Methods
Compressed Sensing 4D Flow Reconstruction
PC MRI encodes flow velocity at spatial location during cardiac phase () according to the following equation:
(4) |
where is the velocity corresponding to a phase of ,
are the encoded velocity vector components. The four-point velocity encoding matrix is given as
(5) |
Therefore, flow velocity can be calculated from the phase difference of reconstructed PC images .
Let be a discretized image on a grid corresponding to a cardiac phase and velocity encoding . Assuming Cartesian sampling on a regular
grid, the Fourier transform
, and coil sensitivity maps define the spatial encoding operator :(6) |
Considering a single velocity-encoded image sequence, let and be stacked column-vectors of signals and zero-filled k-space samples respectively, while defines the undersampling mask. Iterative image reconstruction methods seek for a maximum a posteriori (MAP) solution defined by the following optimization problem:
(7) |
where the regularization term enforces prior assumptions about image regularities. Herein we consider the local low-rank (LLR) regularization 14 to leverage image correlations among cardiac phases:
(8) |
where is the corresponding patch extraction operator, yielding patches, and is the nuclear norm. For LLR regularization the optimization problem (7) is convex and can be efficiently solved using operator splitting techniques such as the fast iterative shrinkage-thresholding algorithm (FISTA) 20.
FlowVN Training
We employ a =10 layer VN and perform 5 iterations of the ADAM algorithm (learning rate , , , batch size of 3) for training, during which we continually adjust with being the iteration number. On every layer, each 3D filter bank contains = filters of size = voxels. Activation functions are parametrized by = control knots with spacing =:
(9) | ||||
with gradients provided by the following formulas:
(10) | ||||
The acquired zero-filled k-space with undersampling mask was normalized by .
To enable backpropagation to be carried out with limited GPU memory, we employ spatio-temporal equivariance of the convolution and exploit the fact that k-space is fully sampled in the readout dimension
for Cartesian acquisitions. Therefore, to draw a training sample, we perform random cropping of width and in dimensions and respectively and simulate Fourier encoding in dimensions as illustrated in Fig. 2(a). The network was implemented using the Tensorflow framework 32. Fully-sampled and partial Fourier acquisition data from 11 healthy volunteers was used during training.In Vivo Data Acquisition
As illustrated in Fig. 1, we used 11 subject for network training, and 7 healthy subjects and 1 patient for evaluation. All in-vivo work was performed upon written informed consent of the subjects and according to local ethics regulations.
Training datasets comprised 4D flow data measured in the aorta of 11 healthy subjects, 9 of them fully sampled and 2 acquired with partial Fourier 38 (factor 0.750.75).
For evaluation, data in the ascending aorta of 7 healthy subjects were acquired on a 3T Philips Ingenia system (Philips Healthcare, Best, the Netherlands) using a Cartesian 4-point referenced phase-contrast gradient-echo sequence with an encoding velocity , a spatial resolution of , , , cardiac phases and flip angle = 8. Exams for each of the 7 healthy subjects comprised a standard navigator-gated 2-fold accelerated parallel imaging 5 exam for reference, and a CS acquisition with an acceleration factor of =, using Cartesian pseudo-radial golden angle sampling pattern 39 and data driven-respiratory motion detection, as in 11. Only data in expiration were kept for reconstruction as shown in Fig. 1.
To evaluate reconstruction accuracy on pathological anatomy, 4D flow data was acquired in a single patient with dilation of the ascending aorta, combined aortic stenosis and regurgitation due to a bicuspid aortic valve on a 3T Philips Ingenia system (Philips Healthcare, Best, the Netherlands) using a navigator-gated 2-fold accelerated parallel imaging 5 scan.
A receiver coil with 28 channels was used for acquisition which were reduced to 5 channels using coil compression 40. Coil sensitivity maps were estimated with ESPIRiT 41. Concomitant field correction was applied to the signal phase according to Bernstein et al. 42 and eddy currents were corrected for with a third-order polynomial model fitted to stationary tissue 43, 44.
Evaluation
We compared the proposed FlowVN to the state-of-the-art compressed sensing LLR-regularized (8) reconstruction 14 and the variational network by Hammernik et al. 15 which we refer to as HamVN. The LLR implementation from the Berkeley advanced reconstruction toolbox (BART) 45 was used with patch size = and a maximum number of optimization iterations of 80. The optimal value of regularization parameter = was chosen via grid search to minimize the reconstructed flow field residual averaged over the manually segmented aorta on the retrospectively 12 undersampled acquisition. Since the original VN 15 was proposed for magnitude reconstruction of 2D and 3D data, we introduced the following modifications for the presented 4D flow evaluation: (i) 3D filters were grouped into 4 banks as in FlowVN (see Supplemental Algorithm 1), (ii) -norm of reconstruction was optimized (i.e. equation (3) with + ). We refer to this architecture as “HamVN”, the number of network layers, filters and control knots were the same as in FlowVN.
Retrospective Study
For simulated retrospective undersampling experiments, we used 2 PI data and simulate a pseudo-radial Golden angle sampling pattern 39 with acceleration factors of 6 to 22.
For each undersampling factor we evaluated the nRMSE of the image magnitude, the relative error (RelErr) of velocity magnitudes inside the aorta and the angular error (AngErr) of the estimated velocity vectors:
(11) | ||||
Additionally, we report the structural similarity index (SSIM) 46 with = on the reconstructed magnitude images.
Prospective Study
Using manual aorta segmentations we compute flow over cross sections of the aorta by integrating velocity components projected onto the cross section normal. The peak flow is then defined as the maximal flow over cardiac phases for a given cross section. Moreover, we calculate peak through-plane velocity defined as maximum velocity projection across cross sections of the aorta over cardiac phases.
To quantify agreement with the reference 2 PI reconstruction, we performed Bland-Altman analysis 47 of peak flow and peak through-plane velocities.
Data and code availability
The code for the network training and inference used in this study and network weights are avaliable on CodeOcean together with volunteer data: https://codeocean.com/capsule/0115983/tree 48. The code for analysis is available on CodeOcean: https://codeocean.com/capsule/2587940/tree 49.
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1 Supplementary Material
Input: — zero-filled k-space samples, — undersampling mask |
Parameters: |
for to |
Output: reconstructed image |

Method | Peak Velocity Error[%] | p-value | Peak Flow Error[%] | p-value |
---|---|---|---|---|
HamVN-3D, single coil | 19.3819.01 | 0.0001 | 21.3715.11 | 0.0001 |
HamVN-3D | 6.4413.64 | 0.0001 | 3.73 12.12 | 0.0020 |
HamVN | 3.6410.10 | 0.0001 | 1.909.69 | 0.3345 |
+linear activation functions | 3.1810.35 | 0.0002 | 1.6510.70 | 0.3833 |
+unroll GD with momentum | 2.959.89 | 0.0004 | 1.479.82 | 0.4749 |
+data activation functions | 2.2910.12 | 0.0213 | 0.639.74 | 0.7957 |
+US-depending modulation | 1.988.43 | 0.0645 | 0.4710.30 | 0.9272 |
+exp. weighting (FlowVN) | 1.599.65 | 0.0875 | 0.059.79 | 0.9550 |