Analysis of cardiac motion using MRI and nonrigid image registration

Imperial Users onl

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

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

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

Hierarchical template matching for 3D myocardial tracking and cardiac strain estimation

Myocardial tracking and strain estimation can non-invasively assess cardiac functioning using subject-specific MRI. As the left-ventricle does not have a uniform shape and functioning from base to apex, the development of 3D MRI has provided opportunities for simultaneous 3D tracking, and 3D strain estimation. We have extended a Local Weighted Mean (LWM) transformation function for 3D, and incorporated in a Hierarchical Template Matching model to solve 3D myocardial tracking and strain estimation problem. The LWM does not need to solve a large system of equations, provides smooth displacement of myocardial points, and adapt local geometric differences in images. Hence, 3D myocardial tracking can be performed with 1.49 mm median error, and without large error outliers. The maximum error of tracking is up to 24% reduced compared to benchmark methods. Moreover, the estimated strain can be insightful to improve 3D imaging protocols, and the computer code of LWM could also be useful for geo-spatial and manufacturing image analysis researchers

Motion tracking tMRI datasets to quantify abnormal left ventricle motion using finite element modelling

According to `The Atlas of Heart Disease and Stroke'[MMMG04] published by the World Health Organization, heart disease accounts for nearly half the deaths in both the developed and developing countries and is the world's single biggest killer. However, early detection of a diseased heart condition can prevent many of these fatalities. Regional wall motion abnormalities of the heart precede both ECG abnormalities and chest pain as an indicator of myocardial ischaemia and are an excellent indicator of coronary stenosis [GZM97]. These motion abnormalities of the heart muscle are difficult to observe and track, because the heart is a relatively smooth organ with few landmarks and non-rigid motion with a twisting motion or tangential component. The MRI tissue-tagging technique gives researchers the first glimpse into how the heart actually beats. This research uses the tagged MRI images of the heart to create a three dimensional model of a beating heart indicating the stress of a region. Tagged MRI techniques are still developing and vary vastly, meaning that there needs to be a methodology that can adapt to these changes rapidly and effectively, to meet the needs of the evolving technology. The focus of this research is to develop and test such a methodology by the means of a Strain Estimation Pipeline along with an effective way of validating any changes made to the individual processes that it comprises of

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

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

Cardiac motion and deformation estimation in tagged magnetic resonance imaging

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Electrónica Médica)Cardiovascular diseases are the main cause of death in Europe, with an estimate of 4.3 million deaths each year. The assessment of the regional wall deformation is a relevant clinical indicator, and can be used to detect several cardiac lesions. Nowadays, this study can be performed using several image modalities. In the current thesis, we focus on tagged Magnetic Resonance imaging (t-MRI) technique. Such technique allows acquiring images with tags on the myocardium, which deform with the muscle. The present thesis intends to assess the left ventricle (LV) deformation using radial and circumferential strain. To compute such strain values, both endo- and epicardial contours of the LV are required. As such, a new framework to automatically assess the LV function is proposed. This framework presents: (i) an automatic segmentation technique, based on a tag suppression strategy followed by an active contour segmentation method, and (ii) a tracking approach to extract myocardial deformation, based on a non-rigid registration method. The automatic segmentation uses the B-spline Explicit Active Surface framework, which was previously applied in ultra-sound and cine-MRI images. In both cases, a real-time and accurate contour was achieved. Regarding the registration step, starting from a state-of-art approach, termed sequential 2D, we suggest a new method (termed sequential 2D+t), where the temporal information is included on the model. The tracking methods were first tested on synthetic data to study the registration parameters influence. Furthermore, the proposed and original methods were applied on porcine data with myocardial ischemia. Both methods were able to detect dysfunctional regions. A comparison between the strain curve in the sequential 2D and sequential 2D+t strategies was also shown. As conclusion, a smoothing effect in the strain curve was detected in the sequential 2D+t strategy. The validation of the segmentation approach uses a human dataset. A comparison between the manual contour and the proposed segmentation method results was performed. The results, suggest that proposed method has an acceptable performance, removing the tedious task related with manual segmentation and the intra-observer variability. Finally, a comparison between the proposed framework and the currently available commercial software was performed. The commercial software results were obtained from core-lab analysis. An acceptable result (r = 0.601) was achieved when comparing the strain peak values. Importantly, the proposed framework appears to present a more acceptable result.As doenças cardiovasculares são a principal causa de morte na Europa, com aproximadamente 4.7 milhões de mortes por ano. A avaliação da deformação do miocárdio a um nível local é um importante indicador clínico e pode ser usado para a deteção de lesões cardíacas. Este estudo é normalmente realizado usando várias modalidades de imagem médica. Nesta tese, a Resonância Magnética (RM) marcada foi a técnica selecionada. Estas imagens têm marcadores no músculo cardíaco, os quais se deformam com o miocárdio e podem ser usados para o estudo da deformação cardíaca. Nesta tese, pretende-se estudar a deformação radial e circunferencial do ventrículo esquerdo (VE). Assim, um contorno do endo- e epicárdio no VE é essencial. Desta forma, uma ferramenta para o estudo da deformação do VE foi desenvolvida. Esta possui: (i) um método de segmentação automático, usando uma estratégia de supressão dos marcadores, seguido de uma segmentação c um contorno ativo, e (ii) um método de tracking para determinação da deformação cardíaca, baseado em registo não rígido. A segmentação automática utiliza a ferramenta B-spline Explicit Active Surface, que foi previamente aplicada em imagens de ultrassons e cine-RM. Em ambos os casos, uma segmentação em tempo real e com elevada exatidão foi alcançada. Vários esquemas de registo foram apresentados. Neste ponto, começando com uma técnica do estado da arte (designada de sequencial 2D), uma nova metodologia foi proposta (sequencial 2D+t), onde a informação temporal é incorporada no modelo. De forma a analisar a influência dos parâmetros do registo, estes foram estudados num dataset sintético. De seguida, os diferentes esquemas de registo foram testados num dataset suíno com isquemia. Ambos os métodos foram capazes de detetar as regiões disfuncionais. De igual forma, utilizando as curvas de deformação obtidas para cada um dos métodos propostos, foi possível observar uma suavização na direção temporal para o método sequencial 2D+t. Relativamente à segmentação, esta foi validada com um dataset humano. Um contorno manual foi comparado com o obtido pelo método proposto. Os resultados sugerem que a nova estratégia é aceitável, sendo mais rápida do que a realização de um contorno manual e eliminando a variabilidade entre observadores. Por fim, realizou-se uma comparação entre a ferramenta proposta e um software comercial (com análise de core-lab). A comparação entre os valores de pico da deformação exibe uma correlação plausível (r=0.601). Contudo, é importante notar, que a nova ferramenta tende a apresentar um resultado mais aceitável