Feasibility of online non-rigid motion correction for high-resolution supine breast MRI.

PURPOSE: Conventional breast MRI is performed in the prone position with a dedicated coil. This allows high-resolution images without breast motion, but the patient position is inconsistent with that of other breast imaging modalities or interventions. Supine breast MRI may be an interesting alternative, but respiratory motion becomes an issue. Motion correction methods have typically been performed offline, for instance, the corrected images were not directly accessible from the scanner console. In this work, we seek to show the feasibility of a fast, online, motion-corrected reconstruction integrated into the clinical workflow. METHODS: Fully sampled T2 -weighted (T2 w) and accelerated T1 -weighted (T1 w) breast supine MR images were acquired during free-breathing and were reconstructed using a non-rigid motion correction technique (generalized reconstruction by inversion of coupled systems). Online reconstruction was implemented using a dedicated system combining the MR raw data and respiratory signals from an external motion sensor. Reconstruction parameters were optimized on a parallel computing platform, and image quality was assessed by objective metrics and by radiologist scoring. RESULTS: Online reconstruction time was 2 to 2.5 min. The metrics and the scores related to the motion artifacts significantly improved for both T2 w and T1 w sequences. The overall quality of T2 w images was approaching that of the prone images, whereas the quality of T1 w images remained significantly lower. CONCLUSION: The proposed online algorithm allows a noticeable reduction of motion artifacts and an improvement of the diagnostic quality for supine breast imaging with a clinically acceptable reconstruction time. These findings serve as a starting point for further development aimed at improving the quality of T1 w images.

A hardware and software system for MRI applications requiring external device data.

PURPOSE: Numerous MRI applications require data from external devices. Such devices are often independent of the MRI system, so synchronizing these data with the MRI data is often tedious and limited to offline use. In this work, a hardware and software system is proposed for acquiring data from external devices during MR imaging, for use online (in real-time) or offline. METHODS: The hardware includes a set of external devices - electrocardiography (ECG) devices, respiration sensors, microphone, electronics of the MR system etc. - using various channels for data transmission (analog, digital, optical fibers), all connected to a server through a universal serial bus (USB) hub. The software is based on a flexible client-server architecture, allowing real-time processing pipelines to be configured and executed. Communication protocols and data formats are proposed, in particular for transferring the external device data to an open-source reconstruction software (Gadgetron), for online image reconstruction using external physiological data. The system performance is evaluated in terms of accuracy of the recorded signals and delays involved in the real-time processing tasks. Its flexibility is shown with various applications. RESULTS: The real-time system had low delays and jitters (on the order of 1 ms). Example MRI applications using external devices included: prospectively gated cardiac cine imaging, multi-modal acquisition of the vocal tract (image, sound, and respiration) and online image reconstruction with nonrigid motion correction. CONCLUSION: The performance of the system and its versatile architecture make it suitable for a wide range of MRI applications requiring online or offline use of external device data.

Coupled transfer function model for the evaluation of implanted cables safety in MRI.

PURPOSE: Multiple medical-device leads implanted next to each other are often encountered in clinical practice. The aim of this work is to study a coupled transfer function model to evaluate the safety of these coupled leads submitted to the RF field of a 1.5T MRI scanner for a constant distance between both leads. METHODS: The effect of coupling on the heating of 2 cables with different termination conditions is evaluated experimentally. The coupled and single transfer functions are determined experimentally and used to predict the relative temperature increases of both cables alone and coupled. Two different coupled models, an additive model and a global model, are proposed. The coupled transfer functions are also simulated. RESULTS: The coupling between cables has a strong influence on the resulting heating at the electrodes. The coupled additive transfer function model is a relevant tool to evaluate the heating of coupled leads separated by a constant distance. The global model underestimates the heating in one of the coupled cases by about 30%. The measured coupled transfer functions coincide with the simulated models. CONCLUSION: It is necessary to take into account the coupling effect between leads to evaluate the safety of implanted devices. This work shows that, in the case of 2 cables separated by a constant distance, that an experimentally determined coupled transfer function allows estimation of the heating of the 2 electrodes for a given incident field. Further work should take into account the in vivo varying distance between the 2 cables.

One-millimeter isotropic breast diffusion-weighted imaging: Evaluation of a superresolution strategy in terms of signal-to-noise ratio, sharpness and apparent diffusion coefficient.

PURPOSE: To quantitatively evaluate a superresolution technique for 3D, one-millimeter isotropic diffusion-weighted imaging (DWI) of the whole breasts. METHODS: Isotropic 3D DWI datasets are obtained using a combination of (i) a readout-segmented diffusion-weighted-echo-planar imaging (DW-EPI) sequence (rs-EPI), providing high in-plane resolution, and (ii) a superresolution (SR) strategy, which consists of acquiring 3 datasets with thick slices (3 mm) and 1-mm shifts in the slice direction, and combining them into a 1 × 1 × 1-mm3 dataset using a dedicated reconstruction. Two SR reconstruction schemes were investigated, based on different regularization schemes: conventional Tikhonov or Beltrami (an edge-preserving constraint). The proposed SR strategy was compared to native 1 × 1 × 1-mm3 acquisitions (i.e. with 1-mm slice thickness) in 8 healthy subjects, in terms of signal-to-noise ratio (SNR) efficiency, using a theoretical framework, Monte Carlo simulations and region-of-interest (ROI) measurements, and image sharpness metrics. Apparent diffusion coefficient (ADC) values in normal breast tissue were also compared. RESULTS: The SR images resulted in an SNR gain above 3 compared to native 1 × 1 × 1-mm3 using the same acquisition duration (acquisition gain 3 and reconstruction gain >1). Beltrami-SR provided the best results in terms of SNR and image sharpness. The ADC values in normal breast measured from Beltrami-SR were preserved compared to low-resolution images (1.91 versus 1.97 ×10-3 mm2 /s, P = .1). CONCLUSION: A combination of rs-EPI and SR allows 3D, 1-mm isotropic breast DWI data to be obtained with better SNR than a native 1-mm isotropic acquisition. The proposed DWI protocol might be of interest for breast cancer monitoring/screening without injection.

Isotropic 3D cardiac cine MRI allows efficient sparse segmentation strategies based on 3D surface reconstruction.

PURPOSE: Segmentation of cardiac cine MRI data is routinely used for the volumetric analysis of cardiac function. Conventionally, 2D contours are drawn on short-axis (SAX) image stacks with relatively thick slices (typically 8 mm). Here, an acquisition/reconstruction strategy is used for obtaining isotropic 3D cine datasets; reformatted slices are then used to optimize the manual segmentation workflow. METHODS: Isotropic 3D cine datasets were obtained from multiple 2D cine stacks (acquired during free-breathing in SAX and long-axis (LAX) orientations) using nonrigid motion correction (cine-GRICS method) and super-resolution. Several manual segmentation strategies were then compared, including conventional SAX segmentation, LAX segmentation in three views only, and combinations of SAX and LAX slices. An implicit B-spline surface reconstruction algorithm is proposed to reconstruct the left ventricular cavity surface from the sparse set of 2D contours. RESULTS: All tested sparse segmentation strategies were in good agreement, with Dice scores above 0.9 despite using fewer slices (3-6 sparse slices instead of 8-10 contiguous SAX slices). When compared to independent phase-contrast flow measurements, stroke volumes computed from four or six sparse slices had slightly higher precision than conventional SAX segmentation (error standard deviation of 5.4 mL against 6.1 mL) at the cost of slightly lower accuracy (bias of -1.2 mL against 0.2 mL). Functional parameters also showed a trend to improved precision, including end-diastolic volumes, end-systolic volumes, and ejection fractions). CONCLUSION: The postprocessing workflow of 3D isotropic cardiac imaging strategies can be optimized using sparse segmentation and 3D surface reconstruction. Magn Reson Med 79:2665-2675, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Calibration and non-orthogonality correction of three-axis Hall sensors for the monitoring of MRI workers' exposure to static magnetic fields.

A Magnetic Resonance Imaging (MRI) scanner uses three different electromagnetic fields (EMF) to produce body images: a static permanent magnetic field (MF), several pulsed magnetic gradients, and a radiofrequency pulse. As a result, any occupation that includes an MRI exposes workers to a strong MF. The World Health Organization has now given the monitoring of occupational EMF exposure a high priority. One design for a low-cost, compact MF exposure monitor (« MR exposimeter ¼) uses a set of three orthogonally assembled Hall sensors. However, at such a strong EMF exposure intensity, the non-linearity and non-orthogonality (misalignment between the three Hall sensors) have an impact on the accuracy of EMF measurement. Therefore, a sensor characterization was performed in order to link Hall-effect output voltage to MF intensity. The sensor was then calibrated using an orthogonalization matrix and an offset vector. For each sensor configuration, the matrix and vector parameters were optimized with a calibration set generated by the movement of a three-axis sensor inside homogeneous MF areas. Once calibrated, the sensor was tested at different MF intensities and returned accuracy improvements. This calibration procedure was tested on synthetic data and performed on experimental data. The calibration parameters can be easily reused by the user, and their stability could be used as a quality control sensor. Finally, real-time monitoring test for static MF exposure was completed and validated on an MRI worker during a typical working day. Bioelectromagnetics. 39:108-119, 2018. © 2018 Wiley Periodicals, Inc.

Chronic urinary obstruction: evaluation of dynamic contrast-enhanced MR urography for measurement of split renal function.

PURPOSE: To evaluate if measurement of split renal function ( SRF split renal function ) with dynamic contrast material-enhanced ( DCE dynamic contrast enhanced ) magnetic resonance (MR) urography is equivalent to that with renal scintigraphy ( RS renal scintigraphy ) in patients suspected of having chronic urinary obstruction. MATERIALS AND METHODS: The study protocol was approved by the institutional ethics committee of the coordinating center on behalf of all participating centers. Informed consent was obtained from all adult patients or both parents of children. This prospective, comparative study included 369 pediatric and adult patients from 14 university hospitals who were suspected of having chronic or intermittent urinary obstruction, and data from 295 patients with complete data were used for analysis. SRF split renal function was measured by using the area under the curve and the Patlak-Rutland methods, including successive review by a senior and an expert reviewer and measurement of intra- and interobserver agreement for each technique. An equivalence test for mean SRF split renal function was conducted with an α of 5%. RESULTS: Reproducibility was substantial to almost perfect for both methods. Equivalence of DCE dynamic contrast enhanced MR urography and RS renal scintigraphy for measurement of SRF split renal function was shown in patients with moderately dilated kidneys (P < .001 with the Patlak-Rutland method). However, in severely dilated kidneys, the mean SRF split renal function measurement was underestimated by 4% when DCE dynamic contrast enhanced MR urography was used compared with that when RS renal scintigraphy was used. Age and type of MR imaging device had no significant effect. CONCLUSION: For moderately dilated kidneys, equivalence of DCE dynamic contrast enhanced MR urography to RS renal scintigraphy was shown, with a standard deviation of approximately 12% between the techniques, making substitution of DCE dynamic contrast enhanced MR urography for RS renal scintigraphy acceptable. For severely dilated kidneys, a mean underestimation of SRF split renal function of 4% should be expected with DCE dynamic contrast enhanced MR urography, making substitution questionable.

Longitudinal myocardial peak velocities using high temporal resolution phase-contrast and simple averaging are comparable to tissue Doppler echocardiography.

OBJECT: Phase contrast imaging is widely used to measure blood velocity. However tissue Doppler imaging (TDI) echocardiography is the reference for myocardial velocity assessment. This study aims at validating the ability of phase contrast (PC) sequences to correctly assess myocardial velocities and to compare these velocities to TDI. The phase contrast sequence was performed with breath-hold parameters and with parameters tuned to increase temporal resolution in free breathing. MATERIALS AND METHODS: Left and Right auriculo-ventricular annuluses longitudinal velocities were recorded on six healthy volunteers with different temporal resolutions (TDI: 5 ms, breath-hold PC: 94 ms and free-breathing PC: 19 ms). Free-breathing PC was obtained by averaging of three excitations. Amplitudes of four standard echocardiographic and clinically relevant myocardial longitudinal velocity waves were compared: Early filling and auricular, systolic and isovolumic contractions. RESULTS: Isovolumic contraction waves were only visible with free-breathing PC and TDI. The differences with the reference TDI wave velocities were lower (p = 0.02) for free-breathing PC (19.2 ± 2.6%) than for breath-hold PC (28.1 ± 2.9%). These differences for free-breathing PC were close to (p = 0.21) the coefficient of variation of the measurements provided by TDI (14.8 ± 1.2%). CONCLUSION: Myocardial longitudinal peak velocities can be assessed with a PC sequence tuned to optimize temporal resolution.

Surface-length index: a novel index for rapid detection of right ventricles with abnormal ejection fraction using cardiac MRI.

OBJECTIVE: To validate a new index, the surface-length index (SLI) based on area change in a short-axis view and length reduction in the horizontal long-axis view, which is used to quickly (<1 min) detect right ventricles with an abnormal ejection fraction (EF) during a cardiac MRI examination. SLI can be used to avoid a complete delineation of the endocardial contours of normal right ventricles. METHODS: Sixty patients (group A) were retrospectively included to calibrate the SLI formula by optimisation of the area under the ROC curves and SLI thresholds were chosen to obtain 100 % sensitivity. Another 340 patients (group B) were prospectively recruited to test SLI's capacity to detect right ventricles (RVs) with an abnormal EF (<0.5). RESULTS: The appropriate threshold to obtain 100 % sensitivity in group A was 0.58. In group B, with the 0.58 threshold, SLI yielded a sensitivity of 100 % and specificity of 51 %. SLI would have saved 35 % of the RV studies in our population, without inducing any diagnostic error. SLI and EF correlation was good (r (2) = 0.64). CONCLUSION: SLI combines two simple RV measures, and brings significant improvement in post-processing efficiency by preselecting RVs that require a complete study. KEY POINTS: • Assessment of right ventricle ejection fraction (RVEF) with cine-MRI is time consuming. • Therefore, RVEF is not always assessed during cardiac MRI. • Surface-length index (SLI) allows rapid detection of abnormal RVEF during cardiac MRI. • SLI saves one third of the operator time. • Every cardiac MRI could include RVEF assessment by means of SLI.

Methodology for quantitative evaluation of mandibular condyles motion symmetricity from real-time MRI in the axial plane.

Diagnosis of temporomandibular disorders is currently based on clinical examination and static MRI. Real-time MRI enables tracking of condylar motion and, thus, evaluation of their motion symmetricity (which could be associated with temporomandibular joint disorders). The purpose of this work is to propose an acquisition protocol, an image processing approach, and a set of parameters enabling objective assessment of motion asymmetry; to check the reliability and find the limitations of the approach, and to verify if the automatically calculated parameters are associated with the motion symmetricity. A rapid radial FLASH sequence was used to acquire a dynamic set of axial images for 10 subjects. One more subject was involved to estimate the dependence of the motion parameters on the slice placement. The images were segmented with a semi-automatic approach based on U-Net convolutional neural network, and the condyles' mass centers were projected on the mid-sagittal axis. Resulting projection curves were used for the extraction of various motion parameters including latency, velocity peak delay, and maximal displacement between the right and the left condyle. These automatically calculated parameters were compared with the physicians' scores. The proposed segmentation approach allowed a reliable center of mass tracking. Latency and velocity peak delay were found to be invariant to the slice position, and maximal displacement difference considerably varied. The automatically calculated parameters demonstrated a significant correlation with the experts' scores. The proposed acquisition and data processing protocol enables the automatizable extraction of quantitative parameters that characterize the symmetricity of condylar motion.

Super-Resolved Dynamic 3D Reconstruction of the Vocal Tract during Natural Speech.

MRI is the gold standard modality for speech imaging. However, it remains relatively slow, which complicates imaging of fast movements. Thus, an MRI of the vocal tract is often performed in 2D. While 3D MRI provides more information, the quality of such images is often insufficient. The goal of this study was to test the applicability of super-resolution algorithms for dynamic vocal tract MRI. In total, 25 sagittal slices of 8 mm with an in-plane resolution of 1.6 × 1.6 mm2 were acquired consecutively using a highly-undersampled radial 2D FLASH sequence. The volunteers were reading a text in French with two different protocols. The slices were aligned using the simultaneously recorded sound. The super-resolution strategy was used to reconstruct 1.6 × 1.6 × 1.6 mm3 isotropic volumes. The resulting images were less sharp than the native 2D images but demonstrated a higher signal-to-noise ratio. It was also shown that the super-resolution allows for eliminating inconsistencies leading to regular transitions between the slices. Additionally, it was demonstrated that using visual stimuli and shorter text fragments improves the inter-slice consistency and the super-resolved image sharpness. Therefore, with a correct speech task choice, the proposed method allows for the reconstruction of high-quality dynamic 3D volumes of the vocal tract during natural speech.

Assessment of right ventricle volumes and function by cardiac MRI: quantification of the regional and global interobserver variability.

Reproducibility of the manual assessment of right ventricle volumes by short-axis cine-MRI remains low and is often attributed to the difficulty in separating the right atrium from the ventricle. This study was designed to evaluate the regional interobserver variability of the right ventricle volume assessment to identify segmentation zones with the highest interobserver variability. Short-axis views of 90 right ventricles (30 hypertrophic, 30 dilated, and 30 normal) were acquired with 2D steady-state free precession sequences at 1.5 T and were manually segmented by two observers. The two segmentations were compared and the variations were quantified with a variation score based on the Hausdorff distance between the two segmentations and the interobserver 95% limits of concordance of the global volumes. The right ventricles were semiautomatically split into four subregions: apex, mid-ventricle, tricuspid zone, and infundibulum. These four subregions represented 11%, 34%, 36%, and 19% of the volume but, respectively, yielded variation scores of 8%, 16%, 42%, and 34%. The infundibulum yielded the highest interobserver regional variability although its variation score remained comparable to the tricuspid zone due to its lower volume. These results emphasize the importance of standardizing the segmentation of the infundibulum and the tricuspid zone to improve reproducibility.

Free-breathing imaging of the heart using 2D cine-GRICS (generalized reconstruction by inversion of coupled systems) with assessment of ventricular volumes and function.

PURPOSE: To assess cardiac function by means of a novel free-breathing cardiac magnetic resonance imaging (MRI) strategy. MATERIALS AND METHODS: A stack of ungated 2D steady-state free precession (SSFP) slices was acquired during free breathing and reconstructed as cardiac cine imaging based on the generalized reconstruction by inversion of coupled systems (GRICS). A motion-compensated sliding window approach allows reconstructing cine movies with most motion artifacts cancelled. The proposed reconstruction uses prior knowledge from respiratory belts and electrocardiogram recordings and features a piecewise linear model that relates the electrocardiogram signal to cardiac displacements. The free-breathing protocol was validated in six subjects against a standard breath-held protocol. RESULTS: Image sharpness, as assessed by the image gradient entropy, was comparable to that of breath-held images and significantly better than in uncorrected images. Volumetric parameters of cardiac function in the left ventricle (LV) and right ventricle (RV) were similar, including end-systolic volumes, end-diastolic volumes and mass, stroke volumes, and ejection fractions (with differences of 3% ± 2.4 in the LV and 2.9% ± 4.4 in the RV). The duration of the free-breathing protocol was nearly the same as the breath-held protocol. CONCLUSION: Free-breathing cine-GRICS enables accurate assessment of volumetric parameters of cardiac function with efficient correction of motion.

3D Dynamic Spatiotemporal Atlas of the Vocal Tract during Consonant-Vowel Production from 2D Real Time MRI.

In this work, we address the problem of creating a 3D dynamic atlas of the vocal tract that captures the dynamics of the articulators in all three dimensions in order to create a global speaker model independent of speaker-specific characteristics. The core steps of the proposed method are the temporal alignment of the real-time MR images acquired in several sagittal planes and their combination with adaptive kernel regression. As a preprocessing step, a reference space was created to be used in order to remove anatomical information of the speakers and keep only the variability in speech production for the construction of the atlas. The adaptive kernel regression makes the choice of atlas time points independently of the time points of the frames that are used as an input for the construction. The evaluation of this atlas construction method was made by mapping two new speakers to the atlas and by checking how similar the resulting mapped images are. The use of the atlas helps in reducing subject variability. The results show that the use of the proposed atlas can capture the dynamic behavior of the articulators and is able to generalize the speech production process by creating a universal-speaker reference space.

Multimodal dataset of real-time 2D and static 3D MRI of healthy French speakers.

The study of articulatory gestures has a wide spectrum of applications, notably in speech production and recognition. Sets of phonemes, as well as their articulation, are language-specific; however, existing MRI databases mostly include English speakers. In our present work, we introduce a dataset acquired with MRI from 10 healthy native French speakers. A corpus consisting of synthetic sentences was used to ensure a good coverage of the French phonetic context. A real-time MRI technology with temporal resolution of 20 ms was used to acquire vocal tract images of the participants speaking. The sound was recorded simultaneously with MRI, denoised and temporally aligned with the images. The speech was transcribed to obtain phoneme-wise segmentation of sound. We also acquired static 3D MR images for a wide list of French phonemes. In addition, we include annotations of spontaneous swallowing.

Reconstruction from free-breathing cardiac MRI data using reproducing kernel Hilbert spaces.

This paper describes a rigorous framework for reconstructing MR images of the heart, acquired continuously over the cardiac and respiratory cycle. The framework generalizes existing techniques, commonly referred to as retrospective gating, and is based on the properties of reproducing kernel Hilbert spaces. The reconstruction problem is formulated as a moment problem in a multidimensional reproducing kernel Hilbert spaces (a two-dimensional space for cardiac and respiratory resolved imaging). Several reproducing kernel Hilbert spaces were tested and compared, including those corresponding to commonly used interpolation techniques (sinc-based and splines kernels) and a more specific kernel allowed by the framework (based on a first-order Sobolev RKHS). The Sobolev reproducing kernel Hilbert spaces was shown to allow improved reconstructions in both simulated and real data from healthy volunteers, acquired in free breathing.

Adaptive black blood fast spin echo for end-systolic rest cardiac imaging.

Black Blood Fast Spin Echo imaging of the heart is usually performed during mid-diastolic rest. This is a direct consequence of the long inversion time required to suppress the blood signal, which is constrained by the T(1) of the blood, and of the heart rate. To overcome these constraints, and to acquire black blood images in the end-systolic rest period, a new approach is introduced aiming at adaptively predicting the best time to prepare and acquire MR signals. It is based on a RR interval prediction algorithm and on a cardiac cycle model. The proposed method was applied to 14 healthy volunteers and is compared to a simple alternative method using a fixed delay and to the standard black blood imaging method for imaging in the mid-diastolic rest period. Results show that the proposed method offers an increased robustness in terms of trigger delay error and image quality compared to the tested simple alternative. Also, it has been shown by qualitative analysis done by an experienced observer that the right ventricle, especially the thin right ventricle free wall, is better depicted with our method than with the standard mid-diastolic rest acquisition.

Measurement of Tongue Tip Velocity from Real-Time MRI and Phase-Contrast Cine-MRI in Consonant Production.

We evaluate velocity of the tongue tip with magnetic resonance imaging (MRI) using two independent approaches. The first one consists in acquisition with a real-time technique in the mid-sagittal plane. Tracking of the tongue tip manually and with a computer vision method allows its trajectory to be found and the velocity to be calculated as the derivative of the coordinate. We also propose to use another approach-phase contrast MRI-which enables velocities of the moving tissues to be measured directly. We recorded the sound simultaneously with the MR acquisition which enabled us to make conclusions regarding the relation between the movements and the sound. We acquired the data from two French-speaking subjects articulating /tata/. The results of both methods are in qualitative agreement and are consistent with other reviewer techniques used for evaluation of the tongue tip velocity.