Physiological noise artifacts, especially those originating from cardiac pulsation and subject motion, are common in clinical Diffusion tensor‐MRI acquisitions. Previous works show that signal perturbations produced by artifacts can be severe and neglecting to account for their contribution can result in erroneous diffusion tensor values. The Robust Estimation of Tensors by Outlier Rejection (RESTORE) method has been shown to be an effective strategy for improving tensor estimation on a voxel‐by‐voxel basis in the presence of artifactual data points in diffusion‐weighted images. In this article, we address potential instabilities that may arise when using RESTORE and propose practical constraints to improve its usability. Moreover, we introduce a method, called informed RESTORE designed to remove physiological noise artifacts in datasets acquired with low redundancy (less than 30–40 diffusion‐weighted image volumes)—a condition in which the original RESTORE algorithm may converge to an incorrect solution. This new method is based on the notion that physiological noise is more likely to result in signal dropouts than signal increases. Results from both Monte Carlo simulation and clinical diffusion data indicate that informed RESTORE performs very well in removing physiological noise artifacts for low redundancy diffusion‐weighted image datasets. Magn Reson Med, 2012.
The longitudinal relaxation time, T1, can be estimated from two or more spoiled gradient recalled echo images (SPGR) acquired with different flip angles and/or repetition times (TRs). The function relating signal intensity to flip angle and TR is nonlinear; however, a linear form proposed 30 years ago is currently widely used. Here we show that this linear method provides T1 estimates that have similar precision but lower accuracy than those obtained with a nonlinear method. We also show that T1 estimated by the linear method is biased due to improper accounting for noise in the fitting. This bias can be significant for clinical SPGR images; for example, T1 estimated in brain tissue (800 ms < T1 < 1600 ms) can be overestimated by 10% to 20%. We propose a weighting scheme that correctly accounts for the noise contribution in the fitting procedure. Monte Carlo simulations of SPGR experiments are used to evaluate the accuracy of the estimated T1 from the widely‐used linear, the proposed weighted‐uncertainty linear, and the nonlinear methods. We show that the linear method with weighted uncertainties reduces the bias of the linear method, providing T1 estimates comparable in precision and accuracy to those of the nonlinear method while reducing computation time significantly. Magn Reson Med 60:496–501, 2008.
1 January 2016 in Journal of Cardiovascular Magnetic Resonance
Quantitative assessment of myocardial blood flow (MBF) with first-pass perfusion cardiovascular magnetic resonance (CMR) requires a measurement of the arterial input function (AIF). This study presents an automated method to improve the objectivity and reduce processing time for measuring the AIF from first-pass perfusion CMR images. This automated method is used to compare the impact of different AIF measurements on MBF quantification. Gadolinium-enhanced perfusion CMR was performed on a 1.5 T scanner using a saturation recovery dual-sequence technique. Rest and stress perfusion series from 270 clinical studies were analyzed. Automated image processing steps included motion correction, intensity correction, detection of the left ventricle (LV), independent component analysis, and LV pixel thresholding to calculate the AIF signal. The results were compared with manual reference measurements using several quality metrics based on the contrast enhancement and timing characteristics of the AIF. The median and 95 % confidence interval (CI) of the median were reported. Finally, MBF was calculated and compared in a subset of 21 clinical studies using the automated and manual AIF measurements. Two clinical studies were excluded from the comparison due to a congenital heart defect present in one and a contrast administration issue in the other. The proposed method successfully processed 99.63 % of the remaining image series. Manual and automatic AIF time-signal intensity curves were strongly correlated with median correlation coefficient of 0.999 (95 % CI [0.999, 0.999]). The automated method effectively selected bright LV pixels, excluded papillary muscles, and required less processing time than the manual approach. There was no significant difference in MBF estimates between manually and automatically measured AIFs (p = NS). However, different sizes of regions of interest selection in the LV cavity could change the AIF measurement and affect MBF calculation (p = NS to p = 0.03). The proposed automatic method produced AIFs similar to the reference manual method but required less processing time and was more objective. The automated algorithm may improve AIF measurement from the first-pass perfusion CMR images and make quantitative myocardial perfusion analysis more robust and readily available.
First pass gadolinium-enhanced cardiovascular magnetic resonance (CMR) perfusion imaging allows fully quantitative pixel-wise myocardial blood flow (MBF) assessment, with proven diagnostic value for coronary artery disease. Segmental analysis requires manual segmentation of the myocardium. This work presents a fully automatic method of segmenting the left ventricular myocardium from MBF pixel maps, validated on a retrospective dataset of 247 clinical CMR perfusion studies, each including rest and stress images of three slice locations, performed on a 1.5T scanner. Pixel-wise MBF maps were segmented using an automated pipeline including region growing, edge detection, principal component analysis, and active contours to segment the myocardium, detect key landmarks, and divide the myocardium into sectors appropriate for analysis. Automated segmentation results were compared against a manually defined reference standard using three quantitative metrics: Dice coefficient, Cohen Kappa and myocardial border distance. Sector-wise average MBF and myocardial perfusion reserve (MPR) were compared using Pearson's correlation coefficient and Bland-Altman Plots. The proposed method segmented stress and rest MBF maps of 243 studies automatically. Automated and manual myocardial segmentation had an average (± standard deviation) Dice coefficient of 0.86 ± 0.06, Cohen Kappa of 0.86 ± 0.06, and Euclidian distances of 1.47 ± 0.73 mm and 1.02 ± 0.51 mm for the epicardial and endocardial border, respectively. Automated and manual sector-wise MBF and MPR values correlated with Pearson's coefficient of 0.97 and 0.92, respectively, while Bland-Altman analysis showed bias of 0.01 and 0.07 ml/g/min. The validated method has been integrated with our fully automated MBF pixel mapping pipeline to aid quantitative assessment of myocardial perfusion CMR.
Microscopy techniques, particularly the family of epifluorescence modalities, are workhorses of modern cell and molecular biology that enable microscale spatial insight. Intensity- and/or phase-based microscopy techniques such as brightfield, phase contrast, differential interference contrast, digital holography, Fourier ptychography, and optical diffraction tomography,1–7 among other modalities, have the potential to visualize the subcellular structure. However, these methods depend largely on light scattering that is defined by the internal structure-based index of refraction, which lacks biomolecular specificity. Fluorescence-based techniques, on the other hand, excite fluorophores, which act as labels to spatially localize biological molecules and structures within cells. These imaging techniques, especially fluorescence approaches, involve time-consuming preparation steps and costly reagents, introduce the possibility of signal bias due to photobleaching, and in time-lapse vital imaging, allow for possible misinterpretation of cell behavior due to gradual accumulation of sublethal damage from intense ultraviolet and other wavelengths used to excite molecular labels.8 Thus microscopy of cells is challenging due to the inherent trade-offs in sample preservation, image quality, and data acquisition time and the variability between labeling experiments.
Visualization of coronary computed tomography angiography (CCTA) in standard cardiac planes requires reorientation of the three-dimensional image volume because the heart is double-oblique relative to the axial scan plane. To standardize this process across multi-phase cine CCTA, we developed an automated framework that segments cardiac structures and detects anatomic landmarks to define a patient-specific cardiac coordinate system. Landmark-derived left ventricular (LV) long-axis and LV-to-right ventricular transverse vectors were used to compute a rotation matrix for reorienting all 20 cine CCTA volumes. Six fixed slice planes were then defined to extract three long-axis (LAX) and three short-axis (SAX) slices at each phase. Matched CCTA and cardiac magnetic resonance (MR) slices were compared in 25 patients at diastasis, end-diastole (ED), and end-systole (ES), using automated segmentation-derived measurements of the combined LV cavity and LV myocardium area (LV + LVM). Agreement was evaluated with intraclass correlation coefficients (ICCs), Bland–Altman analysis, and repeated-measures mixed-effects models. ICCs were 0.927 (95% CI, 0.895 to 0.950) at diastasis, 0.950 (95% CI, 0.928 to 0.966) at ED, and 0.919 (95% CI, 0.887 to 0.943) at ES. Bland–Altman analysis showed small CT-positive biases of 1.05, 0.47, and 1.86 cm2 at diastasis, ED, and ES, corresponding to relative biases of 2.8%, 1.2%, and 5.8% of the phase-specific mean MR LV + LVM area. Mixed-effects models showed no statistically significant phase-level bias at diastasis or ED, whereas ES showed a small but significant CT-positive bias. These findings support automated CCTA reorientation as an interpretable framework for reproducible LAX/SAX slice extraction and future quantitative functional cine CCTA analysis.