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

Motion-robust free-running volumetric cardiovascular MRI

PURPOSE

To present and assess an outlier mitigation method that makes free-running volumetric cardiovascular MRI (CMR) more robust to motion.

METHODS

The proposed method, called compressive recovery with outlier rejection (CORe), models outliers in the measured data as an additive auxiliary variable. We enforce MR physics-guided group sparsity on the auxiliary variable, and jointly estimate it along with the image using an iterative algorithm. For evaluation, CORe is first compared to traditional compressed sensing (CS), robust regression (RR), and an existing outlier rejection method using two simulation studies. Then, CORe is compared to CS using seven three-dimensional (3D) cine, 12 rest four-dimensional (4D) flow, and eight stress 4D flow imaging datasets.

RESULTS

Our simulation studies show that CORe outperforms CS, RR, and the existing outlier rejection method in terms of normalized mean square error and structural similarity index across 55 different realizations. The expert reader evaluation of 3D cine images demonstrates that CORe is more effective in suppressing artifacts while maintaining or improving image sharpness. Finally, 4D flow images show that CORe yields more reliable and consistent flow measurements, especially in the presence of involuntary subject motion or exercise stress.

CONCLUSION

An outlier rejection method is presented and tested using simulated and measured data. This method can help suppress motion artifacts in a wide range of free-running CMR applications.

Intra-bin correction and inter-bin compensation of respiratory motion in free-running five-dimensional whole-heart magnetic resonance imaging

BACKGROUND

Free-running cardiac and respiratory motion-resolved whole-heart five-dimensional (5D) cardiovascular magnetic resonance (CMR) can reduce scan planning and provide a means of evaluating respiratory-driven changes in clinical parameters of interest. However, respiratory-resolved imaging can be limited by user-defined parameters which create trade-offs between residual artifact and motion blur. In this work, we develop and validate strategies for both correction of intra-bin and compensation of inter-bin respiratory motion to improve the quality of 5D CMR.

METHODS

Each component of the reconstruction framework was systematically validated and compared to the previously established 5D approach using simulated free-running data (N = 50) and a cohort of 32 patients with congenital heart disease. The impact of intra-bin respiratory motion correction was evaluated in terms of image sharpness while inter-bin respiratory motion compensation was evaluated in terms of reconstruction error, compression of respiratory motion, and image sharpness. The full reconstruction framework (intra-acquisition correction and inter-acquisition compensation of respiratory motion [IIMC] 5D) was evaluated in terms of image sharpness and scoring of image quality by expert reviewers.

RESULTS

Intra-bin motion correction provides significantly (p < 0.001) sharper images for both simulated and patient data. Inter-bin motion compensation results in significant (p < 0.001) lower reconstruction error, lower motion compression, and higher sharpness in both simulated (10/11) and patient (9/11) data. The combined framework resulted in significantly (p < 0.001) sharper IIMC 5D reconstructions (End-expiration (End-Exp): 0.45 ± 0.09, End-inspiration (End-Ins): 0.46 ± 0.10) relative to the previously established 5D implementation (End-Exp: 0.43 ± 0.08, End-Ins: 0.39 ± 0.09). Similarly, image scoring by three expert reviewers was significantly (p < 0.001) higher using IIMC 5D (End-Exp: 3.39 ± 0.44, End-Ins: 3.32 ± 0.45) relative to 5D images (End-Exp: 3.02 ± 0.54, End-Ins: 2.45 ± 0.52).

CONCLUSION

The proposed IIMC reconstruction significantly improves the quality of 5D whole-heart MRI. This may be exploited for higher resolution or abbreviated scanning. Further investigation of the diagnostic impact of this framework and comparison to gold standards is needed to understand its full clinical utility, including exploration of respiratory-driven changes in physiological measurements of interest.

Focused navigation for respiratory-motion-corrected free-running radial 4D flow MRI

PURPOSE

To validate a respiratory motion correction method called focused navigation (fNAV) for free-running radial whole-heart 4D flow MRI.

METHODS

Using fNAV, respiratory signals derived from radial readouts are converted into three orthogonal displacements, which are then used to correct respiratory motion in 4D flow datasets. Hundred 4D flow acquisitions were simulated with non-rigid respiratory motion and used for validation. The difference between generated and fNAV displacement coefficients was calculated. Vessel area and flow measurements from 4D flow reconstructions with (fNAV) and without (uncorrected) motion correction were compared to the motion-free ground-truth. In 25 patients, the same measurements were compared between fNAV 4D flow, 2D flow, navigator-gated Cartesian 4D flow, and uncorrected 4D flow datasets.

RESULTS

For simulated data, the average difference between generated and fNAV displacement coefficients was 0.04± $$ \pm $$ 0.32 mm and 0.31± $$ \pm $$ 0.35 mm in the x and y directions, respectively. In the z direction, this difference was region-dependent (0.02± $$ \pm $$ 0.51 mm up to 5.85± $$ \pm $$ 3.41 mm). For all measurements (vessel area, net volume, and peak flow), the average difference from ground truth was higher for uncorrected 4D flow datasets (0.32± $$ \pm $$ 0.11 cm2 , 11.1± $$ \pm $$ 3.5 mL, and 22.3± $$ \pm $$ 6.0 mL/s) than for fNAV 4D flow datasets (0.10± $$ \pm $$ 0.03 cm2 , 2.6± $$ \pm $$ 0.7 mL, and 5.1± 0 $$ \pm 0 $$ .9 mL/s, p < 0.05). In vivo, average vessel area measurements were 4.92± $$ \pm $$ 2.95 cm2 , 5.06± $$ \pm $$ 2.64 cm2 , 4.87± $$ \pm $$ 2.57 cm2 , 4.87± $$ \pm $$ 2.69 cm2 , for 2D flow and fNAV, navigator-gated and uncorrected 4D flow datasets, respectively. In the ascending aorta, all 4D flow datasets except for the fNAV reconstruction had significantly different vessel area measurements from 2D flow. Overall, 2D flow datasets demonstrated the strongest correlation to fNAV 4D flow for both net volume (r2  = 0.92) and peak flow (r2  = 0.94), followed by navigator-gated 4D flow (r2  = 0.83 and r2  = 0.86, respectively), and uncorrected 4D flow (r2  = 0.69 and r2  = 0.86, respectively).

CONCLUSION

fNAV corrected respiratory motion in vitro and in vivo, resulting in fNAV 4D flow measurements that are comparable to those derived from 2D flow and navigator-gated Cartesian 4D flow datasets, with improvements over those from uncorrected 4D flow.

Retrospective motion correction through multi-average k-space data elimination (REMAKE) for free-breathing cardiac cine imaging

PURPOSE

To develop a motion-robust reconstruction technique for free-breathing cine imaging with multiple averages.

METHOD

Retrospective motion correction through multiple average k-space data elimination (REMAKE) was developed using iterative removal of k-space segments (from individual k-space samples) that contribute most to motion corruption while combining any remaining segments across multiple signal averages. A variant of REMAKE, termed REMAKE+, was developed to address any losses in SNR due to k-space information removal. With REMAKE+, multiple reconstructions using different initial conditions were performed, co-registered, and averaged. Both techniques were validated against clinical "standard" signal averaging reconstruction in a static phantom (with simulated motion) and 15 patients undergoing free-breathing cine imaging with multiple averages. Quantitative analysis of myocardial sharpness, blood/myocardial SNR, myocardial-blood contrast-to-noise ratio (CNR), as well as subjective assessment of image quality and rate of diagnostic quality images were performed.

RESULTS

In phantom, motion artifacts using "standard" (RMS error [RMSE]: 2.2 ± 0.5) were substantially reduced using REMAKE/REMAKE+ (RMSE: 1.5 ± 0.4/1.0 ± 0.4, p < 0.01). In patients, REMAKE/REMAKE+ led to higher myocardial sharpness (0.79 ± 0.09/0.79 ± 0.1 vs. 0.74 ± 0.12 for "standard", p = 0.004/0.04), higher image quality (1.8 ± 0.2/1.9 ± 0.2 vs. 1.6 ± 0.4 for "standard", p = 0.02/0.008), and a higher rate of diagnostic quality images (99%/100% vs. 94% for "standard"). Blood/myocardial SNR for "standard" (94 ± 30/33 ± 10) was higher vs. REMAKE (80 ± 25/28 ± 8, p = 0.002/0.005) and tended to be lower vs. REMAKE+ (105 ± 33/36 ± 12, p = 0.02/0.06). Myocardial-blood CNR for "standard" (61 ± 22) was higher vs. REMAKE (53 ± 19, p = 0.003) and lower vs. REMAKE+ (69 ± 24, p = 0.007).

CONCLUSIONS

Compared to "standard" signal averaging reconstruction, REMAKE and REMAKE+ provide improved myocardial sharpness, image quality, and rate of diagnostic quality images.

High-resolution, respiratory-resolved coronary MRA using a Phyllotaxis-reordered variable-density 3D cones trajectory

PURPOSE

To develop a respiratory-resolved motion-compensation method for free-breathing, high-resolution coronary magnetic resonance angiography (CMRA) using a 3D cones trajectory.

METHODS

To achieve respiratory-resolved 0.98 mm resolution images in a clinically relevant scan time, we undersample the imaging data with a variable-density 3D cones trajectory. For retrospective motion compensation, translational estimates from 3D image-based navigators (3D iNAVs) are used to bin the imaging data into four phases from end-expiration to end-inspiration. To ensure pseudo-random undersampling within each respiratory phase, we devise a phyllotaxis readout ordering scheme mindful of eddy current artifacts in steady state free precession imaging. Following binning, residual 3D translational motion within each phase is computed using the 3D iNAVs and corrected for in the imaging data. The noise-like aliasing characteristic of the combined phyllotaxis and cones sampling pattern is leveraged in a compressed sensing reconstruction with spatial and temporal regularization to reduce aliasing in each of the respiratory phases.

RESULTS

In initial studies of six subjects, respiratory motion compensation using the proposed method yields improved image quality compared to non-respiratory-resolved approaches with no motion correction and with 3D translational correction. Qualitative assessment by two cardiologists and quantitative evaluation with the image edge profile acutance metric indicate the superior sharpness of coronary segments reconstructed with the proposed method (P < 0.01).

CONCLUSION

We have demonstrated a new method for free-breathing, high-resolution CMRA based on a variable-density 3D cones trajectory with modified phyllotaxis ordering and respiratory-resolved motion compensation with 3D iNAVs.

Whole-heart non-rigid motion corrected coronary MRA with autofocus virtual 3D iNAV

PURPOSE

Respiratory motion-corrected coronary MR angiography (CMRA) has shown promise for assessing coronary disease. By incorporating coronal 2D image navigators (iNAVs), respiratory motion can be corrected for in a beat-to-beat basis using translational correction in the foot-head (FH) and right-left (RL) directions and in a bin-to-bin basis using non-rigid motion correction addressing the remaining FH, RL and anterior-posterior (AP) motion. However, with this approach beat-to-beat AP motion is not corrected for. In this work we investigate the effect of remaining beat-to-beat AP motion and propose a virtual 3D iNAV that exploits autofocus motion correction to enable beat-to-beat AP and improved RL intra-bin motion correction.

METHODS

Free-breathing 3D whole-heart CMRA was acquired using a 3-fold undersampled variable-density Cartesian trajectory. Beat-to-beat 3D translational respiratory motion was estimated from the 2D iNAVs in FH and RL directions, and in AP direction with autofocus assuming a linear relationship between FH and AP movement of the heart. Furthermore, motion in RL was also refined using autofocus. This virtual 3D (v3D) iNAV was incorporated in a non-rigid motion correction (NRMC) framework. The proposed approach was tested in 12 cardiac patients, and visible vessel length and vessel sharpness for the right (RCA) and left (LAD) coronary arteries were compared against 2D iNAV-based NRMC.

RESULTS

Average vessel sharpness and length in v3D iNAV NRMC was improved compared to 2D iNAV NRMC (vessel sharpness: RCA: 56 ± 1% vs 52 ± 11%, LAD: 49 ± 8% vs 49 ± 7%; visible vessel length: RCA: 5.98 ± 1.37 cm vs 5.81 ± 1.62 cm, LAD: 5.95 ± 1.85 cm vs 4.83 ± 1.56 cm), however these improvements were not statistically significant.

CONCLUSION

The proposed virtual 3D iNAV NRMC reconstruction further improved NRMC CMRA image quality by reducing artefacts arising from residual AP motion, however the level of improvement was subject-dependent.

Generalized low-rank nonrigid motion-corrected reconstruction for MR fingerprinting

PURPOSE

Develop a novel low-rank motion-corrected (LRMC) reconstruction for nonrigid motion-corrected MR fingerprinting (MRF).

METHODS

Generalized motion-corrected (MC) reconstructions have been developed for steady-state imaging. Here we extend this framework to enable nonrigid MC for transient imaging applications with varying contrast, such as MRF. This is achieved by integrating low-rank dictionary-based compression into the generalized MC model to reconstruct MC singular images, reducing motion artifacts in the resulting parametric maps. The proposed LRMC reconstruction was applied for cardiac motion correction in 2D myocardial MRF (T₁ and T₂ ) with extended cardiac acquisition window (~450 ms) and for respiratory MC in free-breathing 3D myocardial and 3D liver MRF. Experiments were performed in phantom and 22 healthy subjects. The proposed approach was compared with reference spin echo (phantom) and with 2D electrocardiogram-triggered/breath-hold MOLLI and T₂ gradient-and-spin echo conventional maps (in vivo 2D and 3D myocardial MRF).

RESULTS

Phantom results were in general agreement with reference spin-echo measurements, presenting relative errors of approximately 5.4% and 5.5% for T₁ and short T₂ (<100 ms), respectively. The proposed LRMC MRF reduced residual blurring artifacts with respect to no MC for cardiac or respiratory motion in all cases (2D and 3D myocardial, 3D abdominal). In 2D myocardial MRF, left-ventricle T₁ values were 1150 ± 41 ms for LRMC MRF and 1010 ± 56 ms for MOLLI; T₂ values were 43.8 ± 2.3 ms for LRMC MRF and 49.5 ± 4.5 ms for T₂ gradient and spin echo. Corresponding measurements for 3D myocardial MRF were 1085 ± 30 ms and 1062 ± 29 ms for T₁ , and 43.5 ± 1.9 ms and 51.7 ± 1.7 ms for T₂ . For 3D liver, LRMC MRF measured liver T₁ at 565 ± 44 ms and liver T₂ at 35.4 ± 2.4 ms.

CONCLUSION

The proposed LRMC reconstruction enabled generalized (nonrigid) MC for 2D and 3D MRF, both for cardiac and respiratory motion. The proposed approach reduced motion artifacts in the MRF maps with respect to no motion compensation and achieved good agreement with reference measurements.

Clinical comparison of sub-mm high-resolution non-contrast coronary CMR angiography against coronary CT angiography in patients with low-intermediate risk of coronary artery disease: a single center trial

BACKGROUND

The widespread clinical application of coronary cardiovascular magnetic resonance (CMR) angiography (CMRA) for the assessment of coronary artery disease (CAD) remains limited due to low scan efficiency leading to prolonged and unpredictable acquisition times; low spatial-resolution; and residual respiratory motion artefacts resulting in limited image quality. To overcome these limitations, we have integrated highly undersampled acquisitions with image-based navigators and non-rigid motion correction to enable high resolution (sub-1 mm3) free-breathing, contrast-free 3D whole-heart coronary CMRA with 100% respiratory scan efficiency in a clinically feasible and predictable acquisition time.

OBJECTIVES

To evaluate the diagnostic performance of this coronary CMRA framework against coronary computed tomography angiography (CTA) in patients with suspected CAD.

METHODS

Consecutive patients (n = 50) with suspected CAD were examined on a 1.5T CMR scanner. We compared the diagnostic accuracy of coronary CMRA against coronary CTA for detecting a ≥ 50% reduction in luminal diameter.

RESULTS

The 50 recruited patients (55 ± 9 years, 33 male) completed coronary CMRA in 10.7 ± 1.4 min. Twelve (24%) had significant CAD on coronary CTA. Coronary CMRA obtained diagnostic image quality in 95% of all, 97% of proximal, 97% of middle and 90% of distal coronary segments. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were: per patient (100%, 74%, 55%, 100% and 80%), per vessel (81%, 88%, 46%, 97% and 88%) and per segment (76%, 95%, 44%, 99% and 94%) respectively.

CONCLUSIONS

The high diagnostic image quality and diagnostic performance of coronary CMRA compared against coronary CTA demonstrates the potential of coronary CMRA as a robust and safe non-invasive alternative for excluding significant disease in patients at low-intermediate risk of CAD.

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.

Noncontrast Magnetic Resonance Angiography in the Era of Nephrogenic Systemic Fibrosis and Gadolinium Deposition

ABSTRACT

Gadolinium-based contrast agents for clinical magnetic resonance imaging are overall safe. However, the discovery of nephrogenic systemic fibrosis in patients with severe renal impairment and gadolinium deposition in patients receiving contrast have generated developments in contrast-free imaging of the vasculature, that is, noncontrast magnetic resonance angiography. This article presents an update on noncontrast magnetic resonance angiography techniques, with comparison to other imaging alternatives. Potential benefits and challenges to implementation, and evidence to date for various clinical applications are discussed.

Free-breathing R 2 ∗ mapping of hepatic iron overload in children using 3D multi-echo UTE cones MRI

PURPOSE

To enable motion-robust, ungated, free-breathing R 2 ∗ mapping of hepatic iron overload in children with 3D multi-echo UTE cones MRI.

METHODS

A golden-ratio re-ordered 3D multi-echo UTE cones acquisition was developed with chemical-shift encoding (CSE). Multi-echo complex-valued source images were reconstructed via gridding and coil combination, followed by confounder-corrected R 2 ∗ (=1/ T 2 ∗ ) mapping. A phantom containing 15 different concentrations of gadolinium solution (0-300 mM) was imaged at 3T. 3D multi-echo UTE cones with an initial TE of 0.036 ms and Cartesian CSE-MRI (IDEAL-IQ) sequences were performed. With institutional review board approval, 85 subjects (81 pediatric patients with iron overload + 4 healthy volunteers) were imaged at 3T using 3D multi-echo UTE cones with free breathing (FB cones), IDEAL-IQ with breath holding (BH Cartesian), and free breathing (FB Cartesian). Overall image quality of R 2 ∗ maps was scored by 2 blinded experts and compared by a Wilcoxon rank-sum test. For each pediatric subject, the paired R 2 ∗ maps were assessed to determine if a corresponding artifact-free 15 mm region-of-interest (ROI) could be identified at a mid-liver level on both images. Agreement between resulting R 2 ∗ quantification from FB cones and BH/FB Cartesian was assessed with Bland-Altman and linear correlation analyses.

RESULTS

ROI-based regression analysis showed a linear relationship between gadolinium concentration and R 2 ∗ in IDEAL-IQ (y = 8.83x - 52.10, R² = 0.995) as well as in cones (y = 9.19x - 64.16, R² = 0.992). ROI-based Bland-Altman analysis showed that the mean difference (MD) was 0.15% and the SD was 5.78%. However, IDEAL-IQ R 2 ∗ measurements beyond 200 mM substantially deviated from a linear relationship for IDEAL-IQ (y = 5.85x + 127.61, R² = 0.827), as opposed to cones (y = 10.87x - 166.96, R² = 0.984). In vivo, FB cones R 2 ∗ had similar image quality with BH and FB Cartesian in 15 and 42 cases, respectively. FB cones R 2 ∗ had better image quality scores than BH and FB Cartesian in 3 and 21 cases, respectively, where BH/FB Cartesian exhibited severe ghosting artifacts. ROI-based Bland-Altman analyses were 2.23% (MD) and 6.59% (SD) between FB cones and BH Cartesian and were 0.21% (MD) and 7.02% (SD) between FB cones and FB Cartesian, suggesting a good agreement between FB cones and BH (FB) Cartesian R 2 ∗ . Strong linear relationships were observed between BH Cartesian and FB cones (y = 1.00x + 1.07, R² = 0.996) and FB Cartesian and FB cones (y = 0.98x + 1.68, R² = 0.999).

CONCLUSION

Golden-ratio re-ordered 3D multi-echo UTE Cones MRI enabled motion-robust, ungated, and free-breathing R 2 ∗ mapping of hepatic iron overload, with comparable R 2 ∗ measurements and image quality to BH Cartesian, and better image quality than FB Cartesian.

Three-dimensional Yarnball k-space acquisition for accelerated MRI

PURPOSE

To introduce an efficient sampling technique named Yarnball, which may serve as a direct alternative to 3D Cones.

METHODS

Yarnball evolves through 3D k-space with increasing loop size, and the differential equations defining this flexible trajectory are presented in detail. The sampling efficiencies of Yarnball and 3D Cones were compared through point spread function analysis and simulated imaging (which highlights undersampling in the absence of other scanning effects). The feasibility of Yarnball implementation was demonstrated for fully sampled T₁ -weighted images of the human head at 3 T.

RESULTS

The mostly large 3D loops of the Yarnball trajectory facilitate rapid sampling under peripheral nerve stimulation constraint, an advantage that increases with readout duration (T_RO ). Point spread function analysis yielded 89% (T_RO = 2 ms) and 77% (T_RO = 10 ms) of Yarnball voxels with magnitude less than 0.01% of the point spread function peak. For 3D Cones, these values were only 52% and 29%. The 3D-Cones technique required 1.4 times (T_RO = 2 ms) and 1.8 times (T_RO = 10 ms) more trajectories than Yarnball to produce simulated images of a sphere free from undersampling artifact. For a prolate spheroidal (head-like) object, 1.75 times and 2.6 times more trajectories were required for 3D Cones. Yarnball produced 0.72 mm (1/2k_max ) isotropic T₁ -weighted human brain images free from undersampling artifact in only 98 seconds at 3 T.

CONCLUSION

Yarnball demonstrated greater k-space sampling efficiency than directly comparable 3D Cones, and may have value wherever 3D Cones has been considered. Yarnball may also have value in the context of rapid T₁ -weighted brain imaging.

3D free-breathing cardiac magnetic resonance fingerprinting

PURPOSE

To develop a novel respiratory motion compensated three-dimensional (3D) cardiac magnetic resonance fingerprinting (cMRF) approach for whole-heart myocardial T₁ and T₂ mapping from a free-breathing scan.

METHODS

Two-dimensional (2D) cMRF has been recently proposed for simultaneous, co-registered T₁ and T₂ mapping from a breath-hold scan; however, coverage is limited. Here we propose a novel respiratory motion compensated 3D cMRF approach for whole-heart myocardial T₁ and T₂ tissue characterization from a free-breathing scan. Variable inversion recovery and T₂ preparation modules are used for parametric encoding, respiratory bellows driven localized autofocus is proposed for beat-to-beat translation motion correction and a subspace regularized reconstruction is employed to accelerate the scan. The proposed 3D cMRF approach was evaluated in a standardized T₁ /T₂ phantom in comparison with reference spin echo values and in 10 healthy subjects in comparison with standard 2D MOLLI, SASHA and T₂ -GraSE mapping techniques at 1.5 T.

RESULTS

3D cMRF T₁ and T₂ measurements were generally in good agreement with reference spin echo values in the phantom experiments, with relative errors of 2.9% and 3.8% for T₁ and T₂ (T₂ < 100 ms), respectively. in vivo left ventricle (LV) myocardial T₁ values were 1054 ± 19 ms for MOLLI, 1146 ± 20 ms for SASHA and 1093 ± 24 ms for the proposed 3D cMRF; corresponding T₂ values were 51.8 ± 1.6 ms for T2-GraSE and 44.6 ± 2.0 ms for 3D cMRF. LV coefficients of variation were 7.6 ± 1.6% for MOLLI, 12.1 ± 2.7% for SASHA and 5.8 ± 0.8% for 3D cMRF T₁ , and 10.5 ± 1.4% for T2-GraSE and 11.7 ± 1.6% for 3D cMRF T₂ .

CONCLUSION

The proposed 3D cMRF can provide whole-heart, simultaneous and co-registered T₁ and T₂ maps with accuracy and precision comparable to those of clinical standards in a single free-breathing scan of about 7 min.

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.

Reconstruction of undersampled 3D non-Cartesian image-based navigators for coronary MRA using an unrolled deep learning model

PURPOSE

To rapidly reconstruct undersampled 3D non-Cartesian image-based navigators (iNAVs) using an unrolled deep learning (DL) model, enabling nonrigid motion correction in coronary magnetic resonance angiography (CMRA).

METHODS

An end-to-end unrolled network is trained to reconstruct beat-to-beat 3D iNAVs acquired during a CMRA sequence. The unrolled model incorporates a nonuniform FFT operator in TensorFlow to perform the data-consistency operation, and the regularization term is learned by a convolutional neural network (CNN) based on the proximal gradient descent algorithm. The training set includes 6,000 3D iNAVs acquired from 7 different subjects and 11 scans using a variable-density (VD) cones trajectory. For testing, 3D iNAVs from 4 additional subjects are reconstructed using the unrolled model. To validate reconstruction accuracy, global and localized motion estimates from DL model-based 3D iNAVs are compared with those extracted from 3D iNAVs reconstructed with l 1 -ESPIRiT. Then, the high-resolution coronary MRA images motion corrected with autofocusing using the l 1 -ESPIRiT and DL model-based 3D iNAVs are assessed for differences.

RESULTS

3D iNAVs reconstructed using the DL model-based approach and conventional l 1 -ESPIRiT generate similar global and localized motion estimates and provide equivalent coronary image quality. Reconstruction with the unrolled network completes in a fraction of the time compared to CPU and GPU implementations of l 1 -ESPIRiT (20× and 3× speed increases, respectively).

CONCLUSIONS

We have developed a deep neural network architecture to reconstruct undersampled 3D non-Cartesian VD cones iNAVs. Our approach decreases reconstruction time for 3D iNAVs, while preserving the accuracy of nonrigid motion information offered by them for correction.

MR-MOTUS: model-based non-rigid motion estimation for MR-guided radiotherapy using a reference image and minimal k-space data

Time-resolved motion estimation from MRI data has received an increasing amount of interest due to the advent of the MR-Linac. The combination of an MRI scanner and a linear accelerator enables radiation plan adaptation based on internal organ motion estimated from MRI data. However, time-resolved estimation of this motion from MRI data still remains a challenge. In light of this application, we propose MR-MOTUS, a framework to estimate non-rigid 3D motion from minimal k-space data. MR-MOTUS consists of two main components: (1) a signal model that explicitly relates the k-space signal of a deforming object to non-rigid motion-fields and a reference image, and (2) model-based reconstructions of the non-rigid motion-fields directly from k-space data. Using an a priori available reference image and the fact that internal body motion exhibits a high level of spatial correlation, we represent the motion-fields in a low-dimensional space and reconstruct them from minimal k-space data that can be acquired very rapidly. The signal model is validated through numerical experiments with a digital 3D phantom and motion-fields are reconstructed from retrospectively undersampled in vivo head and abdomen data using various undersampling strategies. A comparison is made with state-of-the-art image registration performed on images reconstructed from the same undersampled data. Results show that MR-MOTUS reconstructs in vivo 3D rigid head motion from 474-fold retrospectively downsampled k-space data, and in vivo non-rigid 3D respiratory motion from 63-fold retrospectively undersampled k-space data. Preliminary results on prospectively undersampled data acquired with a 2D golden angle acquisition during free-breathing demonstrate the practical feasibility of the method.

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.

Correcting versus resolving respiratory motion in free-breathing whole-heart MRA: a comparison in patients with thoracic aortic disease

Background

Whole-heart magnetic resonance angiography (MRA) requires sophisticated methods accounting for respiratory motion. Our purpose was to evaluate the image quality of compressed sensing-based respiratory motion-resolved three-dimensional (3D) whole-heart MRA compared with self-navigated motion-corrected whole-heart MRA in patients with known thoracic aorta dilation.

Methods

Twenty-five patients were prospectively enrolled in this ethically approved study. Whole-heart 1.5-T MRA was acquired using a prototype 3D radial steady-state free-precession free-breathing sequence. The same data were reconstructed with a one-dimensional motion-correction algorithm (1D-MCA) and an extradimensional golden-angle radial sparse parallel reconstruction (XD-GRASP). Subjective image quality was scored and objective image quality was quantified (signal intensity ratio, SIR; vessel sharpness). Wilcoxon, McNemar, and paired t tests were used.

Results

Subjective image quality was significantly higher using XD-GRASP compared to 1D-MCA (median 4.5, interquartile range 4.5–5.0 versus 4.0 [2.25–4.75]; p < 0.001), as well as signal homogeneity (3.0 [3.0–3.0] versus 2.0 [2.0–3.0]; p = 0.003), and image sharpness (3.0 [2.0–3.0] vs 2.0 [1.25–3.0]; p < 0.001). SIR with the 1D-MCA and XD-GRASP was 6.1 ± 3.9 versus 7.4 ± 2.5, respectively (p < 0.001); while signal homogeneity was 274.2 ± 265.0 versus 199.8 ± 67.2 (p = 0.129). XD-GRASP provided a higher vessel sharpness (45.3 ± 10.7 versus 40.6 ± 101, p = 0.025).

Conclusions

XD-GRASP-based motion-resolved reconstruction of free-breathing 3D whole-heart MRA datasets provides improved image contrast, sharpness, and signal homogeneity and seems to be a promising technique that overcomes some of the limitations of motion correction or respiratory navigator gating.

Deep residual network for off-resonance artifact correction with application to pediatric body MRA with 3D cones

PURPOSE

To enable rapid imaging with a scan time-efficient 3D cones trajectory with a deep-learning off-resonance artifact correction technique.

METHODS

A residual convolutional neural network to correct off-resonance artifacts (Off-ResNet) was trained with a prospective study of pediatric MRA exams. Each exam acquired a short readout scan (1.18 ms ± 0.38) and a long readout scan (3.35 ms ± 0.74) at 3 T. Short readout scans, with longer scan times but negligible off-resonance blurring, were used as reference images and augmented with additional off-resonance for supervised training examples. Long readout scans, with greater off-resonance artifacts but shorter scan time, were corrected by autofocus and Off-ResNet and compared with short readout scans by normalized RMS error, structural similarity index, and peak SNR. Scans were also compared by scoring on 8 anatomical features by two radiologists, using analysis of variance with post hoc Tukey's test and two one-sided t-tests. Reader agreement was determined with intraclass correlation.

RESULTS

The total scan time for long readout scans was on average 59.3% shorter than short readout scans. Images from Off-ResNet had superior normalized RMS error, structural similarity index, and peak SNR compared with uncorrected images across ±1 kHz off-resonance (P < .01). The proposed method had superior normalized RMS error over -677 Hz to +1 kHz and superior structural similarity index and peak SNR over ±1 kHz compared with autofocus (P < .01). Radiologic scoring demonstrated that long readout scans corrected with Off-ResNet were noninferior to short readout scans (P < .05).

CONCLUSION

The proposed method can correct off-resonance artifacts from rapid long-readout 3D cones scans to a noninferior image quality compared with diagnostically standard short readout scans.

Simultaneous 3D whole-heart bright-blood and black blood imaging for cardiovascular anatomy and wall assessment with interleaved T2 prep-IR

PURPOSE

To develop a motion-corrected 3D flow-insensitive imaging approach interleaved T₂ prepared-inversion recovery (iT₂ prep-IR) for simultaneous lumen and wall visualization of the great thoracic vessels and cardiac structures.

METHODS

A 3D flow-insensitive approach for simultaneous cardiovascular lumen and wall visualization (iT₂ prep) has been previously proposed. This approach requires subject-dependent weighted subtraction to completely null the arterial blood signal in the black-blood volume. Here, we propose an (T₂ prep-IR) approach to improve wall visualization and remove need for weighted subtraction. The proposed sequence is based on the acquisition and direct subtraction of 2 interleaved 3D whole-heart data sets acquired with and without T₂ prep-IR preparation. Image navigators are acquired before data acquisition to enable 2D translational and 3D non-rigid motion correction allowing 100% respiratory scan efficiency. The proposed approach was evaluated in 10 healthy subjects and compared with the conventional 2D double inversion recovery (DIR) sequence and the 3D iT₂ prep sequence. Additionally, 5 patients with congenital heart disease were acquired to test the clinical feasibility of the proposed approach.

RESULTS

The proposed iT₂ prep-IR sequence showed improved blood nulling compared to both DIR and iT₂ prep techniques in terms of SNR (SNR_blood = 6.9, 12.2, and 18.2, respectively) and contrast-to-noise-ratio (CNR_myoc-blood = 28.4, 15.4, and 15.3, respectively). No statistical difference was observed between iT₂ prep-IR, iT₂ prep and DIR atrial and ventricular wall thickness quantification.

CONCLUSION

The proposed interleaved T₂ prep-IR sequence enables the simultaneous lumen and wall visualization of cardiac structures and shows promising results in terms of SNR, CNR, and wall thickness measurement.

Highly Accelerated Breath-Hold Noncontrast Electrocardiographically- and Pulse-Gated Balanced Steady-State Free Precession Magnetic Resonance Angiography of the Thoracic Aorta: Comparison With Electrocardiographically-Gated Computed Tomographic Angiography

OBJECTIVE

The aim of this study was to evaluate agreement of measured thoracic aortic caliber in patients with aortic disease, using electrocardiographically-(ECG) and pulse-gated breath-hold noncontrast balanced steady-state free precession MRA (ECG-MRA, P-MRA) at 1.5 T, compared with ECG-gated computed tomographic angiography (CTA).

METHODS

Thirty-one patients underwent ECG-MRA, P-MRA, and CTA. Two readers independently measured aortic caliber in 7 segments, with agreement between techniques and readers evaluated. Image quality was qualitatively assessed.

RESULTS

There was overall excellent agreement among ECG-MRA, P-MRA, and CTA for measured aortic caliber (Lin's concordance correlation coefficient ≥0.94, all comparisons); however, lower concordance was noted at the annulus (Lin's concordance correlation coefficient <0.6) at segmental assessment. There was excellent interreader agreement for aortic caliber for all 3 techniques (intraclass correlation coefficient >0.94). Image quality was poorer for both MRA techniques compared with CTA, particularly at the aortic root.

CONCLUSIONS

Electrocardiographically-gated MRA and P-MRA at 1.5 T achieve comparable thoracic aortic measurements to gated CTA in clinical patients, despite inferior image quality.

Motion-compensated reconstruction of magnetic resonance images from undersampled data

Magnetic resonance imaging of patients who find difficulty lying still or holding their breath can be challenging. Unresolved intra-frame motion yields blurring artifacts and limits spatial resolution. To correct for intra-frame non-rigid motion, such as in pediatric body imaging, this paper describes a multi-scale technique for joint estimation of the motion occurring during the acquisition and of the desired uncorrupted image. This technique regularizes the motion coefficients to enforce invertibility and minimize numerical instability. This multi-scale approach takes advantage of variable-density sampling patterns used in accelerated imaging to resolve large motion from a coarse scale. The resulting method improves image quality for a set of two-dimensional reconstructions from data simulated with independently generated deformations, with statistically significant increases in both peak signal to error ratio and structural similarity index. These improvements are consistent across varying undersampling factors and severities of motion and take advantage of the variable density sampling pattern.

Whole-heart coronary MR angiography using a 3D cones phyllotaxis trajectory

PURPOSE

To develop a 3D cones steady-state free precession sequence with improved robustness to respiratory motion while mitigating eddy current artifacts for free-breathing whole-heart coronary magnetic resonance angiography.

METHOD

The proposed sequence collects cone interleaves using a phyllotaxis pattern, which allows for more distributed k-space sampling for each heartbeat compared to a typical sequential collection pattern. A Fibonacci number of segments is chosen to minimize eddy current effects with the trade-off of an increased number of acquisition heartbeats. For verification, phyllotaxis-cones is compared to sequential-cones through simulations, phantom studies, and in vivo coronary scans with 8 subjects using 2D image-based navigators for retrospective motion correction.

RESULTS

Simulated point spread functions and moving phantom results show less coherent motion artifacts for phyllotaxis-cones compared to sequential-cones. Assessment of the right and left coronary arteries using reader scores and the image edge profile acutance vessel sharpness metric indicate superior image quality and sharpness for phyllotaxis-cones.

CONCLUSION

Phyllotaxis 3D cones results in improved qualitative image scores and coronary vessel sharpness for free-breathing whole-heart coronary magnetic resonance angiography compared to standard sequential ordering when using a steady-state free precession sequence.

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.

Improved respiratory self-navigation for 3D radial acquisitions through the use of a pencil-beam 2D-T2 -prep for free-breathing, whole-heart coronary MRA

PURPOSE

In respiratory self-navigation (SN), signal from static structures, such as the chest wall, may complicate motion detection or introduce post-correction artefacts. Suppressing signal from superfluous tissues may therefore improve image quality. We thus test the hypothesis that SN whole-heart coronary magnetic resonance angiography (MRA) will benefit from an outer-volume suppressing 2D-T2 -Prep and present both phantom and in vivo results.

METHODS

A 2D-T2 -Prep and a conventional T2 -Prep were used prior to a free-breathing 3D-radial SN sequence. Both techniques were compared by imaging a home-built moving cardiac phantom and by performing coronary MRA in nine healthy volunteers. Reconstructions were performed using both a reference-based and a reference-independent approach to motion tracking, along with several coil combinations. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were compared, along with vessel sharpness (VS).

RESULTS

In phantoms, using the 2D-T2 -Prep increased SNR by 16% to 53% and mean VS by 8%; improved motion tracking precision was also achieved. In volunteers, SNR increased by an average of 29% to 33% in the blood pool and by 15% to 25% in the myocardium, depending on the choice of reconstruction coils and algorithm, and VS increased by 34%.

CONCLUSION

A 2D-T2 -Prep significantly improves image quality in both phantoms and volunteers when performing SN coronary MRA. Magn Reson Med 79:1293-1303, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

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.

Simultaneous bright- and black-blood whole-heart MRI for noncontrast enhanced coronary lumen and thrombus visualization

PURPOSE

To develop a 3D whole-heart Bright-blood and black-blOOd phase SensiTive (BOOST) inversion recovery sequence for simultaneous noncontrast enhanced coronary lumen and thrombus/hemorrhage visualization.

METHODS

The proposed sequence alternates the acquisition of two bright-blood datasets preceded by different preparatory pulses to obtain variations in blood/myocardium contrast, which then are combined in a phase-sensitive inversion recovery (PSIR)-like reconstruction to obtain a third, coregistered, black-blood dataset. The bright-blood datasets are used for both visualization of the coronary lumen and motion estimation, whereas the complementary black-blood dataset potentially allows for thrombus/hemorrhage visualization. Furthermore, integration with 2D image-based navigation enables 100% scan efficiency and predictable scan times. The proposed sequence was compared to conventional coronary MR angiography (CMRA) and PSIR sequences in a standardized phantom and in healthy subjects. Feasibility for thrombus depiction was tested ex vivo.

RESULTS

With BOOST, the coronary lumen is visualized with significantly higher (P < 0.05) contrast-to-noise ratio and vessel sharpness when compared to conventional CMRA. Furthermore, BOOST showed effective blood signal suppression as well as feasibility for thrombus visualization ex vivo.

CONCLUSION

A new PSIR sequence for noncontrast enhanced simultaneous coronary lumen and thrombus/hemorrhage detection was developed. The sequence provided improved coronary lumen depiction and showed potential for thrombus visualization. Magn Reson Med 79:1460-1472, 2018. © 2017 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.

5D whole-heart sparse MRI

PURPOSE

A 5D whole-heart sparse imaging framework is proposed for simultaneous assessment of myocardial function and high-resolution cardiac and respiratory motion-resolved whole-heart anatomy in a single continuous noncontrast MR scan.

METHODS

A non-electrocardiograph (ECG)-triggered 3D golden-angle radial balanced steady-state free precession sequence was used for data acquisition. The acquired 3D k-space data were sorted into a 5D dataset containing separated cardiac and respiratory dimensions using a self-extracted respiratory motion signal and a recorded ECG signal. Images were then reconstructed using XD-GRASP, a multidimensional compressed sensing technique exploiting correlations/sparsity along cardiac and respiratory dimensions. 5D whole-heart imaging was compared with respiratory motion-corrected 3D and 4D whole-heart imaging in nine volunteers for evaluation of the myocardium, great vessels, and coronary arteries. It was also compared with breath-held, ECG-gated 2D cardiac cine imaging for validation of cardiac function quantification.

RESULTS

5D whole-heart images received systematic higher quality scores in the myocardium, great vessels and coronary arteries. Quantitative coronary sharpness and length were always better for the 5D images. Good agreement was obtained for quantification of cardiac function compared with 2D cine imaging.

CONCLUSION

5D whole-heart sparse imaging represents a robust and promising framework for simplified comprehensive cardiac MRI without the need for breath-hold and motion correction. Magn Reson Med 79:826-838, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

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.

3D image-based navigators for coronary MR angiography

PURPOSE

To develop a method for acquiring whole-heart 3D image-based navigators (iNAVs) with isotropic resolution for tracking and correction of localized motion in coronary magnetic resonance angiography (CMRA).

METHODS

To monitor motion in all regions of the heart during a free-breathing scan, a variable-density cones trajectory was designed to collect a 3D iNAV every heartbeat in 176 ms with 4.4 mm isotropic spatial resolution. The undersampled 3D iNAV data were reconstructed with efficient self-consistent parallel imaging reconstruction (ESPIRiT). 3D translational and nonrigid motion-correction methods using 3D iNAVs were compared to previous translational and nonrigid methods using 2D iNAVs.

RESULTS

Five subjects were scanned with a 3D cones CMRA sequence, accompanied by both 2D and 3D iNAVs. The quality of the right and left anterior descending coronary arteries was assessed on 2D and 3D iNAV-based motion-corrected images using a vessel sharpness metric and qualitative reader scoring. This assessment showed that nonrigid motion correction based on 3D iNAVs produced results that were noninferior to correction based on 2D iNAVs.

CONCLUSION

The ability to acquire isotropic-resolution 3D iNAVs every heartbeat during a CMRA scan was demonstrated. Such iNAVs enabled direct measurement of localized motion for nonrigid motion correction in free-breathing whole-heart CMRA. Magn Reson Med 77:1874-1883, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Free breathing three-dimensional late gadolinium enhancement cardiovascular magnetic resonance using outer volume suppressed projection navigators

PURPOSE

To develop a three-dimensional, free-breathing, late gadolinium enhancement (3D FB-LGE) cardiovascular magnetic resonance (CMR) technique, and to compare it with clinically used two-dimensional breath-hold LGE (2D BH-LGE).

METHODS

The proposed 3D FB-LGE method consisted of inversion preparation, inversion delay, fat saturation, outer volume suppression, one-dimensional projection navigators, and a segmented stack of spirals acquisition. The 3D FB-LGE and 2D BH-LGE scans were performed on 29 cardiac patients. Qualitative analysis and quantitative analysis (in patients with scar) were performed.

RESULTS

No significant differences were noted between the 3D FB-LGE and 2D BH-LGE data sets in terms of overall image quality score (2D: 4.69 ± 0.60 versus 3D: 4.55 ± 0.51, P = 0.46) and image artifact score (2D: 1.10 ± 0.31 versus 3D: 1.17 ± 0.38; P = 0.63). The average difference in fractional scar volume between the 3D and 2D methods was 1.9% (n = 5). Acquisition time was significantly shorter for the 3D FB-LGE over 2D BH-LGE by a factor of 2.83 ± 0.77 (P < 0.0001).

CONCLUSIONS

The 3D FB-LGE is a viable option for patients, particularly in acute settings or in patients who are unable to comply with breath-hold instructions. Magn Reson Med 77:1533-1543, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

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.

Golden angle dual-inversion recovery acquisition coupled with a flexible time-resolved sparse reconstruction facilitates sequence timing in high-resolution coronary vessel wall MRI at 3 T

PURPOSE

The need for performing dual-inversion recovery (DIR) coronary vessel wall MRI in correspondence to minimal cardiac motion and optimal blood signal nulling is a major challenge. We propose to address this hurdle by combining DIR with a prolonged acquisition window in conjunction with a golden angle radial trajectory and k-t sparse sensitivity encoding (SENSE) reconstruction to enable a flexible a-posteriori selection of optimized imaging parameters.

METHODS

Coronary vessel wall data acquisition was performed with DIR golden angle radial imaging in n=15 healthy subjects. Images reconstructed using k-t sparse SENSE and different reconstruction window settings were quantitatively (vessel wall conspicuity, thickness, acquisition, and reconstruction window settings) compared with those obtained with more conventional radial DIR imaging.

RESULTS

A flexible retrospective selection of the reconstruction window width and position improved vessel wall conspicuity with respect to baseline acquisitions (P < 0.01). Vessel wall thickness remained unchanged (P = nonsignificant (NS)). Temporal window widths were similar for both approaches (P = NS), yet their position within the cardiac cycle differed significantly (P < 0.02).

CONCLUSIONS

A flexible DIR coronary vessel wall MRI technique that alleviates constraints associated with sophisticated sequence timing was proposed. When compared with a more conventional approach, the technique significantly improved image quality. Magn Reson Med 77:961-969, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Combined outer volume suppression and T2 preparation sequence for coronary angiography

PURPOSE

To develop a magnetization preparation sequence for simultaneous outer volume suppression (OVS) and T2 weighting in whole-heart coronary magnetic resonance angiography.

METHODS

A combined OVS and T2 preparation sequence (OVS-T2 Prep) was designed with a nonselective adiabatic 90° tipdown pulse, two adiabatic 180° refocusing pulses, and a 2D spiral -90° tipup pulse. The OVS-T2 Prep preserves the magnetization inside an elliptic cylinder with T2 weighting, while saturating the magnetization outside the cylinder. Its performance was tested on phantoms and on 13 normal subjects with coronary magnetic resonance angiography using 3D cones trajectories.

RESULTS

Phantom studies showed expected T2 -dependent signal amplitude in the spatial passband and suppressed signal in the spatial stopband. In vivo studies with full-field-of-view cones yielded a passband-to-stopband signal ratio of 3.18 ± 0.77 and blood-myocardium contrast-to-noise ratio enhancement by a factor of 1.43 ± 0.20 (P < 0.001). In vivo studies with reduced-field-of-view cones showed that OVS-T2 Prep well suppressed the aliasing artifacts, as supported by significantly reduced signal in the regions with no tissues compared to the images acquired without preparation (P < 0.0001).

CONCLUSION

OVS-T2 Prep is a compact sequence that can accelerate coronary magnetic resonance angiography by suppressing signals from tissues surrounding the heart while simultaneously enhancing the blood-myocardium contrast.

High-resolution variable-density 3D cones coronary MRA

PURPOSE

To improve the spatial/temporal resolution of whole-heart coronary MR angiography by developing a variable-density (VD) 3D cones acquisition suitable for image reconstruction with parallel imaging and compressed sensing techniques.

METHODS

A VD 3D cones trajectory design incorporates both radial and spiral trajectory undersampling techniques to achieve higher resolution. This design is used to generate a VD 3D cones trajectory with 0.8 mm/66 ms isotropic spatial/temporal resolution, using a similar number of readouts as our previous fully sampled cones trajectory (1.2 mm/100 ms). Scans of volunteers and patients are performed to evaluate the performance of the VD trajectory, using non-Cartesian L1 -ESPIRiT for high-resolution image reconstruction.

RESULTS

With gridding reconstruction, the high-resolution scans experience an expected drop in signal-to-noise and contrast-to-noise ratios, but with L1 -ESPIRiT, the apparent noise is substantially reduced. Compared with 1.2 mm images, in each volunteer, the L1 -ESPIRiT 0.8 mm images exhibit higher vessel sharpness values in the right and left anterior descending arteries.

CONCLUSION

Coronary MR angiography with isotropic submillimeter spatial resolution and high temporal resolution can be performed with VD 3D cones to improve the depiction of coronary arteries.

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.

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.

ECG and navigator-free four-dimensional whole-heart coronary MRA for simultaneous visualization of cardiac anatomy and function

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.

Self-gated fat-suppressed cardiac cine MRI

PURPOSE

To develop a self-gated alternating repetition time balanced steady-state free precession (ATR-SSFP) pulse sequence for fat-suppressed cardiac cine imaging.

METHODS

Cardiac gating is computed retrospectively using acquired magnetic resonance self-gating data, enabling cine imaging without the need for electrocardiogram (ECG) gating. Modification of the slice-select rephasing gradients of an ATR-SSFP sequence enables the acquisition of a one-dimensional self-gating readout during the unused short repetition time (TR). Self-gating readouts are acquired during every TR of segmented, breath-held cardiac scans. A template-matching algorithm is designed to compute cardiac trigger points from the self-gating signals, and these trigger points are used for retrospective cine reconstruction. The proposed approach is compared with ECG-gated ATR-SSFP and balanced steady-state free precession in 10 volunteers and five patients.

RESULTS

The difference of ECG and self-gating trigger times has a variability of 13 ± 11 ms (mean ± SD). Qualitative reviewer scoring and ranking indicate no statistically significant differences (P > 0.05) between self-gated and ECG-gated ATR-SSFP images. Quantitative blood-myocardial border sharpness is not significantly different among self-gated ATR-SSFP ( 0.61±0.15 mm -1), ECG-gated ATR-SSFP ( 0.61±0.15 mm -1), or conventional ECG-gated balanced steady-state free precession cine MRI ( 0.59±0.15 mm -1).

CONCLUSION

The proposed self-gated ATR-SSFP sequence enables fat-suppressed cardiac cine imaging at 1.5 T without the need for ECG gating and without decreasing the imaging efficiency of ATR-SSFP.