Analysis and correction of off‐resonance artifacts in echo‐planar cardiac diffusion tensor imaging

Diffusion Tensor Phenomapping of the Healthy and Pressure-Overloaded Human Heart

Current techniques to image the microstructure of the heart with diffusion tensor MRI (DTI) are highly under-resolved. We present a technique to improve the spatial resolution of cardiac DTI by almost 10-fold and leverage this to measure local gradients in cardiomyocyte alignment or helix angle (HA). We further introduce a phenomapping approach based on voxel-wise hierarchical clustering of these gradients to identify distinct microstructural microenvironments in the heart. Initial development was performed in healthy volunteers (n=8). Thereader, subjects with severe but well-compensated aortic stenosis (AS, n=10) were compared to age-matched controls (CTL, n=10). Radial HA gradient was significantly reduced in AS (8.0±0.8°/mm vs. 10.2±1.8°/mm, p=0.001) but the other HA gradients did not change significantly. Four distinct microstructural clusters could be idenJfied in both the CTL and AS subjects and did not differ significantly in their properties or distribution. Despite marked hypertrophy, our data suggest that the myocardium in well-compensated AS can maintain its microstructural coherence. The described phenomapping approach can be used to characterize microstructural plasticity and perturbation in any organ system and disease.

Cardiac q-space trajectory imaging by motion-compensated tensor-valued diffusion encoding in human heart in vivo

PURPOSE

Tensor-valued diffusion encoding can probe more specific features of tissue microstructure than what is available by conventional diffusion weighting. In this work, we investigate the technical feasibility of tensor-valued diffusion encoding at high b-values with q-space trajectory imaging (QTI) analysis, in the human heart in vivo.

METHODS

Ten healthy volunteers were scanned on a 3T scanner. We designed time-optimal gradient waveforms for tensor-valued diffusion encoding (linear and planar) with second-order motion compensation. Data were analyzed with QTI. Normal values and repeatability were investigated for the mean diffusivity (MD), fractional anisotropy (FA), microscopic FA (μFA), isotropic, anisotropic and total mean kurtosis (MKi, MKa, and MKt), and orientation coherence (Cc ). A phantom, consisting of two fiber blocks at adjustable angles, was used to evaluate sensitivity of parameters to orientation dispersion and diffusion time.

RESULTS

QTI data in the left ventricular myocardium were MD = 1.62 ± 0.07 μm2 /ms, FA = 0.31 ± 0.03, μFA = 0.43 ± 0.07, MKa = 0.20 ± 0.07, MKi = 0.13 ± 0.03, MKt = 0.33 ± 0.09, and Cc  = 0.56 ± 0.22 (mean ± SD across subjects). Phantom experiments showed that FA depends on orientation dispersion, whereas μFA was insensitive to this effect.

CONCLUSION

We demonstrated the first tensor-valued diffusion encoding and QTI analysis in the heart in vivo, along with first measurements of myocardial μFA, MKi, MKa, and Cc . The methodology is technically feasible and provides promising novel biomarkers for myocardial tissue characterization.

Characterization and correction of diffusion gradient-induced eddy currents in second-order motion-compensated echo-planar and spiral cardiac DTI

PURPOSE

Very high gradient amplitudes played out over extended time intervals as required for second-order motion-compensated cardiac DTI may violate the assumption of a linear time-invariant gradient system model. The aim of this work was to characterize diffusion gradient-related system nonlinearity and propose a correction approach for echo-planar and spiral spin-echo motion-compensated cardiac DTI.

METHODS

Diffusion gradient-induced eddy currents of 9 diffusion directions were characterized at b values of 150 s/mm² and 450 s/mm² for a 1.5 Tesla system and used to correct phantom, ex vivo, and in vivo motion-compensated cardiac DTI data acquired with echo-planar and spiral trajectories. Predicted trajectories were calculated using gradient impulse response function and diffusion gradient strength- and direction-dependent zeroth- and first-order eddy current responses. A reconstruction method was implemented using the predicted <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:semantics><mml:mrow><mml:mi>k</mml:mi></mml:mrow> <mml:annotation>$$ k $$</mml:annotation></mml:semantics> </mml:math> -space trajectories to additionally include off-resonances and concomitant fields. Resulting images were compared to a reference reconstruction omitting diffusion gradient-induced eddy current correction.

RESULTS

Diffusion gradient-induced eddy currents exhibited nonlinear effects when scaling up the gradient amplitude and could not be described by a 3D basis alone. This indicates that a gradient impulse response function does not suffice to describe diffusion gradient-induced eddy currents. Zeroth- and first-order diffusion gradient-induced eddy current effects of up to -1.7 rad and -16 to +12 rad/m, respectively, were identified. Zeroth- and first-order diffusion gradient-induced eddy current correction yielded improved image quality upon image reconstruction.

CONCLUSION

The proposed approach offers correction of diffusion gradient-induced zeroth- and first-order eddy currents, reducing image distortions to promote improvements of second-order motion-compensated spin-echo cardiac DTI.

Comparison of interpolation methods of predominant cardiomyocyte orientation from in vivo and ex vivo cardiac diffusion tensor imaging data

Cardiac electrophysiology and cardiac mechanics both depend on the average cardiomyocyte long-axis orientation. In the realm of personalized medicine, knowledge of the patient-specific changes in cardiac microstructure plays a crucial role. Patient-specific computational modelling has emerged as a tool to better understand disease progression. In vivo cardiac diffusion tensor imaging (cDTI) is a vital tool to non-destructively measure the average cardiomyocyte long-axis orientation in the heart. However, cDTI suffers from long scan times, rendering volumetric, high-resolution acquisitions challenging. Consequently, interpolation techniques are needed to populate bio-mechanical models with patient-specific average cardiomyocyte long-axis orientations. In this work, we compare five interpolation techniques applied to in vivo and ex vivo porcine input data. We compare two tensor interpolation approaches, one rule-based approximation, and two data-driven, low-rank models. We demonstrate the advantage of tensor interpolation techniques, resulting in lower interpolation errors than do low-rank models and rule-based methods adapted to cDTI data. In an ex vivo comparison, we study the influence of three imaging parameters that can be traded off against acquisition time: in-plane resolution, signal to noise ratio, and number of acquired short-axis imaging slices.

Quantitative effects of off-resonance related distortion on brain mechanical property estimation with magnetic resonance elastography

Off-resonance related geometric distortion can impact quantitative MRI techniques, such as magnetic resonance elastography (MRE), and result in errors to these otherwise sensitive metrics of brain health. MRE is a phase contrast technique to determine the mechanical properties of tissue by imaging shear wave displacements and estimating tissue stiffness through inverse solution of Navier's equation. In this study, we systematically examined the quantitative effects of distortion and corresponding correction approaches on MRE measurements through a series of simulations, phantom models, and in vivo brain experiments. We studied two different k-space trajectories, echo-planar imaging and spiral, and we determined that readout time, off-resonance gradient strength, and the combination of readout direction and off-resonance gradient direction, impact the estimated mechanical properties. Images were also processed through traditional distortion correction pipelines, and we found that each of the correction mechanisms works well for reducing stiffness errors, but are limited in cases of very large distortion. The ability of MRE to detect subtle changes to neural tissue health relies on accurate, artifact-free imaging, and thus off-resonance related geometric distortion must be considered when designing sequences and protocols by limiting readout time and applying correction where appropriate.

Manifold-based respiratory phase estimation enables motion and distortion correction of free-breathing cardiac diffusion tensor MRI

PURPOSE

For in vivo cardiac DTI, breathing motion and B₀ field inhomogeneities produce misalignment and geometric distortion in diffusion-weighted (DW) images acquired with conventional single-shot EPI. We propose using a dimensionality reduction method to retrospectively estimate the respiratory phase of DW images and facilitate both distortion correction (DisCo) and motion compensation.

METHODS

Free-breathing electrocardiogram-triggered whole left-ventricular cardiac DTI using a second-order motion-compensated spin echo EPI sequence and alternating directionality of phase encoding blips was performed on 11 healthy volunteers. The respiratory phase of each DW image was estimated after projecting the DW images into a 2D space with Laplacian eigenmaps. DisCo and motion compensation were applied to the respiratory sorted DW images. The results were compared against conventional breath-held T₂ half-Fourier single shot turbo spin echo. Cardiac DTI parameters including fractional anisotropy, mean diffusivity, and helix angle transmurality were compared with and without DisCo.

RESULTS

The left-ventricular geometries after DisCo and motion compensation resulted in significantly improved alignment of DW images with T₂ reference. DisCo reduced the distance between the left-ventricular contours by 13.2% ± 19.2%, P < .05 (2.0 ± 0.4 for DisCo and 2.4 ± 0.5 mm for uncorrected). DisCo DTI parameter maps yielded no significant differences (mean diffusivity: 1.55 ± 0.13 × 10^-3 mm² /s and 1.53 ± 0.13 × 10^-3 mm² /s, P = .09; fractional anisotropy: 0.375 ± 0.041 and 0.379 ± 0.045, P = .11; helix angle transmurality: 1.00% ± 0.10°/% and 0.99% ± 0.12°/%, P = .44), although the orientation of individual tensors differed.

CONCLUSION

Retrospective respiratory phase estimation with LE-based DisCo and motion compensation in free-breathing cardiac DTI resulting in significantly reduced geometric distortion and improved alignment within and across slices.

Cardiovascular magnetic resonance imaging of functional and microstructural changes of the heart in a longitudinal pig model of acute to chronic myocardial infarction

BACKGROUND

We examined the dynamic response of the myocardium to infarction in a longitudinal porcine study using relaxometry, functional as well as diffusion cardiovascular magnetic resonance (CMR). We sought to compare non contrast CMR methods like relaxometry and in-vivo diffusion to contrast enhanced imaging and investigate the link of microstructural and functional changes in the acute and chronically infarcted heart.

METHODS

CMR was performed on five myocardial infarction pigs and four healthy controls. In the infarction group, measurements were obtained 2 weeks before 90 min occlusion of the left circumflex artery, 6 days after ischemia and at 5 as well as 9 weeks as chronic follow-up. The timing of measurements was replicated in the control cohort. Imaging consisted of functional cine imaging, 3D tagging, T2 mapping, native as well as gadolinium enhanced T1 mapping, cardiac diffusion tensor imaging, and late gadolinium enhancement imaging.

RESULTS

Native T1, extracellular volume (ECV) and mean diffusivity (MD) were significantly elevated in the infarcted region while fractional anisotropy (FA) was significantly reduced. During the transition from acute to chronic stages, native T1 presented minor changes (< 3%). ECV as well as MD increased from acute to the chronic stages compared to baseline: ECV: 125 ± 24% (day 6) 157 ± 24% (week 5) 146 ± 60% (week 9), MD: 17 ± 7% (day 6) 33 ± 14% (week 5) 29 ± 15% (week 9) and FA was further reduced: - 31 ± 10% (day 6) - 38 ± 8% (week 5) - 36 ± 14% (week 9). T2 as marker for myocardial edema was significantly increased in the ischemic area only during the acute stage (83 ± 3 ms infarction vs. 58 ± 2 ms control p < 0.001 and 61 ± 2 ms in the remote area p < 0.001). The analysis of functional imaging revealed reduced left ventricular ejection fraction, global longitudinal strain and torsion in the infarct group. At the same time the transmural helix angle (HA) gradient was steeper in the chronic follow-up and a correlation between longitudinal strain and transmural HA gradient was detected (r = 0.59 with p < 0.05). Comparing non-gadolinium enhanced data T2 mapping showed the largest relative change between infarct and remote during the acute stage (+ 33 ± 4% day 6, with p = 0.013 T2 vs. MD, p = 0.009 T2 vs. FA and p = 0.01 T2 vs. T1) while FA exhibited the largest relative change between infarct and remote during the chronic follow-up (+ 31 ± 2% week 5, with p = N.S. FA vs. MD, p = 0.03 FA vs. T2 and p = 0.003 FA vs. T1). Overall, diffusion parameters provided a higher contrast (> 23% for MD and > 27% for FA) during follow-up compared to relaxometry (T1 17-18%/T2 10-20%).

CONCLUSION

During chronic follow-up after myocardial infarction, cardiac diffusion tensor imaging provides a higher sensitivity for mapping microstructural alterations when compared to non-contrast enhanced relaxometry with the added benefit of providing directional tensor information to assess remodelling of myocyte aggregate orientations, which cannot be otherwise assessed.

Joint image and field map estimation for multi-echo hyperpolarized 13 C metabolic imaging of the heart

PURPOSE

Image reconstruction of metabolic images from hyperpolarized ¹³ C multi-echo data acquisition is sensitive to susceptibility-induced phase offsets, which are particularly challenging in the heart. A model-based framework for joint estimation of metabolite images and field map from echo shift-encoded data is proposed. Using simulations, it is demonstrated that correction of signal spilling due to incorrect decomposition of metabolites and geometrical distortions over a wide range of off-resonance gradients is possible. In vivo feasibility is illustrated using hyperpolarized [1-¹³ C]pyruvate in the pig heart.

METHODS

The model-based reconstruction for multi-echo, multicoil data was implemented as a nonconvex minimization problem jointly optimizing for metabolic images and B₀ . A comprehensive simulation framework for echo shift-encoded hyperpolarized [1-¹³ C]pyruvate imaging was developed and applied to assess reconstruction performance and distortion correction of the proposed method. In vivo data were obtained in four pigs using hyperpolarized [1-¹³ C]pyruvate on a clinical 3T MR system with a six-channel receiver coil. Dynamic images were acquired during suspended ventilation using cardiac-triggered multi-echo single-shot echo-planar imaging in short-axis orientation.

RESULTS

Simulations revealed that off-resonance gradients up to ±0.26 ppm/pixel can be corrected for with reduced signal spilling and geometrical distortions yielding an accuracy of ≥90% in terms of Dice similarity index. In vivo, improved geometrical consistency (10% Dice improvement) compared to image reconstruction without field map correction and with reference to anatomical data was achieved.

CONCLUSION

Joint image and field map estimation allows addressing off-resonance-induced geometrical distortions and metabolite spilling in hyperpolarized ¹³ C metabolic imaging of the heart.

Probing cardiomyocyte mobility with multi-phase cardiac diffusion tensor MRI

PURPOSE

Cardiomyocyte organization and performance underlie cardiac function, but the in vivo mobility of these cells during contraction and filling remains difficult to probe. Herein, a novel trigger delay (TD) scout sequence was used to acquire high in-plane resolution (1.6 mm) Spin-Echo (SE) cardiac diffusion tensor imaging (cDTI) at three distinct cardiac phases. The objective was to characterize cardiomyocyte organization and mobility throughout the cardiac cycle in healthy volunteers.

MATERIALS AND METHODS

Nine healthy volunteers were imaged with cDTI at three distinct cardiac phases (early systole, late systole, and diastasis). The sequence used a free-breathing Spin-Echo (SE) cDTI protocol (b-values = 350s/mm2, twelve diffusion encoding directions, eight repetitions) to acquire high-resolution images (1.6x1.6x8mm3) at 3T in ~7 minutes/cardiac phase. Helix Angle (HA), Helix Angle Range (HAR), E2 angle (E2A), Transverse Angle (TA), Mean Diffusivity (MD), diffusion tensor eigenvalues (λ1-2-3), and Fractional Anisotropy (FA) in the left ventricle (LV) were characterized.

RESULTS

Images from the patient-specific TD scout sequence demonstrated that SE cDTI acquisition was possible at early systole, late systole, and diastasis in 78%, 100% and 67% of the cases, respectively. At the mid-ventricular level, mobility (reported as median [IQR]) was observed in HAR between early systole and late systole (76.9 [72.6, 80.5]° vs 96.6 [85.9, 100.3]°, p<0.001). E2A also changed significantly between early systole, late systole, and diastasis (27.7 [20.8, 35.1]° vs 45.2 [42.1, 49]° vs 20.7 [16.6, 26.4]°, p<0.001).

CONCLUSION

We demonstrate that it is possible to probe cardiomyocyte mobility using multi-phase and high resolution cDTI. In healthy volunteers, aggregate cardiomyocytes re-orient themselves more longitudinally during contraction, while cardiomyocyte sheetlets tilt radially during wall thickening. These observations provide new insights into the three-dimensional mobility of myocardial microstructure during systolic contraction.