Multidimensional and Multiparametric Quantitative Cardiac MRI from Continuous Free-Breathing Acquisition
Lead Research Organisation:
King's College London
Department Name: Imaging & Biomedical Engineering
Abstract
Cardiovascular disease (CVD) is the leading single cause of morbidity and mortality in the Western world, causing over 65.000 deaths every year in England. Improving the treatment and outcome of cardiovascular disease is one of the main priorities of the National Health Service (NHS) and a reduction of 25% in mortality associated to cardiovascular disease by the year 2025 is one of the major challenges proposed by the United Nations. Magnetic Resonance Imaging (MRI) is a very promising non-invasive tool for early risk assessment, guidance of therapy and treatment monitoring of CVD. MRI has been shown to provide exquisite depiction of cardiac anatomy and is considered the gold standard to assess ventricular volumes and function. More recently, quantitative mapping of magnetic relaxation properties (known as e.g. T1 and T2 relaxation times) have been developed to standardise the quantitative measurement of myocardial tissue properties, enabling non-invasive characterisation and differentiation of diseased and healthy tissue. Clinical research studies have shown the potential of parametric mapping techniques for quantification of diffuse myocardial fibrosis (T1 map) and the assessment of myocardial oedema and inflammation (T2 map). Thus, MR parameter mapping offer the promise of early disease detection and monitoring over time or in response to therapy, changing the MR paradigm from visualisation to quantification.
The limitation of the current MRI scheme is that all these images (e.g. cardiac anatomy, function, T1 map and T2 map) are acquired sequentially, usually with different resolution, different geometric orientations and at different breath-hold positions. This scheme requires patient cooperation as acquisitions are usually performed under multiple breath holds, requires experienced radiographers to plan and perform the different acquisitions, and results in long scan times. Moreover patients are usually unable to hold their breath at the same respiratory position. Thus images acquired at different breath-holds cannot be directly fused thereby affecting diagnosis, accuracy and reproducibility of cardiac MRI.
The method proposed in this project will overcome these problems by allowing the simultaneous acquisition of MR images with multiple parameters (e.g. cardiac anatomy, function, T1 map and T2 map), throughout the whole cardiac and respiratory cycles, from a single free-breathing acquisition. Thus providing anatomic and functional information simultaneously with quantitative information of multiple tissue parameters for an efficient (single scan, shorter and predictable scan time), accurate, simplified (less planning required and more comfortable for the patients) and comprehensive assessment of cardiovascular disease.
The limitation of the current MRI scheme is that all these images (e.g. cardiac anatomy, function, T1 map and T2 map) are acquired sequentially, usually with different resolution, different geometric orientations and at different breath-hold positions. This scheme requires patient cooperation as acquisitions are usually performed under multiple breath holds, requires experienced radiographers to plan and perform the different acquisitions, and results in long scan times. Moreover patients are usually unable to hold their breath at the same respiratory position. Thus images acquired at different breath-holds cannot be directly fused thereby affecting diagnosis, accuracy and reproducibility of cardiac MRI.
The method proposed in this project will overcome these problems by allowing the simultaneous acquisition of MR images with multiple parameters (e.g. cardiac anatomy, function, T1 map and T2 map), throughout the whole cardiac and respiratory cycles, from a single free-breathing acquisition. Thus providing anatomic and functional information simultaneously with quantitative information of multiple tissue parameters for an efficient (single scan, shorter and predictable scan time), accurate, simplified (less planning required and more comfortable for the patients) and comprehensive assessment of cardiovascular disease.
Planned Impact
The beneficiaries of this research will be patients with cardiovascular disease (CVD), who will benefit from an efficient, accurate and more comfortable non-invasive diagnostic test. Secondary beneficiaries will be clinicians involved in the diagnosis and treatment of CVD. Complementary and co-registered information provided by both qualitative and quantitative cardiac MR images will enable more reliable diagnosis. In the long term this project will also help reducing NHS healthcare costs by a) reducing planning and scan times, therefore decreasing the exam cost per patient; and b) improving hospital discharge rates by providing more accurate diagnosis. Moreover the technology developed in this project may also have an impact on other applications such as abdominal and liver imaging where accurate quantification and respiratory motion are known major challenges. Through commercialisation, the research will be of benefit to the imaging manufacturers and subsequently to the healthcare system by improving patient management through improved treatment outcome and reduced healthcare costs on a national and international level.
Our goal is to maximise the impact of our work through dissemination of our ideas and results to the academic and clinical communities and potential industrial partners. The scientific methodology results from this research will be output as research publications in high-impact journals in the field of medical imaging. Results of the proposed research will be also presented to the Cardiovascular Patient and Public Involvement group at St Thomas' Hospital as well as to the general public in engagement activities such as Pint of Science and Healthcare Science Week. Throughout the project we will also post blogs about our latest results on the Division's blog (https://kingsimaging.wordpress.com/) to reach a larger community and to make our research results more accessible to a larger community. A large amount of phantom and in-vivo data will be generated during the lifetime of the grant. After the studies are published in scientific journals, and after they are patented if patenting is a viable option, this data will be made publicly available for research use. Moreover the data and reconstruction codes generated during the lifetime of the grant will be used in different teaching, and networking activities. At the completion of this project we plan to work closely together with industrial partners to transfer the developed methodology into their product software to allow wide spread clinical use of this research.
Our goal is to maximise the impact of our work through dissemination of our ideas and results to the academic and clinical communities and potential industrial partners. The scientific methodology results from this research will be output as research publications in high-impact journals in the field of medical imaging. Results of the proposed research will be also presented to the Cardiovascular Patient and Public Involvement group at St Thomas' Hospital as well as to the general public in engagement activities such as Pint of Science and Healthcare Science Week. Throughout the project we will also post blogs about our latest results on the Division's blog (https://kingsimaging.wordpress.com/) to reach a larger community and to make our research results more accessible to a larger community. A large amount of phantom and in-vivo data will be generated during the lifetime of the grant. After the studies are published in scientific journals, and after they are patented if patenting is a viable option, this data will be made publicly available for research use. Moreover the data and reconstruction codes generated during the lifetime of the grant will be used in different teaching, and networking activities. At the completion of this project we plan to work closely together with industrial partners to transfer the developed methodology into their product software to allow wide spread clinical use of this research.
Publications
Chaher N
(2020)
Imaging the Extracellular Matrix in Prevalent Cardiovascular Diseases
in Applied Sciences
Lavin Plaza B
(2020)
Sustained Focal Vascular Inflammation Accelerates Atherosclerosis in Remote Arteries.
in Arteriosclerosis, thrombosis, and vascular biology
Thomas KE
(2023)
Imaging Methods: Magnetic Resonance Imaging.
in Circulation. Cardiovascular imaging
Cruz G
(2019)
Cardiac Magnetic Resonance Fingerprinting: Technical Developments and Initial Clinical Validation.
in Current cardiology reports
Zeilinger MG
(2021)
3D Dixon water-fat LGE imaging with image navigator and compressed sensing in cardiac MRI.
in European radiology
Zeilinger MG
(2022)
Non-rigid motion-corrected free-breathing 3D myocardial Dixon LGE imaging in a clinical setting.
in European radiology
Velasco C
(2022)
Artificial intelligence in cardiac magnetic resonance fingerprinting.
in Frontiers in cardiovascular medicine
Fotaki A
(2022)
Quantitative MRI in cardiometabolic disease: From conventional cardiac and liver tissue mapping techniques to multi-parametric approaches.
in Frontiers in cardiovascular medicine
Bustin A
(2020)
From Compressed-Sensing to Artificial Intelligence-Based Cardiac MRI Reconstruction.
in Frontiers in cardiovascular medicine
Description | Myocardial T1 and T2 mapping have been recognised as one of the most valuable quantitative mapping techniques to support diagnostic, therapeutic and prognostic decision making in ischemic and non-ischemic cardiomyopathies. However current acquisitions cannot cover the whole heart (since scans need to be performed under a breath hold) and may missed regions with disease. We have developed a free-running 3D myocardial T1 mapping technique with whole heart coverage and high isotropic spatial resolution. We have developed a free-running 3D myocardial joint T1 and T2 mapping technique with whole heart coverage and high isotropic spatial resolution that can quantify both parameters from a single scan while providing functional cardiac information. We have further developed this approach to shorten the scan time to only 3 min by incorporating non-rigid cardiac motion correction. In addition, we have developed a 3D Magnetic Resonance Fingerprinting approach to simultaneously quantify myocardial T1 and T2 values. Validation of the proposed approaches in patients with suspected cardiovascular disease is warranted. |
Exploitation Route | This technique could be used by clinicians to improve diagnosis of several cardiovascular diseases and is currently being evaluated in a small cohort of patients. |
Sectors | Healthcare |
Description | We have developed a free-running 3D myocardial joint T1 and T2 mapping technique with whole heart coverage and high isotropic spatial resolution that can quantify both parameters from a single scan while providing functional cardiac information. Currently we are investigating the clinical value of the proposed technique in a small cohort of patients with cardiovascular disease. In addition, we have recently developed a 3D Magnetic Resonance Fingerprinting approach to simultaneously quantify myocardial T1 and T2 values and a free-running approach to quantify T1 and T2 mapping and CINE imaging in a single 3-min scan. We are currently working on further developments in terms of speeding up acquisition and reconstruction of images. |
First Year Of Impact | 2022 |
Sector | Healthcare |
Impact Types | Societal |
Description | BHF Clinical Research Training Fellowship |
Amount | £255,962 (GBP) |
Funding ID | FS/20/13/34857 |
Organisation | British Heart Foundation (BHF) |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 09/2020 |
End | 09/2023 |
Description | EPSRC-KCL IAA Advancing Impact Award Scheme |
Amount | £60,701 (GBP) |
Organisation | King's College London |
Sector | Academic/University |
Country | United Kingdom |
Start | 03/2019 |
End | 11/2019 |
Description | International Society for Magnetic Resonance in Medicine (ISMRM): - ISMRM Educational Stipend 2018 ($ 1815; 2018 - 2018) |
Amount | $400 (USD) |
Organisation | International Society for Magnetic Resonance in Medicine (ISMRM) |
Sector | Charity/Non Profit |
Country | United States |
Start | 03/2020 |
End | 04/2020 |
Description | NIHR Pump-Prime |
Amount | £66,757 (GBP) |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 03/2020 |
End | 11/2020 |
Description | SCMR 2019 Travel Award (3 people) |
Amount | € 1,500 (EUR) |
Organisation | Society for Cardiovascular Magnetic Resonance (SCMR) |
Sector | Charity/Non Profit |
Country | United States |
Start | 02/2019 |
End | 02/2019 |
Description | SMRA 2018 |
Amount | $550 (USD) |
Organisation | Society for Magnetic Resonance Angiography (SMRA) |
Sector | Learned Society |
Country | Canada |
Start | 07/2018 |
End | 08/2018 |
Title | Low-rank Motion Corrected Reconstruction |
Description | Reconstruction framework for low rank motion corrected MRI reconstructions (i.e., combination of motion compensation, global low rank and additional regularizers (e.g. PROST)) using ADMM-based solvers. |
Type Of Material | Improvements to research infrastructure |
Year Produced | 2019 |
Provided To Others? | Yes |
Impact | This method has enabled acceleration of several cardiac MRI methods and is being used by several members of the group and collaborators within and outside KCL |
Description | Imperial College London CMRA |
Organisation | Imperial College London |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Established a collaborative project with Imperial College London to clinically validate a new coronary cardiac MR sequence that includes our under sampled and motion compensated reconstruction developments with intravascular optical coherence tomography in patients with acute coronary syndrome for the simultaneous non-contrast free breathing 3D high resolution magnetic resonance coronary artery angiography and high-risk plaque imaging. Ethical approval for the project has been obtained, an NIHR Pump-Prime award worth (£66,757.50) has been competitively secured and a British Heart Foundation Clinical Research Fellowship grant application has been submitted (currently under assessment). |
Collaborator Contribution | Access to facilities and patients. |
Impact | NIHR Pump-Prime award worth (£66,757.50) has been competitively secured and a British Heart Foundation Clinical Research Fellowship grant application has been submitted (currently under assessment). |
Start Year | 2019 |
Description | Juntendo University Liver MRF |
Organisation | Juntendo University Hospital |
Country | Japan |
Sector | Hospitals |
PI Contribution | We have developed a novel acquisition and reconstruction framework for simultaneous T1, T2, T2* and fat fraction quantification in liver imaging. This approach has been preliminary evaluated in healthy subjects. |
Collaborator Contribution | In collaboration with Juntendo University Hospital we aim to clinically validate the proposed liver MRF in a medium size cohort of patient with fatty liver disease and validate this against histopathology. |
Impact | An abstract has been accepted for publication at upcoming ISMRM international conference |
Start Year | 2020 |
Description | UC Liver MRF |
Organisation | Pontifical Catholic University of Chile |
Country | Chile |
Sector | Academic/University |
PI Contribution | We have developed a novel magnetic resonance fingerprinting for multiparametric liver tissue characterisation. We have developed a reconstruction method for this data. |
Collaborator Contribution | Our collaborators at UC have further developed the reconstruction method to improved quantification of T2* mapping. A postdoctoral researcher from UC spend 3 months in our lab at the start of this collaboration. |
Impact | Two abstracts have been accepted for presentation at the next international conference ISMRM 2020. A paper has been submitted to Magnetic Resonance in Medicine (under review) entitled "Multi-parametric liver tissue characterization using MR Fingerprinting: simultaneous T1, T2, T2* and fat fraction mapping" |
Start Year | 2019 |
Title | METHOD AND APPARATUS FOR RECONSTRUCTING MAGNETIC RESONANCE IMAGE DATA |
Description | In a method for reconstructing magnetic resonance (MR) image data from k-space data, k-space data of an image region of a subject are provided to a computer that is also provided with multiple navigator signals for the image region of the subject. The computer sorts the k-space data into multiple bins, the multiple bins representing different motion states of the subject. For each of the multiple bins, the computer executes a compressed sensing procedure to reconstruct the MR image data from the k-space data in the respective bin. Execution of the compressed sensing procedure includes solving an optimization problem comprising a data consistency component and a transform sparsity component. Motion information is incorporated by the computer into at least one of the data consistency component and the transform sparsity component of the optimization problem. |
IP Reference | US2019317172 |
Protection | Patent application published |
Year Protection Granted | 2019 |
Licensed | No |
Impact | Pre-product software for Siemens MRI scanners |
Title | METHOD OF PERFORMING MAGNETIC RESONANCE IMAGING AND A MAGNETIC RESONANCE APPARATUS |
Description | In a method of performing magnetic resonance (MR) imaging, an MR apparatus, and a computer-readable medium during a first cardiac cycle of a subject, a first imaging sequence is generated for application to a subject. The first imaging sequence has a preparatory pulse and an inversion recovery pulse following the preparatory pulse. First signals emitted from the subject in response to the first imaging sequence are detected, and first image data are generated based on the first signals. During a second cardiac cycle following the first cardiac cycle, a second imaging sequence is generated for application to the subject. The second imaging sequence has a preparatory pulse. Second signals emitted from the subject in response to the second imaging sequence are detected, and second image data are generated based on the second signals. |
IP Reference | US2019064299 |
Protection | Patent application published |
Year Protection Granted | 2019 |
Licensed | No |
Impact | 20190064299 |
Title | METHOD OF RECONSTRUCTING MAGNETIC RESONANCE IMAGE DATA |
Description | A method of reconstructing magnetic resonance (MR) image data from k-space data. The method includes obtaining k-space data of an image region of a subject; and reconstructing, using a sparse image coding procedure, the MR image data from the k-space data by performing an iterative optimization method. The optimization method includes a data consistency iteration step and a denoising iteration step applied to MR image data generated by the data consistency iteration step. The denoising iteration step incorporates a sparsifying operation to provide a sparse representation of the MR image data for the imaged region as an input to the data consistency iteration step. |
IP Reference | US2019346522 |
Protection | Patent application published |
Year Protection Granted | 2019 |
Licensed | No |
Impact | Pre-product software for Siemens MRI scanners |
Description | Art x Science at the Science Museum |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Alina Schneider (PhD student) participated of the Art x Science at the Science Museum, London during the Great Exhibition Road Festival on Saturday 9th October 2022. Art x Science was an art exhibition exploring medical imaging and engineering research, with exhibits were developed in collaboration between PhD students from the School of Biomedical Engineering and Imaging Sciences and the Royal College of Arts. The exhibits covered some perinatal imaging, neurodevelopment, cardiology and cardiac imaging. As well as explaining the science behind the exhibit, Alina was also able to discuss her research with visitors. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.greatexhibitionroadfestival.co.uk/event/art-x-science-2021/ |
Description | Engagement activities for "I CAN BE" |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Schools |
Results and Impact | The activity was carried out by PhD student Alina Psenicny. She participated in online engagement activities for an organisation called I CAN BE; a charity who aim to inspire young girls by introducing them to women with exciting careers. She created a short video explaining her work to children at schools. The video was then shared also with the other charity partner ECHO and they shared the videos on their 'happiness hub' for parents. |
Year(s) Of Engagement Activity | 2020 |
Description | PSMR Training School 2018 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Postgraduate students |
Results and Impact | This 2 day workshop focused on teaching concepts and methods for PET/MRI |
Year(s) Of Engagement Activity | 2019 |