AUTHOR=Tourais Joao , Scannell Cian M. , Schneider Torben , Alskaf Ebraham , Crawley Richard , Bosio Filippo , Sanchez-Gonzalez Javier , Doneva Mariya , Schülke Christophe , Meineke Jakob , Keupp Jochen , Smink Jouke , Breeuwer Marcel , Chiribiri Amedeo , Henningsson Markus , Correia Teresa 

TITLE=High-Resolution Free-Breathing Quantitative First-Pass Perfusion Cardiac MR Using Dual-Echo Dixon With Spatio-Temporal Acceleration

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.884221

DOI=10.3389/fcvm.2022.884221

ISSN=2297-055X

ABSTRACT=<sec><title>Introduction</title><p>To develop and test the feasibility of free-breathing (FB), high-resolution quantitative first-pass perfusion cardiac MR (FPP-CMR) using dual-echo Dixon (FOSTERS; Fat-water separation for mOtion-corrected Spatio-TEmporally accelerated myocardial peRfuSion).</p></sec><sec><title>Materials and Methods</title><p>FOSTERS was performed in FB using a dual-saturation single-bolus acquisition with dual-echo Dixon and a dynamically variable Cartesian k-t undersampling (8-fold) approach, with low-rank and sparsity constrained reconstruction, to achieve high-resolution FPP-CMR images. FOSTERS also included automatic in-plane motion estimation and T<inline-formula><mml:math id="M1" xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:msubsup><mml:mrow></mml:mrow><mml:mrow><mml:mn>2</mml:mn></mml:mrow><mml:mrow><mml:mo>*</mml:mo></mml:mrow></mml:msubsup></mml:math></inline-formula> correction to obtain quantitative myocardial blood flow (MBF) maps. High-resolution (1.6 x 1.6 mm<sup>2</sup>) FB FOSTERS was evaluated in eleven patients, during rest, against standard-resolution (2.6 x 2.6 mm<sup>2</sup>) 2-fold SENSE-accelerated breath-hold (BH) FPP-CMR. In addition, MBF was computed for FOSTERS and spatial wavelet-based compressed sensing (CS) reconstruction. Two cardiologists scored the image quality (IQ) of FOSTERS, CS, and standard BH FPP-CMR images using a 4-point scale (1–4, non-diagnostic – fully diagnostic).</p></sec><sec><title>Results</title><p>FOSTERS produced high-quality images without dark-rim and with reduced motion-related artifacts, using an 8x accelerated FB acquisition. FOSTERS and standard BH FPP-CMR exhibited excellent IQ with an average score of 3.5 ± 0.6 and 3.4 ± 0.6 (no statistical difference, <italic>p</italic> &gt; 0.05), respectively. CS images exhibited severe artifacts and high levels of noise, resulting in an average IQ score of 2.9 ± 0.5. MBF values obtained with FOSTERS presented a lower variance than those obtained with CS.</p></sec><sec><title>Discussion</title><p>FOSTERS enabled high-resolution FB FPP-CMR with MBF quantification. Combining motion correction with a low-rank and sparsity-constrained reconstruction results in excellent image quality.</p></sec>