Low-rank motion correction for accelerated free-breathing first-pass myocardial perfusion imaging.

PURPOSE: Develop a novel approach for accelerated 2D free-breathing myocardial perfusion via low-rank motion-corrected (LRMC) reconstructions. METHODS: Myocardial perfusion imaging requires high spatial and temporal resolution, despite scan time constraints. Here, we incorporate LRMC models into the reconstruction-encoding operator, together with high-dimensionality patch-based regularization, to produce high quality, motion-corrected myocardial perfusion series from free-breathing acquisitions. The proposed framework estimates beat-to-beat nonrigid respiratory (and any other incidental) motion and the dynamic contrast subspace from the actual acquired data, which are then incorporated into the proposed LRMC reconstruction. LRMC was compared with iterative SENSitivity Encoding (SENSE) (itSENSE) and low-rank plus sparse (LpS) reconstruction in 10 patients based on image-quality scoring and ranking by two clinical expert readers. RESULTS: LRMC achieved significantly improved results relative to itSENSE and LpS in terms of image sharpness, temporal coefficient of variation, and expert reader evaluation. Left ventricle image sharpness was approximately 75%, 79%, and 86% for itSENSE, LpS and LRMC, respectively, indicating improved image sharpness for the proposed approach. Corresponding temporal coefficient of variation results were 23%, 11% and 7%, demonstrating improved temporal fidelity of the perfusion signal with the proposed LRMC. Corresponding clinical expert reader scores (1-5, from poor to excellent image quality) were 3.3, 3.9 and 4.9, demonstrating improved image quality with the proposed LRMC, in agreement with the automated metrics. CONCLUSION: LRMC produces motion-corrected myocardial perfusion in free-breathing acquisitions with substantially improved image quality when compared with iterative SENSE and LpS reconstructions.

Single-heartbeat cardiac cine imaging via jointly regularized nonrigid motion-corrected reconstruction.

The aim of the current study was to develop a novel approach for 2D breath-hold cardiac cine imaging from a single heartbeat, by combining cardiac motion-corrected reconstructions and nonrigidly aligned patch-based regularization. Conventional cardiac cine imaging is obtained via motion-resolved reconstructions of data acquired over multiple heartbeats. Here, we achieve single-heartbeat cine imaging by incorporating nonrigid cardiac motion correction into the reconstruction of each cardiac phase, in conjunction with a motion-aligned patch-based regularization. The proposed Motion-Corrected CINE (MC-CINE) incorporates all acquired data into the reconstruction of each (motion-corrected) cardiac phase, resulting in a better posed problem than motion-resolved approaches. MC-CINE was compared with iterative sensitivity encoding (itSENSE) and Extra-Dimensional Golden Angle Radial Sparse Parallel (XD-GRASP) in 14 healthy subjects in terms of image sharpness, reader scoring (range: 1-5) and reader ranking (range: 1-9) of image quality, and single-slice left ventricular assessment. MC-CINE was significantly superior to both itSENSE and XD-GRASP using 20 heartbeats, two heartbeats, and one heartbeat. Iterative SENSE, XD-GRASP, and MC-CINE achieved a sharpness of 74%, 74%, and 82% using 20 heartbeats, and 53%, 66%, and 82% with one heartbeat, respectively. The corresponding results for reader scoring were 4.0, 4.7, and 4.9 with 20 heartbeats, and 1.1, 3.0, and 3.9 with one heartbeat. The corresponding results for reader ranking were 5.3, 7.3, and 8.6 with 20 heartbeats, and 1.0, 3.2, and 5.4 with one heartbeat. MC-CINE using a single heartbeat presented nonsignificant differences in image quality to itSENSE with 20 heartbeats. MC-CINE and XD-GRASP at one heartbeat both presented a nonsignificant negative bias of less than 2% in ejection fraction relative to the reference itSENSE. It was concluded that the proposed MC-CINE significantly improves image quality relative to itSENSE and XD-GRASP, enabling 2D cine from a single heartbeat.

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

OBJECTIVES: To investigate the efficacy of an in-line non-rigid motion-compensated reconstruction (NRC) in an image-navigated high-resolution three-dimensional late gadolinium enhancement (LGE) sequence with Dixon water-fat separation, in a clinical setting. METHODS: Forty-seven consecutive patients were enrolled prospectively and examined with 1.5 T MRI. NRC reconstructions were compared to translational motion-compensated reconstructions (TC) of the same datasets in overall and different sub-category image quality scores, diagnostic confidence, contrast ratios, LGE pattern, and semiautomatic LGE quantification. RESULTS: NRC outperformed TC in all image quality scores (p < 0.001 to 0.016; e.g., overall image quality 5/5 points vs. 4/5). Overall image quality was downgraded in only 23% of NRC datasets vs. 53% of TC datasets due to residual respiratory motion. In both reconstructions, LGE was rated as ischemic in 11 patients and non-ischemic in 10 patients, while it was absent in 26 patients. NRC delivered significantly higher LGE-to-myocardium and blood-to-myocardium contrast ratios (median 6.33 vs. 5.96, p < 0.001 and 4.88 vs. 4.66, p < 0.001, respectively). Automatically detected LGE mass was significantly lower in the NRC reconstruction (p < 0.001). Diagnostic confidence was identical in all cases, with high confidence in 89% and probable in 11% datasets for both reconstructions. No case was rated as inconclusive. CONCLUSIONS: The in-line implementation of a non-rigid motion-compensated reconstruction framework improved image quality in image-navigated free-breathing, isotropic high-resolution 3D LGE imaging with undersampled spiral-like Cartesian sampling and Dixon water-fat separation compared to translational motion correction of the same datasets. The sharper depictions of LGE may lead to more accurate measures of LGE mass. KEY POINTS: • 3D LGE imaging provides high-resolution detection of myocardial scarring. • Non-rigid motion correction provides better image quality in cardiac MRI. • Non-rigid motion correction may lead to more accurate measures of LGE mass.

Myocardial T1, T2, T2*, and fat fraction quantification via low-rank motion-corrected cardiac MR fingerprinting.

PURPOSE: Develop a novel 2D cardiac MR fingerprinting (MRF) approach to enable simultaneous T1, T2, T2*, and fat fraction (FF) myocardial tissue characterization in a single breath-hold scan. METHODS: Simultaneous, co-registered, multi-parametric mapping of T1, T2, and FF has been recently achieved with cardiac MRF. Here, we further incorporate T2* quantification within this approach, enabling simultaneous T1, T2, T2*, and FF myocardial tissue characterization in a single breath-hold scan. T2* quantification is achieved with an eight-echo readout that requires a long cardiac acquisition window. A novel low-rank motion-corrected (LRMC) reconstruction is exploited to correct for cardiac motion within the long acquisition window. The proposed T1/T2/T2*/FF cardiac MRF was evaluated in phantom and in 10 healthy subjects in comparison to conventional mapping techniques. RESULTS: The proposed approach achieved high quality parametric mapping of T1, T2, T2*, and FF with corresponding normalized RMS error (RMSE) T1 = 5.9%, T2 = 9.6% (T2 values <100 ms), T2* = 3.3% (T2* values <100 ms), and FF = 0.8% observed in phantom scans. In vivo, the proposed approach produced higher left-ventricular myocardial T1 values than MOLLI (1148 vs 1056 ms), lower T2 values than T2-GraSE (42.8 vs 50.6 ms), lower T2* values than eight-echo gradient echo (GRE) (35.0 vs 39.4 ms), and higher FF values than six-echo GRE (0.8 vs 0.3 %) reference techniques. The proposed approach achieved considerable reduction in motion artifacts compared to cardiac MRF without motion correction, improved spatial uniformity, and statistically higher apparent precision relative to conventional mapping for all parameters. CONCLUSION: The proposed cardiac MRF approach enables simultaneous, co-registered mapping of T1, T2, T2*, and FF in a single breath-hold for comprehensive myocardial tissue characterization, achieving higher apparent precision than conventional methods.

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.

3D Dixon water-fat LGE imaging with image navigator and compressed sensing in cardiac MRI.

OBJECTIVES: To evaluate an image-navigated isotropic high-resolution 3D late gadolinium enhancement (LGE) prototype sequence with compressed sensing and Dixon water-fat separation in a clinical routine setting. MATERIAL AND METHODS: Forty consecutive patients scheduled for cardiac MRI were enrolled prospectively and examined with 1.5 T MRI. Overall subjective image quality, LGE pattern and extent, diagnostic confidence for detection of LGE, and scan time were evaluated and compared to standard 2D LGE imaging. Robustness of Dixon fat suppression was evaluated for 3D Dixon LGE imaging. For statistical analysis, the non-parametric Wilcoxon rank sum test was performed. RESULTS: LGE was rated as ischemic in 9 patients and non-ischemic in 11 patients while it was absent in 20 patients. Image quality and diagnostic confidence were comparable between both techniques (p = 0.67 and p = 0.66, respectively). LGE extent with respect to segmental or transmural myocardial enhancement was identical between 2D and 3D (water-only and in-phase). LGE size was comparable (3D 8.4 ± 7.2 g, 2D 8.7 ± 7.3 g, p = 0.19). Good or excellent fat suppression was achieved in 93% of the 3D LGE datasets. In 6 patients with pericarditis, the 3D sequence with Dixon fat suppression allowed for a better detection of pericardial LGE. Scan duration was significantly longer for 3D imaging (2D median 9:32 min vs. 3D median 10:46 min, p = 0.001). CONCLUSION: The 3D LGE sequence provides comparable LGE detection compared to 2D imaging and seems to be superior in evaluating the extent of pericardial involvement in patients suspected with pericarditis due to the robust Dixon fat suppression. KEY POINTS: • Three-dimensional LGE imaging provides high-resolution detection of myocardial scarring. • Robust Dixon water-fat separation aids in the assessment of pericardial disease. • The 2D image navigator technique enables 100% respiratory scan efficacy and permits predictable scan times.

3D SASHA myocardial T1 mapping with high accuracy and improved precision.

PURPOSE: To improve the precision of a free-breathing 3D saturation-recovery-based myocardial T1 mapping sequence using a post-processing 3D denoising technique. METHODS: A T1 phantom and 15 healthy subjects were scanned on a 1.5 T MRI scanner using 3D saturation-recovery single-shot acquisition (SASHA) for myocardial T1 mapping. A 3D denoising technique was applied to the native T1-weighted images before pixel-wise T1 fitting. The denoising technique imposes edge-preserving regularity and exploits the co-occurrence of 3D spatial gradients in the native T1-weighted images by incorporating a multi-contrast Beltrami regularization. Additionally, 2D modified Look-Locker inversion recovery (MOLLI) acquisitions were performed for comparison purposes. Accuracy and precision were measured in the myocardial septum of 2D MOLLI and 3D SASHA T1 maps and then compared. Furthermore, the accuracy and precision of the proposed approach were evaluated in a standardized phantom in comparison to an inversion-recovery spin-echo sequence (IRSE). RESULTS: For the phantom study, Bland-Altman plots showed good agreement in terms of accuracy between IRSE and 3D SASHA, both on non-denoised and denoised T1 maps (mean difference -1.4 ± 18.9 ms and -4.4 ± 21.2 ms, respectively), while 2D MOLLI generally underestimated the T1 values (69.4 ± 48.4 ms). For the in vivo study, there was a statistical difference between the precision measured on 2D MOLLI and on non-denoised 3D SASHA T1 maps (P = 0.005), while there was no statistical difference after denoising (P = 0.95). CONCLUSION: The precision of 3D SASHA myocardial T1 mapping was substantially improved using a 3D Beltrami regularization based denoising technique and was similar to that of 2D MOLLI T1 mapping, while preserving the higher accuracy and whole-heart coverage of 3D SASHA.

Correction to: 3D SASHA myocardial T1 mapping with high accuracy and improved precision.

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Utilizing different methods for visualizing susceptibility from a single multi-gradient echo dataset.

PURPOSE: Objects that cause a susceptibility gradient can generate regions of hypo-intensity in MRI. MR techniques developed for positive enhancement of such objects require sequence parameter optimization. Thus comparison of images acquired successively using different techniques is difficult since different parameter settings result in variations in signal and noise. A new method is presented that allows production of positive contrast images, a relaxation rate R*2-map and negative contrast images from a single dataset by post-processing. METHODS: Positive contrast techniques considered include the "white marker" technique, inversion-recovery on-resonance (IRON) and susceptibility gradient mapping (SGM). The new method was tested in phantoms of iron-oxide agent gel solutions and prostate marker seeds. Images produced by post-processing were compared with those obtained directly. The post-processing technique was applied in vivo for the visualization of iron-oxide contrast agent uptake in a balloon-injured swine carotid model. RESULTS: The images produced in the post-processing step allowed determination of optimal parameter settings for each technique. SGM was found to provide the greatest positive contrast, whilst the T*2-weighted images provide more sensitivity to regions that exhibited weaker susceptibility effects. CONCLUSIONS: Combined T*2-weighted imaging and SGM using the same complex image data was found to provide complementary information and high sensitivity to detect distortion inducing agents.