High-Resolution Free-Breathing Quantitative First-Pass Perfusion Cardiac MR Using Dual-Echo Dixon With Spatio-Temporal Acceleration

Joao Tourais; Cian M Scannell; Torben Schneider; Ebraham Alskaf; Richard Crawley; Filippo Bosio; Javier Sanchez-Gonzalez; Mariya Doneva; Christophe Schülke; Jakob Meineke; Jochen Keupp; Jouke Smink; Marcel Breeuwer; Amedeo Chiribiri; Markus Henningsson; Teresa Correia

doi:10.3389/fcvm.2022.884221

High-Resolution Free-Breathing Quantitative First-Pass Perfusion Cardiac MR Using Dual-Echo Dixon With Spatio-Temporal Acceleration

Front Cardiovasc Med. 2022 Apr 29:9:884221. doi: 10.3389/fcvm.2022.884221. eCollection 2022.

Authors

Joao Tourais^{1

2

3}, Cian M Scannell⁴, Torben Schneider⁵, Ebraham Alskaf⁴, Richard Crawley⁴, Filippo Bosio⁴, Javier Sanchez-Gonzalez⁶, Mariya Doneva⁷, Christophe Schülke⁷, Jakob Meineke⁷, Jochen Keupp⁷, Jouke Smink¹, Marcel Breeuwer^{1

2}, Amedeo Chiribiri⁴, Markus Henningsson^{4

8

9}, Teresa Correia^{4

10}

Affiliations

¹ Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.
² Department of MR R&D - Clinical Science, Philips Healthcare, Best, Netherlands.
³ Department of Imaging Physics, Magnetic Resonance Systems Lab, Delft University of Technology, Delft, Netherlands.
⁴ School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.
⁵ Philips Healthcare, Guildford, United Kingdom.
⁶ Philips Healthcare Iberia, Madrid, Spain.
⁷ Philips Research, Hamburg, Germany.
⁸ Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden.
⁹ Center for Medical Image Science and Visualization (CMIV), Linkoping University, Linkoping, Sweden.
¹⁰ Centre for Marine Sciences (CCMAR), Faro, Portugal.

Abstract

Introduction: To develop and test the feasibility of free-breathing (FB), high-resolution quantitative first-pass perfusion cardiac MR (FPP-CMR) using dual-echo Dixon (FOSTERS; Fat-water separation for mOtion-corrected Spatio-TEmporally accelerated myocardial peRfuSion).

Materials and methods: FOSTERS was performed in FB using a dual-saturation single-bolus acquisition with dual-echo Dixon and a dynamically variable Cartesian k-t undersampling (8-fold) approach, with low-rank and sparsity constrained reconstruction, to achieve high-resolution FPP-CMR images. FOSTERS also included automatic in-plane motion estimation and T $_{2}^{*}$ correction to obtain quantitative myocardial blood flow (MBF) maps. High-resolution (1.6 x 1.6 mm²) FB FOSTERS was evaluated in eleven patients, during rest, against standard-resolution (2.6 x 2.6 mm²) 2-fold SENSE-accelerated breath-hold (BH) FPP-CMR. In addition, MBF was computed for FOSTERS and spatial wavelet-based compressed sensing (CS) reconstruction. Two cardiologists scored the image quality (IQ) of FOSTERS, CS, and standard BH FPP-CMR images using a 4-point scale (1-4, non-diagnostic - fully diagnostic).

Results: FOSTERS produced high-quality images without dark-rim and with reduced motion-related artifacts, using an 8x accelerated FB acquisition. FOSTERS and standard BH FPP-CMR exhibited excellent IQ with an average score of 3.5 ± 0.6 and 3.4 ± 0.6 (no statistical difference, p > 0.05), respectively. CS images exhibited severe artifacts and high levels of noise, resulting in an average IQ score of 2.9 ± 0.5. MBF values obtained with FOSTERS presented a lower variance than those obtained with CS.

Discussion: FOSTERS enabled high-resolution FB FPP-CMR with MBF quantification. Combining motion correction with a low-rank and sparsity-constrained reconstruction results in excellent image quality.

Keywords: Dixon; free-breathing; high-resolution; motion correction; myocardial perfusion; quantitative myocardial blood flow.

Grants and funding

203148/Z/16/Z/WT_/Wellcome Trust/United Kingdom