ISMRM 24th Annual Meeting & Exhibition • 07-13 May 2016 • Singapore

Scientific Session: CV Innovations

Tuesday, May 10, 2016
Room 334-336
13:30 - 15:30
Moderators: Rene Botnar, Mathias Stuber

3D black-blood thrombus imaging (BTI) for the diagnosis of deep vein thrombosis: initial clinical experience
Guoxi Xie1, Hanwei Chen2, Zhuonan He2, Jianke Liang2, Xueping He2, Qi Yang3,4, Xin Liu1, Debiao Li3, and Zhaoyang Fan3
1Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China, People's Republic of, 2Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China, People's Republic of, 3Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, 4Xuanwu Hospital, Beijing, China, People's Republic of
Deep vein thrombosis (DVT) is a common but elusive illness that can lead to fatal pulmonary embolism and sudden death. Effective treatment of DVT requires accurate evaluation of thrombus distribution and stage. n this work, we further accommodated the DANTE-SPACE technique to the deep vein system and conducted preliminary clinical validation. Experiment results demonstrated that DANTE-SPACE could provide excellent venous blood signal suppression and definitive thrombus detection and the technique may outperform conventional SPACE, MPRAGE, and and become a non-contrast alternative to CEMRV for the diagnosis of DVT.

A Combined Saturation and Imaging RF-Pulse for Fast and Continuous Black-Blood Preparation in Dynamic Imaging
Simon Reiss1, Axel Joachim Krafft1,2,3, Marius Menza1, Constantin von zur Mühlen4, and Michael Bock1
1Dept. of Radiology - Medical Physics, University Medical Center Freiburg, Freiburg, Germany, 2German Cancer Consortium (DKTK), University Medical Center Freiburg, Heidelberg, Germany, 3German Cancer Research Center (DKFZ), Heidelberg, Germany, 4Department of Cardiology and Angiology I, University Heart Center, Freiburg, Germany
Black-blood preparation is a tool for improved contrast generation in cardiovascular MRI to assess vessel wall constitution, to delineate plaques and to characterize myocardial tissue. Conventionally, black-blood MRI can be done with dual inversion recovery pulses so that selective signal nulling of the inflowing blood is achieved. The inversion delays required to establish the black-blood contrast can be favorably integrated into ECG-triggered diastolic cardiac measurements, but they are by far too time-consuming for dynamic measurements that cover the total cardiac cycle. In this work we investigate the use of conventional saturation pulses for black-blood imaging. We propose a very time-efficient pulse implementation that combines the saturation and the imaging RF pulse into a single pulse structure and enables black-blood contrast in dynamic measurements.

A Novel Method for Contact-Free Cardiac Synchronization Using the Pilot Tone Navigator - Permission Withheld
Lea Schroeder1, Jens Wetzl1,2, Andreas Maier1,2, Lars Lauer3, Jan Bollenbeck4, Matthias Fenchel3, and Peter Speier3
1Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany, 2Erlangen Graduate School in Advanced Optical Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany, 3Magnetic Resonance, Product Definition and Innovation, Siemens Healthcare GmbH, Erlangen, Germany, 4Magnetic Resonance, Research and Development, Hardware, Siemens Healthcare GmbH, Erlangen, Germany
We evaluate the information content of externally generated Pilot Tone signals, received with standard MR local coils, with respect to cardiac motion. Free-breathing and breathhold fluoroscopic measurements were performed with applied electrocardiogram leads to provide ground truth. Average mean correlation between RR intervals of our method and the ground truth was 0.95. Our early results indicate that locally generated PT signals contain information about cardiac motion and suggest that the proposed method could be developed into an electrocardiogram replacement by providing a continuous signal for retrospective gating with minimal hardware requirements.

Free-Breathing, Self-Navigated Isotropic 3-D CINE Imaging of the Whole Heart Using Cartesian Sampling
Jens Wetzl1,2, Felix Lugauer1, Michaela Schmidt3, Andreas Maier1,2, Joachim Hornegger1,2, and Christoph Forman3
1Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany, 2Erlangen Graduate School in Advanced Optical Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany, 3Magnetic Resonance, Product Definition and Innovation, Siemens Healthcare GmbH, Erlangen, Germany
We present a method for free-breathing, isotropic 3-D CINE imaging of the whole heart, demonstrated with experiments in 7 healthy volunteers. Respiratory information for retrospective gating is derived directly from the imaging data. Ventricular function parameters were compared to reference 2-D CINE acquisitions. Excellent image quality and match to ground truth ventricular function parameters could be achieved in an acquisition time similar to multi-slice 2-D CINE with equivalent coverage. Cartesian sampling combined with dual-GPU acceleration enabled a fast reconstruction in under 5 minutes for left-ventricular and under 7 minutes for whole heart coverage.

Using intrinsic Cardiac Shear Waves to measure Myocardial Stiffness: Initial results on a Patient Cohort with Heart failure with preserved Ejection Fraction
Jessica Webb1, Ondrej Holub1, Rachel Clough1, Gerald Carr-White2, Reza Razavi1, and Ralph Sinkus1
1King's College London, London, United Kingdom, 2Guys and St Thomas' NHS Trust, London, United Kingdom
Heart Failure with preserved Ejection Fraction (HFpEF) is common and associated with high morbidity and mortality. There are challenges in diagnosing HFpEF and a non invasive technique to detect myocardial stiffness would have an enormous clinical impact.  


We have developed a novel non invasive technique to quantify myocardial stiffness in vivo using transient Magnetic Resonance Elastography (tMRE). The technique relies on accurately identifying the aortic valve closure time. The speed of the propagating shear wave, created by the valve closure, is measured using a short navigated free breathing MRI sequence. Increased myocardial stiffness results in increased speed of shear wave propagation.  

Three-Dimensional Modelling of the Fetal Vasculature from Prenatal MRI using Motion-Corrected Slice-to-Volume Registration
David F A Lloyd1,2, Bernhard Kainz3, Joshua F P van Amerom1, Kuberan Pushparajah1,2, John M Simpson2, Vita Zidere2, Owen Miller2, Gurleen Sharland2, Tong Zhang1, Maelene Lohezic1, Joanne Allsop1, Matthew Fox1, Christina Malamateniou1, Mary Rutherford1, Jo Hajnal1, and Reza Razavi1,2
1Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom, 2Evelina Children's Hospital, London, United Kingdom, 3Department of Computing (BioMedIA), Imperial College London, London, United Kingdom
The diagnosis of potentially life-threatening vascular abnormalities in the fetus can be difficult with ultrasound alone. MRI is one of the few safe alternative imaging modalities in pregnancy; however to date it has been limited by unpredictable fetal and maternal motion during acquisition. We present six antenatal cases, four with important structural congenital heart disease, in which we employed a novel algorithm for motion-corrected slice-volume registration, producing a navigable 3D volume of the fetal thoracic vasculature. The anatomical findings in each case were then correlated to fetal echocardiographic findings, and finally displayed as interactive surface rendered models.

The Physiological Noise Contribution to Temporal Signal-to-Noise Increases with Decreasing Resolution and Acceleration in Quantitative CMR
Terrence Jao1 and Krishna Nayak2
1Biomedical Engineering, University of Southern California, Los Angeles, CA, United States, 2Electrical Engineering, Los Angeles, CA, United States
Advances in MR hardware, pulse sequences, and calibration have made quantitative CMR a reality. Quantitative maps (e.g. T1, T2, ECV) are formed from multiple images, which make them susceptible to errors caused by signal fluctuations from cardiac or respiratory motion, termed physiological noise. Reproducibility of quantitative CMR maps is critical for future clinical adoption and depends on the ratio of signal amplitude to physiological noise, termed temporal SNR. In this study, we measure temporal SNR in bSSFP quantitative CMR to characterize physiological noise for a range of image resolutions, acceleration factors, and post inversion delays. 

Multi-Resolution Registration and Segmentation for cardiac BOLD MRI
Ilkay Oksuz1,2, Rohan Dharmakumar3,4, and Sotirios A. Tsaftaris2,5
1Diagnostic Radiology, Yale University, New Haven, CT, United States, 2IMT Institute for Advanced Studies Lucca, Lucca, Italy, 3Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, United States, 4University of California, Los Angeles, CA, United States, 5The University of Edinburgh, Edinburgh, United Kingdom
Cardiac Phase-resolved Blood Oxygen-Level-Dependent (CP-BOLD) MRI is a new contrast and stress-free approach for detecting myocardial ischemia, that identifies the ischemic myocardium by examining changes in myocardial signal intensity patterns as a function of cardiac phase. But, these changes coupled with cardiac motion, challenge automated standard CINE MR myocardial segmentation and registration techniques resulting in a significant drop of segmentation and registration accuracy. We propose a dictionary learning based multi-resolution registration scheme for supervised learning and sparse representation of the myocardium. Our results show an improvement of 15% myocardial segmentation w.r.t. the state of the art. 

Optimized Cardiac CEST MRI for Assessment of Metabolic Activity in the Heart
Zhengwei Zhou1,2, Yuhua Chen3, Yibin Xie1, Christopher Nguyen1, Mu Zeng4, James Dawkins5, Zhanming Fan4, Eduardo Marbán5, and Debiao Li1,2,5
1Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, 2Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States,3Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, United States, 4Department of Radiology, Anzhen Hospital, Capital Medical University, Beijing, China, People's Republic of, 5Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
In this work, we developed an optimized cardiac CEST method to detect myocardial metabolic change with significantly reduced scan time. Our initial results in porcine model with chronic myocardial infarction show that scar region has lower metabolic activity compared to healthy myocardium, using LGE as reference. This study also shows the feasibility of cardiac CEST imaging in a patient, for the first time. 

In vivo Quantitative Susceptibility Mapping (QSM) in cardiac MRI
Yan Wen1, Thanh D. Nguyen2, Zhe Liu1, Pascal Spincemaille2, Dong Zhou2, Alexey Dimov1, Youngwook Kee2, Jiwon Kim3, Jonathan W. Weinsaft3, and Yi Wang1,2
1Biomedical Engineering, Cornell University, New York, NY, United States, 2Physics in Radiology, Weill Cornell Medicine, New York, NY, United States, 3Medicine, Weill Cornell Medicine, New York, NY, United States
Quantitative Susceptibility Mapping (QSM) has yet to be applied on cardiac patients due to the challenges from motion artifacts and background fields. In this first attempt to apply QSM in cardiac MRI, we overcome these data acquisition and processing challenges by using robust graph cut phase analysis and a novel preconditioned inversion of total field. Our preliminary results demonstrate high quality susceptibility maps, and the measured heart chamber blood oxygenation level is consistent with reported values from literature.

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