Nonrigid retrospective respiratory motion correction in whole-heart coronary MRA

Stop moving: MR motion correction as an opportunity for artificial intelligence

Subject motion is a long-standing problem of magnetic resonance imaging (MRI), which can seriously deteriorate the image quality. Various prospective and retrospective methods have been proposed for MRI motion correction, among which deep learning approaches have achieved state-of-the-art motion correction performance. This survey paper aims to provide a comprehensive review of deep learning-based MRI motion correction methods. Neural networks used for motion artifacts reduction and motion estimation in the image domain or frequency domain are detailed. Furthermore, besides motion-corrected MRI reconstruction, how estimated motion is applied in other downstream tasks is briefly introduced, aiming to strengthen the interaction between different research areas. Finally, we identify current limitations and point out future directions of deep learning-based MRI motion correction.

Non-rigid motion-corrected free-breathing 3D myocardial Dixon LGE imaging in a clinical setting

Objectives

To investigate the efficacy of an in-line non-rigid motion-compensated reconstruction (NRC) in an image-navigated high-resolution three-dimensional late gadolinium enhancement (LGE) sequence with Dixon water–fat separation, in a clinical setting.

Methods

Forty-seven consecutive patients were enrolled prospectively and examined with 1.5 T MRI. NRC reconstructions were compared to translational motion-compensated reconstructions (TC) of the same datasets in overall and different sub-category image quality scores, diagnostic confidence, contrast ratios, LGE pattern, and semiautomatic LGE quantification.

Results

NRC outperformed TC in all image quality scores (p < 0.001 to 0.016; e.g., overall image quality 5/5 points vs. 4/5). Overall image quality was downgraded in only 23% of NRC datasets vs. 53% of TC datasets due to residual respiratory motion. In both reconstructions, LGE was rated as ischemic in 11 patients and non-ischemic in 10 patients, while it was absent in 26 patients. NRC delivered significantly higher LGE-to-myocardium and blood-to-myocardium contrast ratios (median 6.33 vs. 5.96, p < 0.001 and 4.88 vs. 4.66, p < 0.001, respectively). Automatically detected LGE mass was significantly lower in the NRC reconstruction (p < 0.001). Diagnostic confidence was identical in all cases, with high confidence in 89% and probable in 11% datasets for both reconstructions. No case was rated as inconclusive.

Conclusions

The in-line implementation of a non-rigid motion-compensated reconstruction framework improved image quality in image-navigated free-breathing, isotropic high-resolution 3D LGE imaging with undersampled spiral-like Cartesian sampling and Dixon water–fat separation compared to translational motion correction of the same datasets. The sharper depictions of LGE may lead to more accurate measures of LGE mass.

Key Points

• 3D LGE imaging provides high-resolution detection of myocardial scarring.

• Non-rigid motion correction provides better image quality in cardiac MRI.

• Non-rigid motion correction may lead to more accurate measures of LGE mass.

Deep-learning based super-resolution for 3D isotropic coronary MR angiography in less than a minute

PURPOSE

To develop and evaluate a novel and generalizable super-resolution (SR) deep-learning framework for motion-compensated isotropic 3D coronary MR angiography (CMRA), which allows free-breathing acquisitions in less than a minute.

METHODS

Undersampled motion-corrected reconstructions have enabled free-breathing isotropic 3D CMRA in ~5-10 min acquisition times. In this work, we propose a deep-learning-based SR framework, combined with non-rigid respiratory motion compensation, to shorten the acquisition time to less than 1 min. A generative adversarial network (GAN) is proposed consisting of two cascaded Enhanced Deep Residual Network generator, a trainable discriminator, and a perceptual loss network. A 16-fold increase in spatial resolution is achieved by reconstructing a high-resolution (HR) isotropic CMRA (0.9 mm3 or 1.2 mm3 ) from a low-resolution (LR) anisotropic CMRA (0.9 × 3.6 × 3.6 mm3 or 1.2 × 4.8 × 4.8 mm3 ). The impact and generalization of the proposed SRGAN approach to different input resolutions and operation on image and patch-level is investigated. SRGAN was evaluated on a retrospective downsampled cohort of 50 patients and on 16 prospective patients that were scanned with LR-CMRA in ~50 s under free-breathing. Vessel sharpness and length of the coronary arteries from the SR-CMRA is compared against the HR-CMRA.

RESULTS

SR-CMRA showed statistically significant (P < .001) improved vessel sharpness 34.1% ± 12.3% and length 41.5% ± 8.1% compared with LR-CMRA. Good generalization to input resolution and image/patch-level processing was found. SR-CMRA enabled recovery of coronary stenosis similar to HR-CMRA with comparable qualitative performance.

CONCLUSION

The proposed SR-CMRA provides a 16-fold increase in spatial resolution with comparable image quality to HR-CMRA while reducing the predictable scan time to <1 min.

Motion compensated whole-heart coronary cardiovascular magnetic resonance angiography using focused navigation (fNAV)

BACKGROUND

Radial self-navigated (RSN) whole-heart coronary cardiovascular magnetic resonance angiography (CCMRA) is a free-breathing technique that estimates and corrects for respiratory motion. However, RSN has been limited to a 1D rigid correction which is often insufficient for patients with complex respiratory patterns. The goal of this work is therefore to improve the robustness and quality of 3D radial CCMRA by incorporating both 3D motion information and nonrigid intra-acquisition correction of the data into a framework called focused navigation (fNAV).

METHODS

We applied fNAV to 500 data sets from a numerical simulation, 22 healthy subjects, and 549 cardiac patients. In each of these cohorts we compared fNAV to RSN and respiratory resolved extradimensional golden-angle radial sparse parallel (XD-GRASP) reconstructions of the same data. Reconstruction times for each method were recorded. Motion estimate accuracy was measured as the correlation between fNAV and ground truth for simulations, and fNAV and image registration for in vivo data. Percent vessel sharpness was measured in all simulated data sets and healthy subjects, and a subset of patients. Finally, subjective image quality analysis was performed by a blinded expert reviewer who chose the best image for each in vivo data set and scored on a Likert scale 0-4 in a subset of patients by two reviewers in consensus.

RESULTS

The reconstruction time for fNAV images was significantly higher than RSN (6.1 ± 2.1 min vs 1.4 ± 0.3, min, p < 0.025) but significantly lower than XD-GRASP (25.6 ± 7.1, min, p < 0.025). Overall, there is high correlation between the fNAV and reference displacement estimates across all data sets (0.73 ± 0.29). For simulated data, healthy subjects, and patients, fNAV lead to significantly sharper coronary arteries than all other reconstruction methods (p < 0.01). Finally, in a blinded evaluation by an expert reviewer fNAV was chosen as the best image in 444 out of 571 data sets (78%; p < 0.001) and consensus grades of fNAV images (2.6 ± 0.6) were significantly higher (p < 0.05) than uncorrected (1.7 ± 0.7), RSN (1.9 ± 0.6), and XD-GRASP (1.8 ± 0.8).

CONCLUSION

fNAV is a promising technique for improving the quality of RSN free-breathing 3D whole-heart CCMRA. This novel approach to respiratory self-navigation can derive 3D nonrigid motion estimations from an acquired 1D signal yielding statistically significant improvement in image sharpness relative to 1D translational correction as well as XD-GRASP reconstructions. Further study of the diagnostic impact of this technique is therefore warranted to evaluate its full clinical utility.

3D whole-heart isotropic sub-millimeter resolution coronary magnetic resonance angiography with non-rigid motion-compensated PROST

BACKGROUND

To enable free-breathing whole-heart sub-millimeter resolution coronary magnetic resonance angiography (CMRA) in a clinically feasible scan time by combining low-rank patch-based undersampled reconstruction (3D-PROST) with a highly accelerated non-rigid motion correction framework.

METHODS

Non-rigid motion corrected CMRA combined with 2D image-based navigators has been previously proposed to enable 100% respiratory scan efficiency in modestly undersampled acquisitions. Achieving sub-millimeter isotropic resolution with such techniques still requires prohibitively long acquisition times. We propose to combine 3D-PROST reconstruction with a highly accelerated non-rigid motion correction framework to achieve sub-millimeter resolution CMRA in less than 10 min. Ten healthy subjects and eight patients with suspected coronary artery disease underwent 4-5-fold accelerated free-breathing whole-heart CMRA with 0.9 mm3 isotropic resolution. Vessel sharpness, vessel length and image quality obtained with the proposed non-rigid (NR) PROST approach were compared against translational correction only (TC-PROST) and a previously proposed NR motion-compensated technique (non-rigid SENSE) in healthy subjects. For the patient study, image quality scoring and visual comparison with coronary computed tomography angiography (CCTA) were performed.

RESULTS

Average scan times [min:s] were 6:01 ± 0:59 (healthy subjects) and 8:29 ± 1:41 (patients). In healthy subjects, vessel sharpness of the left anterior descending (LAD) and right (RCA) coronary arteries were improved with the proposed non-rigid PROST (LAD: 51.2 ± 8.8%, RCA: 61.2 ± 9.1%) in comparison to TC-PROST (LAD: 43.8 ± 5.1%, P = 0.051, RCA: 54.3 ± 8.3%, P = 0.218) and non-rigid SENSE (LAD: 46.1 ± 5.8%, P = 0.223, RCA: 56.7 ± 9.6%, P = 0.50), although differences were not statistically significant. The average visual image quality score was significantly higher for NR-PROST (LAD: 3.2 ± 0.6, RCA: 3.3 ± 0.7) compared with TC-PROST (LAD: 2.1 ± 0.6, P = 0.018, RCA: 2.0 ± 0.7, P = 0.014) and non-rigid SENSE (LAD: 2.3 ± 0.5, P = 0.008, RCA: 2.5 ± 0.7, P = 0.016). In patients, the proposed approach showed good delineation of the coronaries, in agreement with CCTA, with image quality scores and vessel sharpness similar to that of healthy subjects.

CONCLUSIONS

We demonstrate the feasibility of combining high undersampling factors with non-rigid motion-compensated reconstruction to obtain high-quality sub-millimeter isotropic CMRA images in ~ 8 min. Validation in a larger cohort of patients with coronary artery disease is now warranted.

A quantitative comparison between a navigated Cartesian and a self-navigated radial protocol from clinical studies for free-breathing 3D whole-heart bSSFP coronary MRA

PURPOSE

Navigator-gated 3D bSSFP whole-heart coronary MRA has been evaluated in several large studies including a multi-center trial. Patient studies have also been performed with more recent self-navigated techniques. In this study, these two approaches are compared side-by-side using a Cartesian navigator-gated and corrected (CNG) and a 3D radial self-navigated (RSN) protocol from published patient studies.

METHODS

Sixteen healthy subjects were examined with both sequences on a 1.5T scanner. Assessment of the visibility of coronary ostia and quantitative comparisons of acquisition times, blood pool homogeneity, and visible length and sharpness of the right coronary artery (RCA) and the combined left main (LM)+left anterior descending (LAD) coronary arteries were performed. Paired sample t-tests with P < .05 considered statistically significant were used for all comparisons.

RESULTS

The acquisition time was 5:40 ± 0:28 min (mean ± SD) for RSN, being significantly shorter than the 16:59 ± 5:05 min of CNG (P < .001). RSN images showed higher blood pool homogeneity (P < .001). All coronary ostia were visible with both techniques. CNG provided significantly higher vessel sharpness in the RCA (CNG: 50.0 ± 8.6%, RSN: 34.2 ± 6.9%, P < .001) and the LM+LAD (CNG: 48.7 ± 6.7%, RSN: 32.3 ± 7.1%, P < .001). The visible vessel length was significantly longer in the LM+LAD using CNG (CNG: 9.8 ± 2.7 cm, RSN: 8.5 ± 2.6 cm, P < .05) but not in the RCA (CNG: 9.7 ± 2.3 cm, RSN: 9.3 ± 2.9 cm, P = .29).

CONCLUSION

CNG provided superior vessel sharpness and might hence be the better option for examining coronary lumina. However, its blood pool inhomogeneity and prolonged and unpredictable acquisition times compared to RSN may make clinical adoption more challenging.

Whole-heart T1 mapping using a 2D fat image navigator for respiratory motion compensation

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.

Five-minute whole-heart coronary MRA with sub-millimeter isotropic resolution, 100% respiratory scan efficiency, and 3D-PROST reconstruction

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.

Optimized respiratory-resolved motion-compensated 3D Cartesian coronary MR angiography

Purpose

To develop a robust and efficient reconstruction framework that provides high‐quality motion‐compensated respiratory‐resolved images from free‐breathing 3D whole‐heart Cartesian coronary magnetic resonance angiography (CMRA) acquisitions.

Methods

Recently, XD‐GRASP (eXtra‐Dimensional Golden‐angle RAdial Sparse Parallel MRI) was proposed to achieve 100% scan efficiency and provide respiratory‐resolved 3D radial CMRA images by exploiting sparsity in the respiratory dimension. Here, a reconstruction framework for Cartesian CMRA imaging is proposed, which provides respiratory‐resolved motion‐compensated images by incorporating 2D beat‐to‐beat translational motion information to increase sparsity in the respiratory dimension. The motion information is extracted from interleaved image navigators and is also used to compensate for 2D translational motion within each respiratory phase. The proposed Optimized Respiratory‐resolved Cartesian Coronary MR Angiography (XD‐ORCCA) method was tested on 10 healthy subjects and 2 patients with cardiovascular disease, and compared against XD‐GRASP.

Results

The proposed XD‐ORCCA provides high‐quality respiratory‐resolved images, allowing clear visualization of the right and left coronary arteries, even for irregular breathing patterns. Compared with XD‐GRASP, the proposed method improves the visibility and sharpness of both coronaries. Significant differences (p < .05) in visible vessel length and proximal vessel sharpness were found between the 2 methods. The XD‐GRASP method provides good‐quality images in the absence of intraphase motion. However, motion blurring is observed in XD‐GRASP images for respiratory phases with larger motion amplitudes and subjects with irregular breathing patterns.

Conclusion

A robust respiratory‐resolved motion‐compensated framework for Cartesian CMRA has been proposed and tested in healthy subjects and patients. The proposed XD‐ORCCA provides high‐quality images for all respiratory phases, independently of the regularity of the breathing pattern.

Technical note: Accelerated nonrigid motion-compensated isotropic 3D coronary MR angiography

PURPOSE

To develop an accelerated and nonrigid motion-compensated technique for efficient isotropic 3D whole-heart coronary magnetic resonance angiography (CMRA) with Cartesian acquisition.

METHODS

Highly efficient whole-heart 3D CMRA was achieved by combining image reconstruction from undersampled data using compressed sensing (CS) with a nonrigid motion compensation framework. Undersampled acquisition was performed using a variable-density Cartesian trajectory with radial order (VD-CAPR). Motion correction was performed in two steps: beat-to-beat 2D translational correction with motion estimated from interleaved image navigators, and bin-to-bin 3D nonrigid correction with motion estimated from respiratory-resolved images reconstructed from undersampled 3D CMRA data using CS. Nonrigid motion fields were incorporated into an undersampled motion-compensated reconstruction, which combines CS with the general matrix description formalism. The proposed approach was tested on 10 healthy subjects and compared against a conventional twofold accelerated 5-mm navigator-gated and tracked acquisition.

RESULTS

The proposed method achieves isotropic 1.2-mm Cartesian whole-heart CMRA in 5 min ± 1 min (~8× acceleration). The proposed approach provides good-quality images of the left and right coronary arteries, comparable to those of a twofold accelerated navigator-gated and tracked acquisition, but scan time was up to about four times faster. For both coronaries, no significant differences (P > 0.05) in vessel sharpness and length were found between the proposed method and reference scan.

CONCLUSION

The feasibility of a highly efficient motion-compensated reconstruction framework for accelerated 3D CMRA has been demonstrated in healthy subjects. Further investigation is required to assess the clinical value of the method.

Motion robust high resolution 3D free-breathing pulmonary MRI using dynamic 3D image self-navigator

PURPOSE

To achieve motion robust high resolution 3D free-breathing pulmonary MRI utilizing a novel dynamic 3D image navigator derived directly from imaging data.

METHODS

Five-minute free-breathing scans were acquired with a 3D ultrashort echo time (UTE) sequence with 1.25 mm isotropic resolution. From this data, dynamic 3D self-navigating images were reconstructed under locally low rank (LLR) constraints and used for motion compensation with one of two methods: a soft-gating technique to penalize the respiratory motion induced data inconsistency, and a respiratory motion-resolved technique to provide images of all respiratory motion states.

RESULTS

Respiratory motion estimation derived from the proposed dynamic 3D self-navigator of 7.5 mm isotropic reconstruction resolution and a temporal resolution of 300 ms was successful for estimating complex respiratory motion patterns. This estimation improved image quality compared to respiratory belt and DC-based navigators. Respiratory motion compensation with soft-gating and respiratory motion-resolved techniques provided good image quality from highly undersampled data in volunteers and clinical patients.

CONCLUSION

An optimized 3D UTE sequence combined with the proposed reconstruction methods can provide high-resolution motion robust pulmonary MRI. Feasibility was shown in patients who had irregular breathing patterns in which our approach could depict clinically relevant pulmonary pathologies. Magn Reson Med 79:2954-2967, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Diagnostic performance of image navigated coronary CMR angiography in patients with coronary artery disease

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.

Accelerated whole-heart MR angiography using a variable-density poisson-disc undersampling pattern and compressed sensing reconstruction

PURPOSE

To accelerate whole-heart three-dimension MR angiography (MRA) by using a variable-density Poisson-disc undersampling pattern and a compressed sensing (CS) reconstruction algorithm, and compare the results with sensitivity encoding (SENSE).

METHODS

For whole-heart MRA, a prospective variable-density Poisson-disc k-space undersampling pattern was developed in which 1-2% of central part of k-space was fully sampled, and sampling in the remainder decreased exponentially toward the periphery. The undersampled data were then estimated using CS reconstruction. In patients, images using this sequence with an undersampling rate of ≈6 were compared with those using a SENSE rate of 2 (n = 15) and a SENSE rate of 6 (n = 13).

RESULTS

Compared with SENSE rate 2, CS rate 6 images had similar objective border sharpness, significantly lower subjective image quality scores at all four locations (all P < 0.01), and shorter scan times (P < 0.05). Compared with SENSE rate 6, CS rate 6 had similar objective border sharpness at all four locations, significantly better subjective image quality scores at three of four locations (all P < 0.01), and similar scan times (P = 0.24).

CONCLUSION

Compared with SENSE with a comparable acceleration rate, a variable-density Poisson-disc undersampling pattern and CS reconstruction achieved better subjective image quality and similar border sharpness. Magn Reson Med 79:761-769, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Coronary MR angiography using image-based respiratory motion compensation with inline correction and fixed gating efficiency

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 (dNAV_G : 6:32 ± 1:09 vs. iNAV-CRUISE: 6:58 ± 0:17, P = not significant). However, the vessel sharpness of the RCA (dNAV_G : 60.2 ± 10.1 vs. iNAV-CRUISE: 71.8 ± 8.9, P = 0.001) and LAD (dNAV_G : 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 dNAV_G (dNAV_G : 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.

High efficiency coronary MR angiography with nonrigid cardiac motion correction

PURPOSE

To improve the coronary visualization quality of four-dimensional (4D) coronary MR angiography (MRA) through cardiac motion correction and iterative reconstruction.

METHODS

A contrast-enhanced, spoiled gradient echo sequence with 3D radial trajectory and self-gating was used for 4D coronary MRA data acquisition at 3 Tesla. A whole-heart 16-phase cine series was reconstructed with respiratory motion correction. Nonrigid registration was performed between the identified quiescent phases and a reference. The motion information of all included phases was then used along with the corresponding k-space data to iteratively reconstruct the final image. Healthy volunteer studies (N = 13) were conducted to compare the proposed method with the conventional strategy, which accepts data from a single, contiguous window out of the original 16-phase data. Apparent signal-to-noise ratio (aSNR) and coronary sharpness were used as the image quality metrics.

RESULTS

The proposed method significantly improved aSNR (11.89 ± 3.76 to 13.97 ± 5.21; P = 0.005) and scan efficiency (18.8% ± 6.0% to 40.9% ± 9.7%; P < 0.001), compared with the conventional strategy. Sharpness of left main (P = 0.002), proximal (P = 0.04), and middle (P = 0.02) right coronary artery, and proximal left anterior descending (P = 0.04) was also significantly improved.

CONCLUSION

The proposed cardiac motion-corrected reconstruction significantly improved the achievable quality of coronary visualization from 4D coronary MRA. Magn Reson Med 76:1345-1353, 2016. © 2016 International Society for Magnetic Resonance in Medicine.

Highly efficient nonrigid motion-corrected 3D whole-heart coronary vessel wall imaging

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

Nonrigid Motion Correction With 3D Image-Based Navigators for Coronary MR Angiography

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.

Accelerated motion corrected three-dimensional abdominal MRI using total variation regularized SENSE reconstruction

PURPOSE

Develop a nonrigid motion corrected reconstruction for highly accelerated free-breathing three-dimensional (3D) abdominal images without external sensors or additional scans.

METHODS

The proposed method accelerates the acquisition by undersampling and performs motion correction directly in the reconstruction using a general matrix description of the acquisition. Data are acquired using a self-gated 3D golden radial phase encoding trajectory, enabling a two stage reconstruction to estimate and then correct motion of the same data. In the first stage total variation regularized iterative SENSE is used to reconstruct highly undersampled respiratory resolved images. A nonrigid registration of these images is performed to estimate the complex motion in the abdomen. In the second stage, the estimated motion fields are incorporated in a general matrix reconstruction, which uses total variation regularization and incorporates k-space data from multiple respiratory positions. The proposed approach was tested on nine healthy volunteers and compared against a standard gated reconstruction using measures of liver sharpness, gradient entropy, visual assessment of image sharpness and overall image quality by two experts.

RESULTS

The proposed method achieves similar quality to the gated reconstruction with nonsignificant differences for liver sharpness (1.18 and 1.00, respectively), gradient entropy (1.00 and 1.00), visual score of image sharpness (2.22 and 2.44), and visual rank of image quality (3.33 and 3.39). An average reduction of the acquisition time from 102 s to 39 s could be achieved with the proposed method.

CONCLUSION

In vivo results demonstrate the feasibility of the proposed method showing similar image quality to the standard gated reconstruction while using data corresponding to a significantly reduced acquisition time. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance.

Four-dimensional respiratory motion-resolved whole heart coronary MR angiography

PURPOSE

Free-breathing whole-heart coronary MR angiography (MRA) commonly uses navigators to gate respiratory motion, resulting in lengthy and unpredictable acquisition times. Conversely, self-navigation has 100% scan efficiency, but requires motion correction over a broad range of respiratory displacements, which may introduce image artifacts. We propose replacing navigators and self-navigation with a respiratory motion-resolved reconstruction approach.

METHODS

Using a respiratory signal extracted directly from the imaging data, individual signal-readouts are binned according to their respiratory states. The resultant series of undersampled images are reconstructed using an extradimensional golden-angle radial sparse parallel imaging (XD-GRASP) algorithm, which exploits sparsity along the respiratory dimension. Whole-heart coronary MRA was performed in 11 volunteers and four patients with the proposed methodology. Image quality was compared with that obtained with one-dimensional respiratory self-navigation.

RESULTS

Respiratory-resolved reconstruction effectively suppressed respiratory motion artifacts. The quality score for XD-GRASP reconstructions was greater than or equal to self-navigation in 80/88 coronary segments, reaching diagnostic quality in 61/88 segments versus 41/88. Coronary sharpness and length were always superior for the respiratory-resolved datasets, reaching statistical significance (P < 0.05) in most cases.

CONCLUSION

XD-GRASP represents an attractive alternative for handling respiratory motion in free-breathing whole heart MRI and provides an effective alternative to self-navigation. Magn Reson Med 77:1473-1484, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

4D respiratory motion-compensated image reconstruction of free-breathing radial MR data with very high undersampling

PURPOSE

To develop four-dimensional (4D) respiratory time-resolved MRI based on free-breathing acquisition of radial MR data with very high undersampling.

METHODS

We propose the 4D joint motion-compensated high-dimensional total variation (4D joint MoCo-HDTV) algorithm, which alternates between motion-compensated image reconstruction and artifact-robust motion estimation at multiple resolution levels. The algorithm is applied to radial MR data of the thorax and upper abdomen of 12 free-breathing subjects with acquisition times between 37 and 41 s and undersampling factors of 16.8. Resulting images are compared with compressed sensing-based 4D motion-adaptive spatio-temporal regularization (MASTeR) and 4D high-dimensional total variation (HDTV) reconstructions.

RESULTS

For all subjects, 4D joint MoCo-HDTV achieves higher similarity in terms of normalized mutual information and cross-correlation than 4D MASTeR and 4D HDTV when compared with reference 4D gated gridding reconstructions with 8.4 ± 1.1 times longer acquisition times. In a qualitative assessment of artifact level and image sharpness by two radiologists, 4D joint MoCo-HDTV reveals higher scores (P < 0.05) than 4D HDTV and 4D MASTeR at the same undersampling factor and the reference 4D gated gridding reconstructions, respectively.

CONCLUSIONS

4D joint MoCo-HDTV enables time-resolved image reconstruction of free-breathing radial MR data with undersampling factors of 16.8 while achieving low-streak artifact levels and high image sharpness. Magn Reson Med 77:1170-1183, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Whole-heart coronary MR angiography using image-based navigation for the detection of coronary anomalies in adult patients with congenital heart disease

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.

Improving thermal dose accuracy in magnetic resonance-guided focused ultrasound surgery: Long-term thermometry using a prior baseline as a reference

PURPOSE

To investigate thermal dose volume (TDV) and non-perfused volume (NPV) of magnetic resonance-guided focused ultrasound (MRgFUS) treatments in patients with soft tissue tumors, and describe a method for MR thermal dosimetry using a baseline reference.

MATERIALS AND METHODS

Agreement between TDV and immediate post treatment NPV was evaluated from MRgFUS treatments of five patients with biopsy-proven desmoid tumors. Thermometry data (gradient echo, 3T) were analyzed over the entire course of the treatments to discern temperature errors in the standard approach. The technique searches previously acquired baseline images for a match using 2D normalized cross-correlation and a weighted mean of phase difference images. Thermal dose maps and TDVs were recalculated using the matched baseline and compared to NPV.

RESULTS

TDV and NPV showed between 47%-91% disagreement, using the standard immediate baseline method for calculating TDV. Long-term thermometry showed a nonlinear local temperature accrual, where peak additional temperature varied between 4-13°C (mean = 7.8°C) across patients. The prior baseline method could be implemented by finding a previously acquired matching baseline 61% ± 8% (mean ± SD) of the time. We found 7%-42% of the disagreement between TDV and NPV was due to errors in thermometry caused by heat accrual. For all patients, the prior baseline method increased the estimated treatment volume and reduced the discrepancies between TDV and NPV (P = 0.023).

CONCLUSION

This study presents a mismatch between in-treatment and post treatment efficacy measures. The prior baseline approach accounts for local heating and improves the accuracy of thermal dose-predicted volume.

Three-dimensional heart locator and compressed sensing for whole-heart MR angiography

PURPOSE

We sought to develop a whole-heart magnetic resonance angiography technique with three-dimensional (3D) respiratory motion compensation and reduced scan time.

METHODS

A novel respiratory motion compensation method was implemented that acquires a 1D navigator (NAV) and a low-resolution 3D-image of the heart (3D-LOC) just before the angiography data. The central 10% of SSFP k-space was fully acquired using NAV-gating, and then 10% of peripheral k-space was randomly undersampled to complete the scan. Spatial registration of the 3D-LOC information was used to correct the central and peripheral k-space lines for the bulk respiratory motion in three dimensions, and then the remaining k-space data was estimated using compressed sensing (CS). Ten volunteers each underwent two angiography acquisitions with 1 mm(3) resolution: (i) conventional NAV with CS, and (ii) the new 3D-LOC with CS.

RESULTS

Compared with conventional NAV, the new 3D-LOC with CS technique had a shorter scan time (4.8 ± 1.1 versus 6.3 ± 1.7 min; P < 0.001), better objective vessel sharpness for all three coronary arteries (P < 0.05), and no difference in subjective vessel sharpness for all three coronary arteries.

CONCLUSION

Compared with conventional NAV with CS, acceleration and respiratory motion correction using 3D-LOC with CS reduces scan time and improves objective vessel sharpness.

Comparison of image-based and reconstruction-based respiratory motion correction for golden radial phase encoding coronary MR angiography

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.

Fast pediatric 3D free-breathing abdominal dynamic contrast enhanced MRI with high spatiotemporal resolution

PURPOSE

To develop a method for fast pediatric 3D free-breathing abdominal dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) and investigate its clinical feasibility.

MATERIALS AND METHODS

A combined locally low rank parallel imaging method with soft gating is proposed for free-breathing DCE MRI acquisition. With Institutional Review Board (IRB) approval and informed consent/assent, 23 consecutive pediatric patients were recruited for this study. Free-breathing DCE MRI with ∼1 mm(3) spatial resolution and a 6.5-sec frame rate was acquired on a 3T scanner. Undersampled data were reconstructed with a compressed sensing method without motion correction (FB-CS) and the proposed method (FB-LR). A follow-up respiratory-triggered acquisition (RT-CS) was performed as a reference standard. The reconstructed images were evaluated independently by two radiologists. Wilcoxon tests were performed to test the hypothesis that there was no significant difference between different reconstructions. Quantitative evaluation of contrast dynamics was also performed.

RESULTS

The mean score of overall image quality of FB-LR was 4.0 on a 5-point scale, significantly better (P < 0.05) than FB-CS reconstruction (mean score 2.9), and similar to RT-CS (mean score 4.1). FB-LR also matched the temporal fidelity of contrast dynamics with a root mean square error less than 5%.

CONCLUSION

Fast 3D free-breathing DCE MRI with high scan efficiency and image quality similar to respiratory-triggered acquisition is feasible in a pediatric clinical setting.

Motion artifacts in MRI: A complex problem with many partial solutions

Subject motion during magnetic resonance imaging (MRI) has been problematic since its introduction as a clinical imaging modality. While sensitivity to particle motion or blood flow can be used to provide useful image contrast, bulk motion presents a considerable problem in the majority of clinical applications. It is one of the most frequent sources of artifacts. Over 30 years of research have produced numerous methods to mitigate or correct for motion artifacts, but no single method can be applied in all imaging situations. Instead, a "toolbox" of methods exists, where each tool is suitable for some tasks, but not for others. This article reviews the origins of motion artifacts and presents current mitigation and correction methods. In some imaging situations, the currently available motion correction tools are highly effective; in other cases, appropriate tools still need to be developed. It seems likely that this multifaceted approach will be what eventually solves the motion sensitivity problem in MRI, rather than a single solution that is effective in all situations. This review places a strong emphasis on explaining the physics behind the occurrence of such artifacts, with the aim of aiding artifact detection and mitigation in particular clinical situations.

Free-breathing pediatric MRI with nonrigid motion correction and acceleration

PURPOSE

To develop and assess motion correction techniques for high-resolution pediatric abdominal volumetric magnetic resonance images acquired free-breathing with high scan efficiency.

MATERIALS AND METHODS

First, variable-density sampling and radial-like phase-encode ordering were incorporated into the 3D Cartesian acquisition. Second, intrinsic multichannel butterfly navigators were used to measure respiratory motion. Lastly, these estimates are applied for both motion-weighted data-consistency in a compressed sensing and parallel imaging reconstruction, and for nonrigid motion correction using a localized autofocusing framework. With Institutional Review Board approval and informed consent/assent, studies were performed on 22 consecutive pediatric patients. Two radiologists independently scored the images for overall image quality, degree of motion artifacts, and sharpness of hepatic vessels and the diaphragm. The results were assessed using paired Wilcoxon test and weighted kappa coefficient for interobserver agreements.

RESULTS

The complete procedure yielded significantly better overall image quality (mean score of 4.7 out of 5) when compared to using no correction (mean score of 3.4, P < 0.05) and to using motion-weighted accelerated imaging (mean score of 3.9, P < 0.05). With an average scan time of 28 seconds, the proposed method resulted in comparable image quality to conventional prospective respiratory-triggered acquisitions with an average scan time of 91 seconds (mean score of 4.5).

CONCLUSION

With the proposed methods, diagnosable high-resolution abdominal volumetric scans can be obtained from free-breathing data acquisitions.

Real-time motion correction using gradient tones and head-mounted NMR field probes

PURPOSE

Sinusoidal gradient oscillations in the kilohertz range are proposed for position tracking of NMR probes and prospective motion correction for arbitrary imaging sequences without any alteration of sequence timing. The method is combined with concurrent field monitoring to robustly perform image reconstruction in the presence of potential dynamic field deviations.

METHODS

Benchmarking experiments were done to assess the accuracy and precision of the method and to compare it with theoretical predictions based on the field probe's time-dependent signal-to-noise ratio. An array of four field probes was used to perform real-time prospective motion correction in vivo. Images were reconstructed based on both predetermined and concurrently measured k-space trajectories.

RESULTS

For observation windows of 4.8 ms, the precision of probe position determination was found to be 35 to 62 µm, and the maximal measurement error was 595 µm root-mean-square on a single axis. Sequence update per repetition time on this basis yielded images free of conspicuous artifacts despite substantial head motion. Predetermined and concurrently observed k-space trajectories yielded equivalent image quality.

CONCLUSION

NMR field probes in conjunction with gradient tones permit the tracking and prospective correction of rigid-body motion. Relying on gradient oscillations in the kilohertz range, the method allows for concurrent motion detection and image encoding.

Dual registration of abdominal motion for motility assessment in free-breathing data sets acquired using dynamic MRI

At present, registration-based quantification of bowel motility from dynamic MRI is limited to breath-hold studies. Here we validate a dual-registration technique robust to respiratory motion for the assessment of small bowel and colonic motility. Small bowel datasets were acquired in breath-hold and free-breathing in 20 healthy individuals. A pre-processing step using an iterative registration of the low rank component of the data was applied to remove respiratory motion from the free breathing data. Motility was then quantified with an existing optic-flow (OF) based registration technique to form a dual-stage approach, termed Dual Registration of Abdominal Motion (DRAM). The benefit of respiratory motion correction was assessed by (1) assessing the fidelity of automatically propagated segmental regions of interest (ROIs) in the small bowel and colon and (2) comparing parametric motility maps to a breath-hold ground truth. DRAM demonstrated an improved ability to propagate ROIs through free-breathing small bowel and colonic motility data, with median error decreased by 90% and 55%, respectively. Comparison between global parametric maps showed high concordance between breath-hold data and free-breathing DRAM. Quantification of segmental and global motility in dynamic MR data is more accurate and robust to respiration when using the DRAM approach.

Reduction of respiratory motion artifacts for free-breathing whole-heart coronary MRA by weighted iterative reconstruction

PURPOSE

To combine weighted iterative reconstruction with self-navigated free-breathing coronary magnetic resonance angiography for retrospective reduction of respiratory motion artifacts.

METHODS

One-dimensional self-navigation was improved for robust respiratory motion detection and the consistency of the acquired data was estimated on the detected motion. Based on the data consistency, the data fidelity term of iterative reconstruction was weighted to reduce the effects of respiratory motion. In vivo experiments were performed in 14 healthy volunteers and the resulting image quality of the proposed method was compared to a navigator-gated reference in terms of acquisition time, vessel length, and sharpness.

RESULT

Although the sampling pattern of the proposed method contained 60% more samples with respect to the reference, the scan efficiency was improved from 39.5 ± 10.1% to 55.1 ± 9.1%. The improved self-navigation showed a high correlation to the standard navigator signal and the described weighting efficiently reduced respiratory motion artifacts. Overall, the average image quality of the proposed method was comparable to the navigator-gated reference.

CONCLUSION

Self-navigated coronary magnetic resonance angiography was successfully combined with weighted iterative reconstruction to reduce the total acquisition time and efficiently suppress respiratory motion artifacts. The simplicity of the experimental setup and the promising image quality are encouraging toward future clinical evaluation.

Blind multirigid retrospective motion correction of MR images

PURPOSE

Physiological nonrigid motion is inevitable when imaging, e.g., abdominal viscera, and can lead to serious deterioration of the image quality. Prospective techniques for motion correction can handle only special types of nonrigid motion, as they only allow global correction. Retrospective methods developed so far need guidance from navigator sequences or external sensors. We propose a fully retrospective nonrigid motion correction scheme that only needs raw data as an input.

METHODS

Our method is based on a forward model that describes the effects of nonrigid motion by partitioning the image into patches with locally rigid motion. Using this forward model, we construct an objective function that we can optimize with respect to both unknown motion parameters per patch and the underlying sharp image.

RESULTS

We evaluate our method on both synthetic and real data in 2D and 3D. In vivo data was acquired using standard imaging sequences. The correction algorithm significantly improves the image quality. Our compute unified device architecture (CUDA)-enabled graphic processing unit implementation ensures feasible computation times.

CONCLUSION

The presented technique is the first computationally feasible retrospective method that uses the raw data of standard imaging sequences, and allows to correct for nonrigid motion without guidance from external motion sensors.

Free-breathing whole-heart coronary MRA: motion compensation integrated into 3D cartesian compressed sensing reconstruction

Respiratory motion remains a major challenge for whole-heart coronary magnetic resonance angiography (CMRA). Recently, iterative reconstruction has been augmented with non-rigid motion compensation to correct for the effects of respiratory motion. The major challenge of this approach is the estimation of dense deformation fields. In this work, the application of such a motion-compensated reconstruction is proposed for accelerated 3D Cartesian whole-heart CMRA. Without the need for extra calibration data or user interaction, the nonrigid deformations due to respiratory motion are directly estimated on the acquired image data. In-vivo experiments on 14 healthy volunteers were performed to compare the proposed method with the result of a navigator-gated reference scan. While reducing the acquisition time by one third, the reconstructed images resulted in equivalent vessel sharpness of 0.44 +/- 0.06 mm(-1) and 0.45 +/- 0.05 mm(-1), respectively.

Highly efficient respiratory motion compensated free-breathing coronary MRA using golden-step Cartesian acquisition

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.

Accelerated whole-heart coronary MRA using motion-corrected sensitivity encoding with three-dimensional projection reconstruction

PURPOSE

To achieve whole-heart coronary magnetic resonance angiography (MRA) with (1.0 mm)(3) spatial resolution and 5 min of free-breathing scan time.

METHODS

We used an electrocardiograph-gated, T2-prepared and fat-saturated balanced steady state free precession sequence with 3DPR trajectory for free-breathing data acquisition with 100% gating efficiency. For image reconstruction, we used a self-calibrating iterative SENSE scheme with integrated retrospective motion correction. We performed healthy volunteer study to compare the proposed method with motion-corrected gridding at different retrospective undersampling levels on apparent signal-to-noise ratio (aSNR) and subjective coronary artery (CA) visualization scores.

RESULTS

Compared with gridding, the proposed method significantly improved both image quality metrics for undersampled datasets with 6000, 8000, and 10,000 projections. With as few as 10,000 projections, the proposed method yielded good CA visualization scores (3.02 of 4) and aSNR values comparable to those with 20,000 projections.

CONCLUSION

Using the proposed method, good image quality was observed for free breathing whole-heart coronary MRA at (1.0 mm)(3) resolution with an achievable scan time of 5 min.

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

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.

Nonrigid autofocus motion correction for coronary MR angiography with a 3D cones trajectory

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.

Iterative k-t principal component analysis with nonrigid motion correction for dynamic three-dimensional cardiac perfusion imaging

PURPOSE

In this study, an iterative k-t principal component analysis (PCA) algorithm with nonrigid frame-to-frame motion correction is proposed for dynamic contrast-enhanced three-dimensional perfusion imaging.

METHODS

An iterative k-t PCA algorithm was implemented with regularization using training data corrected for frame-to-frame motion in the x-pc domain. Motion information was extracted using shape-constrained nonrigid image registration of the composite of training and k-t undersampled data. The approach was tested for 10-fold k-t undersampling using computer simulations and in vivo data sets corrupted by respiratory motion artifacts owing to free-breathing or interrupted breath-holds. Results were compared to breath-held reference data.

RESULTS

Motion-corrected k-t PCA image reconstruction resolved residual aliasing. Signal intensity curves extracted from the myocardium were close to those obtained from the breath-held reference. Upslopes were found to be more homogeneous in space when using the k-t PCA approach with motion correction.

CONCLUSIONS

Iterative k-t PCA with nonrigid motion correction permits correction of respiratory motion artifacts in three-dimensional first-pass myocardial perfusion imaging.

Free-breathing phase contrast MRI with near 100% respiratory navigator efficiency using k-space-dependent respiratory gating

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.

Three-dimensional heart locator for whole-heart coronary magnetic resonance angiography

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.

Advanced respiratory motion compensation for coronary MR angiography

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.

Whole-heart coronary MRA with 100% respiratory gating efficiency: self-navigated three-dimensional retrospective image-based motion correction (TRIM)

PURPOSE

To develop a three-dimensional retrospective image-based motion correction technique for whole-heart coronary MRA with self-navigation that eliminates both the need to setup a diaphragm navigator and gate the acquisition.

METHODS

The proposed technique uses one-dimensional self-navigation to track the superior-inferior translation of the heart, with which the acquired three-dimensional radial k-space data is segmented into different respiratory bins. Respiratory motion is then estimated in image space using an affine transform model and subsequently this information is used to perform efficient motion correction in k-space. The performance of the proposed technique on healthy volunteers is compared with the conventional navigator gating approach as well as data binning using diaphragm navigator.

RESULTS

The proposed method is able to reduce the imaging time to 7.1±0.5 min from 13.9±2.6 min with conventional navigator gating. The scan setup time is reduced as well due to the elimination of the navigator. The proposed method yields excellent image quality comparable with either conventional navigator gating or the navigator binning approach.

CONCLUSION

We have developed a new respiratory motion correction technique for coronary MRA that enables 1 mm(3) isotropic resolution and whole-heart coverage with 7 min of scan time. Further tests on patient population are needed to determine its clinical usage.

Utility of respiratory-navigator-rejected k-space lines for improved signal-to-noise ratio in three-dimensional cardiac MR

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.

Free-breathing 3D cardiac MRI using iterative image-based respiratory motion correction

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.

Nonrigid motion correction in 3D using autofocusing with localized linear translations

MR scans are sensitive to motion effects due to the scan duration. To properly suppress artifacts from nonrigid body motion, complex models with elements such as translation, rotation, shear, and scaling have been incorporated into the reconstruction pipeline. However, these techniques are computationally intensive and difficult to implement for online reconstruction. On a sufficiently small spatial scale, the different types of motion can be well approximated as simple linear translations. This formulation allows for a practical autofocusing algorithm that locally minimizes a given motion metric--more specifically, the proposed localized gradient-entropy metric. To reduce the vast search space for an optimal solution, possible motion paths are limited to the motion measured from multichannel navigator data. The novel navigation strategy is based on the so-called "Butterfly" navigators, which are modifications of the spin-warp sequence that provides intrinsic translational motion information with negligible overhead. With a 32-channel abdominal coil, sufficient number of motion measurements were found to approximate possible linear motion paths for every image voxel. The correction scheme was applied to free-breathing abdominal patient studies. In these scans, a reduction in artifacts from complex, nonrigid motion was observed.

Subject-specific estimation of respiratory navigator tracking factor for free-breathing cardiovascular MR

A mean respiratory navigator tracking factor of 0.6 is commonly used to estimate the respiratory motion of the heart from the displacement of the right hemi-diaphragm. A constant tracking factor can generate significant residual error in estimation of the respiratory motion of the heart for the cases where the actual tracking factor highly deviates from 0.6. In this study, we implemented and evaluated a robust method to calculate a subject-specific tracking factor for free-breathing high resolution cardiac MR. The subject-specific tracking factor was calculated from two consecutive navigator signals placed on the right hemi-diaphragm and the basal left ventricle in a training phase. To verify the accuracy of the estimated subject-specific tracking factor, nineteen subjects were recruited for comparing the estimated tracking factor in real-time with an image-based tracking factor, calculated off-line. Subsequently, in seven adult subjects, whole-heart or targeted coronary artery MR images were acquired using the estimated subject-specific tracking factor and visually compared with those acquired using a constant (0.6) tracking factor. It was shown that the proposed method can accurately estimate the subject-specific tracking factor and improve the quality of coronary images when the subject-specific tracking factor differs from 0.6.