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Dual-phase systolic and diastolic cardiac diffusion tensor imaging using higher order motion compensation spin echo
Maryam Afzali1, Irvin Teh2, Sam Coveney2
1Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom; Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom; Division of Cardiovascular Sciences and the British Heart Foundation Centre of Research Excellence, University of Leicester, National Institute of Health and Care Research Biomedical Research Centre Leicester, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, United Kingdom.
Background:
Cardiac diffusion tensor imaging (cDTI) provides unique insights into myocardial microstructure and its dynamic changes during the cardiac cycle. However, motion sensitivity remains a major obstacle for spin echo (SE)-based approaches, restricting most implementations to a relatively narrow low-motion window near peak systole.
Purpose:
To establish whether higher-order motion-compensated (up to 6th order) diffusion gradients beyond standard second order motion compensation (M2) on a magnetic resonance imaging (MRI) system with a maximum gradient strength of 300 mT/m improve SE-based cDTI techniques for both systolic and diastolic acquisitions.
Methods:
Ten healthy volunteers underwent free-breathing, cardiac-gated SE-cDTI acquisitions in systole and in diastole using diffusion gradients with up to second- (M2), fourth- (M4), and sixth-order (M6) motion compensation. Success rate (percentage of left ventricular voxels with (1.1 < MD < 1.9) × 10-3mm2∕s) and diffusion measures including mean diffusivity, fractional anisotropy, helix angle, and secondary eigenvector angle were quantified and compared between both cardiac phases.
Results:
Second-order motion compensation was sufficient for systolic cDTI, whereas fourth-order motion compensation was required for successful diastolic acquisitions in all participants. Mean diffusivity values in systole were (1.53 ± 0.06), (1.60 ± 0.07), and (1.62 ± 0.06) × 10-3mm2∕s for M2, M4, and M6 respectively, and in diastole were (2.26 ± 0.67), (1.73 ± 0.19), and (1.71 ± 0.12) × 10-3mm2∕s. No significant differences in cDTI-derived parameters were observed between M4 and M6 for systolic and diastolic acquisitions.
Conclusion:
This study demonstrates the feasibility of dual-phase SE-based cDTI techniques enabled by 300 mT/m gradients. This method will allow reliable quantification of myocardial microstructural changes between systole and diastole and represents a step towards clinical translation of dynamic cDTI.
