Motion-corrected 3D whole-heart water-fat high-resolution late gadolinium enhancement cardiovascular magnetic resonance imaging

Abstract

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

Clinical comparison of sub-mm high-resolution non-contrast coronary CMR angiography against coronary CT angiography in patients with low-intermediate risk of coronary artery disease: a single center trial

“…The cine images were used to determine the optimal patient-specific trigger delay and image acquisition window during the mid-diastolic rest period that corresponds with minimized motion of the visualized right coronary artery. Thereafter, an undersampled free-breathing 3D whole-heart ECG-triggered, bSSFP sequence with a 3D variable density spiral-like Cartesian trajectory with golden-angle rotation was employed [ 18 ]. A low-resolution 2D image navigator (iNAV) preceded each spiral-like interleave to allow for 100% respiratory scan efficiency, predictable scan time and 2D translational motion correction of the heart on a beat-to-beat basis.…”

“…An adiabatic T2 preparation pulse (duration = 40 ms) [ 20 , 21 ] was played out at each heartbeat in order to enhance the contrast between blood and cardiac muscle and avoid the use of extracellular contrast agents. The image reconstruction framework consists of 3 different steps (i) beat-to-beat respiratory binning and intra-bin translational motion correction using iNAV; (ii) bin-to-bin 3D non-rigid motion estimation; and (iii) non-rigid motion-corrected 3D patch-based low-rank reconstruction (PROST) [ 18 ]. A schematic overview of the coronary CMRA framework is shown in Fig.…”

“…Recent innovations in cardiovascular magnetic resonance (CMR) technology including respiratory self-gating, trajectory-design, motion-corrected undersampled reconstruction and simplified scan planning have reinvigorated the clinical potential of coronary CMRA [ 12 – 17 ]. Leveraging these breakthroughs, we recently introduced a novel 3D free-breathing, non-contrast, ionizing radiation-free whole-heart coronary CMRA with 100% respiratory scan efficiency at sub-millimeter (≈ 0.9 mm 3 ) spatial-resolution in a clinically feasible acquisition time of ≈ 10 min [ 18 ]. With this clinical study, we sought to investigate whether this novel coronary CMRA framework could reliably assess for significant CAD in patients at low to intermediate risk against the non-invasive clinical reference standard of coronary CTA.…”

Clinical application of free-breathing 3D whole heart late gadolinium enhancement cardiovascular magnetic resonance with high isotropic spatial resolution using Compressed SENSE

“…Further, they are hampered by long breath-hold duration, hence widely unsuitable for clinical routine [15,16]. When applying different techniques for navigator-gating such as respiratory bellows signal [17], respiratory self-navigation [18][19][20], and diaphragmatic pencil-beam navigation [3] to reduce respiratory artifacts, 3D LGE can be performed during free-breathing enabling 3D assessment of the whole heart with higher spatial resolution [21][22][23][24]. Nevertheless, free-breathing 3D LGE techniques suffer from long imaging time, especially when aiming to provide readouts with submillimetre high isotropic spatial resolution [24][25][26].…”

Comparison of free breathing 3D mDIXON with single breath-hold 3D inversion recovery sequences for the assessment of Late Gadolinium Enhancement

“…Advances in image navigator techniques that allow respiratory motion correction of the heart have a high potential in reducing such errors [20]. Furthermore, the use of non-cartesian trajectories such as stack of spirals, can effectively reduce respiratory ghosting artifacts due to their inherent robustness to motion [26].…”