Oliver Welin Odeback

Javier Bisbal, Julio Sotelo, Hernán Mella et al.

This work introduces an unsupervised Divergence and Aliasing-Free neural network (DAF-FlowNet) for 4D Flow Magnetic Resonance Imaging (4D Flow MRI) that jointly enhances noisy velocity fields and corrects phase wrapping artifacts. DAF-FlowNet parameterizes velocities as the curl of a vector potential, enforcing mass conservation by construction and avoiding explicit divergence-penalty tuning. A cosine data-consistency loss enables simultaneous denoising and unwrapping from wrapped phase images. On synthetic aortic 4D Flow MRI generated from computational fluid dynamics, DAF-FlowNet achieved lower errors than existing techniques (up to 11% lower velocity normalized root mean square error, 11% lower directional error, and 44% lower divergence relative to the best-performing alternative across noise levels), with robustness to moderate segmentation perturbations. For unwrapping, at peak velocity/velocity-encoding ratios of 1.4 and 2.1, DAF-FlowNet achieved 0.18% and 5.2% residual wrapped voxels, representing reductions of 72% and 18% relative to the best alternative method, respectively. In scenarios with both noise and aliasing, the proposed single-stage formulation outperformed a state-of-the-art sequential pipeline (up to 15% lower velocity normalized root mean square error, 11% lower directional error, and 28% lower divergence). Across 10 hypertrophic cardiomyopathy patient datasets, DAF-FlowNet preserved fine-scale flow features, corrected aliased regions, and improved internal flow consistency, as indicated by reduced inter-plane flow bias in aortic and pulmonary mass-conservation analyses recommended by the 4D Flow MRI consensus guidelines. These results support DAF-FlowNet as a framework that unifies velocity enhancement and phase unwrapping to improve the reliability of cardiovascular 4D Flow MRI.

Javier Bisbal, Patrick Winter, Sebastian Jofre et al.

Accurate anatomical labeling of intracranial arteries is essential for cerebrovascular diagnosis and hemodynamic analysis but remains time-consuming and subject to interoperator variability. We present a deep learning-based framework for automated artery labeling from 3D Time-of-Flight Magnetic Resonance Angiography (3D ToF-MRA) segmentations (n=35), incorporating uncertainty quantification to enhance interpretability and reliability. We evaluated three convolutional neural network architectures: (1) a UNet with residual encoder blocks, reflecting commonly used baselines in vascular labeling; (2) CS-Net, an attention-augmented UNet incorporating channel and spatial attention mechanisms for enhanced curvilinear structure recognition; and (3) nnUNet, a self-configuring framework that automates preprocessing, training, and architectural adaptation based on dataset characteristics. Among these, nnUNet achieved the highest labeling performance (average Dice score: 0.922; average surface distance: 0.387 mm), with improved robustness in anatomically complex vessels. To assess predictive confidence, we implemented test-time augmentation (TTA) and introduced a novel coordinate-guided strategy to reduce interpolation errors during augmented inference. The resulting uncertainty maps reliably indicated regions of anatomical ambiguity, pathological variation, or manual labeling inconsistency. We further validated clinical utility by comparing flow velocities derived from automated and manual labels in co-registered 4D Flow MRI datasets, observing close agreement with no statistically significant differences. Our framework offers a scalable, accurate, and uncertainty-aware solution for automated cerebrovascular labeling, supporting downstream hemodynamic analysis and facilitating clinical integration.

Oliver Welin Odeback, Arivazhagan Geetha Balasubramanian, Jonas Schollenberger et al.

4D Flow Magnetic Resonance Imaging (4D Flow MRI) enables non-invasive quantification of blood flow and hemodynamic parameters. However, its clinical application is limited by low spatial resolution and noise, particularly affecting near-wall velocity measurements. Machine learning-based super-resolution has shown promise in addressing these limitations, but challenges remain, not least in recovering near-wall velocities. Generative adversarial networks (GANs) offer a compelling solution, having demonstrated strong capabilities in restoring sharp boundaries in non-medical super-resolution tasks. Yet, their application in 4D Flow MRI remains unexplored, with implementation challenged by known issues such as training instability and non-convergence. In this study, we investigate GAN-based super-resolution in 4D Flow MRI. Training and validation were conducted using patient-specific cerebrovascular in-silico models, converted into synthetic images via an MR-true reconstruction pipeline. A dedicated GAN architecture was implemented and evaluated across three adversarial loss functions: Vanilla, Relativistic, and Wasserstein. Our results demonstrate that the proposed GAN improved near-wall velocity recovery compared to a non-adversarial reference (vNRMSE: 6.9% vs. 9.6%); however, that implementation specifics are critical for stable network training. While Vanilla and Relativistic GANs proved unstable compared to generator-only training (vNRMSE: 8.1% and 7.8% vs. 7.2%), a Wasserstein GAN demonstrated optimal stability and incremental improvement (vNRMSE: 6.9% vs. 7.2%). The Wasserstein GAN further outperformed the generator-only baseline at low SNR (vNRMSE: 8.7% vs. 10.7%). These findings highlight the potential of GAN-based super-resolution in enhancing 4D Flow MRI, particularly in challenging cerebrovascular regions, while emphasizing the need for careful selection of adversarial strategies.