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Myocardial perfusion cardiovascular magnetic resonance (pCMR) using first-pass contrast-enhanced imaging could play an important role in the detection of epicardial and microvascular coronary artery disease. Recently, the emergence of quantitative pCMR has provided a more reliable and observer-independent analysis compared to visual interpretation of dynamic images. This review aims to cover the basics of quantitative pCMR, from acquisition protocols, its use in preclinical and clinical studies, image reconstruction and motion handling, to automated quantitative pCMR pipelines. It also offers an overview of emerging tools in the field, including artificial intelligence-based methods., Comment: All copyright for this preprint belongs to the authors. The work is protected under copyright and may not be reproduced, distributed, or used without proper citation and permission, unless otherwise specified

We present a novel approach for the reconstruction of time-resolved free-running first-pass myocardial perfusion MRI, named CMR-MOTUS. This method builds upon the MR-MOTUS framework and addresses the challenges of a contrast varying reference image. By integrating a low-rank plus sparse (L+S) decomposition, CMR-MOTUS efficiently captures both motion fields and contrast variations. This innovative technique eliminates the need for acquiring a motion-static reference image prior to the examination, thereby reducing examination time and complexity for cardiac MRI examinations. Our results demonstrate that CMR-MOTUS can successfully disentangle different dynamic components, offering high-quality motion fields and motion correct a myocardial first-pass perfusion image series.

First-pass perfusion cardiac magnetic resonance (FPP-CMR) is becoming an essential non-invasive imaging method for detecting deficits of myocardial blood flow, allowing the assessment of coronary heart disease. Nevertheless, acquisitions suffer from relatively low spatial resolution and limited heart coverage. Compressed sensing (CS) methods have been proposed to accelerate FPP-CMR and achieve higher spatial resolution. However, the long reconstruction times have limited the widespread clinical use of CS in FPP-CMR. Deep learning techniques based on supervised learning have emerged as alternatives for speeding up reconstructions. However, these approaches require fully sampled data for training, which is not possible to obtain, particularly high-resolution FPP-CMR images. Here, we propose a physics-informed self-supervised deep learning FPP-CMR reconstruction approach for accelerating FPP-CMR scans and hence facilitate high spatial resolution imaging. The proposed method provides high-quality FPP-CMR images from 10x undersampled data without using fully sampled reference data., Comment: Workshop on Machine Learning for Medical Image Reconstruction, MLMIR 2021, held in Conjunction with MICCAI 2021

A key factor for assessing the state of the heart after myocardial infarction (MI) is to measure whether the myocardium segment is viable after reperfusion or revascularization therapy. Delayed enhancement-MRI or DE-MRI, which is performed several minutes after injection of the contrast agent, provides high contrast between viable and nonviable myocardium and is therefore a method of choice to evaluate the extent of MI. To automatically assess myocardial status, the results of the EMIDEC challenge that focused on this task are presented in this paper. The challenge's main objectives were twofold. First, to evaluate if deep learning methods can distinguish between normal and pathological cases. Second, to automatically calculate the extent of myocardial infarction. The publicly available database consists of 150 exams divided into 50 cases with normal MRI after injection of a contrast agent and 100 cases with myocardial infarction (and then with a hyperenhanced area on DE-MRI), whatever their inclusion in the cardiac emergency department. Along with MRI, clinical characteristics are also provided. The obtained results issued from several works show that the automatic classification of an exam is a reachable task (the best method providing an accuracy of 0.92), and the automatic segmentation of the myocardium is possible. However, the segmentation of the diseased area needs to be improved, mainly due to the small size of these areas and the lack of contrast with the surrounding structures., Comment: Submitted to Medical Image Analysis

Delayed-enhancement cardiac magnetic resonance (DE-CMR)provides important diagnostic and prognostic information on myocardial viability. The presence and extent of late gadolinium enhancement (LGE)in DE-CMR is negatively associated with the probability of improvement in left ventricular function after revascularization. Moreover, LGE findings can support the diagnosis of several other cardiomyopathies, but their absence does not rule them out, making disease classification by visual assessment difficult. In this work, we propose deep learning neural networks that can automatically predict myocardial disease from patient clinical information and DE-CMR. All the proposed networks achieve very good classification accuracy (>85%). Including information from DE-CMR (directly as images or as metadata following DE-CMR segmentation) is valuable in this classification task, improving the accuracy to 95-100%., Comment: Accepted for the EMIDEC classification challenge; part of the 11th Statistical Atlases and Computational Modelling of the Heart (STACOM 2020), a MICCAI satellite workshop

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, characterised by a rapid and irregular electrical activation of the atria. Treatments for AF are often ineffective and few atrial biomarkers exist to automatically characterise atrial function and aid in treatment selection for AF. Clinical metrics of left atrial (LA) function, such as ejection fraction (EF) and active atrial contraction ejection fraction (aEF), are promising, but have until now typically relied on volume estimations extrapolated from single-slice images. In this work, we study volumetric functional biomarkers of the LA using a fully automatic SEGmentation of the left Atrium based on a convolutional neural Network (SEGANet). SEGANet was trained using a dedicated data augmentation scheme to segment the LA, across all cardiac phases, in short axis dynamic (CINE) Magnetic Resonance Images (MRI) acquired with full cardiac coverage. Using the automatic segmentations, we plotted volumetric time curves for the LA and estimated LA EF and aEF automatically. The proposed method yields high quality segmentations that compare well with manual segmentations (Dice scores [$0.93 \pm 0.04$], median contour [$0.75 \pm 0.31$] mm and Hausdorff distances [$4.59 \pm 2.06$] mm). LA EF and aEF are also in agreement with literature values and are significantly higher in AF patients than in healthy volunteers. Our work opens up the possibility of automatically estimating LA volumes and functional biomarkers from multi-slice CINE MRI, bypassing the limitations of current single-slice methods and improving the characterisation of atrial function in AF patients., Comment: Accepted at STACOM 2020, a MICCAI workshop