MR imaging of left-ventricular function : novel image acquisition and analysis techniques.

Many cardiac diseases, such as myocardial ischemia, secondary to coronary artery disease, may be identified and localized through the analysis of cardiac deformations. Early efforts for quantifying ventricular wall motion used surgical implantation and tracking of radiopaque markers with X-ray imaging in canine hearts [1]. Such techniques are invasive and affect the regional motion pattern of the ventricular wall during the marker tracking process and, clearly are not feasible clinically. Noninvasive imaging techniques are vital and have been widely applied to the clinic. MRI is a noninvasive imaging technique with the capability to monitor and assess the progression of cardiovascular diseases (CVD) so that effective procedures for the care and treatment of patients can be developed by physicians and researchers. It is capable of providing 3D analysis of global and regional cardiac function with great accuracy and reproducibility. In the past few years, numerous efforts have been devoted to cardiac motion recovery and deformation analysis from MR imaging sequences. In order to assess cardiac function, there are two categories of indices that are used: global and regional indices. Global indices include ejection fraction, cavity volume, and myocardial mass [2]. They are important indices for cardiac disease diagnosis. However, these global indices are not specific for regional analysis. A quantitative assessment of regional parameters may prove beneficial for the diagnosis of disease and evaluation of severity and the quantification of treatment [3]. Local measures, such as wall deformation and strain in all regions of the heart, can provide objective regional quantification of ventricular wall function and relate to the location and extent of ischemic injury. This dissertation is concerned with the development of novel MR imaging techniques and image postprocessing algorithms to analyze left ventricular deformations. A novel pulse sequence, termed Orthogonal CSPAMM (OCSPAMM), has been proposed which results in the same acquisition time as SPAMM for 2D deformation estimation while keeping the main advantages of CSPAMM [4,5]: i.e., maintaining tag contrast through-out the ECG cycle. Different from CSPAMM, in OCSPAMM the second tagging pulse orientation is rotated 90 degrees relative to the first one so that motion information can be obtained simultaneously in two directions. This reduces the acquisition time by a factor of two as compared to the traditional CSPAMM, in which two separate imaging sequences are applied per acquisition. With the application of OCSPAMM, the effect of tag fading encountered in SPAMM tagging due to Tl relaxation is mitigated and tag deformations can be visualized for the entire cardiac cycle, including diastolic phases. A multilevel B-spline fitting method (MBS) has been proposed which incorporates phase-based displacement information for accurate calculation of 2D motion and strain from tagged MRI [6, 7]. The proposed method combines the advantages of continuity and smoothness of MBS, and makes use of phase information derived from tagged MR images. Compared to previous 2D B-spline-based deformation analysis methods, MBS has the following advantages: 1) It can simultaneously achieve a smooth deformation while accurately approximating the given data set; 2) Computationally, it is very fast; and 3) It can produce more accurate deformation results. Since the tag intersections (intersections between two tag lines) can be extracted accurately and are more or less distributed evenly over the myocardium, MBS has proven effective for 2D cardiac motion tracking. To derive phase-based displacements, 2D HARP and SinMod analysis techniques [8,9] were employed. By producing virtual tags from HARP /SinMod and calculating intersections of virtual tag lines, more data points are obtained. In the reference frame, virtual tag lines are the isoparametric curves of an undeformed 2D B-spline model. In subsequent frames, the locations of intersections of virtual tag lines over the myocardium are updated with phase-based displacement. The advantage of the technique is that in acquiring denser myocardial displacements, it uses both real and virtual tag line intersections. It is fast and more accurate than 2D HARP and SinMod tracking. A novel 3D sine wave modeling (3D SinMod) approach for automatic analysis of 3D cardiac deformations has been proposed [10]. An accelerated 3D complementary spatial modulation of magnetization (CSPAMM) tagging technique [11] was used to acquire complete 3D+t tagged MR data sets of the whole heart (3 dynamic CSPAMM tagged MRI volume with tags in different orientations), in-vivo, in 54 heart beats and within 3 breath-holds. In 3D SinMod, the intensity distribution around each pixel is modeled as a cosine wave front. The principle behind 3D SinMod tracking is that both phase and frequency for each voxel are determined directly from the frequency analysis and the displacement is calculated from the quotient of phase difference and local frequency. The deformation fields clearly demonstrate longitudinal shortening during systole. The contraction of the LV base towards the apex as well as the torsional motion between basal and apical slices is clearly observable from the displacements. 3D SinMod can automatically process the image data to derive measures of motion, deformations, and strains between consecutive pair of tagged volumes in 17 seconds. Therefore, comprehensive 4D imaging and postprocessing for determination of ventricular function is now possible in under 10 minutes. For validation of 3D SinMod, 7 3D+t CSPAMM data sets of healthy subjects have been processed. Comparison of mid-wall contour deformations and circumferential shortening results by 3D SinMod showed good agreement with those by 3D HARP. Tag lines tracked by the proposed technique were also compared with manually delineated ones. The average errors calculated for the systolic phase of the cardiac cycles were in the sub-pixel range

Reconstruction and analysis of 4D heart motion from tagged MR images.

Luo Guo.Thesis (M.Phil.)--Chinese University of Hong Kong, 2003.Includes bibliographical references (leaves 97-109).Abstracts in English and Chinese.Abstract --- p.iAcknowledgement --- p.iiiChapter 1 --- Introduction --- p.1Chapter 1.1 --- Motivation --- p.2Chapter 1.2 --- Basics --- p.3Chapter 1.2.1 --- Anatomy of Human Heart --- p.3Chapter 1.2.2 --- The Philosophy of MRI --- p.5Chapter 1.2.3 --- MRI in Practice --- p.7Chapter 1.3 --- Cardiac MR Images Analysis --- p.7Chapter 1.3.1 --- Heart Boundary Segmentation --- p.7Chapter 1.3.2 --- Motion Reconstruction --- p.13Chapter 1.4 --- Summary and Thesis Overview --- p.17Chapter 2 --- Tracking Tags in SPAMM Images --- p.21Chapter 2.1 --- Introduction --- p.21Chapter 2.2 --- The Snake Model --- p.28Chapter 2.3 --- The Improved Snake Model: Tracking Tags Using Snakes --- p.30Chapter 2.3.1 --- Imaging Protocol --- p.30Chapter 2.3.2 --- Model Formulation --- p.31Chapter 2.3.3 --- Numerical Solution --- p.39Chapter 2.4 --- Experimental Results --- p.44Chapter 3 --- B-Spline Based LV Motion Reconstruction --- p.52Chapter 3.1 --- Introduction --- p.52Chapter 3.2 --- LV Shape: Generalized Deformable Ellipsoid --- p.56Chapter 3.3 --- The New Geometric Model: Generalized Prolate Spheroid --- p.58Chapter 3.3.1 --- Generalized Prolate Spheroid --- p.58Chapter 3.3.2 --- Initial Geometric Fitting --- p.59Chapter 3.4 --- Fast Motion Reconstruction: The Enhanced Hi- erarchical Motion Decomposition --- p.65Chapter 3.4.1 --- Hierarchical Motion Decomposition --- p.65Chapter 3.4.2 --- Motion Reconstruction --- p.68Chapter 3.4.3 --- Implementation --- p.76Chapter 3.4.4 --- Time Smoothing --- p.77Chapter 3.5 --- Experimental Results --- p.79Chapter 3.5.1 --- Geometric Fitting --- p.79Chapter 3.5.2 --- Motion Reconstruction --- p.79Chapter 4 --- Conclusion --- p.93Bibliography --- p.10

Myocardial tagging by Cardiovascular Magnetic Resonance: evolution of techniques--pulse sequences, analysis algorithms, and applications

Cardiovascular magnetic resonance (CMR) tagging has been established as an essential technique for measuring regional myocardial function. It allows quantification of local intramyocardial motion measures, e.g. strain and strain rate. The invention of CMR tagging came in the late eighties, where the technique allowed for the first time for visualizing transmural myocardial movement without having to implant physical markers. This new idea opened the door for a series of developments and improvements that continue up to the present time. Different tagging techniques are currently available that are more extensive, improved, and sophisticated than they were twenty years ago. Each of these techniques has different versions for improved resolution, signal-to-noise ratio (SNR), scan time, anatomical coverage, three-dimensional capability, and image quality. The tagging techniques covered in this article can be broadly divided into two main categories: 1) Basic techniques, which include magnetization saturation, spatial modulation of magnetization (SPAMM), delay alternating with nutations for tailored excitation (DANTE), and complementary SPAMM (CSPAMM); and 2) Advanced techniques, which include harmonic phase (HARP), displacement encoding with stimulated echoes (DENSE), and strain encoding (SENC). Although most of these techniques were developed by separate groups and evolved from different backgrounds, they are in fact closely related to each other, and they can be interpreted from more than one perspective. Some of these techniques even followed parallel paths of developments, as illustrated in the article. As each technique has its own advantages, some efforts have been made to combine different techniques together for improved image quality or composite information acquisition. In this review, different developments in pulse sequences and related image processing techniques are described along with the necessities that led to their invention, which makes this article easy to read and the covered techniques easy to follow. Major studies that applied CMR tagging for studying myocardial mechanics are also summarized. Finally, the current article includes a plethora of ideas and techniques with over 300 references that motivate the reader to think about the future of CMR tagging

On motion in dynamic magnetic resonance imaging: Applications in cardiac function and abdominal diffusion

La imagen por resonancia magnética (MRI), hoy en día, representa una potente herramienta para el diagnóstico clínico debido a su flexibilidad y sensibilidad a un amplio rango de propiedades del tejido. Sus principales ventajas son su sobresaliente versatilidad y su capacidad para proporcionar alto contraste entre tejidos blandos. Gracias a esa versatilidad, la MRI se puede emplear para observar diferentes fenómenos físicos dentro del cuerpo humano combinando distintos tipos de pulsos dentro de la secuencia. Esto ha permitido crear distintas modalidades con múltiples aplicaciones tanto biológicas como clínicas. La adquisición de MR es, sin embargo, un proceso lento, lo que conlleva una solución de compromiso entre resolución y tiempo de adquisición (Lima da Cruz, 2016; Royuela-del Val, 2017). Debido a esto, la presencia de movimiento fisiológico durante la adquisición puede conllevar una grave degradación de la calidad de imagen, así como un incremento del tiempo de adquisición, aumentando así tambien la incomodidad del paciente. Esta limitación práctica representa un gran obstáculo para la viabilidad clínica de la MRI. En esta Tesis Doctoral se abordan dos problemas de interés en el campo de la MRI en los que el movimiento fisiológico tiene un papel protagonista. Éstos son, por un lado, la estimación robusta de parámetros de rotación y esfuerzo miocárdico a partir de imágenes de MR-Tagging dinámica para el diagnóstico y clasificación de cardiomiopatías y, por otro, la reconstrucción de mapas del coeficiente de difusión aparente (ADC) a alta resolución y con alta relación señal a ruido (SNR) a partir de adquisiciones de imagen ponderada en difusión (DWI) multiparamétrica en el hígado.Departamento de Teoría de la Señal y Comunicaciones e Ingeniería TelemáticaDoctorado en Tecnologías de la Información y las Telecomunicacione

Analysis of cardiac motion using MRI and nonrigid image registration

Imperial Users onl

An image segmentation and registration approach to cardiac function analysis using MRI

Cardiovascular diseases (CVDs) are one of the major causes of death in the world. In recent years, significant progress has been made in the care and treatment of patients with such diseases. A crucial factor for this progress has been the development of magnetic resonance (MR) imaging which makes it possible to diagnose and assess the cardiovascular function of the patient. The ability to obtain high-resolution, cine volume images easily and safely has made it the preferred method for diagnosis of CVDs. MRI is also unique in its ability to introduce noninvasive markers directly into the tissue being imaged(MR tagging) during the image acquisition process. With the development of advanced MR imaging acquisition technologies, 3D MR imaging is more and more clinically feasible. This recent development has allowed new potentially 3D image analysis technologies to be deployed. However, quantitative analysis of cardiovascular system from the images remains a challenging topic. The work presented in this thesis describes the development of segmentation and motion analysis techniques for the study of the cardiac anatomy and function in cardiac magnetic resonance (CMR) images. The first main contribution of the thesis is the development of a fully automatic cardiac segmentation technique that integrates and combines a series of state-of-the-art techniques. The proposed segmentation technique is capable of generating an accurate 3D segmentation from multiple image sequences. The proposed segmentation technique is robust even in the presence of pathological changes, large anatomical shape variations and locally varying contrast in the images. Another main contribution of this thesis is the development of motion tracking techniques that can integrate motion information from different sources. For example, the radial motion of the myocardium can be tracked easily in untagged MR imaging since the epi- and endocardial surfaces are clearly visible. On the other hand, tagged MR imaging allows easy tracking of both longitudinal and circumferential motion. We propose a novel technique based on non-rigid image registration for the myocardial motion estimation using both untagged and 3D tagged MR images. The novel aspect of our technique is its simultaneous use of complementary information from both untagged and 3D tagged MR imaging. The similarity measure is spatially weighted to maximise the utility of information from both images. The thesis also proposes a sparse representation for free-form deformations (FFDs) using the principles of compressed sensing. The sparse free-form deformation (SFFD) model can capture fine local details such as motion discontinuities without sacrificing robustness. We demonstrate the capabilities of the proposed framework to accurately estimate smooth as well as discontinuous deformations in 2D and 3D CMR image sequences. Compared to the standard FFD approach, a significant increase in registration accuracy can be observed in datasets with discontinuous motion patterns. Both the segmentation and motion tracking techniques presented in this thesis have been applied to clinical studies. We focus on two important clinical applications that can be addressed by the techniques proposed in this thesis. The first clinical application aims at measuring longitudinal changes in cardiac morphology and function during the cardiac remodelling process. The second clinical application aims at selecting patients that positively respond to cardiac resynchronization therapy (CRT). The final chapter of this thesis summarises the main conclusions that can be drawn from the work presented here and also discusses possible avenues for future research

Three Dimensional Tissue Motion Analysis from Tagged Magnetic Resonance Imaging

Motion estimation of soft tissues during organ deformation has been an important topic in medical imaging studies. Its application involves a variety of internal and external organs including the heart, the lung, the brain, and the tongue. Tagged magnetic resonance imaging has been used for decades to observe and quantify motion and strain of deforming tissues. It places temporary noninvasive markers—so called "tags"—in the tissue of interest that deform together with the tissue during motion, producing images that carry motion information in the deformed tagged patterns. These images can later be processed using phase-extraction algorithms to achieve motion estimation and strain computation. In this dissertation, we study three-dimensional (3D) motion estimation and analysis using tagged magnetic resonance images with applications focused on speech studies and traumatic brain injury modeling. Novel algorithms are developed to assist tagged motion analysis. Firstly, a pipeline of methods—TMAP—is proposed to compute 3D motion from tagged and cine images of the tongue during speech. TMAP produces an estimation of motion along with a multi-subject analysis of motion pattern differences between healthy control subjects and post-glossectomy patients. Secondly, an enhanced 3D motion estimation algorithm—E-IDEA—is proposed. E-IDEA tackles the incompressible motion both on the internal tissue region and the tissue boundaries, reducing the boundary errors and yielding a motion estimate that is more accurate overall. Thirdly, a novel 3D motion estimation algorithm—PVIRA—is developed. Based on image registration and tracking, PVIRA is a faster and more robust method that performs phase extraction in a novel way. Lastly, a method to reveal muscles' activity using strain in the line of action of muscle fiber directions is presented. It is a first step toward relating motion production with individual muscles and provides a new tool for future clinical and scientific use

Recent Advances in Signal Processing

The signal processing task is a very critical issue in the majority of new technological inventions and challenges in a variety of applications in both science and engineering fields. Classical signal processing techniques have largely worked with mathematical models that are linear, local, stationary, and Gaussian. They have always favored closed-form tractability over real-world accuracy. These constraints were imposed by the lack of powerful computing tools. During the last few decades, signal processing theories, developments, and applications have matured rapidly and now include tools from many areas of mathematics, computer science, physics, and engineering. This book is targeted primarily toward both students and researchers who want to be exposed to a wide variety of signal processing techniques and algorithms. It includes 27 chapters that can be categorized into five different areas depending on the application at hand. These five categories are ordered to address image processing, speech processing, communication systems, time-series analysis, and educational packages respectively. The book has the advantage of providing a collection of applications that are completely independent and self-contained; thus, the interested reader can choose any chapter and skip to another without losing continuity

Facial soft tissue segmentation

The importance of the face for socio-ecological interaction is the cause for a high demand on any surgical intervention on the facial musculo-skeletal system. Bones and soft-tissues are of major importance for any facial surgical treatment to guarantee an optimal, functional and aesthetical result. For this reason, surgeons want to pre-operatively plan, simulate and predict the outcome of the surgery allowing for shorter operation times and improved quality. Accurate simulation requires exact segmentation knowledge of the facial tissues. Thus semi-automatic segmentation techniques are required. This thesis proposes semi-automatic methods for segmentation of the facial soft-tissues, such as muscles, skin and fat, from CT and MRI datasets, using a Markov Random Fields (MRF) framework. Due to image noise, artifacts, weak edges and multiple objects of similar appearance in close proximity, it is difficult to segment the object of interest by using image information alone. Segmentations would leak at weak edges into neighboring structures that have a similar intensity profile. To overcome this problem, additional shape knowledge is incorporated in the energy function which can then be minimized using Graph-Cuts (GC). Incremental approaches by incorporating additional prior shape knowledge are presented. The proposed approaches are not object specific and can be applied to segment any class of objects be that anatomical or non-anatomical from medical or non-medical image datasets, whenever a statistical model is present. In the first approach a 3D mean shape template is used as shape prior, which is integrated into the MRF based energy function. Here, the shape knowledge is encoded into the data and the smoothness terms of the energy function that constrains the segmented parts to a reasonable shape. In the second approach, to improve handling of shape variations naturally found in the population, the fixed shape template is replaced by a more robust 3D statistical shape model based on Probabilistic Principal Component Analysis (PPCA). The advantages of using the Probabilistic PCA are that it allows reconstructing the optimal shape and computing the remaining variance of the statistical model from partial information. By using an iterative method, the statistical shape model is then refined using image based cues to get a better fitting of the statistical model to the patient's muscle anatomy. These image cues are based on the segmented muscle, edge information and intensity likelihood of the muscle. Here, a linear shape update mechanism is used to fit the statistical model to the image based cues. In the third approach, the shape refinement step is further improved by using a non-linear shape update mechanism where vertices of the 3D mesh of the statistical model incur the non-linear penalty depending on the remaining variability of the vertex. The non-linear shape update mechanism provides a more accurate shape update and helps in a finer shape fitting of the statistical model to the image based cues in areas where the shape variability is high. Finally, a unified approach is presented to segment the relevant facial muscles and the remaining facial soft-tissues (skin and fat). One soft-tissue layer is removed at a time such as the head and non-head regions followed by the skin. In the next step, bones are removed from the dataset, followed by the separation of the brain and non-brain regions as well as the removal of air cavities. Afterwards, facial fat is segmented using the standard Graph-Cuts approach. After separating the important anatomical structures, finally, a 3D fixed shape template mesh of the facial muscles is used to segment the relevant facial muscles. The proposed methods are tested on the challenging example of segmenting the masseter muscle. The datasets were noisy with almost all possessing mild to severe imaging artifacts such as high-density artifacts caused by e.g. dental fillings and dental implants. Qualitative and quantitative experimental results show that by incorporating prior shape knowledge leaking can be effectively constrained to obtain better segmentation results

MRI Evaluation of Injectable Hyaluronic Acid Hydrogel Therapy to Attenuate Myocardial Infarct Remodeling

Left ventricular (LV) remodeling following myocardial infarction (MI) leads to maladaptive processes that often progress to heart failure. Injectable biomaterials can alter the mechanical signaling post-MI to limit this progression. To design optimal therapies, noninvasive techniques are needed to elucidate the reciprocal interaction between the injected material and the surrounding myocardial tissue. Towards this goal, the general hypothesis of this dissertation was that magnetic resonance imaging (MRI) can be used to characterize the properties of injectable materials once delivered to the myocardium and evaluate the temporal effects of injectable materials on myocardial tissue properties post-MI. To test this hypothesis, injectable hyaluronic acid (HA) hydrogels were developed with a range of gelation, degradation and mechanical properties by altering the initiator concentration, macromer modification, and macromer concentration, respectively. Non-contrast MRI was then used to characterize the properties (e.g., distribution, chemical composition) of injectable HA hydrogels in myocardial explants. Altering hydrogel gelation led to differences in distribution in myocardial tissue, as quantified by T2-weighted MRI. As an alternative to conventional (i.e.T2-weighted) MRI where contrast depends on differences in MR properties and thus, is non-specific for the material, chemical exchange saturation transfer (CEST) MRI was used to specifically image hydrogels based on their functional (i.e. exchangeable proton) groups. CEST contrast correlated with changes in material properties, specifically macromer concentration. Furthermore, CEST MRI was shown to simultaneously visualize and discriminate between different injectable materials based on their unique chemistry. Finally, the effect of injectable HA hydrogels on myocardial tissue properties was temporally evaluated in a porcine infarct model up to 12 weeks post-MI. Outcome assessment using MRI (e.g. cine, late-gadolinium enhancement, and spatial modulation of magnetization MRI) and finite element (FE) modeling demonstrated that hydrogel therapy led to improved global LV structure and function, increased wall thickness, preserved borderzone contractility, and increased infarct stiffness, respectively. This work demonstrates that MRI can be used to simultaneously study hydrogel properties after injection into the myocardium and evaluate the ability of injectable hydrogels to alter myocardial tissue properties to ultimately improve cardiac outcomes and enable future optimization of biomaterial therapies to attenuate adverse remodeling post-MI