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

TY - JOUR

T1 - Simultaneous Multi Slice (SMS) SSFP first-pass myocardial perfusion MRI with iterative reconstruction at 1.5T

AU - Nazir, Muhummad Sohaib

AU - Neji, Radhouene

AU - Speier, Peter

AU - Reid, Fiona

AU - Staeb, Daniel

AU - Schmidt, Michaela

AU - Forman, Christoph

AU - Razavi, Reza

AU - Plein, Sven

AU - Ismail, Tevfik Fehmi

AU - Chiribiri, Amedeo

AU - Roujol, Sebastien

PY - 2018/12/10

Y1 - 2018/12/10

N2 - 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.

AB - 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.

UR - https://www.scopus.com/pages/publications/85058099157

U2 - 10.1186/s12968-018-0502-7

DO - 10.1186/s12968-018-0502-7

M3 - Article

SN - 1532-429X

VL - 20

JO - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance

JF - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance

IS - 1

M1 - 84

ER -