Simultaneous multi-slice steady-state free precession myocardial perfusion with iterative reconstruction and integrated motion compensation. Issue 151 (June 2022)

• Record Type: Journal Article
• Authors: McElroy, Sarah; Kunze, Karl P.; Nazir, Muhummad Sohaib; Speier, Peter; Stäb, Daniel; Villa, Adriana D.M.; Yazdani, Momina; Vergani, Vittoria; Roujol, Sébastien; Neji, Radhouene; Chiribiri, Amedeo
• Is Part Of: European journal of radiology. Issue 151(2022)
• Publication Date: 2022-06
• Subjects: Myocardial perfusion -- Simultaneous multi-slice -- Motion compensation; BH Breath-hold -- bSSFP Balanced steady-state free precession -- CAD Coronary artery disease -- CMR Cardiac magnetic resonance -- GC-LOLA Gradient-controlled local Larmor adjustment -- GRAPPA Generalized autocalibrating partial parallel acquisition -- ICC Intraclass correlation coefficient -- MC Motion compensation -- NMC No motion compensation -- SENSE Sensitivity encoding -- SMS Simultaneous multi-slice -- SNR Signal-to-noise ratio -- TE Echo time -- TR Repetition time; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2022.110286
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Motion compensation integrated into temporal regularization improves quality of SMS myocardial perfusion imaging. The integration of motion compensation does not degrade motion-free images. The presented framework will aid translation of high spatial coverage SMS-bSSFP perfusion imaging into clinical practice. Abstract: Purpose: Simultaneous multi-slice (SMS) balanced steady-state free precession (bSSFP) acquisition and iterative reconstruction can provide high spatial resolution and coverage for cardiac magnetic resonance (CMR) perfusion. However, respiratory motion remains a challenge for iterative reconstruction techniques employing temporal regularisation. The aim of this study is to evaluate an iterative reconstruction with integrated motion compensation for SMS-bSSFP first-pass myocardial stress perfusion in the presence of respiratory motion. Methods: Thirty-one patients with suspected coronary artery disease were prospectively recruited and imaged at 1.5 T. A SMS-bSSFP prototype myocardial perfusion sequence was acquired at stress in all patients. All datasets were reconstructed using an iterative reconstruction with temporal regularisation, once with and once without motion compensation (MC and NMC, respectively). Three readers scored each dataset in terms of: image quality (1:poor; 4:excellent), motion/blurring (1:severe motion/blurring; 3:no motion/blurring), and diagnostic confidence (1:poor confidence; 3:high confidence). Quantitative assessment of sharpness was performed. The number of uncorrupted first-pass dynamics was measured on the NMC datasets to classify patients into 'suboptimal breath-hold (BH)' and 'good BH' groups. Results: Compared across all cases, MC performed better than NMC in terms of image quality (3.5 ± 0.5 vs. 3.0 ± 0.8, P = 0.002), motion/blurring (2.9 ± 0.1 vs. 2.2 ± 0.8, P < 0.001), diagnostic confidence (2.9 ± 0.1 vs. 2.3 ± 0.7, P < 0.001) and sharpness index (0.34 ± 0.05 vs. 0.31 ± 0.06, P < 0.001). Fourteen patients with a suboptimal BH were identified. For the suboptimal BH group, MC performed better than NMC in terms of image quality (3.8 ± 0.4 vs. 2.6 ± 0.8, P < 0.001), motion/blurring (3.0 ± 0.1 vs. 1.6 ± 0.7, P < 0.001), diagnostic confidence (3.0 ± 0.1 vs. 1.9 ± 0.7, P < 0.001) and sharpness index (0.34 ± 0.05 vs. 0.30 ± 0.06, P = 0.004). For the good BH group, sharpness index was higher for MC than NMC (0.34 ± 0.06 vs 0.31 ± 0.07, P = 0.03), while there were no significant differences observed for the other three metrics assessed ( P > 0.11). There were no significant differences between suboptimal BH MC and good BH MC for any of the reported metrics ( P > 0.06). Conclusions: Integrated motion compensation significantly reduces motion/blurring and improves image quality, diagnostic confidence and sharpness index of SMS-bSSFP perfusion with iterative reconstruction in the presence of motion.