In vivo myocardial tissue characterization of all four chambers using high-resolution quantitative MRI

Quantitative native T(1) Mapping of the myocardium without the application of contrast agents can be used to detect fibrosis in the left ventricle. Spatial resolution of standard native T(1) mapping is limited by cardiac motion and hence is not sufficient to resolve small myocardial structures, such as the right ventricle and the atria. Here, we present a novel MR approach which provides cardiac motion information and native T(1) maps from the same data. Motion information is utilized to optimize data selection for T(1) mapping and a model-based iterative reconstruction scheme ensures high-resolution T(1) maps for the entire heart. Feasibility of the approach was demonstrated in three healthy volunteers. In the T(1) maps, the myocardium of all four chambers can be visualized and T(1) values of the left atrium and right chambers were comparable to left ventricular T(1) values

Neural networks-based regularization for large-scale medical image reconstruction

In this paper we present a generalized Deep Learning-based approach for solving ill-posed large-scale inverse problems occuring in medical image reconstruction. Recently, Deep Learning methods using iterative neural networks (NNs) and cascaded NNs have been reported to achieve state-of-the-art results with respect to various quantitative quality measures as PSNR, NRMSE and SSIM across different imaging modalities. However, the fact that these approaches employ the application of the forward and adjoint operators repeatedly in the network architecture requires the network to process the whole images or volumes at once, which for some applications is computationally infeasible. In this work, we follow a different reconstruction strategy by strictly separating the application of the NN, the regularization of the solution and the consistency with the measured data. The regularization is given in the form of an image prior obtained by the output of a previously trained NN which is used in a Tikhonov regularization framework. By doing so, more complex and sophisticated network architectures can be used for the removal of the artefacts or noise than it is usually the case in iterative NNs. Due to the large scale of the considered problems and the resulting computational complexity of the employed networks, the priors are obtained by processing the images or volumes as patches or slices. We evaluated the method for the cases of 3D cone-beam low dose CT and undersampled 2D radial cine MRI and compared it to a total variation-minimization-based reconstruction algorithm as well as to a method with regularization based on learned overcomplete dictionaries. The proposed method outperformed all the reported methods with respect to all chosen quantitative measures and further accelerates the regularization step in the reconstruction by several orders of magnitude

Fast myocardial T(1) mapping using cardiac motion correction

PURPOSE: To improve the efficiency of native and postcontrast high-resolution cardiac T(1) mapping by utilizing cardiac motion correction. METHODS: Common cardiac T(1) mapping techniques only acquire data in a small part of the cardiac cycle, leading to inefficient data sampling. Here, we present an approach in which 80% of each cardiac cycle is used for T(1) mapping by integration of cardiac motion correction. Golden angle radial data was acquired continuously for 8 s with in-plane resolution of 1.3 × 1.3 mm(2). Cine images were reconstructed for nonrigid cardiac motion estimation. Images at different TIs were reconstructed from the same data, and motion correction was performed prior to T(1) mapping. Native T(1) mapping was evaluated in healthy subjects. Furthermore, the technique was applied for postcontrast T(1) mapping in 5 patients with suspected fibrosis. RESULTS: Cine images with high contrast were obtained, leading to robust cardiac motion estimation. Motion-corrected T(1) maps showed myocardial T(1) times similar to cardiac-triggered T(1) maps obtained from the same data (1288 ± 49 ms and 1259 ± 55 ms, respectively) but with a 34% improved precision (spatial variation: 57.0 ± 12.5 ms and 94.8 ± 15.4 ms, respectively, P < 0.0001) due to the increased amount of data. In postcontrast T(1) maps, focal fibrosis could be confirmed with late contrast-enhancement images. CONCLUSION: The proposed approach provides high-resolution T(1) maps within 8 s. Data acquisition efficiency for T(1) mapping was improved by a factor of 5 by integration of cardiac motion correction, resulting in precise T(1) maps

Motion-corrected model-based reconstruction for 2D myocardial T1 mapping

PURPOSE: To allow for T1 mapping of the myocardium within 2.3 s for a 2D slice utilizing cardiac motion-corrected, model-based image reconstruction. METHODS: Golden radial data acquisition is continuously carried out for 2.3 s after an inversion pulse. In a first step, dynamic images are reconstructed which show both contrast changes due to T1 recovery and anatomical changes due to the heartbeat. An image registration algorithm with a signal model for T1 recovery is applied to estimate non-rigid cardiac motion. In a second step, estimated motion fields are applied during an iterative model-based T1 reconstruction. The approach was evaluated in numerical simulations, phantom experiments and in in-vivo scans in healthy volunteers. RESULTS: The accuracy of cardiac motion estimation was shown in numerical simulations with an average motion field error of 0.7 ± 0.6 mm for a motion amplitude of 5.1 mm. The accuracy of T1 estimation was demonstrated in phantom experiments, with no significant difference (p = 0.13) in T1 estimated by the proposed approach compared to an inversion-recovery reference method. In vivo, the proposed approach yielded 1.3 × 1.3 mm T1 maps with no significant difference (p = 0.77) in T1 and SDs in comparison to a cardiac-gated approach requiring 16 s scan time (i.e., seven times longer than the proposed approach). Cardiac motion correction improved the precision of T1 maps, shown by a 40% reduced SD. CONCLUSION: We have presented an approach that provides T1 maps of the myocardium in 2.3 s by utilizing both cardiac motion correction and model-based T1 reconstruction

Multilevel comparison of deep learning models for function quantification in cardiovascular magnetic resonance: on the redundancy of architectural variations

BACKGROUND: Cardiac function quantification in cardiovascular magnetic resonance requires precise contouring of the heart chambers. This time-consuming task is increasingly being addressed by a plethora of ever more complex deep learning methods. However, only a small fraction of these have made their way from academia into clinical practice. In the quality assessment and control of medical artificial intelligence, the opaque reasoning and associated distinctive errors of neural networks meet an extraordinarily low tolerance for failure. AIM: The aim of this study is a multilevel analysis and comparison of the performance of three popular convolutional neural network (CNN) models for cardiac function quantification. METHODS: U-Net, FCN, and MultiResUNet were trained for the segmentation of the left and right ventricles on short-axis cine images of 119 patients from clinical routine. The training pipeline and hyperparameters were kept constant to isolate the influence of network architecture. CNN performance was evaluated against expert segmentations for 29 test cases on contour level and in terms of quantitative clinical parameters. Multilevel analysis included breakdown of results by slice position, as well as visualization of segmentation deviations and linkage of volume differences to segmentation metrics via correlation plots for qualitative analysis. RESULTS: All models showed strong correlation to the expert with respect to quantitative clinical parameters (rz′ = 0.978, 0.977, 0.978 for U-Net, FCN, MultiResUNet respectively). The MultiResUNet significantly underestimated ventricular volumes and left ventricular myocardial mass. Segmentation difficulties and failures clustered in basal and apical slices for all CNNs, with the largest volume differences in the basal slices (mean absolute error per slice: 4.2 ± 4.5 ml for basal, 0.9 ± 1.3 ml for midventricular, 0.9 ± 0.9 ml for apical slices). Results for the right ventricle had higher variance and more outliers compared to the left ventricle. Intraclass correlation for clinical parameters was excellent (≥0.91) among the CNNs. CONCLUSION: Modifications to CNN architecture were not critical to the quality of error for our dataset. Despite good overall agreement with the expert, errors accumulated in basal and apical slices for all models

Motion-compensated fat-water imaging for 3D cardiac MRI at ultra-high fields

PURPOSE: Respiratory motion-compensated (MC) 3D cardiac fat-water imaging at 7T. METHODS: Free-breathing bipolar 3D triple-echo gradient-recalled-echo (GRE) data with radial phase-encoding (RPE) trajectory were acquired in 11 healthy volunteers (7M\4F, 21-35 years, mean: 30 years) with a wide range of body mass index (BMI; 19.9-34.0 kg/m2 ) and volunteer tailored B(1)(+) shimming. The bipolar-corrected triple-echo GRE-RPE data were binned into different respiratory phases (self-navigation) and were used for the estimation of non-rigid motion vector fields (MF) and respiratory resolved (RR) maps of the main magnetic field deviations (ΔB0 ). RR ΔB0 maps and MC ΔB0 maps were compared to a reference respiratory phase to assess respiration-induced changes. Subsequently, cardiac binned fat-water images were obtained using a model-based, respiratory motion-corrected image reconstruction. RESULTS: The 3D cardiac fat-water imaging at 7T was successfully demonstrated. Local respiration-induced frequency shifts in MC ΔB(0) maps are small compared to the chemical shifts used in the multi-peak model. Compared to the reference exhale ΔB0 map these changes are in the order of 10 Hz on average. Cardiac binned MC fat-water reconstruction reduced respiration induced blurring in the fat-water images, and flow artifacts are reduced in the end-diastolic fat-water separated images. CONCLUSION: This work demonstrates the feasibility of 3D fat-water imaging at UHF for the entire human heart despite spatial and temporal B(1)(+) and B0 variations, as well as respiratory and cardiac motion

Cardio-respiratory motion-corrected 3D cardiac water-fat MRI using model-based image reconstruction

PURPOSE: Myocardial fat infiltrations are associated with a range of cardiomyopathies. The purpose of this study was to perform cardio-respiratory motion-correction for model-based water-fat separation to image fatty infiltrations of the heart in a free-breathing, non-cardiac-triggered high-resolution 3D MRI acquisition. METHODS: Data were acquired in nine patients using a free-breathing, non-cardiac-triggered high-resolution 3D Dixon gradient-echo sequence and radial phase encoding trajectory. Motion correction was combined with a model-based water-fat reconstruction approach. Respiratory and cardiac motion models were estimated using a dual-mode registration algorithm incorporating both motion-resolved water and fat information. Qualitative comparisons of fat structures were made between 2D clinical routine reference scans and reformatted 3D motion-corrected images. To evaluate the effect of motion correction the local sharpness of epicardial fat structures was analyzed for motion-averaged and motion-corrected fat images. RESULTS: The reformatted 3D motion-corrected reconstructions yielded qualitatively comparable fat structures and fat structure sharpness in the heart as the standard 2D breath-hold. Respiratory motion correction improved the local sharpness on average by 32% ± 24% with maximum improvements of 81% and cardiac motion correction increased the sharpness further by another 15% ± 11% with maximum increases of 31%. One patient showed a fat infiltration in the myocardium and cardio-respiratory motion correction was able to improve its visualization in 3D. CONCLUSION: The 3D water-fat separated cardiac images were acquired during free-breathing and in a clinically feasible and predictable scan time. Compared to a motion-averaged reconstruction an increase in sharpness of fat structures by 51% ± 27% using the presented motion correction approach was observed for nine patients

3D model-based super-resolution motion-corrected cardiac T1 mapping

OBJECTIVE: To provide 3D high-resolution cardiac T1 maps using model-based super-resolution reconstruction (SRR). APPROACH: Due to signal-to-noise ratio (SNR) limitations and the motion of the heart during imaging, often 2D T1 maps with only low through-plane resolution (i.e. slice thickness of 6 to 8 mm) can be obtained. Here, a model-based SRR approach is presented, which combines multiple stacks of 2D acquisitions with 6 to 8 mm slice thickness and generates 3D high-resolution T1 maps with a slice thickness of 1.5 to 2 mm. Every stack was acquired in a different breath hold (BH) and any misalignment between BH was corrected retrospectively. The novelty of the proposed approach is the BH correction and the application of model-based SRR on cardiac T1 Mapping. The proposed approach was evaluated in numerical simulations and phantom experiments and demonstrated in four healthy subjects. MAIN RESULTS: Alignment of BH states was essential for SRR even in healthy volunteers. In simulations, respiratory motion could be estimated with an RMS error of 0.18 ± 0.28 mm. SRR improved the visualization of small structures. High accuracy and precision (average standard deviation of 69.62 ms) of the T1 values was ensured by SRR while the detectability of small structures increased by 40%. SIGNIFICANCE: The proposed SRR approach provided T1 maps with high in-plane and high through-plane resolution (1.3×1.3×1.5 to 2 mm(3)). The approach led to improvements in the visualization of small structures and precise T1 values

Open‐source magnetic resonance imaging: improving access, science, and education through global collaboration

Open-source practices and resources in magnetic resonance imaging (MRI) have increased substantially in recent years. This trend started with software and data being published open-source and, more recently, open-source hardware designs have become increasingly available. These developments towards a culture of sharing and establishing nonexclusive global collaborations have already improved the reproducibility and reusability of code and designs, while providing a more inclusive approach, especially for low-income settings. Community-driven standardization and documentation efforts are further strengthening and expanding these milestones. The future of open-source MRI is bright and we have just started to discover its full collaborative potential. In this review we will give an overview of open-source software and open-source hardware projects in human MRI research

A simulation-based phantom model for generating synthetic mitral valve image data-application to MRI acquisition planning

PURPOSE: Numerical phantom methods are widely used in the development of medical imaging methods. They enable quantitative evaluation and direct comparison with controlled and known ground truth information. Cardiac magnetic resonance has the potential for a comprehensive evaluation of the mitral valve (MV). The goal of this work is the development of a numerical simulation framework that supports the investigation of MRI imaging strategies for the mitral valve. METHODS: We present a pipeline for synthetic image generation based on the combination of individual anatomical 3D models with a position-based dynamics simulation of the mitral valve closure. The corresponding images are generated using modality-specific intensity models and spatiotemporal sampling concepts. We test the applicability in the context of MRI imaging strategies for the assessment of the mitral valve. Synthetic images are generated with different strategies regarding image orientation (SAX and rLAX) and spatial sampling density. RESULTS: The suitability of the imaging strategy is evaluated by comparing MV segmentations against ground truth annotations. The generated synthetic images were compared to ones acquired with similar parameters, and the result is promising. The quantitative analysis of annotation results suggests that the rLAX sampling strategy is preferable for MV assessment, reaching accuracy values that are comparable to or even outperform literature values. CONCLUSION: The proposed approach provides a valuable tool for the evaluation and optimization of cardiac valve image acquisition. Its application to the use case identifies the radial image sampling strategy as the most suitable for MV assessment through MRI