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Improving visualization of 4D flow cardiovascular magnetic resonance with four-dimensional angiographic data: generation of a 4D phase-contrast magnetic resonance CardioAngiography (4D PC-MRCA)
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV).
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV).
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.ORCID iD: 0000-0003-2198-9690
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0003-1395-8296
2017 (English)In: Journal of Cardiovascular Magnetic Resonance, ISSN 1097-6647, E-ISSN 1532-429X, Vol. 19, article id 47Article in journal (Refereed) Published
Abstract [en]

Magnetic Resonance Angiography (MRA) and Phase-Contrast MRA (PC-MRA) approaches used for assessment of cardiovascular morphology typically result in data containing information from the entire cardiac cycle combined into one 2D or 3D image. Information specific to each timeframe of the cardiac cycle is, however, lost in this process. This study proposes a novel technique, called Phase-Contrast Magnetic Resonance CardioAngiography (4D PC-MRCA), that utilizes the full potential of 4D Flow CMR when generating temporally resolved PC-MRA data to improve visualization of the heart and major vessels throughout the cardiac cycle. Using non-rigid registration between the timeframes of the 4D Flow CMR acquisition, the technique concentrates information from the entire cardiac cycle into an angiographic dataset at one specific timeframe, taking movement over the cardiac cycle into account. Registration between the timeframes is used once more to generate a time-resolved angiography. The method was evaluated in ten healthy volunteers. Visual comparison of the 4D PC-MRCAs versus PC-MRAs generated from 4D Flow CMR using the traditional approach was performed by two observers using Maximum Intensity Projections (MIPs). The 4D PC-MRCAs resulted in better visibility of the main anatomical regions of the cardiovascular system, especially where cardiac or vessel motion was present. The proposed method represents an improvement over previous PC-MRA generation techniques that rely on 4D Flow CMR, as it effectively utilizes all the information available in the acquisition. The 4D PC-MRCA can be used to visualize the motion of the heart and major vessels throughout the entire cardiac cycle.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD , 2017. Vol. 19, article id 47
Keyword [en]
Computer-Assisted Image Analysis; 4D flow cardiovascular magnetic resonance (4D flow CMR); Phase-Contrast Magnetic Resonance Angiography (PC-MRA)
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-139277DOI: 10.1186/s12968-017-0360-8ISI: 000404063800001PubMedID: 28645326OAI: oai:DiVA.org:liu-139277DiVA, id: diva2:1120981
Note

Funding Agencies|European Research Council [310612]; Swedish Heart and Lung foundation [20140398]; Swedish Research Council [621-2014-6191]

Available from: 2017-07-07 Created: 2017-07-07 Last updated: 2018-03-22
In thesis
1. Automated Assessment of Blood Flow in the Cardiovascular System Using 4D Flow MRI
Open this publication in new window or tab >>Automated Assessment of Blood Flow in the Cardiovascular System Using 4D Flow MRI
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Medical image analysis focuses on the extraction of meaningful information from medical images in order to facilitate clinical assessment, diagnostics and treatment. Image processing techniques have gradually become an essential part of the modern health care system, a consequence of the continuous technological improvements and the availability of a variety of medical imaging techniques.

Magnetic Resonance Imaging (MRI) is an imaging technique that stands out as non-invasive, highly versatile, and capable of generating high quality images without the use of ionizing radiation. MRI is frequently performed in the clinical setting to assess the morphology and function of the heart and vessels. When focusing on the cardiovascular system, blood flow visualization and quantification is essential in order to fully understand and identify related pathologies. Among the variety of MR techniques available for cardiac imaging, 4D Flow MRI allows for full three-dimensional spatial coverage over time, also including three-directional velocity information. It is a very powerful technique that can be used for retrospective analysis of blood flow dynamics at any location in the acquired volume.

In the clinical routine, however, flow analysis is typically done using two-dimensional imaging methods. This can be explained by their shorter acquisition times, higher in-plane spatial resolution and signal-to-noise ratio, and their relatively simpler post-processing requirements when compared to 4D Flow MRI. The extraction of useful knowledge from 4D Flow MR data is especially challenging due to the large amount of information included in these images, and typically requires substantial user interaction.

This thesis aims to develop and evaluate techniques that facilitate the post-processing of thoracic 4D Flow MRI by automating the steps necessary to obtain hemodynamic parameters of interest from the data. The proposed methods require little to no user interaction, are fairly quick, make effective use of the information available in the four-dimensional images, and can easily be applied to sizable groups of data.The addition of the proposed techniques to the current pipeline of 4D Flow MRI analysis simplifies and expedites the assessment of these images, thus bringing them closer to the clinical routine.

Abstract [sv]

Medicinsk bildanalys fokuserar på extrahering av meningsfull information från medicinska bilder för att underlätta klinisk bedömning, diagnostik, och behandling. Bildbehandlingsteknik har gradvis blivit en viktig del av det moderna sjukvårdsystemet, en följd av de kontinuerliga tekniska förbättringarna och tillgången till en mängd olika medicinska bildtekniker.

Magnetic resonanstomografi (MRT) är en bildteknik som är ickeinvasiv, flexibel och kan generera bilder av hög kvalitet utan joniserande strålning. MRT utförs ofta i klinisk miljö för att bedöma anatomi och funktion av hjärtat och blodkärlen. När man fokuserar på hjärt-kärlsystemet är bedömning av blodflödet viktigt för att kunna förstå och identifiera sjukdomar fullt ut. Bland de olika MRT-teknikerna som är tillgängliga för avbildning av hjärtat möjliggör 4D flödes-MRT komplett täckning av hjärtat i tre dimensioner över tid, och med hastighetsinformation i tre riktningar. 4D flödes-MRT är en mycket effektiv metod som kan användas för retrospektiv analys av blodflödesdynamik på vilken position som helst i den avbildade volymen.

Till vardags görs dock blodflödesanalysen vanligtvis på bilder tagna med tvådimensionella avbildningsmetoder. Detta kan förklaras av deras kortare insamlingstider, högre spatiella upplösning, bättre signal-brusförhållandet, och att de är relativt enklare att efterbehandla jämfört med 4D flödes-MRT. Utvinningen av användbar information från 4D flödes-MRT-data är väldigt utmanande på grund av den stora mängden information som dessa bilder innehåller och kräver vanligtvis väsentlig användarinteraktion.

Denna avhandling syftar till att utveckla och utvärdera metoder som underlättar efterbehandlingen av 4D flödes-MRT genom att automatisera de steg som är nödvändiga för att härleda hemodynamiska parametrarna av intresse från dessa data. De föreslagna metoderna kräver liten eller ingen användarinteraktion, är relativt snabba, använder all information som finns i de fyrdimensionella bilderna, och kan enkelt appliceras på stora datamängder. Tillägget av de i avhandlingen beskrivna metoderna till den nuvarande analysen av 4D flödes-MRT medger en avsevärd förenkling och uppsnabbad utvärdering, vilket gör att den avancerade 4D flödes MRT-tekniken kommer närmare att kunna användas i kliniskt rutinarbete.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2018. p. 77
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1613
Keyword
MRI, 4D Flow MRI, Image Analysis, Segmentation
National Category
Medical Image Processing
Identifiers
urn:nbn:se:liu:diva-145729 (URN)10.3384/diss.diva-145729 (DOI)9789176853467 (ISBN)
Public defence
2018-05-03, Eken, Building 421, Floor 9, Entrance 65, Campus US, Linköping, 13:00 (English)
Opponent
Supervisors
Funder
EU, European Research Council, 310612EU, European Research Council, 223615Swedish Research Council, 621-2014-6191Swedish Heart Lung Foundation, 20140398Wallenberg Foundations, KAW 2013.0076
Available from: 2018-03-23 Created: 2018-03-22 Last updated: 2018-04-09Bibliographically approved

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Bustamante, MarianaGupta, VikasCarlhäll, CarljohanEbbers, Tino
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