Doctor of Philosophy

dissertationEach year in the United States, a quarter million cases of stroke are caused directly by atherosclerotic disease of the cervical carotid artery. This represents a significant portion of health care costs that could be avoided if high-risk carotid artery lesions could be detected early on in disease progression. There is mounting evidence that Magnetic Resonance Imaging of the carotid artery can better classify subjects who would benefit from interventions. Turbo Spin Echo sequences are a class of Magnetic Resonance Imaging sequences that provide a variety of tissue contrasts. While high resolution Turbo Spin Echo images have demonstrated important details of carotid artery morphology, it is evident that pulsatile blood and wall motion related to the cardiac cycle are still significant sources of image degradation. In addition, patient motion artifacts due to the relatively long scan times of Turbo Spin Echo sequences result in an unacceptable fraction of noninterpretable studies. This dissertation presents work done to detect and correct for types of voluntary and physiological patient motion

Self-navigation with compressed sensing for 2D translational motion correction in free-breathing coronary MRI:a feasibility study

PURPOSE: Respiratory motion correction remains a challenge in coronary magnetic resonance imaging (MRI) and current techniques, such as navigator gating, suffer from sub-optimal scan efficiency and ease-of-use. To overcome these limitations, an image-based self-navigation technique is proposed that uses "sub-images" and compressed sensing (CS) to obtain translational motion correction in 2D. The method was preliminarily implemented as a 2D technique and tested for feasibility for targeted coronary imaging. METHODS: During a 2D segmented radial k-space data acquisition, heavily undersampled sub-images were reconstructed from the readouts collected during each cardiac cycle. These sub-images may then be used for respiratory self-navigation. Alternatively, a CS reconstruction may be used to create these sub-images, so as to partially compensate for the heavy undersampling. Both approaches were quantitatively assessed using simulations and in vivo studies, and the resulting self-navigation strategies were then compared to conventional navigator gating. RESULTS: Sub-images reconstructed using CS showed a lower artifact level than sub-images reconstructed without CS. As a result, the final image quality was significantly better when using CS-assisted self-navigation as opposed to the non-CS approach. Moreover, while both self-navigation techniques led to a 69% scan time reduction (as compared to navigator gating), there was no significant difference in image quality between the CS-assisted self-navigation technique and conventional navigator gating, despite the significant decrease in scan time. CONCLUSIONS: CS-assisted self-navigation using 2D translational motion correction demonstrated feasibility of producing coronary MRA data with image quality comparable to that obtained with conventional navigator gating, and does so without the use of additional acquisitions or motion modeling, while still allowing for 100% scan efficiency and an improved ease-of-use. In conclusion, compressed sensing may become a critical adjunct for 2D translational motion correction in free-breathing cardiac imaging with high spatial resolution. An expansion to modern 3D approaches is now warranted

Motion Compensation for Free-Breathing Abdominal Diffusion-Weighted Imaging (MoCo DWI)

Diffusion-weighted imaging (DWI) is a common technique in medical diagnostics. One challenge of thoracic and abdominal DWI is respiratory motion which can result in motion artifacts. To eliminate these artifacts, a new kind of retrospective, respiratory motion compensation for DWI was developed and tested. This new technique — MoCo DWI — is the first in DWI which provides fully-deformable motion compensation. To enable this, despite the low image quality of DWI, two free-breathing sequences were used: (1) a gradient echo sequence (GRE) with a configuration for optimal respiratory motion estimation and (2) a DWI in a configuration of clinical interest. The DWI acquisition was gated into 10 motion phases. Each motion phase was then co-aligned with the motion estimation. The implementation was tested with eleven volunteers. The results showed that MoCo DWI can reduce motion blurring in single b-value images, especially at the liver-lung interface. The improvement of ADC-maps was even more prominent. Individual slices showed motion induced artifacts which could be reduced or even eliminated by MoCo DWI. This was also reflected by expected more homogeneous ADC values in the liver in all data sets. These results promise to reduce measurements with limited diagnostic value while keeping or increasing patient comfort

Respiratory organ motion in interventional MRI : tracking, guiding and modeling

Respiratory organ motion is one of the major challenges in interventional MRI, particularly in interventions with therapeutic ultrasound in the abdominal region. High-intensity focused ultrasound found an application in interventional MRI for noninvasive treatments of different abnormalities. In order to guide surgical and treatment interventions, organ motion imaging and modeling is commonly required before a treatment start. Accurate tracking of organ motion during various interventional MRI procedures is prerequisite for a successful outcome and safe therapy. In this thesis, an attempt has been made to develop approaches using focused ultrasound which could be used in future clinically for the treatment of abdominal organs, such as the liver and the kidney. Two distinct methods have been presented with its ex vivo and in vivo treatment results. In the first method, an MR-based pencil-beam navigator has been used to track organ motion and provide the motion information for acoustic focal point steering, while in the second approach a hybrid imaging using both ultrasound and magnetic resonance imaging was combined for advanced guiding capabilities. Organ motion modeling and four-dimensional imaging of organ motion is increasingly required before the surgical interventions. However, due to the current safety limitations and hardware restrictions, the MR acquisition of a time-resolved sequence of volumetric images is not possible with high temporal and spatial resolution. A novel multislice acquisition scheme that is based on a two-dimensional navigator, instead of a commonly used pencil-beam navigator, was devised to acquire the data slices and the corresponding navigator simultaneously using a CAIPIRINHA parallel imaging method. The acquisition duration for four-dimensional dataset sampling is reduced compared to the existing approaches, while the image contrast and quality are improved as well. Tracking respiratory organ motion is required in interventional procedures and during MR imaging of moving organs. An MR-based navigator is commonly used, however, it is usually associated with image artifacts, such as signal voids. Spectrally selective navigators can come in handy in cases where the imaging organ is surrounding with an adipose tissue, because it can provide an indirect measure of organ motion. A novel spectrally selective navigator based on a crossed-pair navigator has been developed. Experiments show the advantages of the application of this novel navigator for the volumetric imaging of the liver in vivo, where this navigator was used to gate the gradient-recalled echo sequence

Motion Compensated Self Supervised Deep Learning for Highly Accelerated 3D Ultrashort Echo Time Pulmonary MRI

Purpose: To investigate motion compensated, self-supervised, model based deep learning (MBDL) as a method to reconstruct free breathing, 3D Pulmonary ultrashort echo time (UTE) acquisitions. Theory and Methods: A self-supervised eXtra Dimension MBDL architecture (XD-MBDL) was developed that combined respiratory states to reconstruct a single high-quality 3D image. Non-rigid, GPU based motion fields were incorporated into this architecture by estimating motion fields from a low resolution motion resolved (XD-GRASP) iterative reconstruction. Motion Compensated XD-MBDL was evaluated on lung UTE datasets with and without contrast and was compared to constrained reconstructions and variants of self-supervised MBDL that do not consider respiratory motion. Results: Images reconstructed using XD-MBDL demonstrate improved image quality as measured by apparent SNR, CNR and visual assessment relative to self-supervised MBDL approaches that do not account for dynamic respiratory states, XD-GRASP and a recently proposed motion compensated iterative reconstruction strategy (iMoCo). Additionally, XD-MBDL reduced reconstruction time relative to both XD-GRASP and iMoCo. Conclusion: A method was developed to allow self-supervised MBDL to combine multiple respiratory states to reconstruct a single image. This method was combined with GPU-based image registration to further improve reconstruction quality. This approach showed promising results reconstructing a user-selected respiratory phase from free breathing 3D pulmonary UTE acquisitions

Cardiovascular magnetic resonance artefacts

The multitude of applications offered by CMR make it an increasing popular modality to study the heart and the surrounding vessels. Nevertheless the anatomical complexity of the chest, together with cardiac and respiratory motion, and the fast flowing blood, present many challenges which can possibly translate into imaging artefacts. The literature is wide in terms of papers describing specific MR artefacts in great technical detail. In this review we attempt to summarise, in a language accessible to a clinical readership, some of the most common artefacts found in CMR applications. It begins with an introduction of the most common pulse sequences, and imaging techniques, followed by a brief section on typical cardiovascular applications. This leads to the main section on common CMR artefacts with examples, a short description of the mechanisms behind them, and possible solutions

Load-Independent And Regional Measures Of Cardiac Function Via Real-Time Mri

LOAD-INDEPENDENT AND REGIONAL MEASURES OF CARDIAC FUNCTION VIA REAL-TIME MRI Francisco Jose Contijoch Robert C Gorman, MD Expansion of infarcted tissue during left ventricular (LV) remodeling after a myocardial infarction is associated with poor long-term prognosis. Several interventions have been developed to limit infarct expansion by modifying the material properties of the infarcted or surrounding borderzone tissue. Measures of myocardial function and material properties can be obtained non-invasively via imaging. However, these measures are sensitive to variations in loading conditions and acquisition of load-independent measures have been limited by surgically invasive procedures and limited spatial resolution. In this dissertation, a real-time magnetic resonance imaging (MRI) technique was validated in clinical patients and instrumented animals, several technical improvements in MRI acquisition and reconstruction were presented for improved imaging resolution, load-independent measures were obtained in animal studies via non-invasive imaging, and regional variations in function were measured in both na�ve and post-infarction animals. Specifically, a golden-angle radial MRI acquisition with non-Cartesian SENSE-based reconstruction with an exposure time less than 95 ms and a frame rate above 89 fps allows for accurate estimation of LV slice volume in clinical patients and instrumented animals. Two technical developments were pursued to improve image quality and spatial resolution. First, the slice volume obtained can be used as a self-navigator signal to generate retrospectively-gated, high-resolution datasets of multiple beat morphologies. Second, cross-correlation of the ECG with previously observed values resulted in accurate interpretation of cardiac phase in patients with arrhythmias and allowed for multi-shot imaging of dynamic scenarios. Synchronizing the measured LV slice volume with an LV pressure signal allowed for pressure-volume loops and corresponding load-independent measures of function to be obtained in instrumented animals. Acquiring LV slice volume at multiple slice locations revealed regional differences in contractile function. Motion-tracking of the myocardium during real-time imaging allowed for differences in contractile function between normal, borderzone, and infarcted myocardium to be measured. Lastly, application of real-time imaging to patients with arrhythmias revealed the variable impact of ectopic beats on global hemodynamic function, depending on frequency and ectopic pattern. This work established the feasibility of obtaining load-independent measures of function via real-time MRI and illustrated regional variations in cardiac function