Background: Respiratory gating is generally recommended in 4D flow MRI of the heart to avoid blurring and motion artifacts. Recently, a novel automated contact-less camera-based respiratory motion sensor has been introduced. Purpose: To compare camera-based respiratory gating (CAM) with liver-lung-navigator-based gating (NAV) and no gating (NO) for whole-heart 4D flow MRI. Study Type: Retrospective. Subjects: Thirty two patients with a spectrum of cardiovascular diseases. Field Strength/Sequence: A 3T, 3D-cine spoiled-gradient-echo-T1-weighted-sequence with flow-encoding in three spatial directions. Assessment: Respiratory phases were derived and compared against each other by cross-correlation. Three radiologists/cardiologist scored images reconstructed with camera-based, navigator-based, and no respiratory gating with a 4-point Likert scale (qualitative analysis). Quantitative image quality analysis, in form of signal-to-noise ratio (SNR) and liver-lung-edge (LLE) for sharpness and quantitative flow analysis of the valves were performed semi-automatically. Statistical Tests: One-way repeated measured analysis of variance (ANOVA) with Wilks's lambda testing and follow-up pairwise comparisons. Significance level of P ≤ 0.05. Krippendorff's-alpha-test for inter-rater reliability. Results: The respiratory signal analysis revealed that CAM and NAV phases were highly correlated (C = 0.93 ± 0.09, P < 0.01). Image scoring showed poor inter-rater reliability and no significant differences were observed (P ≥ 0.16). The image quality comparison showed that NAV and CAM were superior to NO with higher SNR (P = 0.02) and smaller LLE (P < 0.01). The quantitative flow analysis showed significant differences between the three respiratory-gated reconstructions in the tricuspid and pulmonary valves (P ≤ 0.05), but not in the mitral and aortic valves (P > 0.05). Pairwise comparisons showed that reconstructions without respiratory gating were different in flow measurements to either CAM or NAV or both, but no differences were found between CAM and NAV reconstructions. Data Conclusion: Camera-based respiratory gating performed as well as conventional liver-lung-navigator-based respiratory gating. Quantitative image quality analysis showed that both techniques were equivalent and superior to no-gating-reconstructions. Quantitative flow analysis revealed local flow differences (tricuspid/pulmonary valves) in images of no-gating-reconstructions, but no differences were found between images reconstructed with camera-based and navigator-based respiratory gating. Level of Evidence: 3. Technical Efficacy: Stage 2.@en

Purpose: To develop a free-breathing (FB) 2D radial balanced steady-state free precession cine cardiac MRI method with 100% respiratory gating efficiency using respiratory auto-calibrated motion correction (RAMCO) based on a motion-sensing camera. Methods: The signal from a respiratory motion-sensing camera was recorded during a FB retrospectively electrocardiogram triggered 2D radial balanced steady-state free precession acquisition using pseudo–tiny-golden-angle ordering. With RAMCO, for each acquisition the respiratory signal was retrospectively auto-calibrated by applying different linear translations, using the resulting in-plane image sharpness as a criterium. The auto-calibration determines the optimal magnitude of the linear translations for each of the in-plane directions to minimize motion blurring caused by bulk respiratory motion. Additionally, motion-weighted density compensation was applied during radial gridding to minimize through-plane and non-bulk motion blurring. Left ventricular functional parameters and sharpness scores of FB radial cine were compared with and without RAMCO, and additionally with conventional breath-hold Cartesian cine on 9 volunteers. Results: FB radial cine with RAMCO had similar sharpness scores as conventional breath-hold Cartesian cine and the left ventricular functional parameters agreed. For FB radial cine, RAMCO reduced respiratory motion artifacts with a statistically significant difference in sharpness scores (P < 0.05) compared to reconstructions without motion correction. Conclusion: 2D radial cine imaging with RAMCO allows evaluation of left ventricular functional parameters in FB with 100% respiratory efficiency. It eliminates the need for breath-holds, which is especially valuable for patients with no or impaired breath-holding capacity. Validation of the proposed method on patients is warranted.@en

Purpose: To develop a new 3D radial trajectory based on the natural spiral phyllotaxis (SP), with variable anisotropic FOV. Theory & Methods: A 3D radial trajectory based on the SP with favorable interleaving properties for cardiac imaging has been proposed by Piccini et al (Magn Reson Med. 2011;66:1049-1056), which supports a FOV with a fixed anisotropy. However, a fixed anisotropy can be inefficient when sampling objects with different anisotropic dimensions. We extend Larson’s 3D radial method to provide variable anisotropic FOV for spiral phyllotaxis (VASP). Simulations were performed to measure distance between successive projections, analyze point spread functions, and compare aliasing artifacts for both VASP and conventional SP. VASP was fully implemented on a whole-body clinical MR scanner. Phantom and in vivo cardiac images were acquired at 1.5 tesla. Results: Simulations, phantom, and in vivo experiments confirmed that VASP can achieve variable anisotropic FOV while maintaining the favorable interleaving properties of SP. For an anisotropic FOV with 100:100:35 ratio, VASP required ~65% fewer radial projections than the conventional SP to satisfy Nyquist criteria. Alternatively, when the same number of radial projections were used as in conventional SP, VASP produced fewer aliasing artifacts for anisotropic objects within the excited imaging volumes. Conclusion: We have developed a new method (VASP), which enables variable anisotropic FOV for 3D radial trajectory with SP. For anisotropic objects within the excited imaging volumes, VASP can reduce scan times and/or reduce aliasing artifacts.@en