Mark Wrobel

Mark Wrobel, Michele Pascale, Tina Yao et al.

Background: Conventional cardiovascular magnetic resonance (CMR) in paediatric and congenital heart disease uses 2D, breath-hold, balanced steady state free precession (bSSFP) cine imaging for assessment of function and cardiac-gated, respiratory-navigated, static 3D bSSFP whole-heart imaging for anatomical assessment. Our aim is to concatenate a stack 2D free-breathing real-time cines and use Deep Learning (DL) to create an isotropic a fully segmented 3D cine dataset from these images. Methods: Four DL models were trained on open-source data that performed: a) Interslice contrast correction; b) Interslice respiratory motion correction; c) Super-resolution (slice direction); and d) Segmentation of right and left atria and ventricles (RA, LA, RV, and LV), thoracic aorta (Ao) and pulmonary arteries (PA). In 10 patients undergoing routine cardiovascular examination, our method was validated on prospectively acquired sagittal stacks of real-time cine images. Quantitative metrics (ventricular volumes and vessel diameters) and image quality of the 3D cines were compared to conventional breath hold cine and whole heart imaging. Results: All real-time data were successfully transformed into 3D cines with a total post-processing time of <1 min in all cases. There were no significant biases in any LV or RV metrics with reasonable limits of agreement and correlation. There is also reasonable agreement for all vessel diameters, although there was a small but significant overestimation of RPA diameter. Conclusion: We have demonstrated the potential of creating a 3D-cine data from concatenated 2D real-time cine images using a series of DL models. Our method has short acquisition and reconstruction times with fully segmented data being available within 2 minutes. The good agreement with conventional imaging suggests that our method could help to significantly speed up CMR in clinical practice.

Anirudh Raman, Olivier Jaubert, Mark Wrobel et al.

Purpose: To investigate whether synthetically generated fractal data can be used to train deep learning (DL) models for dynamic MRI reconstruction, thereby avoiding the privacy, licensing, and availability limitations associated with cardiac MR training datasets. Methods: A training dataset was generated using quaternion Julia fractals to produce 2D+time images. Multi-coil MRI acquisition was simulated to generate paired fully sampled and radially undersampled k-space data. A 3D UNet deep artefact suppression model was trained using these fractal data (F-DL) and compared with an identical model trained on cardiac MRI data (CMR-DL). Both models were evaluated on prospectively acquired radial real-time cardiac MRI from 10 patients. Reconstructions were compared against compressed sensing(CS) and low-rank deep image prior (LR-DIP). All reconstrctuions were ranked for image quality, while ventricular volumes and ejection fraction were compared with reference breath-hold cine MRI. Results: There was no significant difference in qualitative ranking between F-DL and CMR-DL (p=0.9), while both outperformed CS and LR-DIP (p<0.001). Ventricular volumes and function derived from F-DL were similar to CMR-DL, showing no significant bias and accptable limits of agreement compared to reference cine imaging. However, LR-DIP had a signifcant bias (p=0.016) and wider lmits of agreement. Conclusion: DL models trained using synthetic fractal data can reconstruct real-time cardiac MRI with image quality and clinical measurements comparable to models trained on true cardiac MRI data. Fractal training data provide an open, scalable alternative to clinical datasets and may enable development of more generalisable DL reconstruction models for dynamic MRI.