Andrew Phair1, Anastasia Fotaki1, Lina Felsner1, Thomas J. Fletcher1, René M. Botnar1,2,3,4,5, and Claudia Prieto1,3,4
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, 2Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile, 3School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile, 4Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile, 5Institute for Advanced Study, Technical University of Munich, Munich, Germany
Synopsis
Keywords: Image Reconstruction, Cardiovascular
Motivation: Whole-heart CMR with high isotropic spatial resolution involves long and unpredictable scan times.
Goal(s): To propose and validate a super-resolution motion-corrected reconstruction framework to enable accelerated high-resolution whole-heart CMR from lower-resolution acquisitions.
Approach: Low resolution was treated as a k-space down-sampling problem, enabling the adaptation of an end-to-end motion-corrected iterative deep-learning network reconstruction, previously demonstrated for undersampled whole-heart CMRA.
Results: High-resolution whole-heart images (1.5×1.5×1.5 mm3) were obtained from prospective low-resolution data (1.5×6×6 mm3) using the proposed Super-MoCo-MoDL framework, with comparable image quality to a high-resolution acquisition. Scan times decreased from ~3.2 to ~1.2 minutes and reconstruction times were clinically feasible, at ~30 seconds.
Impact: The proposed
Super-MoCo-MoDL framework enables data-consistent 3D whole-heart image
reconstruction at high isotropic resolution from lower-resolution anisotropic
scans. It has the potential to either accelerate whole-heart CMR, increase the
feasibility of high-resolution clinical scanning, or a combination of the two.
Introduction
Whole-heart cardiovascular magnetic resonance (CMR)
is a principal imaging modality for the assessment and management of patients
with congenital heart disease (CHD)1. Traditional acquisition
techniques utilise diaphragmatic respiratory gating to avoid respiratory motion
artefacts, leading to long and unpredictable scan times. Scans can be
accelerated by combining undersampled k-space trajectories with iterative
reconstruction techniques, although these are often slow and computationally
expensive. Recently, various deep-learning reconstruction methods have been
proposed to provide fast reconstructions of undersampled data2. Among
these is the motion-corrected model-based deep-learning (MoCo-MoDL) framework3, which incorporates a motion estimation network and an image
regularisation network trained end-to-end.
Alternatively, faster scans can be realised by
acquiring at lower image resolution, corresponding to a smaller k-space
field-of-view (FOV). Super-resolution (SR) techniques can be employed to
up-sample the images to the desired higher resolution. Deep-learning networks
have also been proposed to perform this task, by learning the relationship
between low-resolution and high-resolution images in large sets of training
data4-7. These methods are often image based, and thus
fidelity to the acquired low-resolution k-space data is not guaranteed.
In this work, we propose to adapt MoCo-MoDL to
generate super-resolved 3D whole-heart images with isotropic spatial resolution. k-Space data is acquired with low resolution in the phase-encode and slice
directions, and scan times are ~1.2 minutes. By treating SR as a k-space down-sampling
problem, data consistency (DC) is maintained in the output high-resolution 3D
images.Methods
45 adult patients with CHD were scanned on a 1.5-T
scanner (MAGNETOM Aera, Siemens Healthcare) using an ECG-triggered
free-breathing T2-prepared bSSFP sequence8, a 3D variable-density Cartesian spiral-like trajectory (VD-CASPR)9 to
ensure incoherent undersampling artefacts and the following imaging parameters: FOV=400×300×72-108 mm3, flip angle=90°,
T2-prep duration=40 ms,
TE=1.75 ms, coronal orientation. A 2D image navigator (iNAV) was acquired at
each heartbeat to enable respiratory binning. Each patient was scanned once at
high isotropic resolution (1.5×1.5×1.5 mm3) with four-fold undersampling and
again with four-fold lower resolution in two dimensions (sixteen-fold overall,1.5×6×6 mm3)
and full k-space sampling (within an elliptical shutter).
The data were randomly sorted into a training set (40
patients) and a test set (5 patients). For training-set patients, the four-fold-undersampled
high-resolution data were reconstructed using the non-rigid-motion-corrected patch-based
low-rank method NR-PROST10 (Figure 1) to generate
ground-truth respiratory-bin images. Corresponding low-resolution images were
formed by cropping and zero-padding the $$$k_y-k_z$$$ plane, followed
by a zero-filled reconstruction (Figure 1). Since the high-resolution data were undersampled using a VD-CASPR9 trajectory, the cropped centre was
sufficiently sampled to allow retrospective undersampling to be applied to
match the sampling density of the fully sampled low-resolution acquisitions
(with elliptical shutter). For test-set patients, before input to the network,
the low-resolution data were sorted into respiratory bins, zero-padded in
k-space and underwent a zero-filled reconstruction.
Our proposed deep-learning reconstruction framework, which we call Super-MoCo-MoDL, is depicted in Figure 2. It consists of a diffeomorphic motion
estimation network11, which estimates the motion fields between
respiratory bins, and a motion-informed model-based iterative reconstruction
network, which alternates between a DC term, which enforces DC in the acquired
k-space centre, and a super-resolving U-Net. To improve convergence stability
during training, an ADMM iterative scheme was employed for the iterative reconstruction, as opposed to
the alternating minimisation used in MoDL12.
The framework was trained on a 16-GB GPU over 1200
epochs and tested on retrospective and prospective low-resolution data for the 5
test-set patients.Results
Average acquisition times were ~1.2 minutes (low
resolution, fully sampled) and ~3.2 minutes (high resolution, four-fold undersampled). Transverse slices of the 3D
high-resolution cardiac images obtained with Super-MoCo-MoDL are
presented for the five test-set patients in Figures 3 (retrospective) and 4
(prospective). Additionally, prospective coronal slices, where SR is
applied in one dimension, are shown in Figure
5. For comparison, the same slices are presented for high-resolution
ground-truth images, bicubic interpolations of low-resolution NR-PROST reconstructions
and NR-PROST reconstructions of zero-padded low-resolution data.Discussion
The image quality seen in Figures 3-5 suggests the Super-MoCo-MoDL
framework achieves comparable results to the four-fold-undersampled
high-resolution NR-PROST reconstructions, despite the ~2.6-fold faster
acquisition times. Additionally, network inference took ~30 seconds per
subject, a ~240-fold computational speedup relative to the iterative NR-PROST
algorithm.
Future work will focus on generalising the
framework for a range of image resolutions, fine-tuning the network
hyperparameters and expanding the training set to improve robustness.Conclusion
Super-MoCo-MoDL, a data-consistent super-resolution
framework, was introduced to obtain 3D whole-heart CMR images for CHD patients
with isotropic spatial resolution (1.5 mm3) from scans acquired at
low $$$k_y-k_z$$$ resolution
(1.5×6×6 mm3). Scan times were ~1.2 minutes
and super-resolved reconstruction times were ~30 seconds.Acknowledgements
The
authors acknowledge financial support from: (1) King’s BHF Centre for Award
Excellence PG/18/59/33955 and RG/20/1/34802, (2) EPSRC EP/V044087/1,
EP/P001009/1, EP/P032311/1, EP/P007619, (3) Wellcome EPSRC Centre for Medical
Engineering (NS/A000049/1), (4) Millennium Institute for Intelligent Healthcare
Engineering ICN2021 004, FONDECYT 1210637 and 1210638, (5) IMPACT, Center of
Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago,
Chile. ANID-Basal funding for Scientific and Technological Center of
Excellence, IMPACT, #FB210024 (6) the Department of Health through the National
Institute for Health Research (NIHR) comprehensive Biomedical Research Centre
award, (7) NIHR Cardiovascular MedTech Co-operative, (8) the Technical University
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