Simultaneous Multi-Slice Cardiac MR Multitasking for Motion-Resolved, Non-ECG, Free-Breathing T1-T2 Mapping.

Xianglun Mao,Anthony G Christodoulou,Fei Han,Yibin Xie,Fardad M Serry,Debiao Li,Zhehao Hu,Zhaoyang Fan,Hsu-Lei Lee,Sen Ma,Tianle Cao

doi:10.3389/fcvm.2022.833257

Abstract

The aim of this study is to simultaneously quantify T1/T2 across three slices of the left-ventricular myocardium without breath-holds or ECG monitoring, all within a 3 min scan. Radial simultaneous multi-slice (SMS) encoding, self-gating, and image reconstruction was incorporated into the cardiovascular magnetic resonance (CMR) Multitasking framework to simultaneously image three short-axis slices. A T2prep-IR FLASH sequence with two flip angles was designed and implemented to allow B1+-robust T1 and T2 mapping. The proposed Multitasking-SMS method was validated in a standardized phantom and 10 healthy volunteers, comparing T1 and T2 measurements and scan-rescan repeatability against corresponding reference methods in one layer of phantom vials and in 16 American Heart Association (AHA) myocardial segments. In phantom, Multitasking-SMS T1/T2 measurements showed substantial correlation (R2 > 0.996) and excellent agreement [intraclass correlation coefficients (ICC) ≥ 0.999)] with reference measurements. In healthy volunteers, Multitasking-SMS T1/T2 maps reported similar myocardial T1/T2 values (1,215 ± 91.0/41.5 ± 6.3 ms) to the reference myocardial T1/T2 values (1,239 ± 67.5/42.7 ± 4.1 ms), with P = 0.347 and P = 0.296, respectively. Bland–Altman analyses also demonstrated good in vivo repeatability in both the multitasking and references, with segment-wise coefficients of variation of 4.7% (multitasking T1), 8.9% (multitasking T2), 2.4% [modified look-locker inversion recovery (MOLLI)], and 4.6% (T2-prep FLASH), respectively. In summary, multitasking-SMS is feasible for free-breathing, non-ECG, myocardial T1/T2 quantification in 16 AHA segments over 3 short-axis slices in 3 min. The method shows the great potential for reducing exam time for quantitative CMR without ECG or breath-holds.

Highlights

Cardiac magnetic resonance (CMR) imaging is rapidly evolving toward quantitative multiparameter measurement for myocardial tissue characterization [1–6]
T2 measurements from Multitasking-SMS and T2prep FLASH were each highly correlated (R2 > 0.998) with the reference 2D SE-T2 acquisition
It represents several new developments that have not previously been a part of T1-T2 multitasking: [1] this is the first SMS acceleration with multitasking framework; and [2] the first use of a dual flip angle scheme interleaved with T2prep-IR blocks for B1+-robust T1-T2 mapping

Summary

Introduction

Cardiac magnetic resonance (CMR) imaging is rapidly evolving toward quantitative multiparameter measurement for myocardial tissue characterization [1–6]. Conventional cardiac T1 [24–27] and T2 [28] mapping techniques are inherently inefficient because [1] they rely on breath-holds (often one per slice, with pauses between acquisitions for patients to recover before the breathhold) and pauses in acquisition (via ECG triggering) to avoid respiratory and cardiac motion; and [2] are performed in series (slice-by-slice, biomarker-by-biomarker) instead of simultaneously. This approach becomes impractical for patients having difficulty holding their breath or for whom ECG triggering fails. Respiratory gating [29] is an alternative to breathholding, but typically comes with low scan efficiency as well

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Conclusion