Publications

PURPOSE: To develop a three-dimensional (3D) free-breathing myocardial T1 mapping sequence for assessment of left ventricle diffuse fibrosis after contrast administration. METHODS: In the proposed sequence, multiple 3D inversion recovery images are acquired in an interleaved manner. A mixed prospective/retrospective navigator scheme is used to obtain the 3D Cartesian k-space data with fully sampled center and randomly undersampled outer k-space. The resulting undersampled 3D k-space data are then reconstructed using compressed sensing. Subsequently, T1 maps are generated by voxel-wise curve fitting of the individual interleaved images. In a phantom study, the accuracy of the 3D sequence was evaluated against two-dimensional (2D) modified Look-Locker inversion recovery (MOLLI) and spin-echo sequences. In vivo T1 times of the proposed method were compared with 2D multislice MOLLI T1 mapping. Subsequently, the feasibility of high-resolution 3D T1 mapping with spatial resolution of 1.7 × 1.7 × 4 mm(3) was demonstrated. RESULTS: The proposed method shows good agreement with 2D MOLLI and the spin-echo reference in phantom. No significant difference was found in the in vivo T1 times estimated using the proposed sequence and the 2D MOLLI technique (myocardium, 330 ± 66 ms versus 319 ± 93 ms; blood pools, 211 ± 68 ms versus 210 ± 98 ms). However, improved homogeneity, as measured using standard deviation of the T1 signal, was observed in the 3D T1 maps. CONCLUSION: The proposed sequence enables high-resolution 3D T1 mapping after contrast injection during free-breathing with volumetric left ventricle coverage.

PURPOSE: To develop a novel MR sequence for combined three-dimensional (3D) phase-sensitive (PS) late gadolinium enhancement (LGE) and T1 mapping to allow for simultaneous assessment of focal and diffuse myocardial fibrosis. METHODS: In the proposed sequence, four 3D imaging volumes are acquired with different T1 weightings using a combined saturation and inversion preparation, after administration of a gadolinium contrast agent. One image is acquired fully sampled with the inversion time selected to null the healthy myocardial signal (the LGE image). The other three images are three-fold under-sampled and reconstructed using compressed sensing. An acquisition scheme with two interleaved imaging cycles and joint navigator-gating of those cycles ensures spatial registration of the imaging volumes. T1 maps are generated using all four imaging volumes. The signal-polarity in the LGE image is restored using supplementary information from the T1 fit to generate PS-LGE images. The accuracy of the proposed method was assessed with respect to a inversion-recovery spin-echo sequence. In vivo T1 maps and LGE images were acquired with the proposed sequence and quantitatively compared with 2D multislice Modified Look-Locker inversion recovery (MOLLI) T1 maps. Exemplary images in a patient with focal scar were compared with conventional LGE imaging. RESULTS: The deviation of the proposed method and the spin-echo reference was < 11 ms in phantom for T1 times between 250 and 600 ms, regardless of the inversion time selected in the LGE image. There was no significant difference in the in vivo T1 times of the proposed sequence and the 2D MOLLI technique (myocardium: 292 ± 75 ms versus 310 ± 49 ms, blood-pools: 191 ± 75 ms versus 182.0 ± 33). The LGE images showed proper nulling of the healthy myocardium in all subjects and clear depiction of scar in the patient. CONCLUSION: The proposed sequence enables simultaneous acquisition of 3D PS-LGE images and spatially registered 3D T1 maps in a single scan.

PURPOSE: To propose and evaluate a novel nonrigid image registration approach for improved myocardial T1 mapping. METHODS: Myocardial motion is estimated as global affine motion refined by a novel local nonrigid motion estimation algorithm. A variational framework is proposed, which simultaneously estimates motion field and intensity variations, and uses an additional regularization term to constrain the deformation field using automatic feature tracking. The method was evaluated in 29 patients by measuring the DICE similarity coefficient and the myocardial boundary error in short axis and four chamber data. Each image series was visually assessed as "no motion" or "with motion." Overall T1 map quality and motion artifacts were assessed in the 85 T1 maps acquired in short axis view using a 4-point scale (1-nondiagnostic/severe motion artifact, 4-excellent/no motion artifact). RESULTS: Increased DICE similarity coefficient (0.78 ± 0.14 to 0.87 ± 0.03, P < 0.001), reduced myocardial boundary error (1.29 ± 0.72 mm to 0.84 ± 0.20 mm, P < 0.001), improved overall T1 map quality (2.86 ± 1.04 to 3.49 ± 0.77, P < 0.001), and reduced T1 map motion artifacts (2.51 ± 0.84 to 3.61 ± 0.64, P < 0.001) were obtained after motion correction of "with motion" data (∼56% of data). CONCLUSIONS: The proposed nonrigid registration approach reduces the respiratory-induced motion that occurs during breath-hold T1 mapping, and significantly improves T1 map quality.

PURPOSE: To provide a method for the optimal selection of sampling points for myocardial T1 mapping, and to evaluate how this selection affects the precision. THEORY: The Cramér-Rao lower bound on the variance of the unbiased estimator was derived for the sampling of the longitudinal magnetization curve, as a function of T1 , signal-to-noise ratio, and noise mean. The bound was then minimized numerically over a search space of possible sampling points to find the optimal selection of sampling points. METHODS: Numerical simulations were carried out for a saturation recovery-based T1 mapping sequence, comparing the proposed point selection method to a uniform distribution of sampling points along the recovery curve for various T1 ranges of interest, as well as number of sampling points. Phantom imaging was performed to replicate the scenarios in numerical simulations. In vivo imaging for myocardial T1 mapping was also performed in healthy subjects. RESULTS: Numerical simulations show that the precision can be improved by 13-25% by selecting the sampling points according to the target T1 values of interest. Results of the phantom imaging were not significantly different than the theoretical predictions for different sampling strategies, signal-to-noise ratio and number of sampling points. In vivo imaging showed precision can be improved in myocardial T1 mapping using the proposed point selection method as predicted by theory. CONCLUSION: The framework presented can be used to select the sampling points to improve the precision without penalties on accuracy or scan time.

PURPOSE: To develop an improved T2 prepared (T2 prep) balanced steady-state free-precession (bSSFP) sequence and signal relaxation curve fitting method for myocardial T2 mapping. METHODS: Myocardial T2 mapping is commonly performed by acquisition of multiple T2 prep bSSFP images and estimating the voxel-wise T2 values using a two-parameter fit for relaxation. However, a two-parameter fit model does not take into account the effect of imaging pulses in a bSSFP sequence or other imperfections in T2 prep RF pulses, which may decrease the robustness of T2 mapping. Therefore, we propose a novel T2 mapping sequence that incorporates an additional image acquired with saturation preparation, simulating a very long T2 prep echo time. This enables the robust estimation of T2 maps using a 3-parameter fit model, which captures the effect of imaging pulses and other imperfections. Phantom imaging is performed to compare the T2 maps generated using the proposed 3-parameter model with the conventional two-parameter model, as well as a spin echo reference. In vivo imaging is performed on eight healthy subjects to compare the different fitting models. RESULTS: Phantom and in vivo data show that the T2 values generated by the proposed 3-parameter model fitting do not change with different choices of the T2 prep echo times, and are not statistically different than the reference values for the phantom (P = 0.10 with three T2 prep echoes). The two-parameter model exhibits dependence on the choice of T2 prep echo times and are significantly different than the reference values (P = 0.01 with three T2 prep echoes). CONCLUSION: The proposed imaging sequence in combination with a three-parameter model allows accurate measurement of myocardial T2 values, which is independent of number and duration of T2 prep echo times. Magn Reson Med, 2014. © 2014 Wiley Periodicals, Inc.

PURPOSE: To evaluate the feasibility of accelerated cardiac MR (CMR) perfusion with radial sampling using nonlinear image reconstruction after exercise on an MR-compatible supine bike ergometer. METHODS: Eight healthy subjects were scanned on two separate days using radial and Cartesian CMR perfusion sequences in rest and exercise stress perfusion. Four different methods (standard gridding, conjugate gradient SENSE [CG-SENSE], nonlinear inversion with joint estimation of coil-sensitivity profiles [NLINV] and compressed sensing with a total variation constraint [TV]) were compared for the reconstruction of radial data. Cartesian data were reconstructed using SENSE. All images were assessed by two blinded readers in terms of image quality and diagnostic value. RESULTS: CG-SENSE and NLINV were scored more favorably than TV (in both rest and stress perfusion cases, P < 0.05) and gridding (for rest perfusion cases, P < 0.05). TV images showed patchy artifacts, which negatively influenced image quality especially in the stress perfusion images acquired with a low number of radial spokes. Although CG-SENSE and NLINV received better scores than Cartesian sampling in both rest and exercise stress perfusion cases, these differences were not statistically significant (P > 0.05). CONCLUSION: We have demonstrated the feasibility of accelerated CMR perfusion using radial sampling after physical exercise using a supine bicycle ergometer in healthy subjects. For reconstruction of undersampled radial perfusion, CG-SENSE and NLINV resulted in better image quality than standard gridding or TV reconstruction. Further technical improvements and clinical assessment are needed before using this approach in patients with suspected coronary artery disease.

The aim of this study was to implement and evaluate an accelerated three-dimensional (3D) cine phase contrast MRI sequence by combining a randomly sampled 3D k-space acquisition sequence with an echo planar imaging (EPI) readout. An accelerated 3D cine phase contrast MRI sequence was implemented by combining EPI readout with randomly undersampled 3D k-space data suitable for compressed sensing (CS) reconstruction. The undersampled data were then reconstructed using low-dimensional structural self-learning and thresholding (LOST). 3D phase contrast MRI was acquired in 11 healthy adults using an overall acceleration of 7 (EPI factor of 3 and CS rate of 3). For comparison, a single two-dimensional (2D) cine phase contrast scan was also performed with sensitivity encoding (SENSE) rate 2 and approximately at the level of the pulmonary artery bifurcation. The stroke volume and mean velocity in both the ascending and descending aorta were measured and compared between two sequences using Bland-Altman plots. An average scan time of 3 min and 30 s, corresponding to an acceleration rate of 7, was achieved for 3D cine phase contrast scan with one direction flow encoding, voxel size of 2 × 2 × 3 mm(3) , foot-head coverage of 6 cm and temporal resolution of 30 ms. The mean velocity and stroke volume in both the ascending and descending aorta were statistically equivalent between the proposed 3D sequence and the standard 2D cine phase contrast sequence. The combination of EPI with a randomly undersampled 3D k-space sampling sequence using LOST reconstruction allows a seven-fold reduction in scan time of 3D cine phase contrast MRI without compromising blood flow quantification.

Coronary magnetic resonance imaging (MRI) requires a correctly timed trigger delay derived from a scout cine scan to synchronize k-space acquisition with the quiescent period of the cardiac cycle. However, heart rate changes between breath-held cine and free-breathing coronary imaging may result in inaccurate timing errors. Additionally, the determined trigger delay may not reflect the period of minimal motion for both left and right coronary arteries or different segments. In this work, we present a whole-heart coronary imaging approach that allows flexible selection of the trigger delay timings by performing k-space sampling over an enlarged acquisition window. Our approach addresses coronary motion in an interactive manner by allowing the operator to determine the temporal window with minimal cardiac motion for each artery region. An electrocardiogram-gated, k-space segmented 3D radial stack-of-stars sequence that employs a custom rotation angle is developed. An interactive reconstruction and visualization platform is then employed to determine the subset of the enlarged acquisition window for minimal coronary motion. Coronary MRI was acquired on eight healthy subjects (5 male, mean age = 37 ± 18 years), where an enlarged acquisition window of 166-220 ms was set 50 ms prior to the scout-derived trigger delay. Coronary visualization and sharpness scores were compared between the standard 120 ms window set at the trigger delay, and those reconstructed using a manually adjusted window. The proposed method using manual adjustment was able to recover delineation of five mid and distal right coronary artery regions that were otherwise not visible from the standard window, and the sharpness scores improved in all coronary regions using the proposed method. This paper demonstrates the feasibility of a whole-heart coronary imaging approach that allows interactive selection of any subset of the enlarged acquisition window for a tailored reconstruction for each branch region.