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Subject-tailored parallel transmission pulses for ultra-high fields body applications are typically calculated based on subject-specific126 channel-wise, complex, relative 2DThe deep learning-basedThe feasibility of estimating 2D relative

Electrocardiography is a very common, non-invasive diagnostic procedure and its interpretation is increasingly supported by automatic interpretation algorithms. The progress in the field of automatic ECG interpretation has up to now been hampered by a lack of appropriate datasets for training as well as a lack of well-defined evaluation procedures to ensure comparability of different algorithms. To alleviate these issues, we put forward first benchmarking results for the recently published, freely accessible PTB-XL dataset, covering a variety of tasks from different ECG statement prediction tasks over age and gender prediction to signal quality assessment. We find that convolutional neural networks, in particular resnet- and inception-based architectures, show the strongest performance across all tasks outperforming feature-based algorithms by a large margin. These results are complemented by deeper insights into the classification algorithm in terms of hidden stratification, model uncertainty and an exploratory interpretability analysis. We also put forward benchmarking results for the ICBEB2018 challenge ECG dataset and discuss prospects of transfer learning using classifiers pretrained on PTB-XL. With this resource, we aim to establish the PTB-XL dataset as a resource for structured benchmarking of ECG analysis algorithms and encourage other researchers in the field to join these efforts., Comment: 12 pages, 8 figures

Background Cardiac PET has recently found novel applications in coronary atherosclerosis imaging using [18F]NaF as a radiotracer, highlighting vulnerable plaques. However, the resulting uptakes are relatively small, and cardiac motion and respiration-induced movement of the heart can impair the reconstructed images due to motion blurring and attenuation correction mismatches. This study aimed to apply an MR-based motion compensation framework to [18F]NaF data yielding high-resolution motion-compensated PET and MR images. Methods Free-breathing 3-dimensional Dixon MR data were acquired, retrospectively binned into multiple respiratory and cardiac motion states, and split into fat and water fraction using a model-based reconstruction framework. From the dynamic MR reconstructions, both a non-rigid cardiorespiratory motion model and a motion-resolved attenuation map were generated and applied to the PET data to improve image quality. The approach was tested in 10 patients and focal tracer hotspots were evaluated concerning their target-to-background ratio, contrast-to-background ratio, and their diameter. Results MR-based motion models were successfully applied to compensate for physiological motion in both PET and MR. Target-to-background ratios of identified plaques improved by 7 ± 7%, contrast-to-background ratios by 26 ± 38%, and the plaque diameter decreased by −22 ± 18%. MR-based dynamic attenuation correction strongly reduced attenuation correction artefacts and was not affected by stent-related signal voids in the underlying MR reconstructions. Conclusions The MR-based motion correction framework presented here can improve the target-to-background, contrast-to-background, and width of focal tracer hotspots in the coronary system. The dynamic attenuation correction could effectively mitigate the risk of attenuation correction artefacts in the coronaries at the lung-soft tissue boundary. In combination, this could enable a more reproducible and reliable plaque localisation.

PURPOSE To introduce and investigate a method for free-breathing three-dimensional (3D) B1+ mapping of the human body at ultrahigh field (UHF), which can be used to generate homogenous flip angle (FA) distributions in the human body at UHF. METHODS A 3D relative B1+ mapping sequence with a radial phase-encoding (RPE) k-space trajectory was developed and applied in 11 healthy subjects at 7T. An RPE-based actual flip angle mapping method was applied with a dedicated B1+ shim setting to calibrate the relative B1+ maps yielding absolute B1+ maps of the individual transmit channels. The method was evaluated in a motion phantom and by multidimensional in vivo measurements. Additionally, 3D gradient echo scans with and without static phase-only B1+ shims were used to qualitatively validate B1+ shim predictions. RESULTS The phantom validation revealed good agreement for B1+ maps between dynamic measurement and static reference acquisition. The proposed 3D method was successfully validated in vivo by comparing magnitude and phase distributions with a 2D Cartesian reference. 3D B1+ maps free from visible motion artifacts were successfully acquired for 11 subjects with body mass indexes ranging from 19 kg/m2 to 34 kg/m2 . 3D respiration-resolved absolute B1+ maps indicated FA differences between inhalation and exhalation up to 15% for one channel and up to 24% for combined channels for shallow breathing. CONCLUSION The proposed method provides respiration-resolved absolute 3D B1+ maps of the human body at UHF, which enables the investigation and development of 3D B1+ shimming and parallel transmission methods to further enhance body imaging at UHF.

Purpose: Cardiovascular magnetic resonance first-pass perfusion for the pixel-wise detection of coronary artery disease is rapidly becoming the clinical standard, yet no widely available method exists for its assessment and validation. This study introduces a novel phantom capable of generating spatially dependent flow values to enable assessment of new perfusion imaging methods at the pixel level. Methods: A synthetic multicapillary myocardial phantom mimicking transmural myocardial perfusion gradients was designed and manufactured with high-precision 3D printing. The phantom was used in a stationary flow setup providing reference myocardial perfusion rates and was scanned on a 3T system. Repeated first-pass perfusion MRI for physiological perfusion rates between 1 and 4 mL/g/min was performed using a clinical dual-sequence technique. Fermi function-constrained deconvolution was used to estimate pixel-wise perfusion rate maps. Phase contrast (PC)-MRI was used to obtain velocity measurements that were converted to perfusion rates for validation of reference values and cross-method comparison. The accuracy of pixel-wise maps was assessed against simulated reference maps. Results: PC-MRI indicated excellent reproducibility in perfusion rate (coefficient of variation [CoV] 2.4-3.5%) and correlation with reference values (R2 = 0.985) across the full physiological range. Similar results were found for first-pass perfusion MRI (CoV 3.7-6.2%, R2 = 0.987). Pixel-wise maps indicated a transmural perfusion difference of 28.8-33.7% for PC-MRI and 23.8-37.7% for first-pass perfusion, matching the reference values (30.2-31.4%). Conclusion: The unique transmural perfusion pattern in the phantom allows effective pixel-wise assessment of first-pass perfusion acquisition protocols and quantification algorithms before their introduction into routine clinical use.

Objective To provide respiratory motion correction for free-breathing myocardial T1 mapping using a pilot tone (PT) and a continuous golden-angle radial acquisition. Materials and methods During a 45 s prescan the PT is acquired together with a dynamic sagittal image covering multiple respiratory cycles. From these images, the respiratory heart motion in head-feet and anterior–posterior direction is estimated and two linear models are derived between the PT and heart motion. In the following scan through-plane motion is corrected prospectively with slice tracking based on the PT. In-plane motion is corrected for retrospectively. Our method was evaluated on a motion phantom and 11 healthy subjects. Results Non-motion corrected measurements using a moving phantom showed T1 errors of 14 ± 4% (p p p Discussion Our proposed PT-based motion correction approach allows for T1 mapping during free-breathing with the same accuracy as a corresponding breathhold T1 mapping scan.

Objective. T1 mapping of the liver is time consuming and can be challenging due to respiratory motion. Here we present a prospective slice tracking approach, which utilizes an external ultra-wide band radar signal and allows for efficient T1 mapping during free-breathing. Approach. The fast radar signal is calibrated to an MR-based motion signal to create a motion model. This motion model provides motion estimates, which are used to carry out slice tracking for any subsequent clinical scan. This approach was evaluated in simulations, phantom experiments and in vivo scans. Main results. Radar-based slice tracking was implemented on an MR system with a total latency of 77 ms. Moving phantom experiments showed accurate motion prediction with an error of 0.12 mm in anterior-posterior and 0.81 mm in head-feet direction. The model error remained stable for up to two hours. In vivo experiments showed visible image improvement with a motion model error three times smaller than with a respiratory bellow. For T1 mapping during free-breathing the proposed approach provided similar results compared to reference T1 mapping during a breathhold. Significance. The proposed radar-based approach achieves accurate slice tracking and enables efficient T1 mapping of the liver during free-breathing. This motion correction approach is independent from scanning parameters and could also be used for applications like MR guided radiotherapy or MR Elastography.

Purpose: Respiratory motion‐compensated (MC) 3D cardiac fat‐water imaging at 7T. Methods: Free‐breathing bipolar 3D triple‐echo gradient‐recalled‐echo (GRE) data with radial phase‐encoding (RPE) trajectory were acquired in 11 healthy volunteers (7M\4F, 21–35 years, mean: 30 years) with a wide range of body mass index (BMI; 19.9–34.0 kg/m2) and volunteer tailored B1+ shimming. The bipolar‐corrected triple‐echo GRE‐RPE data were binned into different respiratory phases (self‐navigation) and were used for the estimation of non‐rigid motion vector fields (MF) and respiratory resolved (RR) maps of the main magnetic field deviations (ΔB0). RR ΔB0 maps and MC ΔB0 maps were compared to a reference respiratory phase to assess respiration‐induced changes. Subsequently, cardiac binned fat‐water images were obtained using a model‐based, respiratory motion‐corrected image reconstruction. Results: The 3D cardiac fat‐water imaging at 7T was successfully demonstrated. Local respiration‐induced frequency shifts in MC ΔB0 maps are small compared to the chemical shifts used in the multi‐peak model. Compared to the reference exhale ΔB0 map these changes are in the order of 10 Hz on average. Cardiac binned MC fat‐water reconstruction reduced respiration induced blurring in the fat‐water images, and flow artifacts are reduced in the end‐diastolic fat‐water separated images. Conclusion: This work demonstrates the feasibility of 3D fat‐water imaging at UHF for the entire human heart despite spatial and temporal B1+ and B0 variations, as well as respiratory and cardiac motion.

PURPOSE: Myocardial fat infiltrations are associated with a range of cardiomyopathies. The purpose of this study was to perform cardio-respiratory motion-correction for model-based water-fat separation to image fatty infiltrations of the heart in a free-breathing, non-cardiac-triggered high-resolution 3D MRI acquisition. METHODS: Data were acquired in nine patients using a free-breathing, non-cardiac-triggered high-resolution 3D Dixon gradient-echo sequence and radial phase encoding trajectory. Motion correction was combined with a model-based water-fat reconstruction approach. Respiratory and cardiac motion models were estimated using a dual-mode registration algorithm incorporating both motion-resolved water and fat information. Qualitative comparisons of fat structures were made between 2D clinical routine reference scans and reformatted 3D motion-corrected images. To evaluate the effect of motion correction the local sharpness of epicardial fat structures was analyzed for motion-averaged and motion-corrected fat images. RESULTS: The reformatted 3D motion-corrected reconstructions yielded qualitatively comparable fat structures and fat structure sharpness in the heart as the standard 2D breath-hold. Respiratory motion correction improved the local sharpness on average by 32% ± 24% with maximum improvements of 81% and cardiac motion correction increased the sharpness further by another 15% ± 11% with maximum increases of 31%. One patient showed a fat infiltration in the myocardium and cardio-respiratory motion correction was able to improve its visualization in 3D. CONCLUSION: The 3D water-fat separated cardiac images were acquired during free-breathing and in a clinically feasible and predictable scan time. Compared to a motion-averaged reconstruction an increase in sharpness of fat structures by 51% ± 27% using the presented motion correction approach was observed for nine patients.

PURPOSE Two-dimensional selective excitation (2DRF) allows shortening 4D flow scan times by reducing the FOV, but the longer 2DRF pulse duration decreases the temporal resolution, yielding underestimated peak flow values. Multiple k-space lines per cardiac phase, nl ≥ 2, are commonly applied in 4D flow MRI to shorten the inherent long scan times. We demonstrate that 2DRF 4D flow with nl ≥ 2 can be easily combined with UNFOLD (UNaliasing by Fourier-encoding the Overlaps using the temporaL Dimension), a technique that allows regaining nominally the temporal resolution of the respective acquisition with nl = 1, to assure peak flow quantification. METHODS Two different 2DRF pulses with spiral k-space trajectories were designed and integrated into a 4D flow sequence. Flow phantom experiments and 7 healthy control 4D flow in vivo measurements, with and without UNFOLD reconstructions, were compared with conventional reconstruction and 1D slab-selective excitation (1DRF) by evaluating time-resolved flow curves, peak flow, peak velocity, blood flow volume per cardiac cycle, and spatial aliasing. RESULTS Applying UNFOLD to 4D flow imaging with 2DRF and reduced FOV increased the quantified in vivo peak flow values significantly by 3.7% ± 2.3% to 5.2% ± 2.4% (P < .05). Accordingly, the peak flow underestimation of 2DRF scans compared with conventional 1DRF scans decreased with UNFOLD. Finally, 2DRF combined with UNFOLD accelerated the 4D flow acquisition 3.5 ± 1.4 fold by reducing the FOV and increasing the effective temporal resolution by 6.7% compared with conventional 1D selective excitation, with 2 k-space lines per cardiac phase. CONCLUSION Two-dimensional selective excitation combined with UNFOLD allows limiting the FOV to shorten 4D flow scan times and compensates for the loss in temporal resolution with 2DRF (Δt = 64.8 ms) compared with 1DRF (Δt = 43.2 ms), yielding an effective resolution of Δteff = 40.5 ms to enhance peak flow quantification.

INTRODUCTION Multiple cardiac magnetic resonance (CMR)-derived indices of atrial fibrillation (AF) substrate have been shown in isolation to predict long-term outcome following catheter ablation. Left atrial (LA) fibrosis, LA volume, LA ejection fraction (EF), left ventricular ejection fraction (LVEF), LA shape (sphericity) and pulmonary vein anatomy have all been shown to correlate with late AF recurrence. This study aimed to validate and assess the relative contribution of multiple indices in a long-term single-center study. METHODS AND RESULTS Eighty-nine patients (53% paroxysmal AF, 73% male) underwent comprehensive CMR study before first-time AF ablation (median follow-up 726 days [IQR: 418-1010 days]). The 3D late gadolinium-enhanced acquisition (1.5T, 1.3 × 1.3 × 2 mm) was quantified for fibrosis; LA volume and sphericity were assessed on manual segmentation at atrial diastole; LAEF and LVEF were quantified on multislice cine imaging. AF recurred in 43 patients (48%) overall (31 at 1 year). In the recurrence group, LA fibrosis was higher (42% vs 29%; hazard ratio [HR]: 1.032; P = .002), left atrial ejection fraction (LAEF) lower (25% vs 34%; HR: 0.063; P = .016) and LVEF lower (57% vs 63%; HR: 0.011; P = .008). LA volume (135 vs 124 mL) and sphericity (0.819 vs 0.822) were similar. Multivariate Cox regression analysis was adjusted for age and sex (Model 1), additionally AF type (Model 2) and combined (Model 3). In Models 1 and 2, LA fibrosis, LAEF, and LVEF were independently associated with outcome, but only LA fibrosis was independent in Model 3 (HR: 1.021; P = .022). CONCLUSIONS LAEF, LVEF, and LA fibrosis differed significantly in the AF recurrence cohort. However, on combined multivariate analysis only LA fibrosis remained independently associated with outcome.

PURPOSE To improve the efficiency of native and postcontrast high-resolution cardiac T1 mapping by utilizing cardiac motion correction. METHODS Common cardiac T1 mapping techniques only acquire data in a small part of the cardiac cycle, leading to inefficient data sampling. Here, we present an approach in which 80% of each cardiac cycle is used for T1 mapping by integration of cardiac motion correction. Golden angle radial data was acquired continuously for 8 s with in-plane resolution of 1.3 × 1.3 mm2 . Cine images were reconstructed for nonrigid cardiac motion estimation. Images at different TIs were reconstructed from the same data, and motion correction was performed prior to T1 mapping. Native T1 mapping was evaluated in healthy subjects. Furthermore, the technique was applied for postcontrast T1 mapping in 5 patients with suspected fibrosis. RESULTS Cine images with high contrast were obtained, leading to robust cardiac motion estimation. Motion-corrected T1 maps showed myocardial T1 times similar to cardiac-triggered T1 maps obtained from the same data (1288 ± 49 ms and 1259 ± 55 ms, respectively) but with a 34% improved precision (spatial variation: 57.0 ± 12.5 ms and 94.8 ± 15.4 ms, respectively, P < 0.0001) due to the increased amount of data. In postcontrast T1 maps, focal fibrosis could be confirmed with late contrast-enhancement images. CONCLUSION The proposed approach provides high-resolution T1 maps within 8 s. Data acquisition efficiency for T1 mapping was improved by a factor of 5 by integration of cardiac motion correction, resulting in precise T1 maps.

Quantification and imaging of magnetic nanoparticles is of vital importance for various novel biomedical applications, like cell tracking, drug targeting or hyperthermia treatments. In this work we studied the performance of magnetic resonance imaging (MRI) and magnetic particle imaging (MPI) for quantitative imaging of magnetic nanoparticles (MNP). This was done by measurements of serial dilutions of MNP (Ferucarbotran) in two different media (water and CuSO4 solution). The concentration range in which quantification was possible was determined for each technique, and the influence of the environment was analyzed and discussed. This revealed a significantly stronger influence of the surrounding medium on MRI performance as compared to MPI. All results were validated by measurements using their respective zero-dimensional (spectroscopic) techniques nuclear magnetic resonance and magnetic particle spectroscopy, showing similar behavior compared to the imaging modalities. Physical explanations of all observed effects are given, and a concentration range is determined in which the advantages of both imaging techniques can be utilized.

Purpose MRI at ultra-high fields in the human body is highly challenging and requires lengthy calibration times to compensate for spatially heterogeneous B 1 + profiles. This study investigates the feasibility of using pre-computed universal pulses for calibration-free homogeneous 3D flip angle distribution in the human heart at 7T. Methods Twenty-two channel-wise 3D B 1 + data sets were acquired under free-breathing in 19 subjects to generate a library for an offline universal pulse (UP) design (group 1: 12 males [M] and 7 females [F], 21-66 years, 19.8-28.3 kg/m2 ). Three of these subjects (2M/1F, 21-33 years, 20.8-23.6 kg/m2 ) were re-scanned on different days. A 4kT-points UP optimized for the 22 channel-wise 3D B 1 + data sets in group 1 (UP22-4kT) is proposed and applied at 7T in 9 new and unseen subjects (group 2: 4M/5F, 25-56 years, 19.5-35.3 kg/m2 ). Multiple tailored and universal static and dynamic parallel-transmit (pTx) pulses were designed and evaluated for different permutations of the B 1 + data sets in group 1 and 2. Results The proposed UP22-4kT provides low B 1 + variation in all subjects, seen and unseen, without severe signal drops. Experimental data at 7T acquired with UP22-4kT shows comparable image quality as data acquired with tailored-4kT pulses and demonstrates successful calibration-free pTx of the human heart. Conclusion UP22-4kT allows for calibration-free homogeneous flip angle distributions across the human heart at 7T. Large inter-subject variations because of sex, age, and body mass index are well tolerated. The proposed universal pulse removes the need for lengthy (10-15 min) calibration scans and therefore has the potential to bring body imaging at 7T closer to the clinical application.