High-Resolution Maps of Left Atrial Displacements and Strains Estimated with 3D CINE MRI and Unsupervised Neural Networks

The functional analysis of the left atrium (LA) is important for evaluating cardiac health and understanding diseases like atrial fibrillation. Cine MRI is ideally placed for the detailed 3D characterisation of LA motion and deformation, but it is lacking appropriate acquisition and analysis tools. In this paper, we present Analysis for Left Atrial Displacements and Deformations using unsupervIsed neural Networks, \textit{Aladdin}, to automatically and reliably characterise regional LA deformations from high-resolution 3D Cine MRI. The tool includes: an online few-shot segmentation network (Aladdin-S), an online unsupervised image registration network (Aladdin-R), and a strain calculations pipeline tailored to the LA. We create maps of LA Displacement Vector Field (DVF) magnitude and LA principal strain values from images of 10 healthy volunteers and 8 patients with cardiovascular disease (CVD). We additionally create an atlas of these biomarkers using the data from the healthy volunteers. Aladdin is able to accurately track the LA wall across the cardiac cycle and characterize its motion and deformation. The overall DVF magnitude and principal strain values are significantly higher in the healthy group vs CVD patients: $2.85 \pm 1.59~mm$ and $0.09 \pm 0.05$ vs $1.96 \pm 0.74~mm$ and $0.03 \pm 0.04$, respectively. The time course of these metrics is also different in the two groups, with a more marked active contraction phase observed in the healthy cohort. Finally, utilizing the LA atlas allows us to identify regional deviations from the population distribution that may indicate focal tissue abnormalities. The proposed tool for the quantification of novel regional LA deformation biomarkers should have important clinical applications. The source code, anonymized images, generated maps and atlas are publicly available: https://github.com/cgalaz01/aladdin_cmr_la.

Physics-informed self-supervised deep learning reconstruction for accelerated first-pass perfusion cardiac MRI

First-pass perfusion cardiac magnetic resonance (FPP-CMR) is becoming an essential non-invasive imaging method for detecting deficits of myocardial blood flow, allowing the assessment of coronary heart disease. Nevertheless, acquisitions suffer from relatively low spatial resolution and limited heart coverage. Compressed sensing (CS) methods have been proposed to accelerate FPP-CMR and achieve higher spatial resolution. However, the long reconstruction times have limited the widespread clinical use of CS in FPP-CMR. Deep learning techniques based on supervised learning have emerged as alternatives for speeding up reconstructions. However, these approaches require fully sampled data for training, which is not possible to obtain, particularly high-resolution FPP-CMR images. Here, we propose a physics-informed self-supervised deep learning FPP-CMR reconstruction approach for accelerating FPP-CMR scans and hence facilitate high spatial resolution imaging. The proposed method provides high-quality FPP-CMR images from 10x undersampled data without using fully sampled reference data.