PurposeDevelop a framework for efficient free‐breathing simultaneous whole‐heart coronary magnetic resonance angiography (CMRA) and cardiac positron emission tomography (PET) on a 3 Tesla PET‐MR system.MethodsAn acquisition that enables nonrigid motion correction of both CMRA and PET has been developed. The proposed method estimates translational motion from low‐resolution 2D MR image navigators acquired at each heartbeat and 3D nonrigid respiratory motion between different respiratory bins from the CMRA data itself. Estimated motion is used for correcting the CMRA as well as the emission and attenuation PET data sets to the same respiratory position. The CMRA approach was studied in 10 healthy subjects and compared for both left and right coronary arteries (LCA, RCA) against a reference scan with diaphragmatic navigator gating and tracking. The PET‐CMRA approach was tested in 5 oncology patients with 18F‐FDG myocardial uptake. PET images were compared against uncorrected and gated PET reconstructions.ResultsFor the healthy subjects, no statistically significant differences in vessel length and sharpness (P > 0.01) were observed between the proposed approach and the reference acquisition with navigator gating and tracking, although data acquisition was significantly shorter. The proposed approach improved CMRA vessel sharpness by 37.9% and 49.1% (LCA, RCA) and vessel length by 48.0% and 36.7% (LCA, RCA) in comparison with no motion correction for all the subjects. Motion‐corrected PET images showed improved sharpness of the myocardium compared to uncorrected reconstructions and reduced noise compared to gated reconstructions.ConclusionFeasibility of a new respiratory motion‐compensated simultaneous cardiac PET‐CMRA acquisition has been demonstrated. Magn Reson Med 79:339–350, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Background: Conventional 2D inversion recovery (IR) and phase sensitive inversion recovery (PSIR) late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) have been widely incorporated into routine CMR for the assessment of myocardial viability. However, reliable suppression of fat signal, and increased isotropic spatial resolution and volumetric coverage within a clinically feasible scan time remain a challenge. In order to address these challenges, this work proposes a highly efficient respiratory motion-corrected 3D whole-heart water/fat LGE imaging framework. Methods: An accelerated IR-prepared 3D dual-echo acquisition and motion-corrected reconstruction framework for whole-heart water/fat LGE imaging was developed. The acquisition sequence includes 2D image navigators (iNAV), which are used to track the respiratory motion of the heart and enable 100% scan efficiency. Non-rigid motion information estimated from the 2D iNAVs and from the data itself is integrated into a high-dimensional patchbased undersampled reconstruction technique (HD-PROST), to produce high-resolution water/fat 3D LGE images. A cohort of 20 patients with known or suspected cardiovascular disease was scanned with the proposed 3D water/fat LGE approach. 3D water LGE images were compared to conventional breath-held 2D LGE images (2-chamber, 4chamber and stack of short-axis views) in terms of image quality (1: full diagnostic to 4: non-diagnostic) and presence of LGE findings. Results: Image quality was considered diagnostic in 18/20 datasets for both 2D and 3D LGE magnitude images, with comparable image quality scores (2D: 2.05 ± 0.72, 3D: 1.88 ± 0.90, p-value = 0.62) and overall agreement in LGE findings. Acquisition time for isotropic high-resolution (1.3mm 3) water/fat LGE images was 8.0 ± 1.4 min (3-fold acceleration, 60-88 slices covering the whole heart), while 2D LGE images were acquired in 5.6 ± 2.2 min (12-18 slices, including pauses between breath-holds) albeit with a lower spatial resolution (1.40-1.75 mm in-plane × 8 mm

Type B aortic dissection increases the diameter, length and volume of the descending thoracic aorta. The predissection aortic diameter most closely resembles the post-dissection maximum diameter of the true lumen.

Objectives To evaluate an image-navigated isotropic high-resolution 3D late gadolinium enhancement (LGE) prototype sequence with compressed sensing and Dixon water-fat separation in a clinical routine setting. Material and methods Forty consecutive patients scheduled for cardiac MRI were enrolled prospectively and examined with 1.5 T MRI. Overall subjective image quality, LGE pattern and extent, diagnostic confidence for detection of LGE, and scan time were evaluated and compared to standard 2D LGE imaging. Robustness of Dixon fat suppression was evaluated for 3D Dixon LGE imaging. For statistical analysis, the non-parametric Wilcoxon rank sum test was performed. Results LGE was rated as ischemic in 9 patients and non-ischemic in 11 patients while it was absent in 20 patients. Image quality and diagnostic confidence were comparable between both techniques (p = 0.67 and p = 0.66, respectively). LGE extent with respect to segmental or transmural myocardial enhancement was identical between 2D and 3D (water-only and in-phase). LGE size was comparable (3D 8.4 ± 7.2 g, 2D 8.7 ± 7.3 g, p = 0.19). Good or excellent fat suppression was achieved in 93% of the 3D LGE datasets. In 6 patients with pericarditis, the 3D sequence with Dixon fat suppression allowed for a better detection of pericardial LGE. Scan duration was significantly longer for 3D imaging (2D median 9:32 min vs. 3D median 10:46 min, p = 0.001). Conclusion The 3D LGE sequence provides comparable LGE detection compared to 2D imaging and seems to be superior in evaluating the extent of pericardial involvement in patients suspected with pericarditis due to the robust Dixon fat suppression. Key Points • Three-dimensional LGE imaging provides high-resolution detection of myocardial scarring. • Robust Dixon water-fat separation aids in the assessment of pericardial disease. • The 2D image navigator technique enables 100% respiratory scan efficacy and permits predictable scan times.

Cardiac and respiratory motion cause image quality degradation in PET imaging, affecting diagnostic accuracy of the images. Whole-body simultaneous PET-MR scanners allow for using motion information estimated from MR images to correct PET data and produce motion-compensated PET images. This article reviews methods that have been proposed to estimate motion from MR images and different techniques to include this information in PET reconstruction, in order to overcome the problem of cardiac and respiratory motion in PET-MR imaging. MR-based motion correction techniques significantly increase lesion detectability and contrast, and also improve accuracy of uptake values in PET images.

Purpose To develop a fast and accurate method for 3D T2 mapping of prostate cancer using undersampled acquisition and dictionary‐based fitting. Methods 3D high‐resolution T2‐weighted images (0.9 × 0.9 × 3 mm3) were obtained with a multishot T2‐prepared balanced steady‐state free precession (T2‐prep‐bSSFP) acquisition sequence using a 3D variable density undersampled Cartesian trajectory. Each T2‐weighted image was reconstructed using total variation regularized sensitivity encoding. A flexible simulation framework based on extended phase graphs generated a dictionary of magnetization signals, which was customized to the proposed sequence. The dictionary was matched to the acquired T2‐weighted images to retrieve quantitative T2 values, which were then compared to gold‐standard spin echo acquisition values using monoexponential fitting. The proposed approach was validated in simulations and a T1/T2 phantom, and feasibility was tested in 8 healthy subjects. Results The simulation analysis showed that the proposed T2 mapping approach is robust to noise and typically observed T1 variations. T2 values obtained in the phantom with T2prep‐bSSFP and the acquisition‐specific, dictionary‐based matching were highly correlated with the gold‐standard spin echo method (r = 0.99). Furthermore, no differences were observed with the accelerated acquisition compared to the fully sampled acquisition (r = 0.99). T2 values obtained in prostate peripheral zone, central gland, and muscle in healthy subjects (age, 26 ± 6 years) were 97 ± 14, 76 ± 7, and 36 ± 3 ms, respectively. Conclusion 3D quantitative T2 mapping of the whole prostate can be achieved in 3 minutes.

Purpose To develop and evaluate a novel and generalizable super‐resolution (SR) deep‐learning framework for motion‐compensated isotropic 3D coronary MR angiography (CMRA), which allows free‐breathing acquisitions in less than a minute. Methods Undersampled motion‐corrected reconstructions have enabled free‐breathing isotropic 3D CMRA in ~5‐10 min acquisition times. In this work, we propose a deep‐learning–based SR framework, combined with non‐rigid respiratory motion compensation, to shorten the acquisition time to less than 1 min. A generative adversarial network (GAN) is proposed consisting of two cascaded Enhanced Deep Residual Network generator, a trainable discriminator, and a perceptual loss network. A 16‐fold increase in spatial resolution is achieved by reconstructing a high‐resolution (HR) isotropic CMRA (0.9 mm3 or 1.2 mm3) from a low‐resolution (LR) anisotropic CMRA (0.9 × 3.6 × 3.6 mm3 or 1.2 × 4.8 × 4.8 mm3). The impact and generalization of the proposed SRGAN approach to different input resolutions and operation on image and patch‐level is investigated. SRGAN was evaluated on a retrospective downsampled cohort of 50 patients and on 16 prospective patients that were scanned with LR‐CMRA in ~50 s under free‐breathing. Vessel sharpness and length of the coronary arteries from the SR‐CMRA is compared against the HR‐CMRA. Results SR‐CMRA showed statistically significant (P < .001) improved vessel sharpness 34.1% ± 12.3% and length 41.5% ± 8.1% compared with LR‐CMRA. Good generalization to input resolution and image/patch‐level processing was found. SR‐CMRA enabled recovery of coronary stenosis similar to HR‐CMRA with comparable qualitative performance. Conclusion The proposed SR‐CMRA provides a 16‐fold increase in spatial resolution with comparable image quality to HR‐CMRA while reducing the predictable scan time to <1 min.

PurposeCardiac PET-MR has shown potential for the comprehensive assessment of coronary heart disease. However, image degradation due to physiological motion remains a challenge that could hinder the adoption of this technology in clinical practice. The purpose of this study was to validate a recently proposed respiratory motion-corrected PET-MR framework for the simultaneous visualisation of myocardial viability (18F-FDG PET) and coronary artery anatomy (coronary MR angiography, CMRA) in patients with chronic total occlusion (CTO).MethodsA cohort of 14 patients was scanned with the proposed PET-CMRA framework. PET and CMRA images were reconstructed with and without the proposed motion correction approach for comparison purposes. Metrics of image quality including visible vessel length and sharpness were obtained for CMRA for both the right and left anterior descending coronary arteries (RCA, LAD), and relative increase in 18F-FDG PET signal after motion correction for standard 17-segment polar maps was computed. Resulting coronary anatomy by CMRA and myocardial integrity by PET were visually compared against X-ray angiography and conventional Late Gadolinium Enhancement (LGE) MRI, respectively.ResultsMotion correction increased CMRA visible vessel length by 49.9% and 32.6% (RCA, LAD) and vessel sharpness by 12.3% and 18.9% (RCA, LAD) on average compared to uncorrected images. Coronary lumen delineation on motion-corrected CMRA images was in good agreement with X-ray angiography findings. For PET, motion correction resulted in an average 8% increase in 18F-FDG signal in the inferior and inferolateral segments of the myocardial wall. An improved delineation of myocardial viability defects and reduced noise in the 18F-FDG PET images was observed, improving correspondence to subendocardial LGE-MRI findings compared to uncorrected images.ConclusionThe feasibility of the PET-CMRA framework for simultaneous cardiac PET-MR imaging in a short and predictable scan time (~11 min) has been demonstrated in 14 patients with CTO. Motion correction increased visible length and sharpness of the coronary arteries by CMRA, and improved delineation of the myocardium by 18F-FDG PET, resulting in good agreement with X-ray angiography and LGE-MRI.