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Zhang JH, Neumann T, Schaeffter T, Kolbitsch C, Kerkering KM. Respiratory motion-corrected T1 mapping of the abdomen. MAGMA (NEW YORK, N.Y.) 2024:10.1007/s10334-024-01196-1. [PMID: 39133420 DOI: 10.1007/s10334-024-01196-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVE The purpose of this study was to investigate an approach for motion-corrected T1 mapping of the abdomen that allows for free breathing data acquisition with 100% scan efficiency. MATERIALS AND METHODS Data were acquired using a continuous golden radial trajectory and multiple inversion pulses. For the correction of respiratory motion, motion estimation based on a surrogate was performed from the same data used for T1 mapping. Image-based self-navigation allowed for binning and reconstruction of respiratory-resolved images, which were used for the estimation of respiratory motion fields. Finally, motion-corrected T1 maps were calculated from the data applying the estimated motion fields. The method was evaluated in five healthy volunteers. For the assessment of the image-based navigator, we compared it to a simultaneously acquired ultrawide band radar signal. Motion-corrected T1 maps were evaluated qualitatively and quantitatively for different scan times. RESULTS For all volunteers, the motion-corrected T1 maps showed fewer motion artifacts in the liver as well as sharper kidney structures and blood vessels compared to uncorrected T1 maps. Moreover, the relative error to the reference breathhold T1 maps could be reduced from up to 25% for the uncorrected T1 maps to below 10% for the motion-corrected maps for the average value of a region of interest, while the scan time could be reduced to 6-8 s. DISCUSSION The proposed approach allows for respiratory motion-corrected T1 mapping in the abdomen and ensures accurate T1 maps without the need for any breathholds.
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Affiliation(s)
- Jana Huiyue Zhang
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany.
- Department of Biomedical Engineering, Technical University of Berlin, Berlin, Germany.
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
| | - Tom Neumann
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Tobias Schaeffter
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
- Department of Biomedical Engineering, Technical University of Berlin, Berlin, Germany
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Christoph Kolbitsch
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
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Zhang Q, Fotaki A, Ghadimi S, Wang Y, Doneva M, Wetzl J, Delfino JG, O'Regan DP, Prieto C, Epstein FH. Improving the efficiency and accuracy of cardiovascular magnetic resonance with artificial intelligence-review of evidence and proposition of a roadmap to clinical translation. J Cardiovasc Magn Reson 2024; 26:101051. [PMID: 38909656 PMCID: PMC11331970 DOI: 10.1016/j.jocmr.2024.101051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 06/09/2024] [Accepted: 06/18/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) is an important imaging modality for the assessment of heart disease; however, limitations of CMR include long exam times and high complexity compared to other cardiac imaging modalities. Recently advancements in artificial intelligence (AI) technology have shown great potential to address many CMR limitations. While the developments are remarkable, translation of AI-based methods into real-world CMR clinical practice remains at a nascent stage and much work lies ahead to realize the full potential of AI for CMR. METHODS Herein we review recent cutting-edge and representative examples demonstrating how AI can advance CMR in areas such as exam planning, accelerated image reconstruction, post-processing, quality control, classification and diagnosis. RESULTS These advances can be applied to speed up and simplify essentially every application including cine, strain, late gadolinium enhancement, parametric mapping, 3D whole heart, flow, perfusion and others. AI is a unique technology based on training models using data. Beyond reviewing the literature, this paper discusses important AI-specific issues in the context of CMR, including (1) properties and characteristics of datasets for training and validation, (2) previously published guidelines for reporting CMR AI research, (3) considerations around clinical deployment, (4) responsibilities of clinicians and the need for multi-disciplinary teams in the development and deployment of AI in CMR, (5) industry considerations, and (6) regulatory perspectives. CONCLUSIONS Understanding and consideration of all these factors will contribute to the effective and ethical deployment of AI to improve clinical CMR.
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Affiliation(s)
- Qiang Zhang
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK; Big Data Institute, University of Oxford, Oxford, UK.
| | - Anastasia Fotaki
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK; Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
| | - Sona Ghadimi
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
| | - Yu Wang
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
| | | | - Jens Wetzl
- Siemens Healthineers AG, Erlangen, Germany.
| | - Jana G Delfino
- US Food and Drug Administration, Center for Devices and Radiological Health (CDRH), Office of Science and Engineering Laboratories (OSEL), Silver Spring, MD, USA.
| | - Declan P O'Regan
- MRC Laboratory of Medical Sciences, Imperial College London, London, UK.
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK; School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - Frederick H Epstein
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
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Aizaz M, van der Pol JAJ, Schneider A, Munoz C, Holtackers RJ, van Cauteren Y, van Langen H, Meeder JG, Rahel BM, Wierts R, Botnar RM, Prieto C, Moonen RPM, Kooi ME. Extended MRI-based PET motion correction for cardiac PET/MRI. EJNMMI Phys 2024; 11:36. [PMID: 38581561 PMCID: PMC10998820 DOI: 10.1186/s40658-024-00637-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/25/2024] [Indexed: 04/08/2024] Open
Abstract
PURPOSE A 2D image navigator (iNAV) based 3D whole-heart sequence has been used to perform MRI and PET non-rigid respiratory motion correction for hybrid PET/MRI. However, only the PET data acquired during the acquisition of the 3D whole-heart MRI is corrected for respiratory motion. This study introduces and evaluates an MRI-based respiratory motion correction method of the complete PET data. METHODS Twelve oncology patients scheduled for an additional cardiac 18F-Fluorodeoxyglucose (18F-FDG) PET/MRI and 15 patients with coronary artery disease (CAD) scheduled for cardiac 18F-Choline (18F-FCH) PET/MRI were included. A 2D iNAV recorded the respiratory motion of the myocardium during the 3D whole-heart coronary MR angiography (CMRA) acquisition (~ 10 min). A respiratory belt was used to record the respiratory motion throughout the entire PET/MRI examination (~ 30-90 min). The simultaneously acquired iNAV and respiratory belt signal were used to divide the acquired PET data into 4 bins. The binning was then extended for the complete respiratory belt signal. Data acquired at each bin was reconstructed and combined using iNAV-based motion fields to create a respiratory motion-corrected PET image. Motion-corrected (MC) and non-motion-corrected (NMC) datasets were compared. Gating was also performed to correct cardiac motion. The SUVmax and TBRmax values were calculated for the myocardial wall or a vulnerable coronary plaque for the 18F-FDG and 18F-FCH datasets, respectively. RESULTS A pair-wise comparison showed that the SUVmax and TBRmax values of the motion corrected (MC) datasets were significantly higher than those for the non-motion-corrected (NMC) datasets (8.2 ± 1.0 vs 7.5 ± 1.0, p < 0.01 and 1.9 ± 0.2 vs 1.2 ± 0.2, p < 0.01, respectively). In addition, the SUVmax and TBRmax of the motion corrected and gated (MC_G) reconstructions were also higher than that of the non-motion-corrected but gated (NMC_G) datasets, although for the TBRmax this difference was not statistically significant (9.6 ± 1.3 vs 9.1 ± 1.2, p = 0.02 and 2.6 ± 0.3 vs 2.4 ± 0.3, p = 0.16, respectively). The respiratory motion-correction did not lead to a change in the signal to noise ratio. CONCLUSION The proposed respiratory motion correction method for hybrid PET/MRI improved the image quality of cardiovascular PET scans by increased SUVmax and TBRmax values while maintaining the signal-to-noise ratio. Trial registration METC162043 registered 01/03/2017.
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Affiliation(s)
- Mueez Aizaz
- CARIM, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Jochem A J van der Pol
- CARIM, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Alina Schneider
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Camila Munoz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Robert J Holtackers
- CARIM, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Yvonne van Cauteren
- CARIM, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Department of Cardiology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Herman van Langen
- Department of Medical Physics and Devices, VieCuri Medical Centre, Venlo, The Netherlands
| | - Joan G Meeder
- Department of Cardiology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Braim M Rahel
- Department of Cardiology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Roel Wierts
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millenium Institute for Intelligent Healthcare Engineering iHEALTH, Santiago, Chile
- Instituto de Ingeniería Biológica y Médica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millenium Institute for Intelligent Healthcare Engineering iHEALTH, Santiago, Chile
| | - Rik P M Moonen
- CARIM, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - M Eline Kooi
- CARIM, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands.
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.
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Fotaki A, Pushparajah K, Rush C, Munoz C, Velasco C, Neji R, Kunze KP, Botnar RM, Prieto C. Highly efficient free-breathing 3D whole-heart imaging in 3-min: single center study in adults with congenital heart disease. J Cardiovasc Magn Reson 2023; 26:100008. [PMID: 38194762 PMCID: PMC11211218 DOI: 10.1016/j.jocmr.2023.100008] [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: 11/24/2023] [Accepted: 12/10/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Three dimensional, whole-heart (3DWH) MRI is an established non-invasive imaging modality in patients with congenital heart disease (CHD) for the diagnosis of cardiovascular morphology and for clinical decision making. Current techniques utilise diaphragmatic navigation (dNAV) for respiratory motion correction and gating and are frequently limited by long acquisition times. This study proposes and evaluates the diagnostic performance of a respiratory gating-free framework, which considers respiratory image-based navigation (iNAV), and highly accelerated variable density Cartesian sampling in concert with non-rigid motion correction and low-rank patch-based denoising (iNAV-3DWH-PROST). The method is compared to the clinical dNAV-3DWH sequence in adult patients with CHD. METHODS In this prospective single center study, adult patients with CHD who underwent the clinical dNAV-3DWH MRI were also scanned with the iNAV-3DWH-PROST. Diagnostic confidence (4-point Likert scale) and diagnostic accuracy for common cardiovascular lesions was assessed by three readers. Scan times and diagnostic confidence were compared using the Wilcoxon-signed rank test. Co-axial vascular dimensions at three anatomic landmarks were measured, and agreement between the research and the corresponding clinical sequence was assessed with Bland-Altman analysis. RESULTS The study included 60 participants (mean age ± [SD]: 33 ± 14 years; 36 men). The mean acquisition time of iNAV-3DWH-PROST was significantly lower compared with the conventional clinical sequence (3.1 ± 0.9 min vs 13.9 ± 3.9 min, p < 0.0001). Diagnostic confidence was higher for the iNAV-3DWH-PROST sequence compared with the clinical sequence (3.9 ± 0.2 vs 3.4 ± 0.8, p < 0.001), however there was no significant difference in diagnostic accuracy. Narrow limits of agreement and mean bias less than 0.08 cm were found between the research and the clinical vascular measurements. CONCLUSIONS The iNAV-3DWH-PROST framework provides efficient, high quality and robust 3D whole-heart imaging in significantly shorter scan time compared to the standard clinical sequence.
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Affiliation(s)
- Anastasia Fotaki
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
| | - Kuberan Pushparajah
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Christopher Rush
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Camila Munoz
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom
| | - Carlos Velasco
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom
| | - Radhouene Neji
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom
| | - Karl P Kunze
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom
| | - René M Botnar
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile; Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile; Institute for Advanced Study, Technical University of Munich, Lichtenbergstrasse 2 a, D-85748 Garching, Germany
| | - Claudia Prieto
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile
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5
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Fotaki A, Pushparajah K, Hajhosseiny R, Schneider A, Alam H, Ferreira J, Neji R, Kunze KP, Frigiola A, Botnar RM, Prieto C. Free-breathing, Contrast Agent-free Whole-Heart MTC-BOOST Imaging: Single-Center Validation Study in Adult Congenital Heart Disease. Radiol Cardiothorac Imaging 2023; 5:e220146. [PMID: 36860831 PMCID: PMC9969217 DOI: 10.1148/ryct.220146] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 02/18/2023]
Abstract
Purpose To assess the clinical performance of the three-dimensional, free-breathing, Magnetization Transfer Contrast Bright-and-black blOOd phase-SensiTive (MTC-BOOST) sequence in adult congenital heart disease (ACHD). Materials and Methods In this prospective study, participants with ACHD undergoing cardiac MRI between July 2020 and March 2021 were scanned with the clinical T2-prepared balanced steady-state free precession sequence and proposed MTC-BOOST sequence. Four cardiologists scored their diagnostic confidence on a four-point Likert scale for sequential segmental analysis on images acquired with each sequence. Scan times and diagnostic confidence were compared using the Mann-Whitney test. Coaxial vascular dimensions at three anatomic landmarks were measured, and agreement between the research sequence and the corresponding clinical sequence was assessed with Bland-Altman analysis. Results The study included 120 participants (mean age, 33 years ± 13 [SD]; 65 men). The mean acquisition time of the MTC-BOOST sequence was significantly lower compared with that of the conventional clinical sequence (9 minutes ± 2 vs 14 minutes ± 5; P < .001). Diagnostic confidence was higher for the MTC-BOOST sequence compared with the clinical sequence (mean, 3.9 ± 0.3 vs 3.4 ± 0.7; P < .001). Narrow limits of agreement and mean bias less than 0.08 cm were found between the research and clinical vascular measurements. Conclusion The MTC-BOOST sequence provided efficient, high-quality, and contrast agent-free three-dimensional whole-heart imaging in ACHD, with shorter, more predictable acquisition time and improved diagnostic confidence compared with the reference standard clinical sequence.Keywords: MR Angiography, Cardiac Supplemental material is available for this article. Published under a CC BY 4.0 license.
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Rashid I, Ginami G, Nordio G, Fotaki A, Neji R, Alam H, Pushparajah K, Frigiola A, Valverde I, Botnar RM, Prieto C. Magnetization Transfer BOOST Noncontrast Angiography Improves Pulmonary Vein Imaging in Adults With Congenital Heart Disease. J Magn Reson Imaging 2023; 57:521-531. [PMID: 35642573 PMCID: PMC10084321 DOI: 10.1002/jmri.28280] [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: 01/16/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cardiac MRI plays an important role in the diagnosis and follow-up of patients with congenital heart disease (CHD). Gadolinium-based contrast agents are often needed to overcome flow-related and off-resonance artifacts that can impair the quality of conventional noncontrast 3D imaging. As serial imaging is often required in CHD, the development of robust noncontrast 3D MRI techniques is desirable. PURPOSE To assess the clinical utility of noncontrast enhanced magnetization transfer and inversion recovery prepared 3D free-breathing sequence (MTC-BOOST) compared to conventional 3D whole heart imaging in patients with CHD. STUDY TYPE Prospective, image quality. POPULATION A total of 27 adult patients (44% female, mean age 30.9 ± 14.8 years) with CHD. FIELD STRENGTH/SEQUENCE A 1.5 T; free-breathing 3D MTC-BOOST sequence. ASSESSMENT MTC-BOOST was compared to diaphragmatic navigator-gated, noncontrast T2 prepared 3D whole-heart imaging sequence (T2prep-3DWH) for comparison of vessel dimensions, lumen-to-myocardium contrast ratio (CR), and image quality (vessel wall sharpness and presence and type of artifacts) assessed by two experienced cardiologists on a 5-point scale. STATISTICAL TESTS Mann-Whitney test, paired Wilcoxon signed-rank test, Bland-Altman plots. P < 0.05 was considered statistically significant. RESULTS MTC-BOOST significantly improved image quality and CR of the right-sided pulmonary veins (PV): (CR: right upper PV 1.06 ± 0.50 vs. 0.58 ± 0.74; right lower PV 1.32 ± 0.38 vs. 0.81 ± 0.73) compared to conventional T2prep-3DWH imaging where the PVs were not visualized in some cases due to off-resonance effects. MTC-BOOST demonstrated resistance to degradation of luminal signal (assessed by CR) secondary to accelerated or turbulent flow conditions. T2prep-3DWH had higher image quality scores than MTC-BOOST for the aorta and coronary arteries; however, great vessel dimensions derived from MTC-BOOST showed excellent agreement with standard T2prep-3DWH imaging. DATA CONCLUSION MTC-BOOST allows for improved contrast-free imaging of pulmonary veins and regions characterized by accelerated or turbulent blood flow compared to standard T2prep-3DWH imaging, with excellent agreement of great vessel dimensions. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Imran Rashid
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Giulia Ginami
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Giovanna Nordio
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Anastasia Fotaki
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Radhouene Neji
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
| | - Harith Alam
- Guy's and St Thomas' Hospital, Department of Cardiology, London, UK
| | - Kuberan Pushparajah
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Guy's and St Thomas' Hospital, Department of Cardiology, London, UK
| | | | - Israel Valverde
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Paediatric Cardiology Unit, Hospital Virgen del Rocio and Institute of Biomedicine of Seville, IBIS Ciber-CV, Seville, Spain
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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Reiss S, Wäscher K, Caglar Özen A, Lottner T, Timo Heidt, von Zur Mühlen C, Bock M. Quantifying myocardial perfusion during MR-guided interventions without exogenous contrast agents: intra-arterial spin labeling. Z Med Phys 2023:S0939-3889(23)00002-8. [PMID: 36717310 DOI: 10.1016/j.zemedi.2023.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/30/2023]
Abstract
PURPOSE To test intra-arterial spin labeling (iASL) using active guiding catheters for myocardial perfusion measurements during magnetic resonance (MR)-guided interventions in a pig study. METHODS In this work, a single-loop radiofrequency (RF) coil at the tip of a 6F active coronary catheter was used as a transmit coil for local spin labeling. The transmit magnetic RF field (B1) of the coil and the labeling efficiency were determined, and iASL was tested in two pigs after the catheter was engaged in the aortic root, the ostium of the left coronary artery (LCA) under MR-guidance. The iASL effect was assessed by the signal difference between spin-labeling On and control (spin-labeling OFF) images, and in a cross-correlation between ON/Off states of spin-labeling a binary labeling paradigm. In addition, quantitative myocardial perfusion was calculated from the iASL experiments. RESULTS The maximum B1 in the vicinity of the catheter coil was 2.1 µT. A strong local labeling effect with a labeling efficiency of 0.45 was achieved with iASL both in vitro and in vivo. In both pigs, the proximal myocardial segments supplied by the LCA showed significant labelling effect up to distances of 60 mm from the aortic root with a relative signal difference of (3.14 ± 2.89)% in the first and (3.50 ± 1.25)% in the second animal. The mean correlation coefficients were R = 0.63 ± 0.22 and 0.42 ± 0.16, respectively. The corresponding computed myocardial perfusion values in this region of the myocardium were similar to those obtained with contrast perfusion methods ((1.2 ± 1.1) mL/min/g and (0.8 ± 0.6) mL/min/g). CONCLUSION The proposed iASL method demonstrates the feasibility of selective myocardial perfusion measurements during MR-guided coronary interventions, which with further technical improvements may provide an alternative to exogenous contrast-based perfusion. Due to the invasive nature of the iASL method, it can potentially be used in concert with MRI-guided coronary angioplasty.
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Affiliation(s)
- Simon Reiss
- Department of Diagnostic and Interventional Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Kevin Wäscher
- Department of Diagnostic and Interventional Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ali Caglar Özen
- Department of Diagnostic and Interventional Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Lottner
- Department of Diagnostic and Interventional Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Timo Heidt
- Department of Cardiology and Angiology I, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Constantin von Zur Mühlen
- Department of Cardiology and Angiology I, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Bock
- Department of Diagnostic and Interventional Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Aimo A, Huang L, Tyler A, Barison A, Martini N, Saccaro LF, Roujol S, Masci PG. Quantitative susceptibility mapping (QSM) of the cardiovascular system: challenges and perspectives. J Cardiovasc Magn Reson 2022; 24:48. [PMID: 35978351 PMCID: PMC9387036 DOI: 10.1186/s12968-022-00883-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/05/2022] [Indexed: 11/10/2022] Open
Abstract
Quantitative susceptibility mapping (QSM) is a powerful, non-invasive, magnetic resonance imaging (MRI) technique that relies on measurement of magnetic susceptibility. So far, QSM has been employed mostly to study neurological disorders characterized by iron accumulation, such as Parkinson's and Alzheimer's diseases. Nonetheless, QSM allows mapping key indicators of cardiac disease such as blood oxygenation and myocardial iron content. For this reason, the application of QSM offers an unprecedented opportunity to gain a better understanding of the pathophysiological changes associated with cardiovascular disease and to monitor their evolution and response to treatment. Recent studies on cardiovascular QSM have shown the feasibility of a non-invasive assessment of blood oxygenation, myocardial iron content and myocardial fibre orientation, as well as carotid plaque composition. Significant technical challenges remain, the most evident of which are related to cardiac and respiratory motion, blood flow, chemical shift effects and susceptibility artefacts. Significant work is ongoing to overcome these challenges and integrate the QSM technique into clinical practice in the cardiovascular field.
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Affiliation(s)
- Alberto Aimo
- Scuola Superiore Sant'Anna, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Li Huang
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Andrew Tyler
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Andrea Barison
- Scuola Superiore Sant'Anna, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | | | - Sébastien Roujol
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
- Department of Biomedical Engineering, School of Imaging Sciences & Biomedical Engineering, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, London, SE1 7EH, UK.
| | - Pier-Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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Dorfman AL, Geva T, Samyn MM, Greil G, Krishnamurthy R, Messroghli D, Festa P, Secinaro A, Soriano B, Taylor A, Taylor MD, Botnar RM, Lai WW. SCMR expert consensus statement for cardiovascular magnetic resonance of acquired and non-structural pediatric heart disease. J Cardiovasc Magn Reson 2022; 24:44. [PMID: 35864534 PMCID: PMC9302232 DOI: 10.1186/s12968-022-00873-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 06/24/2022] [Indexed: 12/14/2022] Open
Abstract
Cardiovascular magnetic resonance (CMR) is widely used for diagnostic imaging in the pediatric population. In addition to structural congenital heart disease (CHD), for which published guidelines are available, CMR is also performed for non-structural pediatric heart disease, for which guidelines are not available. This article provides guidelines for the performance and reporting of CMR in the pediatric population for non-structural ("non-congenital") heart disease, including cardiomyopathies, myocarditis, Kawasaki disease and systemic vasculitides, cardiac tumors, pericardial disease, pulmonary hypertension, heart transplant, and aortopathies. Given important differences in disease pathophysiology and clinical manifestations as well as unique technical challenges related to body size, heart rate, and sedation needs, these guidelines focus on optimization of the CMR examination in infants and children compared to adults. Disease states are discussed, including the goals of CMR examination, disease-specific protocols, and limitations and pitfalls, as well as newer techniques that remain under development.
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Affiliation(s)
- Adam L. Dorfman
- Department of Pediatrics, Division of Pediatric Cardiology, University of Michigan C.S. Mott Children’s Hospital, 1540 E. Medical Center Drive, Ann Arbor, MI 48109 USA
| | - Tal Geva
- Department of Cardiology, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 USA
| | - Margaret M. Samyn
- Department of Pediatrics, Division of Pediatric Cardiology, Medical College of Wisconsin/Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI 53226 USA
| | - Gerald Greil
- Department of Pediatrics, Division of Pediatric Cardiology, University of Texas Southwestern Medical Center, Dallas, TX 75235 USA
| | - Rajesh Krishnamurthy
- Department of Radiology, Nationwide Children’s Hospital, 700 Children’s Dr. E4A, Columbus, OH 43205 USA
| | - Daniel Messroghli
- Department of Internal Medicine-Cardiology, Deutsches Herzzentrum Berlin and Charité-University Medicine Berlin, Berlin, Germany
| | - Pierluigi Festa
- Department of Cardiology, Fondazione Toscana G. Monasterio, Massa, Italy
| | - Aurelio Secinaro
- Advanced Cardiothoracic Imaging Unit, Department of Imaging, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
| | - Brian Soriano
- Department of Pediatrics, Division of Pediatric Cardiology, Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105 USA
| | - Andrew Taylor
- Department of Cardiovascular Imaging, Great Ormond Street Hospital for Sick Children, University College London, London, UK
| | - Michael D. Taylor
- Department of Pediatrics, Division of Pediatric Cardiology, Cincinnati Children’s Hospital, 3333 Burnet Ave #2129, Cincinnati, OH 45229 USA
| | - René M. Botnar
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Wyman W. Lai
- CHOC Children’s, 1201 W. La Veta Avenue, Orange, CA 92868 USA
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10
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Holtackers RJ, Van De Heyning CM, Chiribiri A, Wildberger JE, Botnar RM, Kooi ME. Dark-blood late gadolinium enhancement cardiovascular magnetic resonance for improved detection of subendocardial scar: a review of current techniques. J Cardiovasc Magn Reson 2021; 23:96. [PMID: 34289866 PMCID: PMC8296731 DOI: 10.1186/s12968-021-00777-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/17/2021] [Indexed: 12/02/2022] Open
Abstract
For almost 20 years, late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) has been the reference standard for the non-invasive assessment of myocardial viability. Since the blood pool often appears equally bright as the enhanced scar regions, detection of subendocardial scar patterns can be challenging. Various novel LGE methods have been proposed that null or suppress the blood signal by employing additional magnetization preparation mechanisms. This review aims to provide a comprehensive overview of these dark-blood LGE methods, discussing the magnetization preparation schemes and findings in phantom, preclinical, and clinical studies. Finally, conclusions on the current evidence and limitations are drawn and new avenues for future research are discussed. Dark-blood LGE methods are a promising new tool for non-invasive assessment of myocardial viability. For a mainstream adoption of dark-blood LGE, however, clinical availability and ease of use are crucial.
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Affiliation(s)
- Robert J. Holtackers
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, PO Box 616, Maastricht, 6200 MD The Netherlands
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | | | - Amedeo Chiribiri
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Joachim E. Wildberger
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, PO Box 616, Maastricht, 6200 MD The Netherlands
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - René M. Botnar
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M. Eline Kooi
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, PO Box 616, Maastricht, 6200 MD The Netherlands
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
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11
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Holtackers RJ, Gommers S, Van De Heyning CM, Mihl C, Smink J, Higgins DM, Wildberger JE, Ter Bekke RMA. Steadily Increasing Inversion Time Improves Blood Suppression for Free-Breathing 3D Late Gadolinium Enhancement MRI With Optimized Dark-Blood Contrast. Invest Radiol 2021; 56:335-340. [PMID: 33273374 DOI: 10.1097/rli.0000000000000747] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
MATERIALS AND METHODS Fifty consecutive patients with previous cardiac arrhythmias, scheduled for high-resolution 3D LGE MRI, were prospectively enrolled between October 2017 and February 2020. Free-breathing 3D dark-blood LGE MRI with high isotropic resolution (1.6 × 1.6 × 1.6 mm) was performed using a conventional fixed TI (n = 25) or a dynamic TI (n = 25). The average increase in blood nulling TI per minute was obtained from Look-Locker scans before and after the 3D acquisition in the first fixed TI group. This average increment in TI was used as input to calculate the dynamic increment of the initial blood nulling TI value as set in the second dynamic TI group. Regions of interest were drawn in the left ventricular blood pool to assess mean signal intensity as a measure for blood pool suppression. Overall image quality, observer confidence, and scar demarcation were scored on a 3-point scale. RESULTS Three-dimensional dark-blood LGE data sets were successfully acquired in 46/50 patients (92%). The calculated average TI increase of 2.3 ± 0.5 ms/min obtained in the first fixed TI group was incorporated in the second dynamic TI group and led to a significant decrease of 72% in the mean blood pool signal intensity compared with the fixed TI group (P < 0.001). Overall image quality (P = 0.02), observer confidence (P = 0.02), and scar demarcation (P = 0.01) significantly improved using a dynamic TI. CONCLUSIONS A steadily increasing dynamic TI improves blood pool suppression for optimized dark-blood contrast and increases observer confidence in free-breathing 3D dark-blood LGE MRI with high isotropic resolution.
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Affiliation(s)
| | - Suzanne Gommers
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
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12
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A multi-scale variational neural network for accelerating motion-compensated whole-heart 3D coronary MR angiography. Magn Reson Imaging 2020; 70:155-167. [DOI: 10.1016/j.mri.2020.04.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/03/2020] [Accepted: 04/12/2020] [Indexed: 11/22/2022]
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13
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Nordio G, Schneider T, Cruz G, Correia T, Bustin A, Prieto C, Botnar RM, Henningsson M. Whole-heart T 1 mapping using a 2D fat image navigator for respiratory motion compensation. Magn Reson Med 2019; 83:178-187. [PMID: 31400054 PMCID: PMC6791811 DOI: 10.1002/mrm.27919] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 07/01/2019] [Accepted: 07/05/2019] [Indexed: 01/25/2023]
Abstract
Purpose To combine a 3D saturation‐recovery‐based myocardial T1 mapping (3D SASHA) sequence with a 2D image navigator with fat excitation (fat‐iNAV) to allow 3D T1 maps with 100% respiratory scan efficiency and predictable scan time. Methods Data from T1 phantom and 10 subjects were acquired at 1.5T. For respiratory motion compensation, a 2D fat‐iNAV was acquired before each 3D SASHA k‐space segment to correct for 2D translational motion in a beat‐to‐beat fashion. The effect of the fat‐iNAV on the 3D SASHA T1 estimation was evaluated on the T1 phantom. For 3 representative subjects, the proposed free‐breathing 3D SASHA with fat‐iNAV was compared to the original implementation with the diaphragmatic navigator. The 3D SASHA with fat‐iNAV was compared to the breath‐hold 2D SASHA sequence in terms of accuracy and precision. Results In the phantom study, the Bland‐Altman plot shows that the 2D fat‐iNAVs does not affect the T1 quantification of the 3D SASHA acquisition (0 ± 12.5 ms). For the in vivo study, the 2D fat‐iNAV permits to estimate the respiratory motion of the heart, while allowing for 100% scan efficiency, improving the precision of the T1 measurement compared to non‐motion‐corrected 3D SASHA. However, the image quality achieved with the proposed 3D SASHA with fat‐iNAV is lower compared to the original implementation, with reduced delineation of the myocardial borders and papillary muscles. Conclusions We demonstrate the feasibility to combine the 3D SASHA T1 mapping imaging sequence with a 2D fat‐iNAV for respiratory motion compensation, allowing 100% respiratory scan efficiency and predictable scan time.
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Affiliation(s)
- Giovanna Nordio
- School of Biomedical Engineering and Imaging Sciences, King's College of London, London, United Kingdom
| | - Torben Schneider
- School of Biomedical Engineering and Imaging Sciences, King's College of London, London, United Kingdom.,Philips Healthcare, Guildford, United Kingdom
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College of London, London, United Kingdom
| | - Teresa Correia
- School of Biomedical Engineering and Imaging Sciences, King's College of London, London, United Kingdom
| | - Aurelien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College of London, London, United Kingdom
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College of London, London, United Kingdom.,Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College of London, London, United Kingdom.,Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Markus Henningsson
- School of Biomedical Engineering and Imaging Sciences, King's College of London, London, United Kingdom
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14
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Moyé DM, Hussain T, Botnar RM, Tandon A, Greil GF, Dyer AK, Henningsson M. Dual-phase whole-heart imaging using image navigation in congenital heart disease. BMC Med Imaging 2018; 18:36. [PMID: 30326847 PMCID: PMC6192322 DOI: 10.1186/s12880-018-0278-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/01/2018] [Indexed: 02/04/2023] Open
Abstract
Background Dual-phase 3-dimensional whole-heart acquisition allows simultaneous imaging during systole and diastole. Respiratory navigator gating and tracking of the diaphragm is used with limited accuracy. Prolonged scan time is common, and navigation often fails in patients with erratic breathing. Image-navigation (iNAV) tracks movement of the heart itself and is feasible in single phase whole heart imaging. To evaluate its diagnostic ability in congenital heart disease, we sought to apply iNAV to dual-phase sequencing. Methods Healthy volunteers and patients with congenital heart disease underwent dual-phase imaging using the conventional diaphragmatic-navigation (dNAV) and iNAV. Acquisition time was recorded and image quality assessed. Sharpness and length of the right coronary (RCA), left anterior descending (LAD), and circumflex (LCx) arteries were measured in both cardiac phases for both approaches. Qualitative and quantitative analyses were performed in a blinded and randomized fashion. Results In volunteers, there was no significant difference in vessel sharpness between approaches (p > 0.05). In patients, analysis showed equal vessel sharpness for LAD and RCA (p > 0.05). LCx sharpness was greater with dNAV (p < 0.05). Visualized length with iNAV was 0.5 ± 0.4 cm greater than that with dNAV for LCx in diastole (p < 0.05), 1.0 ± 0.3 cm greater than dNAV for LAD in diastole (p < 0.05), and 0.8 ± 0.7 cm greater than dNAV for RCA in systole (p < 0.05). Qualitative scores were similar between modalities (p = 0.71). Mean iNAV scan time was 5:18 ± 2:12 min shorter than mean dNAV scan time in volunteers (p = 0.0001) and 3:16 ± 1:12 min shorter in patients (p = 0.0001). Conclusions Image quality of iNAV and dNAV was similar with better distal vessel visualization with iNAV. iNAV acquisition time was significantly shorter. Complete cardiac diagnosis was achieved. Shortened acquisition time will improve clinical applicability and patient comfort.
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Affiliation(s)
- Danielle M Moyé
- Department of Pediatrics, Division of Cardiology, UT Southwestern Medical Center Dallas, Dallas, TX, USA. .,Department of Pediatrics, Division of Cardiology, Children's Health, Children's Medical Center Dallas, Dallas, TX, USA. .,Pediatric Cardiology, Children's Health Children's Medical Center of Dallas, 1935 Medical District Drive, Dallas, TX, 75235, USA.
| | - Tarique Hussain
- Department of Pediatrics, Division of Cardiology, UT Southwestern Medical Center Dallas, Dallas, TX, USA.,Department of Pediatrics, Division of Cardiology, Children's Health, Children's Medical Center Dallas, Dallas, TX, USA.,Departments of Radiology and Biomedical Engineering, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rene M Botnar
- Division of Imaging Sciences, King's College London, London, UK.,Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
| | - Animesh Tandon
- Department of Pediatrics, Division of Cardiology, UT Southwestern Medical Center Dallas, Dallas, TX, USA.,Department of Pediatrics, Division of Cardiology, Children's Health, Children's Medical Center Dallas, Dallas, TX, USA.,Departments of Radiology and Biomedical Engineering, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Gerald F Greil
- Department of Pediatrics, Division of Cardiology, UT Southwestern Medical Center Dallas, Dallas, TX, USA.,Department of Pediatrics, Division of Cardiology, Children's Health, Children's Medical Center Dallas, Dallas, TX, USA.,Departments of Radiology and Biomedical Engineering, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Adrian K Dyer
- Department of Pediatrics, Division of Cardiology, UT Southwestern Medical Center Dallas, Dallas, TX, USA.,Department of Pediatrics, Division of Cardiology, Children's Health, Children's Medical Center Dallas, Dallas, TX, USA
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15
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Bustin A, Ginami G, Cruz G, Correia T, Ismail TF, Rashid I, Neji R, Botnar RM, Prieto C. Five-minute whole-heart coronary MRA with sub-millimeter isotropic resolution, 100% respiratory scan efficiency, and 3D-PROST reconstruction. Magn Reson Med 2018; 81:102-115. [PMID: 30058252 PMCID: PMC6617822 DOI: 10.1002/mrm.27354] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/23/2018] [Accepted: 04/19/2018] [Indexed: 01/08/2023]
Abstract
Purpose To enable whole‐heart 3D coronary magnetic resonance angiography (CMRA) with isotropic sub‐millimeter resolution in a clinically feasible scan time by combining respiratory motion correction with highly accelerated variable density sampling in concert with a novel 3D patch‐based undersampled reconstruction (3D‐PROST). Methods An undersampled variable density spiral‐like Cartesian trajectory was combined with 2D image‐based navigators to achieve 100% respiratory efficiency and predictable scan time. 3D‐PROST reconstruction integrates structural information from 3D patch neighborhoods through sparse representation, thereby exploiting the redundancy of the 3D anatomy of the coronary arteries in an efficient low‐rank formulation. The proposed framework was evaluated in a static resolution phantom and in 10 healthy subjects with isotropic resolutions of 1.2 mm3 and 0.9 mm3 and undersampling factors of ×5 and ×9. 3D‐PROST was compared against fully sampled (1.2 mm3 only), conventional parallel imaging, and compressed sensing reconstructions. Results Phantom and in vivo (1.2 mm3) reconstructions were in excellent agreement with the reference fully sampled image. In vivo average acquisition times (min:s) were 7:57 ± 1:18 (×5) and 4:35 ± 0:44 (×9) for 0.9 mm3 resolution. Sub‐millimeter 3D‐PROST resulted in excellent depiction of the left and right coronary arteries including small branch vessels, leading to further improvements in vessel sharpness and visible vessel length in comparison with conventional reconstruction techniques. Image quality rated by 2 experts demonstrated that 3D‐PROST provides good image quality and is robust even at high acceleration factors. Conclusion The proposed approach enables free‐breathing whole‐heart 3D CMRA with isotropic sub‐millimeter resolution in <5 min and achieves improved coronary artery visualization in a short and predictable scan time.
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Affiliation(s)
- Aurélien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Giulia Ginami
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gastão Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Teresa Correia
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Tevfik F Ismail
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Imran Rashid
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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16
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Silva Vieira M, Henningsson M, Dedieu N, Vassiliou VS, Bell A, Mathur S, Pushparajah K, Figueroa CA, Hussain T, Botnar R, Greil GF. Improved coronary magnetic resonance angiography using gadobenate dimeglumine in pediatric congenital heart disease. Magn Reson Imaging 2018; 49:47-54. [PMID: 29339139 DOI: 10.1016/j.mri.2017.12.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 12/25/2017] [Accepted: 12/29/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND CMRA in pediatrics remains challenging due to the smaller vessel size, high heart rates (HR), potential image degradation caused by limited patient cooperation and long acquisition times. High-relaxivity contrast agents have been shown to improve coronary imaging in adults, but limited data is available in children. We sought to investigate whether gadobenate dimeglumine (Gd-BOPTA) together with self-navigated inversion-prepared coronary magnetic resonance angiography (CMRA) sequence design improves coronary image quality in pediatric patients. METHODS Forty consecutive patients (mean age 6±2.8years; 73% males) were prospectively recruited for a 1.5-T MRI study under general anesthesia. Two electrocardiographic-triggered free breathing steady-state free precession (SSFP) angiography sequences (A and B) with isotropic spatial resolution (1.3mm3) were acquired using a recently developed image-based self-navigation technique. Sequence A was acquired prior to contrast administration using T2 magnetization preparation (T2prep). Sequence B was acquired 5-8min after a bolus of Gd-BOPTA with the T2prep replaced by an inversion recovery (IR) pulse to null the signal from the myocardium. Scan time, signal-to noise and contrast-to-noise ratios (SNR and CNR), vessel wall sharpness (VWS) and qualitative visual score for each sequence were compared. RESULTS Scan time was similar for both sequences (5.3±1.8 vs 5.2±1.5min, p=.532) and average heart rate (78±14.7 vs 78±14.5bpm, p=.443) remained constant throughout both acquisitions. Sequence B resulted in higher SNR (12.6±4.4 vs 31.1±7.4, p<.001) and CNR (9.0±1.8 vs 13.5±3.7, p<.001) and provided improved coronary visualization in all coronary territories (VWS A=0.53±0.07 vs B=0.56±0.07, p=.001; and visual scoring A=3.8±0.59 vs B=4.1±0.53, p<.001). The number of non-diagnostic coronary segments was lower for sequence B [A=42 (13.1%) segments vs B=33 (10.3%) segments; p=.002], and contrary to the pre-contrast sequence, never involved a proximal segment. These results were independent of the patients' age, body surface area and HR. CONCLUSIONS The use of Gd-BOPTA with a 3D IR SSFP CMRA sequence results in improved coronary visualization in small infants and young children with high HR within a clinically acceptable scan time.
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Affiliation(s)
- Miguel Silva Vieira
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK.
| | - Markus Henningsson
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK.
| | - Nathalie Dedieu
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
| | | | - Aaron Bell
- Evelina Children's Hospital London, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Sujeev Mathur
- Evelina Children's Hospital London, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Kuberan Pushparajah
- Evelina Children's Hospital London, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Carlos Alberto Figueroa
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK; Departments of Surgery and Biomedical Engineering, University of Michigan, MI, USA.
| | - Tarique Hussain
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, USA.
| | - René Botnar
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK; Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile.
| | - Gerald F Greil
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, USA.
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17
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Schultz J, Andersen A, Gade IL, Ringgaard S, Kjaergaard B, Nielsen-Kudsk JE. A porcine in-vivo model of acute pulmonary embolism. Pulm Circ 2018; 8:2045893217738217. [PMID: 28971735 PMCID: PMC5798692 DOI: 10.1177/2045893217738217] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/01/2017] [Indexed: 11/16/2022] Open
Abstract
Acute pulmonary embolism (PE) is the third most common cardiovascular cause of death after acute myocardial infarction and stroke. Patients are, however, often under-treated due to the risks associated with systemic thrombolysis and surgical embolectomy. Novel pharmacological and catheter-based treatment strategies show promise, but the data supporting their use in patients are sparse. We therefore aimed to develop an in vivo model of acute PE enabling controlled evaluations of efficacy and safety of novel therapies. Danish Landrace pigs (n = 8) were anaesthetized and mechanically ventilated. Two pre-formed autologous PEs (PE1, PE2, 20 × 1 cm) were administered consecutively via the right external jugular vein. The intact nature and central location were visualized in situ by magnetic resonance imaging (MRI). The hemodynamic and biochemical responses were evaluated at baseline (BL) and after each PE by invasive pressure measurements, MRI, plus arterial and venous blood analysis. Pulmonary arterial pressure increased after administration of the PEs (BL: 16.3 ± 1.2, PE1: 27.6 ± 2.9, PE2: 31.6 ± 3.1 mmHg, BL vs. PE1: P = 0.0027, PE1 vs. PE2: P = 0.22). Animals showed signs of right ventricular strain evident by increased end systolic volume (BL: 60.9 ± 5.1, PE1: 83.3 ± 5.0, PE2: 99.4 ± 6.5 mL, BL vs. PE1: P = 0.0005, PE1 vs. PE2: P = 0.0045) and increased plasma levels of Troponin T. Ejection fraction decreased (BL: 58.9 ± 2.4, PE1: 46.4 ± 2.9, PE2: 37.3 ± 3.5%, BL vs. PE1: p = 0.0008, PE1 vs. PE2: P = 0.009) with a compensatory increase in heart rate preserving cardiac output and systemic blood pressure. The hemodynamic and biochemical responses were comparable to that of patients suffering from intermediate-high-risk PE. This porcine model mirrors the anatomical and physiologic changes seen in human patients with intermediate-high-risk PE, and may enable testing of future therapies for this disease.
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Affiliation(s)
- Jacob Schultz
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Asger Andersen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Inger Lise Gade
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Benedict Kjaergaard
- Department of Thoracic Surgery, Aalborg University Hospital, Aalborg, Denmark
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18
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Henningsson M, Shome J, Bratis K, Vieira MS, Nagel E, Botnar RM. Diagnostic performance of image navigated coronary CMR angiography in patients with coronary artery disease. J Cardiovasc Magn Reson 2017; 19:68. [PMID: 28893296 PMCID: PMC5594598 DOI: 10.1186/s12968-017-0381-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/17/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The use of coronary MR angiography (CMRA) in patients with coronary artery disease (CAD) remains limited due to the long scan times, unpredictable and often non-diagnostic image quality secondary to respiratory motion artifacts. The purpose of this study was to evaluate CMRA with image-based respiratory navigation (iNAV CMRA) and compare it to gold standard invasive x-ray coronary angiography in patients with CAD. METHODS Consecutive patients referred for CMR assessment were included to undergo iNAV CMRA on a 1.5 T scanner. Coronary vessel sharpness and a visual score were assigned to the coronary arteries. A diagnostic reading was performed on the iNAV CMRA data, where a lumen narrowing >50% was considered diseased. This was compared to invasive x-ray findings. RESULTS Image-navigated CMRA was performed in 31 patients (77% male, 56 ± 14 years). The iNAV CMRA scan time was 7 min:21 s ± 0 min:28 s. Out of a possible 279 coronary segments, 26 segments were excluded from analysis due to stents or diameter less than 1.5 mm, resulting in a total of 253 coronary segments. Diagnostic image quality was obtained for 98% of proximal coronary segments, 94% of middle segments, and 91% of distal coronary segments. The sensitivity and specificity was 86% and 83% per patient, 80% and 92% per vessel and 73% and 95% per segment. CONCLUSION In this study, iNAV CMRA offered a very good diagnostic performance when compared against invasive x-ray angiography. Due to the short and predictable scan time it can add clinical value as a part of a comprehensive CAD assessment protocol.
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Affiliation(s)
- Markus Henningsson
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Joy Shome
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Konstantinos Bratis
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Miguel Silva Vieira
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Eike Nagel
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Institute for Experimental and Translational Cardiovascular Imaging, Goethe University, Frankfurt/Main, Germany
- DZHK (German Centre for Cardiovascular Research, Standort RheinMain), Berlin, Germany
| | - Rene M. Botnar
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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19
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Henningsson M, Smink J, van Ensbergen G, Botnar R. Coronary MR angiography using image-based respiratory motion compensation with inline correction and fixed gating efficiency. Magn Reson Med 2017; 79:416-422. [PMID: 28321900 PMCID: PMC5763408 DOI: 10.1002/mrm.26678] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 02/13/2017] [Accepted: 02/22/2017] [Indexed: 12/26/2022]
Abstract
PURPOSE The purpose of this study was to evaluate a new inline motion compensation approach called image-based navigation with Constant Respiratory efficiency UsIng Single End-expiratory threshold (iNAV-CRUISE) for coronary MR angiography (CMRA). METHODS The CRUISE gating technique was combined with iNAV motion correction and implemented inline for motion-compensated CMRA on a 1.5 Tesla scanner. The approach was compared to conventional diaphragmatic navigator gating (dNAVG) in 10 healthy subjects. The CMRA images were compared for vessel sharpness and visual score of the right coronary artery (RCA), left anterior descending artery (LAD), left circumflex, and scan time. RESULTS The scan time was similar between the methods (dNAVG : 6:32 ± 1:09 vs. iNAV-CRUISE: 6:58 ± 0:17, P = not significant). However, the vessel sharpness of the RCA (dNAVG : 60.2 ± 10.1 vs. iNAV-CRUISE: 71.8 ± 8.9, P = 0.001) and LAD (dNAVG : 58.0 ± 8.0 vs. iNAV-CRUISE: 67.4 ± 7.1, P = 0.008) were significantly improved using iNAV-CRUISE. The visual score of the RCA was higher using iNAV-CRUISE compared to dNAVG (dNAVG : 3,4,3 vs. iNAV-CRUISE: 4,4,3, P < 0.01). CONCLUSION The iNAV-CRUISE approach out-performs the conventional respiratory motion compensation technique in healthy subjects. Although scan time was comparable, the image quality was improved using iNAV-CRUISE. Magn Reson Med 79:416-422, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Markus Henningsson
- Division of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | | | | | - Rene Botnar
- Division of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
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20
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Tavallaei MA, Johnson PM, Liu J, Drangova M. Design and evaluation of an MRI-compatible linear motion stage. Med Phys 2016; 43:62. [PMID: 26745900 DOI: 10.1118/1.4937780] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To develop and evaluate a tool for accurate, reproducible, and programmable motion control of imaging phantoms for use in motion sensitive magnetic resonance imaging (MRI) appli cations. METHODS In this paper, the authors introduce a compact linear motion stage that is made of nonmagnetic material and is actuated with an ultrasonic motor. The stage can be positioned at arbitrary positions and orientations inside the scanner bore to move, push, or pull arbitrary phantoms. Using optical trackers, measuring microscopes, and navigators, the accuracy of the stage in motion control was evaluated. Also, the effect of the stage on image signal-to-noise ratio (SNR), artifacts, and B0 field homogeneity was evaluated. RESULTS The error of the stage in reaching fixed positions was 0.025 ± 0.021 mm. In execution of dynamic motion profiles, the worst-case normalized root mean squared error was below 7% (for frequencies below 0.33 Hz). Experiments demonstrated that the stage did not introduce artifacts nor did it degrade the image SNR. The effect of the stage on the B0 field was less than 2 ppm. CONCLUSIONS The results of the experiments indicate that the proposed system is MRI-compatible and can create reliable and reproducible motion that may be used for validation and assessment of motion related MRI applications.
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Affiliation(s)
- Mohammad Ali Tavallaei
- Imaging Research Laboratories, Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 5B7, Canada and Biomedical Engineering Graduate Program, The University of Western Ontario, London, Ontario N6A 5B9, Canada
| | - Patricia M Johnson
- Imaging Research Laboratories, Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 5B7, Canada and Department of Medical Biophysics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Junmin Liu
- Imaging Research Laboratories, Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 5B7, Canada
| | - Maria Drangova
- Imaging Research Laboratories, Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 5B7, Canada; Biomedical Engineering Graduate Program, The University of Western Ontario, London, Ontario N6A 5B9, Canada; and Department of Medical Biophysics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario N6A 5C1, Canada
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21
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Wang SC, Patel AR, Tanaka A, Wang H, Ota T, Lang RM, Carroll TJ, Kawaji K. A novel profile/view ordering with a non-convex star shutter for high-resolution 3D volumetric T 1 mapping under multiple breath-holds. Magn Reson Med 2016; 77:2215-2224. [PMID: 27404803 DOI: 10.1002/mrm.26303] [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: 03/03/2016] [Revised: 04/26/2016] [Accepted: 05/20/2016] [Indexed: 01/20/2023]
Abstract
PURPOSE To examine a novel non-convex star ordering/shutter for reducing the number of breath-holds in cardiac three-dimensional (3D) T1 Mapping MRI with multiple breath-holds. METHODS A novel ordering, Non-Convex Star (NCS) was designed to acquire 3D volumes in a modified look-locker inversion recovery (MOLLI) T1 mapping sequence to provide more spatial resolution and coverage in fewer breath-holds. The proposed 3D-MOLLI approach using NCS was first validated in two phantoms using artifact power (AP) measurement against the fully sampled phantom. This was followed by an in vivo study in seven swine, in which the T1 values of the left ventricular (LV) myocardium divided into the American Heart Association (AHA) 16-segment model was compared against the reference multislice two-dimensional (2D) clinical reference and 3D volume without NCS breath-hold reduction. RESULTS NCS breath-hold reduction yielded less AP compared with the matched SENSE accelerated phantom volume (P < 0.0005), and was shown to be optimal at 25% fewer breath-holds. Calculated T1 values from 3D in vivo volumes with/without NCS were comparable in all AHA segments (P = NS), whereas 3D-NCS yielded significantly higher T1 values than 2D at midslice of the LV myocardium in each AHA segment (P < 0.05). CONCLUSION We successfully demonstrate the feasibility of the NCS approach for a 3D T1 mapping acquisition requiring fewer breath-holds. Magn Reson Med 77:2215-2224, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Sui-Cheng Wang
- Department of Medicine, The University of Chicago, Chicago, Illinois, USA.,Biomedical Engineering, Northwestern University, Evanston, Illinois, USA
| | - Amit R Patel
- Department of Medicine, The University of Chicago, Chicago, Illinois, USA.,Radiology, The University of Chicago, Chicago, Illinois, USA
| | - Akiko Tanaka
- Surgery, The University of Chicago, Chicago, Illinois, USA
| | - Hui Wang
- Philips Healthcare, Cleveland, Ohio, USA
| | - Takeyoshi Ota
- Surgery, The University of Chicago, Chicago, Illinois, USA
| | - Roberto M Lang
- Department of Medicine, The University of Chicago, Chicago, Illinois, USA.,Radiology, The University of Chicago, Chicago, Illinois, USA
| | | | - Keigo Kawaji
- Department of Medicine, The University of Chicago, Chicago, Illinois, USA
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22
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Cruz G, Atkinson D, Henningsson M, Botnar RM, Prieto C. Highly efficient nonrigid motion-corrected 3D whole-heart coronary vessel wall imaging. Magn Reson Med 2016; 77:1894-1908. [PMID: 27221073 PMCID: PMC5412916 DOI: 10.1002/mrm.26274] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 04/20/2016] [Accepted: 04/20/2016] [Indexed: 12/25/2022]
Abstract
Purpose To develop a respiratory motion correction framework to accelerate free‐breathing three‐dimensional (3D) whole‐heart coronary lumen and coronary vessel wall MRI. Methods We developed a 3D flow‐independent approach for vessel wall imaging based on the subtraction of data with and without T2‐preparation prepulses acquired interleaved with image navigators. The proposed method corrects both datasets to the same respiratory position using beat‐to‐beat translation and bin‐to‐bin nonrigid corrections, producing coregistered, motion‐corrected coronary lumen and coronary vessel wall images. The proposed method was studied in 10 healthy subjects and was compared with beat‐to‐beat translational correction (TC) and no motion correction for the left and right coronary arteries. Additionally, the coronary lumen images were compared with a 6‐mm diaphragmatic navigator gated and tracked scan. Results No significant differences (P > 0.01) were found between the proposed method and the gated and tracked scan for coronary lumen, despite an average improvement in scan efficiency to 96% from 59%. Significant differences (P < 0.01) were found in right coronary artery vessel wall thickness, right coronary artery vessel wall sharpness, and vessel wall visual score between the proposed method and TC. Conclusion The feasibility of a highly efficient motion correction framework for simultaneous whole‐heart coronary lumen and vessel wall has been demonstrated. Magn Reson Med 77:1894–1908, 2017. © 2016 International Society for Magnetic Resonance in Medicine
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Affiliation(s)
- Gastão Cruz
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
| | - David Atkinson
- Centre for Medical Imaging, University College London, London, United Kingdom
| | - Markus Henningsson
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
| | - Rene M Botnar
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom.,Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
| | - Claudia Prieto
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom.,Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
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23
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Luo J, Addy NO, Ingle RR, Baron CA, Cheng JY, Hu BS, Nishimura DG. Nonrigid Motion Correction With 3D Image-Based Navigators for Coronary MR Angiography. Magn Reson Med 2016; 77:1884-1893. [PMID: 27174673 DOI: 10.1002/mrm.26273] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 03/31/2016] [Accepted: 04/19/2016] [Indexed: 11/09/2022]
Abstract
PURPOSE To develop a retrospective nonrigid motion-correction method based on 3D image-based navigators (iNAVs) for free-breathing whole-heart coronary magnetic resonance angiography (MRA). METHODS The proposed method detects global rigid-body motion and localized nonrigid motion from 3D iNAVs and compensates them with an autofocusing algorithm. To model the global motion, 3D rotation and translation are estimated from the 3D iNAVs. Two sets of localized nonrigid motions are obtained from deformation fields between 3D iNAVs and reconstructed binned images, respectively. A bank of motion-corrected images is generated and the final image is assembled pixel-by-pixel by selecting the best focused pixel from this bank. In vivo studies with six healthy volunteers were conducted to compare the performance of the proposed method with 3D translational motion correction and no correction. RESULTS In vivo studies showed that compared to no correction, 3D translational motion correction and the proposed method increased the vessel sharpness by 13% ± 13% and 19% ± 16%, respectively. Out of 90 vessel segments, 75 segments showed improvement with the proposed method compared to 3D translational correction. CONCLUSION We have developed a nonrigid motion-correction method based on 3D iNAVs and an autofocusing algorithm that improves the vessel sharpness of free-breathing whole-heart coronary MRA. Magn Reson Med 77:1884-1893, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Jieying Luo
- Department of Electrical Engineering, Magnetic Resonance Systems Research Laboratory, Stanford University, Stanford, California, USA
| | - Nii Okai Addy
- Department of Electrical Engineering, Magnetic Resonance Systems Research Laboratory, Stanford University, Stanford, California, USA
| | - R Reeve Ingle
- Department of Electrical Engineering, Magnetic Resonance Systems Research Laboratory, Stanford University, Stanford, California, USA
| | - Corey A Baron
- Department of Electrical Engineering, Magnetic Resonance Systems Research Laboratory, Stanford University, Stanford, California, USA
| | - Joseph Y Cheng
- Department of Electrical Engineering, Magnetic Resonance Systems Research Laboratory, Stanford University, Stanford, California, USA
| | - Bob S Hu
- Department of Electrical Engineering, Magnetic Resonance Systems Research Laboratory, Stanford University, Stanford, California, USA.,Palo Alto Medical Foundation, Palo Alto, California, USA
| | - Dwight G Nishimura
- Department of Electrical Engineering, Magnetic Resonance Systems Research Laboratory, Stanford University, Stanford, California, USA
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24
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Kawaji K, Spincemaille P, Nguyen TD, Thimmappa N, Cooper MA, Prince MR, Wang Y. Direct coronary motion extraction from a 2D fat image navigator for prospectively gated coronary MR angiography. Magn Reson Med 2016; 71:599-607. [PMID: 23504975 DOI: 10.1002/mrm.24698] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE Direct 2D tracking of cardiac motion may provide superior respiratory navigator gating for coronary magnetic resonance angiography compared to conventional liver-diaphragm navigators. However, additional 2D processing for motion extraction is unsuitable for real-time prospective gating. In this work, a 2D fat-selective image navigator, which delineates the epicardial fat surrounding coronary arteries, is developed to directly monitor epicardial fat motion at every heartbeat in real-time for prospective gating. METHODS The proposed navigator is incorporated into a real-time interactive software that allows rapid setup and efficient motion extraction, and runs on standard clinical hardware without any additional dedicated components for processing. The proposed 2D cardiac fat image navigator was compared with the conventional 1D diaphragm navigator in free-breathing b-SSFP coronary MRAs in 12 healthy volunteers at 1.5T. RESULTS Real-time motion extraction from 2D cardiac fat navigator images was feasible within 20 ms, enabling successful prospectively gated coronary magnetic resonance angiographies in all subjects. Compared to 1D diaphragmatic navigator, 2D fat image navigator reduced scan time by 38% (P < 0.0005), and significantly improved vessel sharpness, myocardial suppression, and image quality (P < 0.05). CONCLUSION This demonstrates the feasibility of a 3D SSFP coronary magnetic resonance angiography sequence using a 2D epicardial fat image as a navigator for real-time prospective motion tracking.
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Affiliation(s)
- Keigo Kawaji
- Department of Biomedical Engineering, Cornell University, Ithaca, New York, USA; Department of Radiology, Weill Cornell Medical College, New York, New York, USA
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25
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Henningsson M, Hussain T, Vieira MS, Greil GF, Smink J, Ensbergen GV, Beck G, Botnar RM. Whole-heart coronary MR angiography using image-based navigation for the detection of coronary anomalies in adult patients with congenital heart disease. J Magn Reson Imaging 2015; 43:947-55. [PMID: 26451972 DOI: 10.1002/jmri.25058] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/15/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate a recently developed two-dimensional (2D) image-based navigation approach (iNAVG+C ) combined with respiratory bellows gating for CMRA in patients with congenital heart disease. METHODS Nine healthy volunteers (mean age 32 ± 6 years [standard deviation]) and 29 patients (28 ± 9 years) were scanned on a 1.5 Tesla clinical scanner using iNAV(G+C) motion compensated T2prepared CMRA, and the conventional 1D NAV approach. Scan time was recorded for each CMRA scan. An image quality score was given to each coronary artery from (0, uninterpretable; to 4, excellent image quality). Additionally, vessel sharpness of each coronary artery was measured. RESULTS Average scan time was significantly shorter (P < 0.01) using the proposed iNAVC+G approach (7:57 ± 1:34) compared with 1D NAV (9:15 ± 3:02). Improved visual scores of the right coronary artery (iNAV(G+C) : 4,3,4 (median, 25th percentile, 75th percentile) versus 1D NAV: 3,3,4; P < 0.001) and left anterior descending artery (iNAV(G+C) : 3,3,4 versus 1D NAV: 3,2,3; P < 0.001) were obtained using iNAV(G+C) compared with 1D NAV as well as an increased vessel sharpness of the right coronary artery (iNAV(G+C) : 65.3% ± 6.6% (mean ± standard deviation) versus 1D NAV: 60.2% ± 11.4%; P < 0.05) and left anterior descending artery (iNAV(G+C) : 63.2% ± 6.7% versus 1D NAV: 58.3% ± 9.5%; P < 0.05). CONCLUSION Image-based navigation in combination with respiratory bellows gating allows for more robust suppression of respiratory motion artifacts for whole-heart CMRA compared with conventional 1D NAV as images can be acquired in a shorter time and with improved image quality.
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Affiliation(s)
- Markus Henningsson
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Tarique Hussain
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Miguel S Vieira
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Gerald F Greil
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | | | | | | | - Rene M Botnar
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
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26
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Monney P, Piccini D, Rutz T, Vincenti G, Coppo S, Koestner SC, Sekarski N, Di Bernardo S, Bouchardy J, Stuber M, Schwitter J. Single centre experience of the application of self navigated 3D whole heart cardiovascular magnetic resonance for the assessment of cardiac anatomy in congenital heart disease. J Cardiovasc Magn Reson 2015; 17:55. [PMID: 26156377 PMCID: PMC4496886 DOI: 10.1186/s12968-015-0156-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 06/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For free-breathing cardiovascular magnetic resonance (CMR), the self-navigation technique recently emerged, which is expected to deliver high-quality data with a high success rate. The purpose of this study was to test the hypothesis that self-navigated 3D-CMR enables the reliable assessment of cardiovascular anatomy in patients with congenital heart disease (CHD) and to define factors that affect image quality. METHODS CHD patients ≥2 years-old and referred for CMR for initial assessment or for a follow-up study were included to undergo a free-breathing self-navigated 3D CMR at 1.5T. Performance criteria were: correct description of cardiac segmental anatomy, overall image quality, coronary artery visibility, and reproducibility of great vessels diameter measurements. Factors associated with insufficient image quality were identified using multivariate logistic regression. RESULTS Self-navigated CMR was performed in 105 patients (55% male, 23 ± 12y). Correct segmental description was achieved in 93% and 96% for observer 1 and 2, respectively. Diagnostic quality was obtained in 90% of examinations, and it increased to 94% if contrast-enhanced. Left anterior descending, circumflex, and right coronary arteries were visualized in 93%, 87% and 98%, respectively. Younger age, higher heart rate, lower ejection fraction, and lack of contrast medium were independently associated with reduced image quality. However, a similar rate of diagnostic image quality was obtained in children and adults. CONCLUSION In patients with CHD, self-navigated free-breathing CMR provides high-resolution 3D visualization of the heart and great vessels with excellent robustness.
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Affiliation(s)
- Pierre Monney
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Davide Piccini
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland.
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland.
- Center for Biomedical Imaging and Center for Cardiovascular Magnetic Resonance Research, University of Lausanne, Lausanne, Switzerland.
| | - Tobias Rutz
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Gabriella Vincenti
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Simone Coppo
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland.
- Center for Biomedical Imaging and Center for Cardiovascular Magnetic Resonance Research, University of Lausanne, Lausanne, Switzerland.
| | - Simon C Koestner
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Nicole Sekarski
- Pediatric Cardiology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Stefano Di Bernardo
- Pediatric Cardiology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Judith Bouchardy
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Matthias Stuber
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland.
- Center for Biomedical Imaging and Center for Cardiovascular Magnetic Resonance Research, University of Lausanne, Lausanne, Switzerland.
| | - Juerg Schwitter
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
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Paschke NK, Dössel O, Schaeffter T, Prieto C, Kolbitsch C. Comparison of image-based and reconstruction-based respiratory motion correction for golden radial phase encoding coronary MR angiography. J Magn Reson Imaging 2015; 42:964-71. [PMID: 25639861 DOI: 10.1002/jmri.24858] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/13/2015] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To evaluate two commonly used respiratory motion correction techniques for coronary magnetic resonance angiography (MRA) regarding their dependency on motion estimation accuracy and final image quality and to compare both methods to the respiratory gating approach used in clinical practice. MATERIALS AND METHODS Ten healthy volunteers were scanned using a non-Cartesian radial phase encoding acquisition. Respiratory motion was corrected for coronary MRA according to two motion correction techniques, image-based (IMC) and reconstruction-based (RMC) respiratory motion correction. Both motion correction approaches were compared quantitatively and qualitatively against a reference standard navigator-based respiratory gating (RG) approach. Quantitative comparisons were performed regarding visible vessel length, vessel sharpness, and total acquisition time. Two experts carried out a visual scoring of image quality. Additionally, numerical simulations were performed to evaluate the effect of motion estimation inaccuracy on RMC and IMC. RESULTS RMC led to significantly better image quality than IMC (P's paired Student's t-test were smaller than 0.001 for vessel sharpness and visual scoring). RMC did not show a statistically significant difference compared to reference standard RG (vessel length [99% confidence interval]: 86.913 [83.097-95.015], P = 0.107; vessel sharpness: 0.640 [0.605-0.802], P = 0.012; visual scoring: 2.583 [2.410-3.424], P = 0.018) in terms of vessel visualization and image quality while reducing scan times by 56%. Simulations showed higher dependencies for RMC than for IMC on motion estimation inaccuracies. CONCLUSION RMC provides a similar image quality as the clinically used RG approach but almost halves the scan time and is independent of subjects' breathing patterns. Clinical validation of RMC is now desirable.
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Affiliation(s)
- Nadia K Paschke
- Karlsruhe Institute of Technology, Institute of Biomedical Engineering, Karlsruhe, Germany.,King's College London, Division of Imaging Sciences and Biomedical Engineering, London, UK
| | - Olaf Dössel
- Karlsruhe Institute of Technology, Institute of Biomedical Engineering, Karlsruhe, Germany
| | - Tobias Schaeffter
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, UK
| | - Claudia Prieto
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, UK.,Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
| | - Christoph Kolbitsch
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, UK
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28
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100% Efficient three-dimensional coronary MR angiography with two-dimensional beat-to-beat translational and bin-to-bin affine motion correction. Magn Reson Med 2014; 74:756-64. [DOI: 10.1002/mrm.25460] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 07/31/2014] [Accepted: 08/21/2014] [Indexed: 12/25/2022]
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Pang J, Sharif B, Fan Z, Bi X, Arsanjani R, Berman DS, Li D. ECG and navigator-free four-dimensional whole-heart coronary MRA for simultaneous visualization of cardiac anatomy and function. Magn Reson Med 2014; 72:1208-17. [PMID: 25216287 DOI: 10.1002/mrm.25450] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 08/17/2014] [Accepted: 08/22/2014] [Indexed: 11/08/2022]
Abstract
PURPOSE To develop a cardiac and respiratory self-gated four-dimensional (4D) coronary MRA technique for simultaneous cardiac anatomy and function visualization. METHODS A contrast-enhanced, ungated spoiled gradient echo sequence with self-gating (SG) and 3DPR trajectory was used for image acquisition. Data were retrospectively binned into different cardiac and respiratory phases based on information extracted from SG projections using principal component analysis. Each cardiac phase was reconstructed using a respiratory motion-corrected self-calibrating SENSE framework, and those belong to the quiescent period were retrospectively combined for coronary visualization. Healthy volunteer studies were conducted to evaluate the efficacy of the SG method, the accuracy of the left ventricle (LV) function parameters and the quality of coronary artery visualization. RESULTS SG performed reliably for all subjects including one with poor electrocardiogram (ECG). The LV function parameters showed excellent agreement with those from a conventional cine protocol. For coronary imaging, the proposed method yielded comparable apparent signal to noise ratio and coronary sharpness and lower apparent contrast to noise ratio on three subjects compared with an ECG and navigator-gated Cartesian protocol and an ECG-gated, respiratory motion-corrected 3DPR protocol. CONCLUSION A fully self-gated 4D whole-heart imaging technique was developed, potentially allowing cardiac anatomy and function assessment from a single measurement.
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Affiliation(s)
- Jianing Pang
- Department of Radiology and Biomedical Engineering, Northwestern University, Chicago, Illinois, USA; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
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30
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Self-navigation with compressed sensing for 2D translational motion correction in free-breathing coronary MRI: a feasibility study. PLoS One 2014; 9:e105523. [PMID: 25171369 PMCID: PMC4149508 DOI: 10.1371/journal.pone.0105523] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 07/23/2014] [Indexed: 11/30/2022] Open
Abstract
Purpose Respiratory motion correction remains a challenge in coronary magnetic resonance imaging (MRI) and current techniques, such as navigator gating, suffer from sub-optimal scan efficiency and ease-of-use. To overcome these limitations, an image-based self-navigation technique is proposed that uses “sub-images” and compressed sensing (CS) to obtain translational motion correction in 2D. The method was preliminarily implemented as a 2D technique and tested for feasibility for targeted coronary imaging. Methods During a 2D segmented radial k-space data acquisition, heavily undersampled sub-images were reconstructed from the readouts collected during each cardiac cycle. These sub-images may then be used for respiratory self-navigation. Alternatively, a CS reconstruction may be used to create these sub-images, so as to partially compensate for the heavy undersampling. Both approaches were quantitatively assessed using simulations and in vivo studies, and the resulting self-navigation strategies were then compared to conventional navigator gating. Results Sub-images reconstructed using CS showed a lower artifact level than sub-images reconstructed without CS. As a result, the final image quality was significantly better when using CS-assisted self-navigation as opposed to the non-CS approach. Moreover, while both self-navigation techniques led to a 69% scan time reduction (as compared to navigator gating), there was no significant difference in image quality between the CS-assisted self-navigation technique and conventional navigator gating, despite the significant decrease in scan time. Conclusions CS-assisted self-navigation using 2D translational motion correction demonstrated feasibility of producing coronary MRA data with image quality comparable to that obtained with conventional navigator gating, and does so without the use of additional acquisitions or motion modeling, while still allowing for 100% scan efficiency and an improved ease-of-use. In conclusion, compressed sensing may become a critical adjunct for 2D translational motion correction in free-breathing cardiac imaging with high spatial resolution. An expansion to modern 3D approaches is now warranted.
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Prieto C, Doneva M, Usman M, Henningsson M, Greil G, Schaeffter T, Botnar RM. Highly efficient respiratory motion compensated free-breathing coronary MRA using golden-step Cartesian acquisition. J Magn Reson Imaging 2014; 41:738-46. [PMID: 24573992 DOI: 10.1002/jmri.24602] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 01/31/2014] [Indexed: 11/05/2022] Open
Abstract
PURPOSE To develop an efficient 3D affine respiratory motion compensation framework for Cartesian whole-heart coronary magnetic resonance angiography (MRA). MATERIALS AND METHODS The proposed method achieves 100% scan efficiency by estimating the affine respiratory motion from the data itself and correcting the acquired data in the reconstruction process. For this, a golden-step Cartesian sampling with spiral profile ordering was performed to enable reconstruction of respiratory resolved images at any breathing position and with different respiratory window size. Affine motion parameters were estimated from image-based registration of 3D undersampled respiratory resolved images reconstructed with iterative SENSE and motion correction was performed directly in the reconstruction using a multiple-coils generalized matrix formulation method. This approach was tested on healthy volunteers and compared against a conventional diaphragmatic navigator-gated acquisition using quantitative and qualitative image quality assessment. RESULTS The proposed approach achieved 47 ± 12% and 59 ± 6% vessel sharpness for the right (RCA) and left (LAD) coronary arteries, respectively. Also, good quality visual scores of 2.4 ± 0.74 and 2.44 ± 0.86 were observed for the RCA and LAD (scores from 0, no to 4, excellent coronary vessel delineation). A not statically significant difference (P = 0.05) was found between the proposed method and an 8-mm navigator-gated and tracked scan, although scan efficiency increased from 61 ± 10% to 100%. CONCLUSION We demonstrate the feasibility of a new 3D affine respiratory motion correction technique for Cartesian whole-heart CMRA that achieves 100% scan efficiency and therefore a predictable acquisition time. This approach yields image quality comparable to that of an 8-mm navigator-gated acquisition with lower scan efficiency. Further evaluation of this technique in patients is now warranted to determine its clinical use.
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Affiliation(s)
- Claudia Prieto
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, UK; Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
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High-resolution 3D whole-heart coronary MRA: a study on the combination of data acquisition in multiple breath-holds and 1D residual respiratory motion compensation. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2014; 27:435-43. [PMID: 24402560 DOI: 10.1007/s10334-013-0428-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 12/09/2013] [Accepted: 12/16/2013] [Indexed: 10/25/2022]
Abstract
OBJECT To study a scan protocol for coronary magnetic resonance angiography based on multiple breath-holds featuring 1D motion compensation and to compare the resulting image quality to a navigator-gated free-breathing acquisition. Image reconstruction was performed using L1 regularized iterative SENSE. MATERIALS AND METHODS The effects of respiratory motion on the Cartesian sampling scheme were minimized by performing data acquisition in multiple breath-holds. During the scan, repetitive readouts through a k-space center were used to detect and correct the respiratory displacement of the heart by exploiting the self-navigation principle in image reconstruction. In vivo experiments were performed in nine healthy volunteers and the resulting image quality was compared to a navigator-gated reference in terms of vessel length and sharpness. RESULTS Acquisition in breath-hold is an effective method to reduce the scan time by more than 30% compared to the navigator-gated reference. Although an equivalent mean image quality with respect to the reference was achieved with the proposed method, the 1D motion compensation did not work equally well in all cases. CONCLUSION In general, the image quality scaled with the robustness of the motion compensation. Nevertheless, the featured setup provides a positive basis for future extension with more advanced motion compensation methods.
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[Cardiac MRI: technology, clinical applications, and future directions]. Ann Cardiol Angeiol (Paris) 2013; 62:326-41. [PMID: 24035258 DOI: 10.1016/j.ancard.2013.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 08/12/2013] [Indexed: 11/23/2022]
Abstract
The field of cardiovascular MRI has evolved rapidly over the past decade, feeding new applications across a broad spectrum of clinical and research areas. Advances in magnet hardware technology, and key developments such as segmented k-space acquisitions, advanced motion encoding techniques, ultra-rapid perfusion imaging and delayed myocardial enhancement imaging have all contributed to a revolution in how patients with ischemic and non-ischemic heart disease are diagnosed and treated. Actually, cardiac MRI is a widely accepted method as the "gold standard" for detection and characterization of many forms of cardiac diseases. The aim of this review is to present an overview of cardiac MRI technology, advances in clinical applications, and future directions.
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Ingle RR, Wu HH, Addy NO, Cheng JY, Yang PC, Hu BS, Nishimura DG. Nonrigid autofocus motion correction for coronary MR angiography with a 3D cones trajectory. Magn Reson Med 2013; 72:347-61. [PMID: 24006292 DOI: 10.1002/mrm.24924] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 07/16/2013] [Accepted: 07/28/2013] [Indexed: 11/10/2022]
Abstract
PURPOSE To implement a nonrigid autofocus motion correction technique to improve respiratory motion correction of free-breathing whole-heart coronary magnetic resonance angiography acquisitions using an image-navigated 3D cones sequence. METHODS 2D image navigators acquired every heartbeat are used to measure superior-inferior, anterior-posterior, and right-left translation of the heart during a free-breathing coronary magnetic resonance angiography scan using a 3D cones readout trajectory. Various tidal respiratory motion patterns are modeled by independently scaling the three measured displacement trajectories. These scaled motion trajectories are used for 3D translational compensation of the acquired data, and a bank of motion-compensated images is reconstructed. From this bank, a gradient entropy focusing metric is used to generate a nonrigid motion-corrected image on a pixel-by-pixel basis. The performance of the autofocus motion correction technique is compared with rigid-body translational correction and no correction in phantom, volunteer, and patient studies. RESULTS Nonrigid autofocus motion correction yields improved image quality compared to rigid-body-corrected images and uncorrected images. Quantitative vessel sharpness measurements indicate superiority of the proposed technique in 14 out of 15 coronary segments from three patient and two volunteer studies. CONCLUSION The proposed technique corrects nonrigid motion artifacts in free-breathing 3D cones acquisitions, improving image quality compared to rigid-body motion correction.
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Affiliation(s)
- R Reeve Ingle
- Department of Electrical Engineering, Magnetic Resonance Systems Research Laboratory, Stanford University, Stanford, California, USA
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Akçakaya M, Gulaka P, Basha TA, Ngo LH, Manning WJ, Nezafat R. Free-breathing phase contrast MRI with near 100% respiratory navigator efficiency using k-space-dependent respiratory gating. Magn Reson Med 2013; 71:2172-9. [PMID: 23900942 DOI: 10.1002/mrm.24874] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 06/10/2013] [Accepted: 06/16/2013] [Indexed: 11/08/2022]
Abstract
PURPOSE To investigate the efficacy of a novel respiratory motion scheme, where only the center of k-space is gated using respiratory navigators, versus a fully respiratory-gated acquisition for three-dimensional flow imaging. METHODS Three-dimensional flow images were acquired axially using a gradient echo sequence in a volume, covering the ascending and descending aorta, and the pulmonary artery bifurcation in 12 healthy subjects (33.2 ± 15.8 years; five men). For respiratory motion compensation, two gating and tracking strategies were used with a 7-mm gating window: (1) All of k-space acquired within the gating window (fully gated) and (2) central k-space acquired within the gating window, and the remainder of k-space acquired without any gating (center gated). Each scan was repeated twice. Stroke volume, mean flow, peak velocity, and signal-to-noise-ratio measurements were performed both on the ascending and on the descending aorta for all acquisitions, which were compared using a linear mixed-effects model and Bland-Altman analysis. RESULTS There were no statistical differences between the fully gated and the center-gated strategies for the quantification of stroke volume, peak velocity, and mean flow, as well as the signal-to-noise-ratio measurements. Furthermore, the proposed center-gated strategy had significantly shorter acquisition time compared to the fully gated strategy (13:19 ± 3:02 vs. 19:35 ± 5:02, P < 0.001). CONCLUSIONS The proposed novel center-gated strategy for three-dimensional flow MRI allows for markedly shorter acquisition time without any systematic variation in quantitative flow measurements in this small group of healthy volunteers.
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Affiliation(s)
- Mehmet Akçakaya
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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Moghari MH, Roujol S, Henningsson M, Kissinger KV, Annese D, Nezafat R, Manning WJ, Geva T, Powell AJ. Three-dimensional heart locator for whole-heart coronary magnetic resonance angiography. Magn Reson Med 2013; 71:2118-26. [PMID: 23878103 DOI: 10.1002/mrm.24881] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 06/19/2013] [Accepted: 06/20/2013] [Indexed: 01/08/2023]
Abstract
PURPOSE Coronary magnetic resonance angiography (MRA) is commonly performed with diaphragmatic navigator (NAV) gating to compensate for respiratory motion, but this approach is inefficient as data must be reacquired when it is outside the acceptance window. We therefore developed and validated a motion compensation technique based on three-dimensional (3D) spatial registration in which data are accepted throughout the respiratory cycle. METHODS A novel respiratory motion compensation method was implemented that acquires a low-resolution 3D-image of the heart (3D-LOC) just prior to coronary MRA data acquisition. 3D-LOC volumes were registered to the first 3D-LOC to estimate the respiratory-induced heart motion and to modify the coronary MRA data and reconstruct motion-corrected images. Whole-heart coronary MRA datasets were acquired from nine healthy subjects using a diaphragmatic NAV and using 3D-LOC. RESULTS There was no significant difference between the subjective image score of NAV and 3D-LOC in three main coronary branches. The vessel sharpness of 3D-LOC was higher than NAV in the right (0.44 ± 0.08 vs. 0.49 ± 0.08; P = 0.055) and left circumflex arteries (0.49 ± 0.05 vs. 0.52 ± 0.04; P = 0.039). Scan time for 3D-LOC was significantly shorter than NAV (4.3 ± 0.6 vs. 8.3 ± 2.3 min; P = 0.004). CONCLUSION Compared to NAV gating, 3D-LOC for coronary MRA reduces scan time by nearly 50% without compromising image quality.
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Affiliation(s)
- Mehdi H Moghari
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA; Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Advanced respiratory motion compensation for coronary MR angiography. SENSORS 2013; 13:6882-99. [PMID: 23708271 PMCID: PMC3715228 DOI: 10.3390/s130606882] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 05/15/2013] [Accepted: 05/21/2013] [Indexed: 12/14/2022]
Abstract
Despite technical advances, respiratory motion remains a major impediment in a substantial amount of patients undergoing coronary magnetic resonance angiography (CMRA). Traditionally, respiratory motion compensation has been performed with a one-dimensional respiratory navigator positioned on the right hemi-diaphragm, using a motion model to estimate and correct for the bulk respiratory motion of the heart. Recent technical advancements has allowed for direct respiratory motion estimation of the heart, with improved motion compensation performance. Some of these new methods, particularly using image-based navigators or respiratory binning, allow for more advanced motion correction which enables CMRA data acquisition throughout most or all of the respiratory cycle, thereby significantly reducing scan time. This review describes the three components typically involved in most motion compensation strategies for CMRA, including respiratory motion estimation, gating and correction, and how these processes can be utilized to perform advanced respiratory motion compensation.
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Henningsson M, Prieto C, Chiribiri A, Vaillant G, Razavi R, Botnar RM. Whole-Heart Coronary MRA with 3D Affine Motion Correction Using 3D Image-Based Navigation. Magn Reson Med 2013; 71:173-81. [DOI: 10.1002/mrm.24652] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 12/27/2012] [Accepted: 12/27/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Markus Henningsson
- Division of Imaging Sciences & Biomedical Engineering; King's College London; London UK
| | - Claudia Prieto
- Division of Imaging Sciences & Biomedical Engineering; King's College London; London UK
- Escuela de Ingeniería; Pontificia Universidad Catolica de Chile; Santiago Chile
| | - Amedeo Chiribiri
- Division of Imaging Sciences & Biomedical Engineering; King's College London; London UK
| | - Ghislain Vaillant
- Division of Imaging Sciences & Biomedical Engineering; King's College London; London UK
| | - Reza Razavi
- Division of Imaging Sciences & Biomedical Engineering; King's College London; London UK
| | - René M Botnar
- Division of Imaging Sciences & Biomedical Engineering; King's College London; London UK
- Wellcome Trust and EPSRC Medical Engineering Center; King's College London; London UK
- BHF Centre of Excellence; King's College London; London UK
- NIHR Biomedical Research Centre; King's College London; London UK
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Abstract
Although cardiovascular magnetic resonance allows the non-invasive and radiation free visualization of both the coronary arteries and veins, coronary vessel wall imaging is still undergoing technical development to improve diagnostic quality. Assessment of the coronary vessels is a valuable addition to the analysis of cardiac function, cardiac anatomy, viability and perfusion which magnetic resonance imaging reliably allows. However, cardiac and respiratory motion and the small size of the coronary vessels present a challenge and require several technical solutions for image optimization. Furthermore, the acquisition protocols need to be adapted to the specific clinical question. This review provides an update on the current clinical applications of cardiovascular magnetic resonance coronary angiography, recent technical advances and describes the acquisition protocols in use.
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Affiliation(s)
- Amedeo Chiribiri
- Division of Imaging Sciences and Biomedical Engineering, King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre, London, SE1 7EH, UK.
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Akçakaya M, Shaw JL, Hauser TH, Nezafat R. Utility of respiratory-navigator-rejected k-space lines for improved signal-to-noise ratio in three-dimensional cardiac MR. Magn Reson Med 2012; 70:1332-9. [PMID: 23233381 DOI: 10.1002/mrm.24566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 10/20/2012] [Accepted: 10/26/2012] [Indexed: 01/17/2023]
Abstract
PURPOSE To develop and evaluate a technique that uses the k-space lines rejected by prospective respiratory navigator (NAV) to improve the signal-to-noise ratio (SNR) without increasing the scan time. METHODS In conventional image reconstruction, the motion-corrupted k-space lines rejected by the NAV are not used. In this study, a set of translational motion parameters for the NAV-rejected lines and a phase-corrected average for the k-space line are estimated jointly using a maximum-likelihood approach and the information from the corresponding accepted k-space lines. Left coronary artery images were acquired in 10 healthy adult subjects, and the proposed approach incorporating the NAV-rejected lines was compared with the conventional dataset with NAV-accepted lines only, as well as a simple average of all k-space lines, in terms of SNR, normalized vessel sharpness and qualitative image scores on a four-point scale (1 = poor, 4 = excellent). Late gadolinium enhancement images of the left atrium were also acquired in 21 patients with atrial fibrillation pre- or post-pulmonary vein isolation. Images reconstructed with the proposed, conventional, and simple averaging methods were compared in terms of SNR, and subjective image quality on a four-point scale. RESULTS For coronary MRI, there was a significant improvement in SNR with the proposed technique, but no significant difference in normalized vessel sharpness or qualitative image scores were observed with respect to the conventional method. Simple averaging resulted in an SNR gain, but significant loss in vessel sharpness and image quality. For late gadolinium enhancement, there was a significant increase in SNR, but no significant differences were observed in subjective image quality scores between the proposed and conventional methods. There was an SNR gain, but image quality loss for simple averaging, when compared with the conventional technique. In both coronary MRI and late gadolinium enhancement, the SNR gain of the proposed method was not significantly different than the maximum theoretical SNR gain. CONCLUSION The proposed technique improves SNR using the additional information from NAV-rejected k-space lines, while providing similar image quality to standard reconstruction using motion-free k-space data only, with no increase in scan time.
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Affiliation(s)
- Mehmet Akçakaya
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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Moghari MH, Roujol S, Chan RH, Hong SN, Bello N, Henningsson M, Ngo LH, Goddu B, Goepfert L, Kissinger KV, Manning WJ, Nezafat R. Free-breathing 3D cardiac MRI using iterative image-based respiratory motion correction. Magn Reson Med 2012; 70:1005-15. [PMID: 23132549 DOI: 10.1002/mrm.24538] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 09/06/2012] [Accepted: 10/01/2012] [Indexed: 11/07/2022]
Abstract
Respiratory motion compensation using diaphragmatic navigator gating with a 5 mm gating window is conventionally used for free-breathing cardiac MRI. Because of the narrow gating window, scan efficiency is low resulting in long scan times, especially for patients with irregular breathing patterns. In this work, a new retrospective motion compensation algorithm is presented to reduce the scan time for free-breathing cardiac MRI that increasing the gating window to 15 mm without compromising image quality. The proposed algorithm iteratively corrects for respiratory-induced cardiac motion by optimizing the sharpness of the heart. To evaluate this technique, two coronary MRI datasets with 1.3 mm(3) resolution were acquired from 11 healthy subjects (seven females, 25 ± 9 years); one using a navigator with a 5 mm gating window acquired in 12.0 ± 2.0 min and one with a 15 mm gating window acquired in 7.1 ± 1.0 min. The images acquired with a 15 mm gating window were corrected using the proposed algorithm and compared to the uncorrected images acquired with the 5 and 15 mm gating windows. The image quality score, sharpness, and length of the three major coronary arteries were equivalent between the corrected images and the images acquired with a 5 mm gating window (P-value > 0.05), while the scan time was reduced by a factor of 1.7.
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Affiliation(s)
- Mehdi H Moghari
- Department of Medicine (Cardiovascular Division), Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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