relatively lengthy processing time (~8 min per slice with 64 frames using a graphics processing unit), thereby making it impractical for clinical translation. The purpose of this study was to implement and test whether an image reconstruction pipeline including a neural network is capable of reconstructing 6.4-fold accelerated, non-Cartesian (radial) cardiac perfusion k-space data at least 10 times faster than CS, without significant loss in image quality. We implemented a 3D (2D + time) U-Net and trained it with 132 2D + time datasets (coil combined, zero filled as input; CS reconstruction as reference) with 64 time frames from 28 patients (8448 2D images in total). For testing, we used 56 2D + time coil-combined, zero-filled datasets (3584 2D images in total) from 12 different patients as input to our trained U-Net, and compared the resulting images with CS reconstructed images using quantitative metrics of image quality and visual scores (conspicuity of wall enhancement, noise, artifacts; each score ranging from 1 (worst) to 5 (best), with 3 defined as clinically acceptable) evaluated by readers. Including pre- and post-processing steps, compared with CS, U-Net significantly reduced the reconstruction time by 14.4-fold (32.1 ± 1.4 s for U-Net versus 461.3 ± 16.9 s for CS, p < 0.001), while maintaining high data fidelity (structural similarity index = 0.914 ± 0.023, normalized root mean square error = 1.7 ± 0.3%, identical mean edge sharpness of 1.2 mm). The median visual summed score was not significantly different (p = 0.053) between CS (14; interquartile range (IQR) = 0.5) and U-Net (12; IQR = 0.5). This study shows that the proposed pipeline with a U-Net is capable of reconstructing 6.4-fold accelerated, non-Cartesian cardiac perfusion k-space data 14.4 times faster than CS, without significant loss in data fidelity or image quality.
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Affiliation(s)
- Lexiaozi Fan
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Biomedical Engineering, Northwestern University, Evanston, IL
| | - Daming Shen
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Biomedical Engineering, Northwestern University, Evanston, IL
| | - Hassan Haji-Valizadeh
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Biomedical Engineering, Northwestern University, Evanston, IL
| | | | - James C. Carr
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Benjamin H. Freed
- Division of Cardiology, Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Daniel C. Lee
- Division of Cardiology, Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Daniel Kim
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Biomedical Engineering, Northwestern University, Evanston, IL
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10
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von Spiczak J, Mannil M, Model H, Schwemmer C, Kozerke S, Ruschitzka F, Alkadhi H, Manka R. Multimodal Multiparametric Three-dimensional Image Fusion in Coronary Artery Disease: Combining the Best of Two Worlds. Radiol Cardiothorac Imaging 2020; 2:e190116. [PMID: 33778554 PMCID: PMC7977970 DOI: 10.1148/ryct.2020190116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/19/2019] [Accepted: 09/26/2019] [Indexed: 11/11/2022]
Abstract
PURPOSE To allow for comprehensive noninvasive diagnostics of coronary artery disease (CAD) by using three-dimensional (3D) image fusion of CT coronary angiography, CT-derived fractional flow reserve (CT FFR), whole-heart dynamic 3D cardiac MRI perfusion, and 3D cardiac MRI late gadolinium enhancement (LGE). MATERIALS AND METHODS Seventeen patients (54 years ± 10 [standard deviation], one female) who underwent cardiac CT and cardiac MRI were included (combined subcohort of three prospective trials). Software facilitating multimodal 3D image fusion was developed. Postprocessing of CT data included segmentation of the coronary tree and heart contours, calculation of CT FFR values, and color coding of the coronary tree according to CT FFR. Postprocessing of cardiac MRI data included segmentation of the left ventricle (LV) in cardiac MRI perfusion and cardiac MRI LGE, co-registration of cardiac MRI to CT data, and projection of cardiac MRI perfusion and LGE values onto the high spatial resolution LV from CT. RESULTS Image quality was rated as good to excellent (scores: 2.5-2.6; 3 = excellent). CT coronary angiography revealed significant stenoses in seven of 17 cases (41%). CT FFR was possible in 16 of 17 cases (94%) and showed pathologic flow in seven of 17 cases (41%), six of which coincided with cases revealing significant stenoses at CT coronary angiography. Cardiac MRI perfusion identified eight of 17 patients (47%) with hypoperfusion (ischemic burden of 17% ± 5). Cardiac MRI LGE showed myocardial scar in three of 17 cases (18%, scar burden of 7% ± 4). Conventional two-dimensional readout of CT coronary angiography and cardiac MRI resulted in eight of 17 cases (47%) with uncertain findings. Most of these divergent findings could be solved when adding information from CT FFR and 3D image fusion (six of eight, 75%). CONCLUSION Multimodal 3D cardiac image fusion is feasible and may help with comprehensive noninvasive CAD diagnostics.Supplemental material is available for this article.© RSNA, 2020.
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Affiliation(s)
- Jochen von Spiczak
- From the Institute of Diagnostic and Interventional Radiology (J.v.S., M.M., H.M., H.A., R.M.) and Department of Cardiology, University Heart Center (F.R., R.M.), University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Siemens Healthineers, Forchheim, Germany (C.S.); and Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland (J.v.S., S.K., R.M.)
| | - Manoj Mannil
- From the Institute of Diagnostic and Interventional Radiology (J.v.S., M.M., H.M., H.A., R.M.) and Department of Cardiology, University Heart Center (F.R., R.M.), University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Siemens Healthineers, Forchheim, Germany (C.S.); and Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland (J.v.S., S.K., R.M.)
| | - Hanna Model
- From the Institute of Diagnostic and Interventional Radiology (J.v.S., M.M., H.M., H.A., R.M.) and Department of Cardiology, University Heart Center (F.R., R.M.), University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Siemens Healthineers, Forchheim, Germany (C.S.); and Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland (J.v.S., S.K., R.M.)
| | - Chris Schwemmer
- From the Institute of Diagnostic and Interventional Radiology (J.v.S., M.M., H.M., H.A., R.M.) and Department of Cardiology, University Heart Center (F.R., R.M.), University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Siemens Healthineers, Forchheim, Germany (C.S.); and Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland (J.v.S., S.K., R.M.)
| | - Sebastian Kozerke
- From the Institute of Diagnostic and Interventional Radiology (J.v.S., M.M., H.M., H.A., R.M.) and Department of Cardiology, University Heart Center (F.R., R.M.), University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Siemens Healthineers, Forchheim, Germany (C.S.); and Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland (J.v.S., S.K., R.M.)
| | - Frank Ruschitzka
- From the Institute of Diagnostic and Interventional Radiology (J.v.S., M.M., H.M., H.A., R.M.) and Department of Cardiology, University Heart Center (F.R., R.M.), University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Siemens Healthineers, Forchheim, Germany (C.S.); and Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland (J.v.S., S.K., R.M.)
| | - Hatem Alkadhi
- From the Institute of Diagnostic and Interventional Radiology (J.v.S., M.M., H.M., H.A., R.M.) and Department of Cardiology, University Heart Center (F.R., R.M.), University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Siemens Healthineers, Forchheim, Germany (C.S.); and Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland (J.v.S., S.K., R.M.)
| | - Robert Manka
- From the Institute of Diagnostic and Interventional Radiology (J.v.S., M.M., H.M., H.A., R.M.) and Department of Cardiology, University Heart Center (F.R., R.M.), University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Siemens Healthineers, Forchheim, Germany (C.S.); and Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland (J.v.S., S.K., R.M.)
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11
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Naresh NK, Haji-Valizadeh H, Aouad PJ, Barrett MJ, Chow K, Ragin AB, Collins JD, Carr JC, Lee DC, Kim D. Accelerated, first-pass cardiac perfusion pulse sequence with radial k-space sampling, compressed sensing, and k-space weighted image contrast reconstruction tailored for visual analysis and quantification of myocardial blood flow. Magn Reson Med 2018; 81:2632-2643. [PMID: 30417932 DOI: 10.1002/mrm.27573] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/19/2018] [Accepted: 09/28/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE To develop an accelerated cardiac perfusion pulse sequence and test whether it is capable of increasing spatial coverage, generating high-quality images, and enabling quantification of myocardial blood flow (MBF). METHODS We implemented an accelerated first-pass cardiac perfusion pulse sequence by combining radial k-space sampling, compressed sensing (CS), and k-space weighted image contrast (KWIC) filtering. The proposed and clinical standard pulse sequences were evaluated in a randomized order in 13 patients at rest. For visual analysis, 3 readers graded the conspicuity of wall enhancement, artifact, and noise level on a 5-point Likert scale (overall score index = sum of 3 individual scores). Resting MBF was calculated using a Fermi function model with and without KWIC filtering. Mean visual scores and MBF values were compared between sequences using appropriate statistical tests. RESULTS The proposed pulse sequence produced greater spatial coverage (6-8 slices) with higher spatial resolution (1.6 × 1.6 × 8 mm3 ) and shorter readout duration (78 ms) compared to clinical standard (3-4 slices, 3 × 3 × 8 mm3 , 128 ms, respectively). The overall image score index between accelerated (11.1 ± 1.3) and clinical standard (11.2 ± 1.3) was not significantly different (P = 0.64). Mean resting MBF values with KWIC filtering (0.9-1.2 mL/g/min across different slices) were significantly lower (P < 0.0001) than those without KWIC filtering (3.1-4.3 mL/g/min) and agreed better with values reported in literature. CONCLUSION An accelerated, first-pass cardiac perfusion pulse sequence with radial k-space sampling, CS, and KWIC filtering is capable of increasing spatial coverage, generating high-quality images, and enabling quantification of MBF.
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Affiliation(s)
- Nivedita K Naresh
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Hassan Haji-Valizadeh
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
| | - Pascale J Aouad
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Matthew J Barrett
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kelvin Chow
- Siemens Medical Solutions USA, Inc, Chicago, Illinois
| | - Ann B Ragin
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jeremy D Collins
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - James C Carr
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Daniel C Lee
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Internal Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Daniel Kim
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
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12
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Mandava S, Keerthivasan MB, Li Z, Martin DR, Altbach MI, Bilgin A. Accelerated MR parameter mapping with a union of local subspaces constraint. Magn Reson Med 2018; 80:2744-2758. [PMID: 30009531 PMCID: PMC10164411 DOI: 10.1002/mrm.27344] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE A new reconstruction method for multi-contrast imaging and parameter mapping based on a union of local subspaces constraint is presented. THEORY Subspace constrained reconstructions use a predetermined subspace to explicitly constrain the relaxation signals. The choice of subspace size ( K ) impacts the approximation error vs noise-amplification tradeoff associated with these methods. A different approach is used in the model consistency constraint (MOCCO) framework to leverage the subspace model to enforce a softer penalty. Our proposed method, MOCCO-LS, augments the MOCCO model with a union of local subspaces (LS) approach. The union of local subspaces model is coupled with spatial support constraints and incorporated into the MOCCO framework to regularize the contrast signals in the scene. METHODS The performance of the MOCCO-LS method was evaluated in vivo on T1 and T2 mapping of the human brain and with Monte-Carlo simulations and compared against MOCCO and the explicit subspace constrained models. RESULTS The results demonstrate a clear improvement in the multi-contrast images and parameter maps. We sweep across the model order space ( K ) to compare the different reconstructions and demonstrate that the reconstructions have different preferential operating points. Experiments on T2 mapping show that the proposed method yields substantial improvements in performance even when operating at very high acceleration rates. CONCLUSIONS The use of a union of local subspace constraints coupled with a sparsity promoting penalty leads to improved reconstruction quality of multi-contrast images and parameter maps.
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Affiliation(s)
- Sagar Mandava
- Department of Electrical and Computer Engineering; University of Arizona; Tucson Arizona
- Department of Medical Imaging; University of Arizona; Tucson Arizona
| | - Mahesh B. Keerthivasan
- Department of Electrical and Computer Engineering; University of Arizona; Tucson Arizona
- Department of Medical Imaging; University of Arizona; Tucson Arizona
| | - Zhitao Li
- Department of Electrical and Computer Engineering; University of Arizona; Tucson Arizona
- Department of Medical Imaging; University of Arizona; Tucson Arizona
| | - Diego R. Martin
- Department of Medical Imaging; University of Arizona; Tucson Arizona
| | - Maria I. Altbach
- Department of Medical Imaging; University of Arizona; Tucson Arizona
- Department of Biomedical Engineering; University of Arizona; Tucson Arizona
| | - Ali Bilgin
- Department of Electrical and Computer Engineering; University of Arizona; Tucson Arizona
- Department of Medical Imaging; University of Arizona; Tucson Arizona
- Department of Biomedical Engineering; University of Arizona; Tucson Arizona
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13
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Comprehensive morphologic and functional imaging of heart transplant patients: first experience with dynamic perfusion CT. Eur Radiol 2018; 28:4111-4121. [PMID: 29713770 DOI: 10.1007/s00330-018-5436-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/05/2018] [Accepted: 03/16/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVES We aimed to assess the diagnostic performance of a combined protocol with coronary computed tomography angiography (CCTA) and stress CT perfusion imaging (CTP) in heart transplant patients for comprehensive morphological and functional imaging. METHODS In this prospective study, 13 patients undergoing routine follow-up 8±6 years after heart transplantation underwent CCTA and dynamic adenosine stress CTP using a third-generation dual-source CT scanner, cardiac magnetic resonance (MR) adenosine stress perfusion imaging at 1.5 T, and catheter coronary angiography. In CCTA stenoses >50% luminal diameter narrowing were noted. Myocardial perfusion deficits were documented in CTP and MR. Quantitative myocardial blood flow (MBF) was calculated with CTP. Left ventricular ejection fraction was determined on cardiac MR cine images. Radiation doses of CT were determined. RESULTS One of the 13 patients had to be excluded because of severe motion artifacts. CCTA identified three patients with stenosis >50%, which were confirmed with catheter coronary angiography. CTP showed four patients with stress-induced myocardial hypoperfusion, which were confirmed by MR stress perfusion imaging. Quantitative analysis of global MBF showed lower mean values as compared to known reference values (MBF under stress 125.5 ± 34.5 ml/100 ml/min). Average left ventricular ejection fraction was preserved (56 ± 5%). CONCLUSIONS In heart transplant patients, a comprehensive CT protocol for the assessment of morphology and function including CCTA and CTP showed good concordance to results from MR perfusion imaging and catheter coronary angiography. KEY POINTS • Stress CT perfusion imaging enables the detection of myocardial ischemia • CT myocardial perfusion imaging can be combined with coronary computed tomography angiography • Combining perfusion and coronary CT imaging is accurate in heart transplant patients • CT myocardial perfusion imaging can be performed at a reasonable radiation dose.
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14
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von Spiczak J, Mannil M, Kozerke S, Alkadhi H, Manka R. 3D image fusion of whole-heart dynamic cardiac MR perfusion and late gadolinium enhancement: Intuitive delineation of myocardial hypoperfusion and scar. J Magn Reson Imaging 2018; 48:1129-1138. [DOI: 10.1002/jmri.26020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/01/2018] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jochen von Spiczak
- Institute of Diagnostic and Interventional Radiology; University Hospital Zurich; Zurich Switzerland
| | - Manoj Mannil
- Institute of Diagnostic and Interventional Radiology; University Hospital Zurich; Zurich Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering; University and ETH Zurich; Zurich Switzerland
| | - Hatem Alkadhi
- Institute of Diagnostic and Interventional Radiology; University Hospital Zurich; Zurich Switzerland
| | - Robert Manka
- Institute of Diagnostic and Interventional Radiology; University Hospital Zurich; Zurich Switzerland
- Institute for Biomedical Engineering; University and ETH Zurich; Zurich Switzerland
- Department of Cardiology; University Heart Center, University Hospital Zurich; Zurich Switzerland
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15
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Pagé G, Bettoni J, Salsac AV, Balédent O. Influence of principal component analysis acceleration factor on velocity measurement in 2D and 4D PC-MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2018; 31:469-481. [PMID: 29357015 DOI: 10.1007/s10334-018-0673-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/28/2017] [Accepted: 01/03/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The objective of the study was to determine how to optimize 2D and 4D phase-contrast magnetic resonance imaging (PC-MRI) acquisitions to acquire flow velocities in millimetric vessels. In particular, we search for the best compromise between acquisition time and accuracy and assess the influence of the principal component analysis (PCA). MATERIALS AND METHODS 2D and 4D PC-MRI measurements are conducted within two in vitro vessel phantoms: a Y-bifurcation phantom, the branches of which range from 2 to 5 mm in diameter, and a physiological subject-specific phantom of the carotid bifurcation. The same sequences are applied in vivo in carotid vasculature. RESULTS For a vessel oriented in the axial direction, both 2D and axial 4D PC-MRI provided accuracy measurements regardless of the k-t PCA factor, while the acquisition time is reduced by a factor 6 for k-t PCA maximum value. The in vivo measurements show that the proposed sequences are adequate to acquire 2D and 4D velocity fields in millimetric vessels and with clinically realistic time durations. CONCLUSION The study shows the feasibility of conducting fast, high-resolution PC-MRI flow measurements in millimetric vessels and that it is worth maximizing the k-t PCA factor to reduce the acquisition time in the case of 2D and 4D axial acquisitions.
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Affiliation(s)
- Gwenaël Pagé
- BioFlow Image, University Hospital of Amiens Picardy, Université de Picardie Jules Verne, Avenue Rene Laennec, Salouël, 80480, Amiens, France.
| | - Jérémie Bettoni
- Maxillo-Facial Surgery, University Hospital of Amiens-Picardie, Amiens, France
| | - Anne-Virginie Salsac
- Biomechanics and Bioengineering Laboratory (UMR CNRS 7338), Sorbonne Universités, Université de Technologie de Compiègne-CNRS, Compiègne, France
| | - Olivier Balédent
- BioFlow Image, University Hospital of Amiens Picardy, Université de Picardie Jules Verne, Avenue Rene Laennec, Salouël, 80480, Amiens, France.,Laboratory of Image Processing, University Hospital of Amiens-Picardie, Amiens, France
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16
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Liu Y, Tao X, Ma J, Bian Z, Zeng D, Feng Q, Chen W, Zhang H. Motion guided Spatiotemporal Sparsity for high quality 4D-CBCT reconstruction. Sci Rep 2017; 7:17461. [PMID: 29234074 PMCID: PMC5727071 DOI: 10.1038/s41598-017-17668-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 11/29/2017] [Indexed: 11/25/2022] Open
Abstract
Conventional cone-beam computed tomography is often deteriorated by respiratory motion blur, which negatively affects target delineation. On the other side, the four dimensional cone-beam computed tomography (4D-CBCT) can be considered to describe tumor and organ motion. But for current on-board CBCT imaging system, the slow rotation speed limits the projection number at each phase, and the associated reconstructions are contaminated by noise and streak artifacts using the conventional algorithm. To address the problem, we propose a novel framework to reconstruct 4D-CBCT from the under-sampled measurements—Motion guided Spatiotemporal Sparsity (MgSS). In this algorithm, we try to divide the CBCT images at each phase into cubes (3D blocks) and track the cubes with estimated motion field vectors through phase, then apply regional spatiotemporal sparsity on the tracked cubes. Specifically, we recast the tracked cubes into four-dimensional matrix, and use the higher order singular value decomposition (HOSVD) technique to analyze the regional spatiotemporal sparsity. Subsequently, the blocky spatiotemporal sparsity is incorporated into a cost function for the image reconstruction. The phantom simulation and real patient data are used to evaluate this algorithm. Results show that the MgSS algorithm achieved improved 4D-CBCT image quality with less noise and artifacts compared to the conventional algorithms.
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Affiliation(s)
- Yang Liu
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Xi Tao
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Jianhua Ma
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Zhaoying Bian
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Dong Zeng
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Qianjin Feng
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Wufan Chen
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China.
| | - Hua Zhang
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China.
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17
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Sharif B, Motwani M, Arsanjani R, Dharmakumar R, Fish MB, Germano G, Li D, Berman DS, Slomka P. Impact of incomplete ventricular coverage on diagnostic performance of myocardial perfusion imaging. Int J Cardiovasc Imaging 2017; 34:661-669. [PMID: 29197024 PMCID: PMC5859027 DOI: 10.1007/s10554-017-1265-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/26/2017] [Indexed: 12/24/2022]
Abstract
In the context of myocardial perfusion imaging (MPI) with cardiac magnetic resonance (CMR), there is ongoing debate on the merits of using technically complex acquisition methods to achieve whole-heart spatial coverage, rather than conventional 3-slice acquisition. An adequately powered comparative study is difficult to achieve given the requirement for two separate stress CMR studies in each patient. The aim of this work is to draw relevant conclusions from SPECT MPI by comparing whole-heart versus simulated 3-slice coverage in a large existing dataset. SPECT data from 651 patients with suspected coronary artery disease who underwent invasive angiography were analyzed. A computational approach was designed to model 3-slice MPI by retrospective subsampling of whole- heart data. For both whole-heart and 3-slice approaches, the diagnostic performance and the stress total perfusion deficit (TPD) score-a measure of ischemia extent/severity-were quantified and compared. Diagnostic accuracy for the 3-slice and whole-heart approaches were similar (area under the curve: 0.843 vs. 0.855, respectively; P = 0.07). The majority (54%) of cases missed by 3-slice imaging had primarily apical ischemia. Whole-heart and 3-slice TPD scores were strongly correlated (R2 = 0.93, P < 0.001) but 3-slice TPD showed a small yet significant bias compared to whole-heart TPD (- 1.19%; P < 0.0001) and the 95% limits of agreement were relatively wide (- 6.65% to 4.27%). Incomplete ventricular coverage typically acquired in 3-slice CMR MPI does not significantly affect the diagnostic accuracy. However, 3-slice MPI may fail to detect severe apical ischemia and underestimate the extent/severity of perfusion defects. Our results suggest that caution is required when comparing the ischemic burden between 3-slice and whole-heart datasets, and corroborate the need to establish prognostic thresholds specific to each approach.
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Affiliation(s)
- Behzad Sharif
- Laboratory for Translational Imaging of Microcirculation, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
- David Geffen School of Medicine at UCLA, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.
| | - Manish Motwani
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
| | - Reza Arsanjani
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
- Division of Cardiovascular Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Rohan Dharmakumar
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
- David Geffen School of Medicine at UCLA, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Mathews B Fish
- Oregon Heart and Vascular Institute, Sacred Heart Medical Center, 3311 Riverbend Dr, Springfield, OR, 97477, USA
| | - Guido Germano
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
- David Geffen School of Medicine at UCLA, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
- David Geffen School of Medicine at UCLA, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Daniel S Berman
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
- David Geffen School of Medicine at UCLA, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Piotr Slomka
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
- David Geffen School of Medicine at UCLA, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.
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Fusion of CT coronary angiography and whole-heart dynamic 3D cardiac MR perfusion: building a framework for comprehensive cardiac imaging. Int J Cardiovasc Imaging 2017; 34:649-660. [DOI: 10.1007/s10554-017-1260-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/19/2017] [Indexed: 10/18/2022]
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Improved k- t PCA Algorithm Using Artificial Sparsity in Dynamic MRI. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2017; 2017:4816024. [PMID: 28804506 PMCID: PMC5540396 DOI: 10.1155/2017/4816024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 05/14/2017] [Accepted: 06/14/2017] [Indexed: 11/18/2022]
Abstract
The k-t principal component analysis (k-t PCA) is an effective approach for high spatiotemporal resolution dynamic magnetic resonance (MR) imaging. However, it suffers from larger residual aliasing artifacts and noise amplification when the reduction factor goes higher. To further enhance the performance of this technique, we propose a new method called sparse k-t PCA that combines the k-t PCA algorithm with an artificial sparsity constraint. It is a self-calibrated procedure that is based on the traditional k-t PCA method by further eliminating the reconstruction error derived from complex subtraction of the sampled k-t space from the original reconstructed k-t space. The proposed method is tested through both simulations and in vivo datasets with different reduction factors. Compared to the standard k-t PCA algorithm, the sparse k-t PCA can improve the normalized root-mean-square error performance and the accuracy of temporal resolution. It is thus useful for rapid dynamic MR imaging.
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Wissmann L, Gotschy A, Santelli C, Tezcan KC, Hamada S, Manka R, Kozerke S. Analysis of spatiotemporal fidelity in quantitative 3D first-pass perfusion cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2017; 19:11. [PMID: 28125995 PMCID: PMC5270366 DOI: 10.1186/s12968-017-0324-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whole-heart first-pass perfusion cardiovascular magnetic resonance (CMR) relies on highly accelerated image acquisition. The influence of undersampling on myocardial blood flow (MBF) quantification has not been systematically investigated yet. In the present work, the effect of spatiotemporal scan acceleration on image reconstruction accuracy and MBF error was studied using a numerical phantom and validated in-vivo. METHODS Up to 10-fold scan acceleration using k-t PCA and k-t SPARSE-SENSE was simulated using the MRXCAT CMR numerical phantom framework. Image reconstruction results were compared to ground truth data in the k-f domain by means of modulation transfer function (MTF) analysis. In the x-t domain, errors pertaining to specific features of signal intensity-time curves and MBF values derived using Fermi model deconvolution were analysed. In-vivo first-pass CMR data were acquired in ten healthy volunteers using a dual-sequence approach assessing the arterial input function (AIF) and myocardial enhancement. 10x accelerated 3D k-t PCA and k-t SPARSE-SENSE were compared and related to non-accelerated 2D reference images. RESULTS MTF analysis revealed good recovery of data upon k-t PCA reconstruction at 10x undersampling with some attenuation of higher temporal frequencies. For 10x k-t SPARSE-SENSE the MTF was found to decrease to zero at high spatial frequencies for all temporal frequencies indicating a loss in spatial resolution. Signal intensity-time curve errors were most prominent in AIFs from 10x k-t PCA, thereby emphasizing the need for separate AIF acquisition using a dual-sequence approach. These findings were confirmed by MBF estimation based on AIFs from fully sampled and undersampled simulations. Average in-vivo MBF estimates were in good agreement between both accelerated and the fully sampled methods. Intra-volunteer MBF variation for fully sampled 2D scans was lower compared to 10x k-t PCA and k-t SPARSE-SENSE data. CONCLUSION Quantification of highly undersampled 3D first-pass perfusion CMR yields accurate MBF estimates provided the AIF is obtained using fully sampled or moderately undersampled scans as part of a dual-sequence approach. However, relative to fully sampled 2D perfusion imaging, intra-volunteer variation is increased using 3D approaches prompting for further developments.
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Affiliation(s)
- Lukas Wissmann
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Alexander Gotschy
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
- Division of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Claudio Santelli
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Kerem Can Tezcan
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Sandra Hamada
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
- Department of Cardiology, RWTH Aachen University, Aachen, Germany
| | - Robert Manka
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
- Division of Imaging Sciences, King’s College London, London, UK
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21
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Niendorf T, Paul K, Oezerdem C, Graessl A, Klix S, Huelnhagen T, Hezel F, Rieger J, Waiczies H, Frahm J, Nagel AM, Oberacker E, Winter L. W(h)ither human cardiac and body magnetic resonance at ultrahigh fields? technical advances, practical considerations, applications, and clinical opportunities. NMR IN BIOMEDICINE 2016; 29:1173-97. [PMID: 25706103 DOI: 10.1002/nbm.3268] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/26/2014] [Accepted: 01/13/2015] [Indexed: 05/12/2023]
Abstract
The objective of this study was to document and review advances and groundbreaking progress in cardiac and body MR at ultrahigh fields (UHF, B0 ≥ 7.0 T) with the goal to attract talent, clinical adopters, collaborations and resources to the biomedical and diagnostic imaging communities. This review surveys traits, advantages and challenges of cardiac and body MR at 7.0 T. The considerations run the gamut from technical advances to clinical opportunities. Key concepts, emerging technologies, practical considerations, frontier applications and future directions of UHF body and cardiac MR are provided. Examples of UHF cardiac and body imaging strategies are demonstrated. Their added value over the kindred counterparts at lower fields is explored along with an outline of research promises. The achievements of cardiac and body UHF-MR are powerful motivators and enablers, since extra speed, signal and imaging capabilities may be invested to overcome the fundamental constraints that continue to hamper traditional cardiac and body MR applications. If practical obstacles, concomitant physics effects and technical impediments can be overcome in equal measure, sophisticated cardiac and body UHF-MR will help to open the door to new MRI and MRS approaches for basic research and clinical science, with the lessons learned at 7.0 T being transferred into broad clinical use including diagnostics and therapy guiding at lower fields. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Thoralf Niendorf
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrueck Center for Molecular Medicine, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany
| | - Katharina Paul
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrueck Center for Molecular Medicine, Berlin, Germany
| | - Celal Oezerdem
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrueck Center for Molecular Medicine, Berlin, Germany
| | - Andreas Graessl
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrueck Center for Molecular Medicine, Berlin, Germany
| | - Sabrina Klix
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrueck Center for Molecular Medicine, Berlin, Germany
| | - Till Huelnhagen
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrueck Center for Molecular Medicine, Berlin, Germany
| | - Fabian Hezel
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrueck Center for Molecular Medicine, Berlin, Germany
| | | | | | - Jens Frahm
- Biomedizinische NMR Forschungs GmbH, am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site, Göttingen, Germany
| | - Armin M Nagel
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eva Oberacker
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrueck Center for Molecular Medicine, Berlin, Germany
| | - Lukas Winter
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrueck Center for Molecular Medicine, Berlin, Germany
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22
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Schnell S, Wu C, Ansari SA. Four-dimensional MRI flow examinations in cerebral and extracerebral vessels - ready for clinical routine? Curr Opin Neurol 2016; 29:419-28. [PMID: 27262148 PMCID: PMC4939804 DOI: 10.1097/wco.0000000000000341] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW To evaluate the feasibility of 4-dimensional (4D) flow MRI for the clinical assessment of cerebral and extracerebral vascular hemodynamics in patients with neurovascular disease. RECENT FINDINGS 4D flow MRI has been applied in multiple studies to qualitatively and quantitatively study intracranial aneurysm blood flow for potential risk stratification and to assess treatment efficacy of various neurovascular lesions, including intraaneurysmal and parent artery blood flow after flow diverter stent placement and staged embolizations of arteriovenous malformations and vein of Galen aneurysmal malformations. Recently, the technique has been utilized to characterize age-related changes of normal cerebral hemodynamics in healthy individuals over a broad age range. SUMMARY 4D flow MRI is a useful tool for the noninvasive, volumetric and quantitative hemodynamic assessment of neurovascular disease without the need for gadolinium contrast agents. Further improvements are warranted to overcome technical limitations before broader clinical implementation. Current developments, such as advanced acceleration techniques (parallel imaging and compressed sensing) for faster data acquisition, dual or multiple velocity encoding strategies for more accurate arterial and venous flow quantification, ultrahigh-field strengths to achieve higher spatial resolution and streamlined postprocessing workflow for more efficient and standardized flow analysis, are promising advancements in 4D flow MRI.
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Affiliation(s)
- Susanne Schnell
- Dept. of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Can Wu
- Dept. of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
- Dept. of Biomedical Engineering, Northwestern University, Evanston, Illinois
| | - Sameer A. Ansari
- Dept. of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
- Dept. of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
- Dept. of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
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23
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Mohsin YQ, Lingala SG, DiBella E, Jacob M. Accelerated dynamic MRI using patch regularization for implicit motion compensation. Magn Reson Med 2016; 77:1238-1248. [PMID: 27091812 DOI: 10.1002/mrm.26215] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 02/19/2016] [Accepted: 02/22/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE To introduce a fast algorithm for motion-compensated accelerated dynamic MRI. METHODS An efficient patch smoothness regularization scheme, which implicitly compensates for inter-frame motion, is introduced to recover dynamic MRI data from highly undersampled measurements. The regularization prior is a sum of distances between each rectangular patch in the dataset with other patches in the dataset using a saturating distance metric. Unlike current motion estimation and motion compensation (ME-MC) methods, the proposed scheme does not require reference frames or complex motion models. The proposed algorithm, which alternates between inter-patch shrinkage step and conjugate gradient algorithm, is considerably more computationally efficient than ME-MC methods. The reconstructions obtained using the proposed algorithm is compared against state-of-the-art methods. RESULTS The proposed method is observed to yield reconstructions with minimal spatiotemporal blurring and motion artifacts. In comparison to the existing state-of-the-art ME-MC methods, PRICE provides comparable or even better image quality with faster reconstruction times (approximately nine times faster). CONCLUSION The presented scheme enables computationally efficient and effective motion-compensated reconstruction in a variety of applications with large inter-frame motion and contrast changes. This algorithm could be seen as an alternative over the current state-of-the-art ME-MC schemes that are computationally expensive. Magn Reson Med 77:1238-1248, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Yasir Q Mohsin
- Department of Electrical and Computer Engineering, the University of Iowa, Iowa, USA
| | - Sajan Goud Lingala
- Department of Electrical Engineering, University of Southern California, California, USA
| | - Edward DiBella
- Department of Radiology, the University of Utah, Utah, USA
| | - Mathews Jacob
- Department of Electrical and Computer Engineering, the University of Iowa, Iowa, USA
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Qi H, Huang F, Zhou H, Chen H. Sequential combination of k-t principle component analysis (PCA) and partial parallel imaging: k-t PCA GROWL. Magn Reson Med 2016; 77:1058-1067. [PMID: 27016133 DOI: 10.1002/mrm.26187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 01/16/2016] [Accepted: 02/08/2016] [Indexed: 12/27/2022]
Abstract
PURPOSE k-t principle component analysis (k-t PCA) is a distinguished method for high spatiotemporal resolution dynamic MRI. To further improve the accuracy of k-t PCA, a combination with partial parallel imaging (PPI), k-t PCA/SENSE, has been tested. However, k-t PCA/SENSE suffers from long reconstruction time and limited improvement. This study aims to improve the combination of k-t PCA and PPI on both reconstruction speed and accuracy. METHODS A sequential combination scheme called k-t PCA GROWL (GRAPPA operator for wider readout line) was proposed. The GRAPPA operator was performed before k-t PCA to extend each readout line into a wider band, which improved the condition of the encoding matrix in the following k-t PCA reconstruction. k-t PCA GROWL was tested and compared with k-t PCA and k-t PCA/SENSE on cardiac imaging. RESULTS k-t PCA GROWL consistently resulted in better image quality compared with k-t PCA/SENSE at high acceleration factors for both retrospectively and prospectively undersampled cardiac imaging, with a much lower computation cost. The improvement in image quality became greater with the increase of acceleration factor. CONCLUSION By sequentially combining the GRAPPA operator and k-t PCA, the proposed k-t PCA GROWL method outperformed k-t PCA/SENSE in both reconstruction speed and accuracy, suggesting that k-t PCA GROWL is a better combination scheme than k-t PCA/SENSE. Magn Reson Med 77:1058-1067, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Haikun Qi
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | | | - Hongmei Zhou
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Huijun Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
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Miao X, Lingala SG, Guo Y, Jao T, Usman M, Prieto C, Nayak KS. Accelerated cardiac cine MRI using locally low rank and finite difference constraints. Magn Reson Imaging 2016; 34:707-714. [PMID: 26968142 DOI: 10.1016/j.mri.2016.03.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 02/14/2016] [Accepted: 03/03/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the potential value of combining multiple constraints for highly accelerated cardiac cine MRI. METHODS A locally low rank (LLR) constraint and a temporal finite difference (FD) constraint were combined to reconstruct cardiac cine data from highly undersampled measurements. Retrospectively undersampled 2D Cartesian reconstructions were quantitatively evaluated against fully-sampled data using normalized root mean square error, structural similarity index (SSIM) and high frequency error norm (HFEN). This method was also applied to 2D golden-angle radial real-time imaging to facilitate single breath-hold whole-heart cine (12 short-axis slices, 9-13s single breath hold). Reconstruction was compared against state-of-the-art constrained reconstruction methods: LLR, FD, and k-t SLR. RESULTS At 10 to 60 spokes/frame, LLR+FD better preserved fine structures and depicted myocardial motion with reduced spatio-temporal blurring in comparison to existing methods. LLR yielded higher SSIM ranking than FD; FD had higher HFEN ranking than LLR. LLR+FD combined the complimentary advantages of the two, and ranked the highest in all metrics for all retrospective undersampled cases. Single breath-hold multi-slice cardiac cine with prospective undersampling was enabled with in-plane spatio-temporal resolutions of 2×2mm(2) and 40ms. CONCLUSION Highly accelerated cardiac cine is enabled by the combination of 2D undersampling and the synergistic use of LLR and FD constraints.
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Affiliation(s)
- Xin Miao
- Department of Biomedical Engineering, University of Southern California, Los Angeles, USA.
| | - Sajan Goud Lingala
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, USA
| | - Yi Guo
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, USA
| | - Terrence Jao
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, USA
| | - Muhammad Usman
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Claudia Prieto
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Krishna S Nayak
- Department of Biomedical Engineering, University of Southern California, Los Angeles, USA; Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, USA
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Wissmann L, Niemann M, Gotschy A, Manka R, Kozerke S. Quantitative three-dimensional myocardial perfusion cardiovascular magnetic resonance with accurate two-dimensional arterial input function assessment. J Cardiovasc Magn Reson 2015; 17:108. [PMID: 26637221 PMCID: PMC4669617 DOI: 10.1186/s12968-015-0212-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 11/24/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Quantification of myocardial perfusion from first-pass cardiovascular magnetic resonance (CMR) images at high contrast agent (CA) dose requires separate acquisition of blood pool and myocardial tissue enhancement. In this study, a dual-sequence approach interleaving 2D imaging of the arterial input function with high-resolution 3D imaging for myocardial perfusion assessment is presented and validated for low and high CA dose. METHODS A dual-sequence approach interleaving 2D imaging of the aortic root and 3D imaging of the whole left ventricle using highly accelerated k-t PCA was implemented. Rest perfusion imaging was performed in ten healthy volunteers after administration of a Gadolinium-based CA at low (0.025 mmol/kg b.w.) and high dose (0.1 mmol/kg b.w.). Arterial input functions extracted from the 2D and 3D images were analysed for both doses. Myocardial contrast-to-noise ratios (CNR) were compared across volunteers and doses. Variations of myocardial perfusion estimates between volunteers and across myocardial territories were studied. RESULTS High CA dose imaging resulted in strong non-linearity of the arterial input function in the 3D images at peak CA concentration, which was avoided when the input function was derived from the 2D images. Myocardial CNR was significantly increased at high dose compared to low dose, with a 2.6-fold mean CNR gain. Most robust myocardial blood flow estimation was achieved using the arterial input function extracted from the 2D image at high CA dose. In this case, myocardial blood flow estimates varied by 24% between volunteers and by 20% between myocardial territories when analysed on a per-volunteer basis. CONCLUSION Interleaving 2D imaging for arterial input function assessment enables robust quantitative 3D myocardial perfusion imaging at high CA dose.
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Affiliation(s)
- Lukas Wissmann
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
| | - Markus Niemann
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
- Clinic of Cardiology, University Hospital Zurich, Zurich, Switzerland.
- Furtwangen University, Faculty Mechanical and Medical Engineering, Villingen-Schwenningen, Germany.
| | - Alexander Gotschy
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
- Clinic of Cardiology, University Hospital Zurich, Zurich, Switzerland.
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland.
| | - Robert Manka
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
- Clinic of Cardiology, University Hospital Zurich, Zurich, Switzerland.
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
- Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
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27
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Cardiovascular magnetic resonance for the assessment of coronary artery disease. Int J Cardiol 2015; 193:84-92. [DOI: 10.1016/j.ijcard.2014.11.098] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 10/13/2014] [Accepted: 11/10/2014] [Indexed: 11/20/2022]
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Fair MJ, Gatehouse PD, DiBella EVR, Firmin DN. A review of 3D first-pass, whole-heart, myocardial perfusion cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2015; 17:68. [PMID: 26231784 PMCID: PMC4522116 DOI: 10.1186/s12968-015-0162-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 06/23/2015] [Indexed: 01/19/2023] Open
Abstract
A comprehensive review is undertaken of the methods available for 3D whole-heart first-pass perfusion (FPP) and their application to date, with particular focus on possible acceleration techniques. Following a summary of the parameters typically desired of 3D FPP methods, the review explains the mechanisms of key acceleration techniques and their potential use in FPP for attaining 3D acquisitions. The mechanisms include rapid sequences, non-Cartesian k-space trajectories, reduced k-space acquisitions, parallel imaging reconstructions and compressed sensing. An attempt is made to explain, rather than simply state, the varying methods with the hope that it will give an appreciation of the different components making up a 3D FPP protocol. Basic estimates demonstrating the required total acceleration factors in typical 3D FPP cases are included, providing context for the extent that each acceleration method can contribute to the required imaging speed, as well as potential limitations in present 3D FPP literature. Although many 3D FPP methods are too early in development for the type of clinical trials required to show any clear benefit over current 2D FPP methods, the review includes the small but growing quantity of clinical research work already using 3D FPP, alongside the more technical work. Broader challenges concerning FPP such as quantitative analysis are not covered, but challenges with particular impact on 3D FPP methods, particularly with regards to motion effects, are discussed along with anticipated future work in the field.
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Affiliation(s)
- Merlin J Fair
- National Heart & Lung Institute, Imperial College London, London, UK.
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
| | - Peter D Gatehouse
- National Heart & Lung Institute, Imperial College London, London, UK.
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
| | - Edward V R DiBella
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, UT, USA.
| | - David N Firmin
- National Heart & Lung Institute, Imperial College London, London, UK.
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
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Manka R, Wissmann L, Gebker R, Jogiya R, Motwani M, Frick M, Reinartz S, Schnackenburg B, Niemann M, Gotschy A, Kuhl C, Nagel E, Fleck E, Marx N, Luescher TF, Plein S, Kozerke S. Multicenter evaluation of dynamic three-dimensional magnetic resonance myocardial perfusion imaging for the detection of coronary artery disease defined by fractional flow reserve. Circ Cardiovasc Imaging 2015; 8:CIRCIMAGING.114.003061. [PMID: 25901043 DOI: 10.1161/circimaging.114.003061] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND First-pass myocardial perfusion cardiovascular magnetic resonance (CMR) imaging yields high diagnostic accuracy for the detection of coronary artery disease (CAD). However, standard 2D multislice CMR perfusion techniques provide only limited cardiac coverage, and hence considerable assumptions are required to assess myocardial ischemic burden. The aim of this prospective study was to assess the diagnostic performance of 3D myocardial perfusion CMR to detect functionally relevant CAD with fractional flow reserve (FFR) as a reference standard in a multicenter setting. METHODS AND RESULTS A total of 155 patients with suspected CAD listed for coronary angiography with FFR were prospectively enrolled from 5 European centers. 3D perfusion CMR was acquired on 3T MR systems from a single vendor under adenosine stress and at rest. All CMR perfusion analyses were performed in a central laboratory and blinded to all clinical data. One hundred fifty patients were successfully examined (mean age 62.9±10 years, 45 female). The prevalence of CAD defined by FFR (<0.8) was 56.7% (85 of 150 patients). The sensitivity and specificity of 3D perfusion CMR were 84.7% and 90.8% relative to the FFR reference. Comparison to quantitative coronary angiography (≥50%) yielded a prevalence of 65.3%, sensitivity and specificity of 76.5% and 94.2%, respectively. CONCLUSIONS In this multicenter study, 3D myocardial perfusion CMR proved highly diagnostic for the detection of significant CAD as defined by FFR.
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Affiliation(s)
- Robert Manka
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Lukas Wissmann
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Rolf Gebker
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Roy Jogiya
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Manish Motwani
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Michael Frick
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Sebastian Reinartz
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Bernhard Schnackenburg
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Markus Niemann
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Alexander Gotschy
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Christiane Kuhl
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Eike Nagel
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Eckart Fleck
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Nikolaus Marx
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Thomas F Luescher
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Sven Plein
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.)
| | - Sebastian Kozerke
- From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
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Heydari B, Kwong RY, Jerosch-Herold M. Technical advances and clinical applications of quantitative myocardial blood flow imaging with cardiac MRI. Prog Cardiovasc Dis 2015; 57:615-22. [PMID: 25727176 DOI: 10.1016/j.pcad.2015.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The recent FAME 2 study highlights the importance of myocardial ischemia assessment, particularly in the post-COURAGE trial era of managing patients with stable coronary artery disease. Qualitative assessment of myocardial ischemia by stress cardiovascular magnetic resonance imaging (CMR) has gained widespread clinical acceptance and utility. Despite the high diagnostic and prognostic performance of qualitative stress CMR, the ability to quantitatively assess myocardial perfusion reserve and absolute myocardial blood flow remains an important and ambitious goal for non-invasive imagers. Quantitative perfusion by stress CMR remains a research technique that has yielded progressively more encouraging results in more recent years. The ability to safely, rapidly, and precisely procure quantitative myocardial perfusion data would provide clinicians with a powerful tool that may substantially alter clinical practice and improve downstream patient outcomes and the cost effectiveness of healthcare delivery. This may also provide a surrogate endpoint for clinical trials, reducing study population sizes and costs through increased power. This review will cover emerging quantitative CMR techniques for myocardial perfusion assessment by CMR, including novel methods, such as 3-dimensional quantitative myocardial perfusion, and some of the challenges that remain before more widespread clinical adoption of these techniques may take place.
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Affiliation(s)
- Bobak Heydari
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02115
| | - Raymond Y Kwong
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02115
| | - Michael Jerosch-Herold
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02115.
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31
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Current state of the art cardiovascular MR imaging techniques for assessment of ischemic heart disease. Radiol Clin North Am 2014; 53:335-44. [PMID: 25726998 DOI: 10.1016/j.rcl.2014.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cardiac magnetic resonance (CMR) imaging is increasingly being used to evaluate patients with known or suspected ischemic heart disease, because of its ability to acquire images in any orientation and the wide variety of sequences available to characterize normal and abnormal structure and function. Substantial improvements have been made in the hardware and software used to perform CMR, resulting in better and more consistent image quality. There has been a greater emphasis recently in developing and validating quantitative CMR techniques. This article reviews advances in CMR techniques for assessing cardiac function, myocardial perfusion, late gadolinium enhancement, and tissue characterization with T1 and T2 mapping sequences.
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Jogiya R, Schuster A, Zaman A, Motwani M, Kouwenhoven M, Nagel E, Kozerke S, Plein S. Three-dimensional balanced steady state free precession myocardial perfusion cardiovascular magnetic resonance at 3T using dual-source parallel RF transmission: initial experience. J Cardiovasc Magn Reson 2014; 16:90. [PMID: 25429993 PMCID: PMC4247198 DOI: 10.1186/s12968-014-0090-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 10/30/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The purpose of this study was to establish the feasibility of three-dimensional (3D) balanced steady-state-free-precession (bSSFP) myocardial perfusion cardiovascular magnetic resonance (CMR) at 3T using local RF shimming with dual-source RF transmission, and to compare it with spoiled gradient echo (TGRE) acquisition. METHODS Dynamic contrast-enhanced 3D bSSFP perfusion imaging was performed on a 3T MRI scanner equipped with dual-source RF transmission technology. Images were reconstructed using k-space and time broad-use linear acquisition speed-up technique (k-t BLAST) and compartment based principle component analysis (k-t PCA). RESULTS In phantoms and volunteers, local RF shimming with dual source RF transmission significantly improved B1 field homogeneity compared with single source transmission (P=0.01). 3D bSSFP showed improved signal-to-noise, contrast-to-noise and signal homogeneity compared with 3D TGRE (29.8 vs 26.9, P=0.045; 23.2 vs 21.6, P=0.049; 14.9% vs 12.4%, p=0.002, respectively). Image quality was similar between bSSFP and TGRE but there were more dark rim artefacts with bSSFP. k-t PCA reconstruction reduced artefacts for both sequences compared with k-t BLAST. In a subset of five patients, both methods correctly identified those with coronary artery disease. CONCLUSION Three-dimensional bSSFP myocardial perfusion CMR using local RF shimming with dual source parallel RF transmission at 3T is feasible and improves signal characteristics compared with TGRE. Image artefact remains an important limitation of bSSFP imaging at 3T but can be reduced with k-t PCA.
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Affiliation(s)
- Roy Jogiya
- />King’s College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy’s and St. Thomas’ NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, SE1 7EH UK
| | - Andreas Schuster
- />King’s College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy’s and St. Thomas’ NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, SE1 7EH UK
- />Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK, Partner Site Göttingen), Georg-August-University, Göttingen, Germany
| | - Arshad Zaman
- />Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT UK
| | - Manish Motwani
- />Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT UK
| | | | - Eike Nagel
- />King’s College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy’s and St. Thomas’ NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, SE1 7EH UK
| | - Sebastian Kozerke
- />King’s College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy’s and St. Thomas’ NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, SE1 7EH UK
- />Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sven Plein
- />King’s College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy’s and St. Thomas’ NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, SE1 7EH UK
- />Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT UK
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Velikina JV, Samsonov AA. Reconstruction of dynamic image series from undersampled MRI data using data-driven model consistency condition (MOCCO). Magn Reson Med 2014; 74:1279-90. [PMID: 25399724 DOI: 10.1002/mrm.25513] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 09/26/2014] [Accepted: 10/10/2014] [Indexed: 11/07/2022]
Abstract
PURPOSE To accelerate dynamic MR imaging through development of a novel image reconstruction technique using low-rank temporal signal models preestimated from training data. THEORY We introduce the model consistency condition (MOCCO) technique, which utilizes temporal models to regularize reconstruction without constraining the solution to be low-rank, as is performed in related techniques. This is achieved by using a data-driven model to design a transform for compressed sensing-type regularization. The enforcement of general compliance with the model without excessively penalizing deviating signal allows recovery of a full-rank solution. METHODS Our method was compared with a standard low-rank approach utilizing model-based dimensionality reduction in phantoms and patient examinations for time-resolved contrast-enhanced angiography (CE-MRA) and cardiac CINE imaging. We studied the sensitivity of all methods to rank reduction and temporal subspace modeling errors. RESULTS MOCCO demonstrated reduced sensitivity to modeling errors compared with the standard approach. Full-rank MOCCO solutions showed significantly improved preservation of temporal fidelity and aliasing/noise suppression in highly accelerated CE-MRA (acceleration up to 27) and cardiac CINE (acceleration up to 15) data. CONCLUSIONS MOCCO overcomes several important deficiencies of previously proposed methods based on pre-estimated temporal models and allows high quality image restoration from highly undersampled CE-MRA and cardiac CINE data.
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Affiliation(s)
- Julia V Velikina
- Deparment of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Alexey A Samsonov
- Deparment of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Wang H, Bangerter NK, Park DJ, Adluru G, Kholmovski EG, Xu J, DiBella E. Comparison of centric and reverse-centric trajectories for highly accelerated three-dimensional saturation recovery cardiac perfusion imaging. Magn Reson Med 2014; 74:1070-6. [PMID: 25285855 DOI: 10.1002/mrm.25478] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 09/03/2014] [Accepted: 09/03/2014] [Indexed: 11/11/2022]
Abstract
PURPOSE Highly undersampled three-dimensional (3D) saturation-recovery sequences are affected by k-space trajectory since the magnetization does not reach steady state during the acquisition and the slab excitation profile yields different flip angles in different slices. This study compares centric and reverse-centric 3D cardiac perfusion imaging. METHODS An undersampled (98 phase encodes) 3D ECG-gated saturation-recovery sequence that alternates centric and reverse-centric acquisitions each time frame was used to image phantoms and in vivo subjects. Flip angle variation across the slices was measured, and contrast with each trajectory was analyzed via Bloch simulation. RESULTS Significant variations in flip angle were observed across slices, leading to larger signal variation across slices for the centric acquisition. In simulation, severe transient artifacts were observed when using the centric trajectory with higher flip angles, placing practical limits on the maximum flip angle used. The reverse-centric trajectory provided less contrast, but was more robust to flip angle variations. CONCLUSION Both of the k-space trajectories can provide reasonable image quality. The centric trajectory can have higher CNR, but is more sensitive to flip angle variation. The reverse-centric trajectory is more robust to flip angle variation.
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Affiliation(s)
- Haonan Wang
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, Utah, USA
| | - Neal K Bangerter
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, Utah, USA.,Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Daniel J Park
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, Utah, USA
| | - Ganesh Adluru
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | | | - Jian Xu
- Siemens Healthcare USA Inc., New York, New York, USA
| | - Edward DiBella
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
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Shehata ML, Basha TA, Hayeri MR, Hartung D, Teytelboym OM, Vogel-Claussen J. MR Myocardial Perfusion Imaging: Insights on Techniques, Analysis, Interpretation, and Findings. Radiographics 2014; 34:1636-57. [DOI: 10.1148/rg.346140074] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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36
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Chen X, Salerno M, Yang Y, Epstein FH. Motion-compensated compressed sensing for dynamic contrast-enhanced MRI using regional spatiotemporal sparsity and region tracking: block low-rank sparsity with motion-guidance (BLOSM). Magn Reson Med 2014; 72:1028-38. [PMID: 24243528 PMCID: PMC4097987 DOI: 10.1002/mrm.25018] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 09/11/2013] [Accepted: 10/08/2013] [Indexed: 11/12/2022]
Abstract
PURPOSE Dynamic contrast-enhanced MRI of the heart is well-suited for acceleration with compressed sensing (CS) due to its spatiotemporal sparsity; however, respiratory motion can degrade sparsity and lead to image artifacts. We sought to develop a motion-compensated CS method for this application. METHODS A new method, Block LOw-rank Sparsity with Motion-guidance (BLOSM), was developed to accelerate first-pass cardiac MRI, even in the presence of respiratory motion. This method divides the images into regions, tracks the regions through time, and applies matrix low-rank sparsity to the tracked regions. BLOSM was evaluated using computer simulations and first-pass cardiac datasets from human subjects. Using rate-4 undersampling, BLOSM was compared with other CS methods such as k-t SLR that uses matrix low-rank sparsity applied to the whole image dataset, with and without motion tracking, and to k-t FOCUSS with motion estimation and compensation that uses spatial and temporal-frequency sparsity. RESULTS BLOSM was qualitatively shown to reduce respiratory artifact compared with other methods. Quantitatively, using root mean squared error and the structural similarity index, BLOSM was superior to other methods. CONCLUSION BLOSM, which exploits regional low-rank structure and uses region tracking for motion compensation, provides improved image quality for CS-accelerated first-pass cardiac MRI.
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Affiliation(s)
- Xiao Chen
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Michael Salerno
- Department of Radiology, University of Virginia, Charlottesville, Virginia
- Department of Cardiology, University of Virginia, Charlottesville, Virginia
| | - Yang Yang
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Frederick H. Epstein
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
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Basha TA, Roujol S, Kissinger KV, Goddu B, Berg S, Manning WJ, Nezafat R. Free-breathing cardiac MR stress perfusion with real-time slice tracking. Magn Reson Med 2014; 72:689-98. [PMID: 24123153 PMCID: PMC3979504 DOI: 10.1002/mrm.24977] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 09/09/2013] [Accepted: 09/11/2013] [Indexed: 12/30/2022]
Abstract
PURPOSE To develop a free-breathing cardiac MR perfusion sequence with slice tracking for use after physical exercise. METHODS We propose to use a leading navigator, placed immediately before each 2D slice acquisition, for tracking the respiratory motion and updating the slice location in real-time. The proposed sequence was used to acquire CMR perfusion datasets in 12 healthy adult subjects and 8 patients. Images were compared with the conventional perfusion (i.e., without slice tracking) results from the same subjects. The location and geometry of the myocardium were quantitatively analyzed, and the perfusion signal curves were calculated from both sequences to show the efficacy of the proposed sequence. RESULTS The proposed sequence was significantly better compared with the conventional perfusion sequence in terms of qualitative image scores. Changes in the myocardial location and geometry decreased by 50% in the slice tracking sequence. Furthermore, the proposed sequence had signal curves that are smoother and less noisy. CONCLUSION The proposed sequence significantly reduces the effect of the respiratory motion on the image acquisition in both rest and stress perfusion scans.
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Affiliation(s)
- Tamer A. Basha
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Sébastien Roujol
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Kraig V. Kissinger
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Beth Goddu
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Sophie Berg
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Warren J. Manning
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Reza Nezafat
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
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Wissmann L, Santelli C, Segars WP, Kozerke S. MRXCAT: Realistic numerical phantoms for cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2014; 16:63. [PMID: 25204441 PMCID: PMC4422262 DOI: 10.1186/s12968-014-0063-3] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 08/06/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Computer simulations are important for validating novel image acquisition and reconstruction strategies. In cardiovascular magnetic resonance (CMR), numerical simulations need to combine anatomical information and the effects of cardiac and/or respiratory motion. To this end, a framework for realistic CMR simulations is proposed and its use for image reconstruction from undersampled data is demonstrated. METHODS The extended Cardiac-Torso (XCAT) anatomical phantom framework with various motion options was used as a basis for the numerical phantoms. Different tissue, dynamic contrast and signal models, multiple receiver coils and noise are simulated. Arbitrary trajectories and undersampled acquisition can be selected. The utility of the framework is demonstrated for accelerated cine and first-pass myocardial perfusion imaging using k-t PCA and k-t SPARSE. RESULTS MRXCAT phantoms allow for realistic simulation of CMR including optional cardiac and respiratory motion. Example reconstructions from simulated undersampled k-t parallel imaging demonstrate the feasibility of simulated acquisition and reconstruction using the presented framework. Myocardial blood flow assessment from simulated myocardial perfusion images highlights the suitability of MRXCAT for quantitative post-processing simulation. CONCLUSION The proposed MRXCAT phantom framework enables versatile and realistic simulations of CMR including breathhold and free-breathing acquisitions.
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Affiliation(s)
- Lukas Wissmann
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, Zurich, 8092, Switzerland.
| | - Claudio Santelli
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, Zurich, 8092, Switzerland.
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK.
| | - William P Segars
- Department of Radiology, Carl E Ravin Advanced Imaging Laboratories, The Duke University Medical Center, Durham, USA.
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, Zurich, 8092, Switzerland.
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK.
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Pflugi S, Roujol S, Akçakaya M, Kawaji K, Foppa M, Heydari B, Goddu B, Kissinger K, Berg S, Manning WJ, Kozerke S, Nezafat R. Accelerated cardiac MR stress perfusion with radial sampling after physical exercise with an MR-compatible supine bicycle ergometer. Magn Reson Med 2014; 74:384-95. [PMID: 25105469 DOI: 10.1002/mrm.25405] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 06/30/2014] [Accepted: 07/22/2014] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate the feasibility of accelerated cardiac MR (CMR) perfusion with radial sampling using nonlinear image reconstruction after exercise on an MR-compatible supine bike ergometer. METHODS Eight healthy subjects were scanned on two separate days using radial and Cartesian CMR perfusion sequences in rest and exercise stress perfusion. Four different methods (standard gridding, conjugate gradient SENSE [CG-SENSE], nonlinear inversion with joint estimation of coil-sensitivity profiles [NLINV] and compressed sensing with a total variation constraint [TV]) were compared for the reconstruction of radial data. Cartesian data were reconstructed using SENSE. All images were assessed by two blinded readers in terms of image quality and diagnostic value. RESULTS CG-SENSE and NLINV were scored more favorably than TV (in both rest and stress perfusion cases, P < 0.05) and gridding (for rest perfusion cases, P < 0.05). TV images showed patchy artifacts, which negatively influenced image quality especially in the stress perfusion images acquired with a low number of radial spokes. Although CG-SENSE and NLINV received better scores than Cartesian sampling in both rest and exercise stress perfusion cases, these differences were not statistically significant (P > 0.05). CONCLUSION We have demonstrated the feasibility of accelerated CMR perfusion using radial sampling after physical exercise using a supine bicycle ergometer in healthy subjects. For reconstruction of undersampled radial perfusion, CG-SENSE and NLINV resulted in better image quality than standard gridding or TV reconstruction. Further technical improvements and clinical assessment are needed before using this approach in patients with suspected coronary artery disease.
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Affiliation(s)
- Silvio Pflugi
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sébastien Roujol
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Mehmet Akçakaya
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Keigo Kawaji
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Murilo Foppa
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Bobby Heydari
- Department of Medicine, Brigham and Women Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Beth Goddu
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Kraig Kissinger
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Sophie Berg
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Warren J Manning
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Reza Nezafat
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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Jogiya R, Morton G, De Silva K, Reyes E, Hachamovitch R, Kozerke S, Nagel E, Underwood SR, Plein S. Ischemic burden by 3-dimensional myocardial perfusion cardiovascular magnetic resonance: comparison with myocardial perfusion scintigraphy. Circ Cardiovasc Imaging 2014; 7:647-54. [PMID: 24867884 DOI: 10.1161/circimaging.113.001620] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The extent and severity of ischemia on myocardial perfusion scintigraphy (MPS) is commonly used to risk-stratify patients with coronary artery disease. Estimation of ischemic burden by cardiovascular magnetic resonance (CMR) with conventional 2-dimensional myocardial perfusion methods is limited by incomplete cardiac coverage. More recently developed 3-dimensional (3D) myocardial perfusion CMR, however, provides whole-heart coverage. The aim of this study was to compare ischemic burden on 3D myocardial perfusion CMR with (99m)Tc-tetrofosmin MPS. METHODS AND RESULTS Forty-five patients who had undergone clinically indicated MPS underwent rest and adenosine stress 3D myocardial perfusion and late gadolinium enhancement CMR. Summed stress and rest scores were calculated for MPS and CMR using a 17-segment model and expressed as a percentage of the maximal possible score. Ischemic burden was defined as the difference between stress and rest scores. 3D myocardial perfusion CMR and MPS agreed in 38 of the 45 patients for the detection of any inducible ischemia. The mean ischemic burden for MPS and CMR was similar (7.5±8.9% versus 6.8±9.5%, respectively, P=0.82) with a strong correlation between techniques (rs=0.70, P<0.001). In a subset of 33 patients who underwent clinically indicated invasive coronary angiography, sensitivities and specificities of the 2 techniques to detect angiographic coronary artery disease were similar (McNemar P=0.45). CONCLUSIONS 3D myocardial perfusion CMR is an alternative to MPS for detecting the presence and rating the severity of ischemia.
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Affiliation(s)
- Roy Jogiya
- From the King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, United Kingdom (R.J., G.M., S.K., E.N., S.P.); King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Cardiovascular Division, The Rayne Institute, London, United Kingdom (K.D.S.); Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, United Kingdom (E.R., S.R.U.); Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (R.H.); Institute for Biomedical Engineering, University and ETH Zurich, Switzerland (S.K.); and Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, United Kingdom (S.P.)
| | - Geraint Morton
- From the King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, United Kingdom (R.J., G.M., S.K., E.N., S.P.); King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Cardiovascular Division, The Rayne Institute, London, United Kingdom (K.D.S.); Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, United Kingdom (E.R., S.R.U.); Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (R.H.); Institute for Biomedical Engineering, University and ETH Zurich, Switzerland (S.K.); and Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, United Kingdom (S.P.)
| | - Kalpa De Silva
- From the King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, United Kingdom (R.J., G.M., S.K., E.N., S.P.); King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Cardiovascular Division, The Rayne Institute, London, United Kingdom (K.D.S.); Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, United Kingdom (E.R., S.R.U.); Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (R.H.); Institute for Biomedical Engineering, University and ETH Zurich, Switzerland (S.K.); and Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, United Kingdom (S.P.)
| | - Eliana Reyes
- From the King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, United Kingdom (R.J., G.M., S.K., E.N., S.P.); King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Cardiovascular Division, The Rayne Institute, London, United Kingdom (K.D.S.); Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, United Kingdom (E.R., S.R.U.); Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (R.H.); Institute for Biomedical Engineering, University and ETH Zurich, Switzerland (S.K.); and Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, United Kingdom (S.P.)
| | - Rory Hachamovitch
- From the King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, United Kingdom (R.J., G.M., S.K., E.N., S.P.); King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Cardiovascular Division, The Rayne Institute, London, United Kingdom (K.D.S.); Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, United Kingdom (E.R., S.R.U.); Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (R.H.); Institute for Biomedical Engineering, University and ETH Zurich, Switzerland (S.K.); and Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, United Kingdom (S.P.)
| | - Sebastian Kozerke
- From the King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, United Kingdom (R.J., G.M., S.K., E.N., S.P.); King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Cardiovascular Division, The Rayne Institute, London, United Kingdom (K.D.S.); Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, United Kingdom (E.R., S.R.U.); Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (R.H.); Institute for Biomedical Engineering, University and ETH Zurich, Switzerland (S.K.); and Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, United Kingdom (S.P.)
| | - Eike Nagel
- From the King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, United Kingdom (R.J., G.M., S.K., E.N., S.P.); King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Cardiovascular Division, The Rayne Institute, London, United Kingdom (K.D.S.); Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, United Kingdom (E.R., S.R.U.); Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (R.H.); Institute for Biomedical Engineering, University and ETH Zurich, Switzerland (S.K.); and Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, United Kingdom (S.P.)
| | - S Richard Underwood
- From the King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, United Kingdom (R.J., G.M., S.K., E.N., S.P.); King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Cardiovascular Division, The Rayne Institute, London, United Kingdom (K.D.S.); Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, United Kingdom (E.R., S.R.U.); Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (R.H.); Institute for Biomedical Engineering, University and ETH Zurich, Switzerland (S.K.); and Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, United Kingdom (S.P.)
| | - Sven Plein
- From the King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, United Kingdom (R.J., G.M., S.K., E.N., S.P.); King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Cardiovascular Division, The Rayne Institute, London, United Kingdom (K.D.S.); Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, United Kingdom (E.R., S.R.U.); Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (R.H.); Institute for Biomedical Engineering, University and ETH Zurich, Switzerland (S.K.); and Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, United Kingdom (S.P.).
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41
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Salerno M, Taylor A, Yang Y, Kuruvilla S, Ragosta M, Meyer CH, Kramer CM. Adenosine stress cardiovascular magnetic resonance with variable-density spiral pulse sequences accurately detects coronary artery disease: initial clinical evaluation. Circ Cardiovasc Imaging 2014; 7:639-46. [PMID: 24759900 DOI: 10.1161/circimaging.113.001584] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Adenosine stress cardiovascular magnetic resonance perfusion imaging can be limited by motion-induced dark-rim artifacts, which may be mistaken for true perfusion abnormalities. A high-resolution variable-density spiral pulse sequence with a novel density compensation strategy has been shown to reduce dark-rim artifacts in first-pass perfusion imaging. We aimed to assess the clinical performance of adenosine stress cardiovascular magnetic resonance using this new perfusion sequence to detect obstructive coronary artery disease. METHODS AND RESULTS Cardiovascular magnetic resonance perfusion imaging was performed during adenosine stress (140 μg/kg per minute) and at rest on a Siemens 1.5-T Avanto scanner in 41 subjects with chest pain scheduled for coronary angiography. Perfusion images were acquired during injection of 0.1 mmol/kg Gadolinium-diethylenetriaminepentacetate at 3 short-axis locations using a saturation recovery interleaved variable-density spiral pulse sequence. Significant stenosis was defined as >50% by quantitative coronary angiography. Two blinded reviewers evaluated the perfusion images for the presence of adenosine-induced perfusion abnormalities and assessed image quality using a 5-point scale (1 [poor] to 5 [excellent]). The prevalence of obstructive coronary artery disease by quantitative coronary angiography was 68%. The average sensitivity, specificity, and accuracy were 89%, 85%, and 88%, respectively, with a positive predictive value and negative predictive value of 93% and 79%, respectively. The average image quality score was 4.4±0.7, with only 1 study with more than mild dark-rim artifacts. There was good inter-reader reliability with a κ statistic of 0.67. CONCLUSIONS Spiral adenosine stress cardiovascular magnetic resonance results in high diagnostic accuracy for the detection of obstructive coronary artery disease with excellent image quality and minimal dark-rim artifacts.
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Affiliation(s)
- Michael Salerno
- From the Cardiovascular Division, Department of Medicine (M.S., A.T., S.K., M.R., C.M.K.) and Department of Radiology and Medical Imaging (M.S., C.H.M., C.M.K.), University of Virginia Health System, Charlottesville; and Department of Biomedical Engineering, University of Virginia, Charlottesville (M.S., Y.Y., C.H.M.).
| | - Angela Taylor
- From the Cardiovascular Division, Department of Medicine (M.S., A.T., S.K., M.R., C.M.K.) and Department of Radiology and Medical Imaging (M.S., C.H.M., C.M.K.), University of Virginia Health System, Charlottesville; and Department of Biomedical Engineering, University of Virginia, Charlottesville (M.S., Y.Y., C.H.M.)
| | - Yang Yang
- From the Cardiovascular Division, Department of Medicine (M.S., A.T., S.K., M.R., C.M.K.) and Department of Radiology and Medical Imaging (M.S., C.H.M., C.M.K.), University of Virginia Health System, Charlottesville; and Department of Biomedical Engineering, University of Virginia, Charlottesville (M.S., Y.Y., C.H.M.)
| | - Sujith Kuruvilla
- From the Cardiovascular Division, Department of Medicine (M.S., A.T., S.K., M.R., C.M.K.) and Department of Radiology and Medical Imaging (M.S., C.H.M., C.M.K.), University of Virginia Health System, Charlottesville; and Department of Biomedical Engineering, University of Virginia, Charlottesville (M.S., Y.Y., C.H.M.)
| | - Michael Ragosta
- From the Cardiovascular Division, Department of Medicine (M.S., A.T., S.K., M.R., C.M.K.) and Department of Radiology and Medical Imaging (M.S., C.H.M., C.M.K.), University of Virginia Health System, Charlottesville; and Department of Biomedical Engineering, University of Virginia, Charlottesville (M.S., Y.Y., C.H.M.)
| | - Craig H Meyer
- From the Cardiovascular Division, Department of Medicine (M.S., A.T., S.K., M.R., C.M.K.) and Department of Radiology and Medical Imaging (M.S., C.H.M., C.M.K.), University of Virginia Health System, Charlottesville; and Department of Biomedical Engineering, University of Virginia, Charlottesville (M.S., Y.Y., C.H.M.)
| | - Christopher M Kramer
- From the Cardiovascular Division, Department of Medicine (M.S., A.T., S.K., M.R., C.M.K.) and Department of Radiology and Medical Imaging (M.S., C.H.M., C.M.K.), University of Virginia Health System, Charlottesville; and Department of Biomedical Engineering, University of Virginia, Charlottesville (M.S., Y.Y., C.H.M.)
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Motwani M, Kidambi A, Sourbron S, Fairbairn TA, Uddin A, Kozerke S, Greenwood JP, Plein S. Quantitative three-dimensional cardiovascular magnetic resonance myocardial perfusion imaging in systole and diastole. J Cardiovasc Magn Reson 2014; 16:19. [PMID: 24565078 PMCID: PMC3941945 DOI: 10.1186/1532-429x-16-19] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 01/29/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Two-dimensional (2D) perfusion cardiovascular magnetic resonance (CMR) remains limited by a lack of complete myocardial coverage. Three-dimensional (3D) perfusion CMR addresses this limitation and has recently been shown to be clinically feasible. However, the feasibility and potential clinical utility of quantitative 3D perfusion measurements, as already shown with 2D-perfusion CMR and positron emission tomography, has yet to be evaluated. The influence of systolic or diastolic acquisition on myocardial blood flow (MBF) estimates, diagnostic accuracy and image quality is also unknown for 3D-perfusion CMR. The purpose of this study was to establish the feasibility of quantitative 3D-perfusion CMR for the detection of coronary artery disease (CAD) and to compare systolic and diastolic estimates of MBF. METHODS Thirty-five patients underwent 3D-perfusion CMR with data acquired at both end-systole and mid-diastole. MBF and myocardial perfusion reserve (MPR) were estimated on a per patient and per territory basis by Fermi-constrained deconvolution. Significant CAD was defined as stenosis ≥70% on quantitative coronary angiography. RESULTS Twenty patients had significant CAD (involving 38 out of 105 territories). Stress MBF and MPR had a high diagnostic accuracy for the detection of CAD in both systole (area under curve [AUC]: 0.95 and 0.92, respectively) and diastole (AUC: 0.95 and 0.94). There were no significant differences in the AUCs between systole and diastole (p values >0.05). At stress, diastolic MBF estimates were significantly greater than systolic estimates (no CAD: 3.21 ± 0.50 vs. 2.75 ± 0.42 ml/g/min, p < 0.0001; CAD: 2.13 ± 0.45 vs. 1.98 ± 0.41 ml/g/min, p < 0.0001); but at rest, there were no significant differences (p values >0.05). Image quality was higher in systole than diastole (median score 3 vs. 2, p = 0.002). CONCLUSIONS Quantitative 3D-perfusion CMR is feasible. Estimates of MBF are significantly different for systole and diastole at stress but diagnostic accuracy to detect CAD is high for both cardiac phases. Better image quality suggests that systolic data acquisition may be preferable.
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Affiliation(s)
- Manish Motwani
- Multidisciplinary Cardiovascular Research Centre & The Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health & Therapeutics, University of Leeds, Leeds, UK
| | - Ananth Kidambi
- Multidisciplinary Cardiovascular Research Centre & The Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health & Therapeutics, University of Leeds, Leeds, UK
| | | | - Timothy A Fairbairn
- Multidisciplinary Cardiovascular Research Centre & The Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health & Therapeutics, University of Leeds, Leeds, UK
| | - Akhlaque Uddin
- Multidisciplinary Cardiovascular Research Centre & The Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health & Therapeutics, University of Leeds, Leeds, UK
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - John P Greenwood
- Multidisciplinary Cardiovascular Research Centre & The Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health & Therapeutics, University of Leeds, Leeds, UK
| | - Sven Plein
- Multidisciplinary Cardiovascular Research Centre & The Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health & Therapeutics, University of Leeds, Leeds, UK
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Weiss K, Sigfridsson A, Wissmann L, Busch J, Batel M, Krajewski M, Ernst M, Kozerke S. Accelerating hyperpolarized metabolic imaging of the heart by exploiting spatiotemporal correlations. NMR IN BIOMEDICINE 2013; 26:1380-1386. [PMID: 23616307 DOI: 10.1002/nbm.2963] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 03/04/2013] [Accepted: 03/24/2013] [Indexed: 06/02/2023]
Abstract
Hyperpolarized (13)C-labeled pyruvate is a promising tool to investigate cardiac metabolism. It has been shown that changes in substrate metabolism occur following the induction of ischemia. To investigate the metabolic changes that are confined to spatial regions, high spatiotemporal resolution is required. The present work exploits both spatial and temporal correlations using k-t principal component analysis (PCA) to undersample the spatiotemporal domain, thereby speeding up data acquisition. A numerical model was implemented to investigate optimal acquisition and reconstruction parameters for pyruvate, lactate and bicarbonate maps of the heart. Subsequently, prospectively undersampled in vivo data on rat hearts were acquired using a combination of spectral-spatial signal excitation and a variable-density single-shot echo planar readout. Using five-fold k-t PCA, a spatial resolution of 1 × 1 mm(2) at a temporal resolution of 3 s was achieved.
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Affiliation(s)
- Kilian Weiss
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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Akçakaya M, Basha TA, Pflugi S, Foppa M, Kissinger KV, Hauser TH, Nezafat R. Localized spatio-temporal constraints for accelerated CMR perfusion. Magn Reson Med 2013; 72:629-39. [PMID: 24123058 DOI: 10.1002/mrm.24963] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 08/12/2013] [Accepted: 09/03/2013] [Indexed: 01/09/2023]
Abstract
PURPOSE To develop and evaluate an image reconstruction technique for cardiac MRI (CMR) perfusion that uses localized spatio-temporal constraints. METHODS CMR perfusion plays an important role in detecting myocardial ischemia in patients with coronary artery disease. Breath-hold k-t-based image acceleration techniques are typically used in CMR perfusion for superior spatial/temporal resolution and improved coverage. In this study, we propose a novel compressed sensing-based image reconstruction technique for CMR perfusion, with applicability to free-breathing examinations. This technique uses local spatio-temporal constraints by regularizing image patches across a small number of dynamics. The technique was compared with conventional dynamic-by-dynamic reconstruction, and sparsity regularization using a temporal principal-component (pc) basis, as well as zero-filled data in multislice two-dimensional (2D) and three-dimensional (3D) CMR perfusion. Qualitative image scores were used (1 = poor, 4 = excellent) to evaluate the technique in 3D perfusion in 10 patients and five healthy subjects. On four healthy subjects, the proposed technique was also compared with a breath-hold multislice 2D acquisition with parallel imaging in terms of signal intensity curves. RESULTS The proposed technique produced images that were superior in terms of spatial and temporal blurring compared with the other techniques, even in free-breathing datasets. The image scores indicated a significant improvement compared with other techniques in 3D perfusion (x-pc regularization, 2.8 ± 0.5 versus 2.3 ± 0.5; dynamic-by-dynamic, 1.7 ± 0.5; zero-filled, 1.1 ± 0.2). Signal intensity curves indicate similar dynamics of uptake between the proposed method with 3D acquisition and the breath-hold multislice 2D acquisition with parallel imaging. CONCLUSION The proposed reconstruction uses sparsity regularization based on localized information in both spatial and temporal domains for highly accelerated CMR perfusion with potential use in free-breathing 3D acquisitions.
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Affiliation(s)
- Mehmet Akçakaya
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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Chen D, Sharif B, Dharmakumar R, Thomson LEJ, Bairey Merz CN, Berman DS, Li D. Improved quantification of myocardial blood flow using highly constrained back projection reconstruction. Magn Reson Med 2013; 72:749-55. [PMID: 24122950 DOI: 10.1002/mrm.24958] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 07/24/2013] [Accepted: 08/27/2013] [Indexed: 01/11/2023]
Abstract
PURPOSE To improve quantification of myocardial blood flow using a fast T1 mapping technique using highly constrained back projection reconstruction (HYPR)-accelerated acquisition. METHODS A major source of error in the measurement of myocardial blood flow (MBF) using MRI is the nonlinear relationship between image signal intensity and contrast agent (CA) concentration. HYPR-accelerated radial acquisition was used to generate pixel-wise T1 maps with a temporal resolution of one heartbeat. HYPR produces images with a temporal footprint of 40 ms and four images within 188 ms. T1 values were converted into CA concentrations by the known linear relationship between CA concentration and T1 . The T1 mapping technique was used to quantify MBF in 10 healthy subjects and compared with MBF found using image signal intensity as well as MBF reported in the literature. RESULTS The MBF measured using the proposed method was more consistent with that previously reported in the literature and was significantly lower (P = 0.002) than that calculated using image signal intensity (1.11 ± 0.27 mL/min/g versus 1.88 ± 0.45 mL/min/g, respectively). CONCLUSION We developed a fast T1 mapping method for MBF quantification using radial sampling and HYPR. Further validation is required to determine its clinical value in assessing myocardial perfusion deficit in coronary artery disease.
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Affiliation(s)
- David Chen
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA; Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Schnell S, Markl M, Entezari P, Mahadewia RJ, Semaan E, Stankovic Z, Collins J, Carr J, Jung B. k-t GRAPPA accelerated four-dimensional flow MRI in the aorta: effect on scan time, image quality, and quantification of flow and wall shear stress. Magn Reson Med 2013; 72:522-33. [PMID: 24006309 DOI: 10.1002/mrm.24925] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 06/27/2013] [Accepted: 07/28/2013] [Indexed: 01/29/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the utility of k-t parallel imaging for accelerating aortic four-dimensional (4D)-flow MRI. The aim was to systematically investigate the impact of different acceleration factors and number of coil elements on acquisition time, image quality and quantification of hemodynamic parameters. METHODS k-t accelerated 4D-flow MRI (spatial/temporal resolution = 2.1 × 2.5 × 2.5 mm/40.0 ms) was acquired in 10 healthy volunteers with acceleration factors R = 3, 5, and 8 using 12- and 32-channel receiver coils. Results were compared with conventional parallel imaging (GRAPPA [generalized autocalibrating partial parallel acquisition], R = 2). Data analysis included radiological grading of three-dimensional blood flow visualization quality as well as quantification of blood flow, velocities and wall shear stress (WSS). RESULTS k-t GRAPPA significantly reduced scan time by 28%, 54%, and 68%, for R = 3, 5, and 8, respectively, while maintaining image quality as demonstrated by overall similar image quality grading. Significant differences in peak WSS (diff12ch = -5.9%, diff32ch = 18.5%) and mean WSS (diff32ch = 13.9%) were found at the descending aorta for both receiver coils for R = 5 (PWSS < 0.04). Peak velocity differed for R=8 at the aortic root (-7.4%) and descending aorta (-12%) with PpeakVelo < 0.03. CONCLUSION k-t GRAPPA acceleration with a 12- or 32-channel receiver coil and an acceleration of 3 or 5 can compete with a standard GRAPPA R = 2 acceleration.
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Affiliation(s)
- Susanne Schnell
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
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Schmidt JFM, Wissmann L, Manka R, Kozerke S. Iterative k-t principal component analysis with nonrigid motion correction for dynamic three-dimensional cardiac perfusion imaging. Magn Reson Med 2013; 72:68-79. [PMID: 23913550 DOI: 10.1002/mrm.24894] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 06/25/2013] [Accepted: 06/27/2013] [Indexed: 11/08/2022]
Abstract
PURPOSE In this study, an iterative k-t principal component analysis (PCA) algorithm with nonrigid frame-to-frame motion correction is proposed for dynamic contrast-enhanced three-dimensional perfusion imaging. METHODS An iterative k-t PCA algorithm was implemented with regularization using training data corrected for frame-to-frame motion in the x-pc domain. Motion information was extracted using shape-constrained nonrigid image registration of the composite of training and k-t undersampled data. The approach was tested for 10-fold k-t undersampling using computer simulations and in vivo data sets corrupted by respiratory motion artifacts owing to free-breathing or interrupted breath-holds. Results were compared to breath-held reference data. RESULTS Motion-corrected k-t PCA image reconstruction resolved residual aliasing. Signal intensity curves extracted from the myocardium were close to those obtained from the breath-held reference. Upslopes were found to be more homogeneous in space when using the k-t PCA approach with motion correction. CONCLUSIONS Iterative k-t PCA with nonrigid motion correction permits correction of respiratory motion artifacts in three-dimensional first-pass myocardial perfusion imaging.
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Affiliation(s)
- Johannes F M Schmidt
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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Hahn T, Kozerke S, Schwizer W, Fried M, Boesiger P, Steingoetter A. Real-time multipoint gastrointestinal 19-fluorine catheter tracking. Magn Reson Med 2013; 71:302-7. [PMID: 23400935 DOI: 10.1002/mrm.24654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 12/28/2012] [Accepted: 12/28/2012] [Indexed: 12/22/2022]
Abstract
PURPOSE To develop MR based real-time gastrointestinal 19-Fluorine (19F) catheter tracking and visualization allowing for real-time detection and feedback of 3D catheter shape and movement as well as catheter-driven adjustments of 1H imaging geometry parameters. METHODS Data were acquired on a 3T clinical system using 3D Golden Angle radial sampling. Two gastrointestinal catheters incorporating four fiducial 19F markers (65 or 50 µL marker volume) were tracked while being pulled through a gel phantom by an operator inside the MR room with velocities of 2-18 mm/s. During continuous acquisition, k-space profiles were transferred in real-time to an external computer for concurrent reconstruction of 3D 19F images and detection and visualization of marker positions. Based on αthe marker positions, automatic adjustments of 1H imaging planes to facilitate targeted anatomical scanning was implemented. RESULTS Mean tracking reliabilities were 94.5 and 83.6% (catheters 1 and 2) for temporal resolutions 185-740 ms. Reconstruction times of 196 ms were achieved. Real-time visual feedback allowed the operator to accurately control the catheter movement. Catheter-guidance for 1H imaging was reliable. CONCLUSION The presented real-time 19F MR based framework for the tracking of 19F labeled devices is applicable to combined 19F and 1H MRI guidance of gastrointestinal devices in vivo.
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Affiliation(s)
- Tobias Hahn
- Institute for Biomedical Engineering, University and ETH Zurich, Switzerland
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Schmidt J, Wissmann L, Manka R, Kozerke S. Whole-heart first-pass myocardial perfusion imaging with non-rigid respiratory motion correction. J Cardiovasc Magn Reson 2013. [PMCID: PMC3559816 DOI: 10.1186/1532-429x-15-s1-p176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Jogiya R, Morton G, De Silva K, Redwood S, Kozerke S, Perera D, Nagel E, Plein S. Validation of dynamic three-dimensional whole heart magnetic resonance myocardial perfusion imaging at 3.0 Tesla against fractional flow reserve for the detection of flow-limiting coronary heart disease. J Cardiovasc Magn Reson 2012. [PMCID: PMC3304790 DOI: 10.1186/1532-429x-14-s1-o92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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