A New Methodology for Multiscale Myocardial Deformation and Strain Analysis Based on Tagging MRI

Myocardial deformation and strain can be investigated using suitably encoded cine MRI that admits disambiguation of material motion. Practical limitations currently restrict the analysis to in-plane motion in cross-sections of the heart (2D + time), but the proposed method readily generalizes to 3D + time. We propose a new, promising methodology, which departs from a multiscale algorithm that exploits local scale selection so as to obtain a robust estimate for the velocity gradient tensor field. Time evolution of the deformation tensor is governed by a first-order ordinary differential equation, which is completely determined by this velocity gradient tensor field. We solve this matrix-ODE analytically and present results obtained from healthy volunteers as well as from patient data. The proposed method requires only off-the-shelf algorithms and is readily applicable to planar or volumetric tagging MRI sampled on arbitrary coordinate grids

Cardiac motion estimation using multi-scale feature points

Heart illnesses influence the functioning of the cardiac muscle and are the major causes of death inthe world. Optic flow methods are essential tools to assess and quantify the contraction of the cardiacwalls, but are hampered by the aperture problem. Harmonic phase (HARP) techniques measure thephase in magnetic resonance (MR) tagged images. Due to the regular geometry, patterns generated bya combination of HARPs and sine HARPs represent a suitable framework to extract landmark features.In this paper we introduce a new aperture-problem free method to study the cardiac motion by trackingmulti-scale features such as maxima, minima, saddles and corners, on HARP and sine HARP taggedimages

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

Feature based estimation of myocardial motion from tagged MR images

In the past few years we witnessed an increase in mortality due to cancer relative to mortality due to cardiovascular diseases. In 2008, the Netherlands Statistics Agency reports that 33.900 people died of cancer against 33.100 deaths due to cardiovascular diseases, making cancer the number one cause of death in the Netherlands [33]. Even if the rate of people affected by heart diseases is continually rising, they "simply don’t die of it", according to the research director Prof. Mat Daemen of research institute CARIM of the University of Maastricht [50]. The reason for this is the early diagnosis, and the treatment of people with identified risk factors for diseases like ischemic heart disease, hypertrophic cardiomyopathy, thoracic aortic disease, pericardial (sac around the heart) disease, cardiac tumors, pulmonary artery disease, valvular disease, and congenital heart disease before and after surgical repair. Cardiac imaging plays a crucial role in the early diagnosis, since it allows the accurate investigation of a large amount of imaging data in a small amount of time. Moreover, cardiac imaging reduces costs of inpatient care, as has been shown in recent studies [77]. With this in mind, in this work we have provided several tools with the aim to help the investigation of the cardiac motion. In chapters 2 and 3 we have explored a novel variational optic flow methodology based on multi-scale feature points to extract cardiac motion from tagged MR images. Compared to constant brightness methods, this new approach exhibits several advantages. Although the intensity of critical points is also influenced by fading, critical points do retain their characteristic even in the presence of intensity changes, such as in MR imaging. In an experiment in section 5.4 we have applied this optic flow approach directly on tagged MR images. A visual inspection confirmed that the extracted motion fields realistically depicted the cardiac wall motion. The method exploits also the advantages from the multiscale framework. Because sparse velocity formulas 2.9, 3.7, 6.21, and 7.5 provide a number of equations equal to the number of unknowns, the method does not suffer from the aperture problem in retrieving velocities associated to the critical points. In chapters 2 and 3 we have moreover introduced a smoothness component of the optic flow equation described by means of covariant derivatives. This is a novelty in the optic flow literature. Many variational optic flow methods present a smoothness component that penalizes for changes from global assumptions such as isotropic or anisotropic smoothness. In the smoothness term proposed deviations from a predefined motion model are penalized. Moreover, the proposed optic flow equation has been decomposed in rotation-free and divergence-free components. This decomposition allows independent tuning of the two components during the vector field reconstruction. The experiments and the Table of errors provided in 3.8 showed that the combination of the smoothness term, influenced by a predefined motion model, and the Helmholtz decomposition in the optic flow equation reduces the average angular error substantially (20%-25%) with respect to a similar technique that employs only standard derivatives in the smoothness term. In section 5.3 we extracted the motion field of a phantom of which we know the ground truth of and compared the performance of this optic flow method with the performance of other optic flow methods well known in the literature, such as the Horn and Schunck [76] approach, the Lucas and Kanade [111] technique and the tuple image multi-scale optic flow constraint equation of Van Assen et al. [163]. Tests showed that the proposed optic flow methodology provides the smallest average angular error (AAE = 3.84 degrees) and L2 norm = 0.1. In this work we employed the Helmholtz decomposition also to study the cardiac behavior, since the vector field decomposition allows to investigate cardiac contraction and cardiac rotation independently. In chapter 4 we carried out an analysis of cardiac motion of ten volunteers and one patient where we estimated the kinetic energy for the different components. This decomposition is useful since it allows to visualize and quantify the contributions of each single vector field component to the heart beat. Local measurements of the kinetic energy have also been used to detect areas of the cardiac walls with little movement. Experiments on a patient and a comparison between a late enhancement cardiac image and an illustration of the cardiac kinetic energy on a bull’s eye plot illustrated that a correspondence between an infarcted area and an area with very small kinetic energy exists. With the aim to extend in the future the proposed optic flow equation to a 3D approach, in chapter 6 we investigated the 3D winding number approach as a tool to locate critical points in volume images. We simplified the mathematics involved with respect to a previous work [150] and we provided several examples and applications such as cardiac motion estimation from 3-dimensional tagged images, follicle and neuronal cell counting. Finally in chapter 7 we continued our investigation on volume tagged MR images, by retrieving the cardiac motion field using a 3-dimensional and simple version of the proposed optic flow equation based on standard derivatives. We showed that the retrieved motion fields display the contracting and rotating behavior of the cardiac muscle. We moreover extracted the through-plane component, which provides a realistic illustration of the vector field and is missed by 2-dimensional approaches

Computer-aided detection of wall motion abnormalities in cardiac MRI

With the increasing prevalence and hospitalization rate of ischaemic heart disease, an explosive growth of diagnostic imaging for ischaemia is ongoing. Clinical decision making on revascularization procedures requires reliable viability assessment to assure long-term patient survival and to elevate cost effectiveness of the therapy and treatment. As such, the demand is increasing for a computer-assisted diagnosis (CAD) method for ischaemic heart disease that supports clinicians with an objective analysis of infarct severity, a viability assessment or a prediction of potential functional improvement before performing revascularization. The goal of this thesis was to explore novel mechanisms that can be used for CAD in ischaemic heart disease, particularly through wall motion analysis from cardiac MR images. Existing diagnostic treatment of wall motion analysis from cardiac MR relies on visual wall motion scoring, which suffers from inter- and intra-observer variability. To minimize this variability, the automated method must contain essential knowledge on how the heart contracts normally. This enables automatic quantification of regional abnormal wall motion, detection of segments with contractile reserve and prediction of functional improvement in stress.1. Bontius Stichting inz. Doelfonds beeldverwerking, 2. Foundation Imago, 3. ASCI research school, and 4. Library of the University of Leiden.UBL - phd migration 201

Cardiac motion estimation using covariant derivatives and Helmholtz decomposition

The investigation and quantification of cardiac movement is important for assessment of cardiac abnormalities and treatment effectiveness. Therefore we consider new aperture problem-free methods to track cardiac motion from 2-dimensional MR tagged images and corresponding sine-phase images. Tracking is achieved by following the movement of scale-space maxima, yielding a sparse set of linear features of the unknown optic flow vector field. Interpolation/reconstruction of the velocity field is then carried out by minimizing an energy functional which is a Sobolev-norm expressed in covariant derivatives (rather than standard derivatives). These covariant derivatives are used to express prior knowledge about the velocity field in the variational framework employed. They are defined on a fiber bundle where sections coincide with vector fields. Furthermore, the optic flow vector field is decomposed in a divergence free and a rotation free part, using our multi-scale Helmholtz decomposition algorithm that combines diffusion and Helmholtz decomposition in a single non-singular analytic kernel operator. Finally, we combine this multi-scale Helmholtz decomposition with vector field reconstruction (based on covariant derivatives) in a single algorithm and present some experiments of cardiac motion estimation. Further experiments on phantom data with ground truth show that both the inclusion of covariant derivatives and the inclusion of the multi-scale Helmholtz decomposition improves the optic flow reconstruction

Joint Strain Analysis in cardia MRI

Master'sMASTER OF ENGINEERIN

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