Simultaneous Multi Slice (SMS) SSFP first-pass myocardial perfusion MRI with iterative reconstruction at 1.5T

Muhummad Sohaib Nazir, Radhouene Neji, Peter Speier, Fiona Reid, Daniel Staeb, Michaela Schmidt, Christoph Forman, Reza Razavi, Sven Plein, Tevfik Fehmi Ismail, Amedeo Chiribiri, Sebastien Roujol

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Abstract

Background
Simultaneous-Multi-Slice (SMS) perfusion imaging has the potential to acquire multiple slices, increasing myocardial coverage without sacrificing in-plane spatial resolution. To maximise signal-to-noise ratio (SNR), SMS can be combined with a balanced steady state free precession (bSSFP) readout. Furthermore, application of gradient-controlled local Larmor adjustment (GC-LOLA) can ensure robustness against off-resonance artifacts and SNR loss can be mitigated by applying iterative reconstruction with spatial and temporal regularisation. The objective of this study was to compare myocardial perfusion imaging using SMS bSSFP imaging with GC-LOLA and iterative reconstruction to 3 slice bSSFP.

Methods
Two contrast-enhanced rest perfusion sequences were acquired in random order in 8 patients: 6-slice SMS bSSFP and 3 slice bSSFP. All images were reconstructed with TGRAPPA. SMS images were also reconstructed using a non-linear iterative reconstruction with L1 regularisation in wavelet space (SMS-iter) with 7 different combinations for spatial (λσ) and temporal (λτ) regularisation parameters. Qualitative ratings of overall image quality (0=poor image quality, 1=major artifact, 2=minor artifact, 3=excellent), perceived SNR (0=poor SNR, 1=major noise, 2=minor noise, 3=high SNR), frequency of sequence related artifacts and patient related artifacts were undertaken. Quantitative analysis of contrast ratio (CR) and percentage of dark rim artifact (DRA) was performed.

Results
Among all SMS-iter reconstructions, SMS-iter 6 (λσ 0.001 λτ 0.005) was identified as the optimal reconstruction with the highest overall image quality, least sequence related artifact and higher perceived SNR. SMS-iter 6 had superior overall image quality (2.50 ± 0.53 vs 1.50 ± 0.53, p=0.005) and perceived SNR (2.25 ± 0.46 vs 0.75 ± 0.46, p=0.010) compared to 3 slice bSSFP. There were no significant differences in sequence related artifact, CR (3.62 ± 0.39 vs 3.66 ± 0.65, p=0.88) or percentage of DRA (5.25 ± 6.56 vs 4.25 ± 4.30, p=0.64) with SMS-iter 6 compared to 3 slice bSSFP.

Conclusions
SMS bSSFP with GC-LOLA and iterative reconstruction improved image quality compared to a 3 slice bSSFP with doubled spatial coverage and preserved in-plane spatial resolution. Future evaluation in patients with coronary artery disease is warranted.
Original languageEnglish
Article number84
JournalJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
Volume20
Issue number1
Early online date10 Dec 2018
DOIs
Publication statusPublished - 10 Dec 2018

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