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Purpose: To provide real-time quantitative organ-specific information - specifically placental and brain T2* - to allow optimization of the MR examination to the individual patient. Methods: A FIRE-based real-time setup segmenting placenta and fetal brain in real-time, performing T2* fitting and analysis and calculation of the centile was implemented. A nn-UNet were trained and tested on 2989 datasets for the fetal brain and a second one trained on 210 datasets for the placenta for automatic segmentation. T2* normal curves were obtained from 106 cases and prospective evaluation was performed on 10 cases between 35 and 39 weeks GA. Results: Quantitative brain and placental T2* maps and centiles were available in all prospective cases within 30 seconds. The robustness of the method was shown with intra-scan repeats (mean difference 1.04+/-12.39 ms for fetal brain and -3.15+/-8.88 ms for placenta) and direct validation with vendor-processed offline results (mean difference 1.62+/-4.33 ms for fetal brain and 0.16+/-6.19 ms for placenta). Discussion and Conclusion: Real-time available organ-specific quantitative information enables more personalized MR examinations, selection of the most pertinent sequences and thus the promise of reduced recalls and specific insights into tissue properties. The here enabled placental T2*, demonstrated in multiple recent studies to be a biomarker sensitive to a range of pregnancy complications, and fetal brain T2* will be explored in further studies in pregnancies with pre-eclampsia, growth restriction as a way of enabling future MR-guided fetal interventions.

Two subsequent deep learning networks, one localizing the fetal chest and one identifying a set of landmarks on a coronal whole-uterus balanced steady-state free precession scan, were trained on 167 and 71 fetal datasets across field strengths, acquisition parameters, and gestational ages and implemented in a real-time setup. Next, a phase-contrast sequence was modified to use the identified landmarks for planning. The OWL pipeline was evaluated retrospectively in 10 datasets and prospectively in 7 fetal subjects (gestational ages between 36+3 and 39+3 weeks). The prospective cases were additionally manually planned to enable direct comparison both qualitatively, by scoring the planning quality, and quantitatively, by comparing the indexed flow measurements. OWL enabled real-time fully automatic planning of the 2D phase-contrast scans in all but one of the prospective participants. The fetal body localization achieved an overall Dice score of 0.94+-0.05 and the cardiac landmark detection accuracy was 5.77+-2.91 mm for the descending aorta, 4.32+-2.44 mm for the spine, and 4.94+-3.82 mm for the umbilical vein. For the prospective cases, overall planning quality was 2.73/4 for the automated scans, compared to 3.0/4 for manual planning, and the flow quantitative evaluation showed a mean difference of -1.8% (range -14.2% to 14.9%) by comparing the indexed flow measurements obtained from gated automatic and manual acquisitions. Real-time automated planning of 2D phase-contrast MRI was effectively accomplished for 2 major vessels of the fetal vasculature. While demonstrated here on 0.55T, the achieved method has wider implications, and training across multiple field strengths enables generalization. OWL thereby presents an important step towards extending access to this modality beyond specialised centres., Comment: 12 pages

MRI systems are traditionally engineered to produce close to idealized performance, enabling a simplified pulse sequence design philosophy. An example of this is control of eddy currents produced by gradient fields; usually these are compensated by pre-emphasizing demanded waveforms. This process typically happens invisibly to the pulse designer, allowing them to assume the achieved gradient waveform will be as desired. Whilst convenient, this imposes stricter limits on the sequence design than the hardware can handle (for example, pre-emphasis adds an additional overhead to amplifiers). This strategy can be undesirable particularly for lower performance or resource-limited hardware. Instead we explore the use of a 'digital twin' (i.e. an end-to-end model of the scanner system) to optimize control inputs, resulting in sequences that inherently compensate for known imperfections. We explore digital twin optimization specifically for gradient system imperfections as an exemplar. This is first explored in simulations using a simple exponential eddy current model, then experimentally using an empirical gradient impulse response function on a 7T MRI system. When unconstrained, digital twin optimization reproduces classic pre-emphasis. When strict hardware constraints are imposed (simulating lower performance hardware), it identifies novel sequences for scenarios where classic pre-emphasis would be unachievable. Experimentally, the optimization approach was demonstrated to substantially reduce ghosting effects in echo planar images on a 7T system. Digital twin optimization may allow more efficient use of hardware by taking a whole system approach. Ultimately this could enable the use of cheaper hardware without loss of performance., Comment: 33 pages, 14 figures (including supporting information)

We introduce a conditional implicit neural atlas (CINA) for spatio-temporal atlas generation from Magnetic Resonance Images (MRI) of the neurotypical and pathological fetal brain, that is fully independent of affine or non-rigid registration. During training, CINA learns a general representation of the fetal brain and encodes subject specific information into latent code. After training, CINA can construct a faithful atlas with tissue probability maps of the fetal brain for any gestational age (GA) and anatomical variation covered within the training domain. Thus, CINA is competent to represent both, neurotypical and pathological brains. Furthermore, a trained CINA model can be fit to brain MRI of unseen subjects via test-time optimization of the latent code. CINA can then produce probabilistic tissue maps tailored to a particular subject. We evaluate our method on a total of 198 T2 weighted MRI of normal and abnormal fetal brains from the dHCP and FeTA datasets. We demonstrate CINA's capability to represent a fetal brain atlas that can be flexibly conditioned on GA and on anatomical variations like ventricular volume or degree of cortical folding, making it a suitable tool for modeling both neurotypical and pathological brains. We quantify the fidelity of our atlas by means of tissue segmentation and age prediction and compare it to an established baseline. CINA demonstrates superior accuracy for neurotypical brains and pathological brains with ventriculomegaly. Moreover, CINA scores a mean absolute error of 0.23 weeks in fetal brain age prediction, further confirming an accurate representation of fetal brain development., Comment: Submitted to MICCAI 2024

Purpose: Widening the availability of fetal MRI with fully automatic real-time planning of radiological brain planes on 0.55T MRI. Methods: Deep learning-based detection of key brain landmarks on a whole-uterus EPI scan enables the subsequent fully automatic planning of the radiological single-shot Turbo Spin Echo acquisitions. The landmark detection pipeline was trained on over 120 datasets from varying field strength, echo times and resolutions and quantitatively evaluated. The entire automatic planning solution was tested prospectively in nine fetal subjects between 20 and 37 weeks. Comprehensive evaluation of all steps, the distance between manual and automatic landmarks, the planning quality and the resulting image quality was conducted. Results: Prospective automatic planning was performed in real-time without latency in all subjects. The landmark detection accuracy was 4.21+-2.56 mm for the fetal eyes and 6.47+-3.23 for the cerebellum, planning quality was 2.44/3 (compared to 2.56/3 for manual planning) and diagnostic image quality was 2.14 compared to 2.07 for manual planning. Conclusions: Real-time automatic planning of all three key fetal brain planes was successfully achieved and will pave the way towards simplifying the acquisition of fetal MRI thereby widening the availability of this modality in non-specialist centres., Comment: 17 pages, 8 figures, 1 table, MRM

Dynamic free-breathing fetal cardiac MRI is one of the most challenging modalities, which requires high temporal and spatial resolution to depict rapid changes in a small fetal heart. The ability of deep learning methods to recover undersampled data could help to optimise the kt-SENSE acquisition strategy and improve non-gated kt-SENSE reconstruction quality. In this work, we explore supervised deep learning networks for reconstruction of kt-SENSE style acquired data using an extensive in vivo dataset. Having access to fully-sampled low-resolution multi-coil fetal cardiac MRI, we study the performance of the networks to recover fully-sampled data from undersampled data. We consider model architectures together with training strategies taking into account their application in the real clinical setup used to collect the dataset to enable networks to recover prospectively undersampled data. We explore a set of modifications to form a baseline performance evaluation for dynamic fetal cardiac MRI on real data. We systematically evaluate the models on coil-combined data to reveal the effect of the suggested changes to the architecture in the context of fetal heart properties. We show that the best-performers recover a detailed depiction of the maternal anatomy on a large scale, but the dynamic properties of the fetal heart are under-represented. Training directly on multi-coil data improves the performance of the models, allows their prospective application to undersampled data and makes them outperform CTFNet introduced for adult cardiac cine MRI. However, these models deliver similar qualitative performances recovering the maternal body very well but underestimating the dynamic properties of fetal heart. This dynamic feature of fast change of fetal heart that is highly localised suggests both more targeted training and evaluation methods might be needed for fetal heart application.

Fetal Magnetic Resonance Imaging at low field strengths is emerging as an exciting direction in perinatal health. Clinical low field (0.55T) scanners are beneficial for fetal imaging due to their reduced susceptibility-induced artefacts, increased T2* values, and wider bore (widening access for the increasingly obese pregnant population). However, the lack of standard automated image processing tools such as segmentation and reconstruction hampers wider clinical use. In this study, we introduce a semi-automatic pipeline using quantitative MRI for the fetal body at low field strength resulting in fast and detailed quantitative T2* relaxometry analysis of all major fetal body organs. Multi-echo dynamic sequences of the fetal body were acquired and reconstructed into a single high-resolution volume using deformable slice-to-volume reconstruction, generating both structural and quantitative T2* 3D volumes. A neural network trained using a semi-supervised approach was created to automatically segment these fetal body 3D volumes into ten different organs (resulting in dice values > 0.74 for 8 out of 10 organs). The T2* values revealed a strong relationship with GA in the lungs, liver, and kidney parenchyma (R^2>0.5). This pipeline was used successfully for a wide range of GAs (17-40 weeks), and is robust to motion artefacts. Low field fetal MRI can be used to perform advanced MRI analysis, and is a viable option for clinical scanning., Comment: Accepted by MICCAI 2023

Coherent multi-transducer ultrasound (CoMTUS) creates an extended effective aperture through the coherent combination of multiple arrays, which results in images with enhanced resolution, extended field-of-view, and higher sensitivity. The subwavelength localization accuracy of the multiple transducers required to coherently beamform the data is achieved by using the echoes backscattered from targeted points. In this study, CoMTUS is implemented and demonstrated for the first time in 3-D imaging using a pair of 256-element 2-D sparse spiral arrays, which keep the channel-count low and limit the amount of data to be processed. The imaging performance of the method was investigated using both simulations and phantom tests. The feasibility of free-hand operation is also experimentally demonstrated. Results show that, in comparison to a single dense array system using the same total number of active elements, the proposed CoMTUS system improves spatial resolution (up to 10 times) in the direction where both arrays are aligned, contrast-to-noise-ratio (CNR, up to 30%), and generalized CNR (up to 11%). Overall, CoMTUS shows narrower main lobe and higher contrast-to-noise-ratio, which results in an increased dynamic range and better target detectability., Comment: 10 pages, 6 figures

Automatic segmentation of the placenta in fetal ultrasound (US) is challenging due to the (i) high diversity of placenta appearance, (ii) the restricted quality in US resulting in highly variable reference annotations, and (iii) the limited field-of-view of US prohibiting whole placenta assessment at late gestation. In this work, we address these three challenges with a multi-task learning approach that combines the classification of placental location (e.g., anterior, posterior) and semantic placenta segmentation in a single convolutional neural network. Through the classification task the model can learn from larger and more diverse datasets while improving the accuracy of the segmentation task in particular in limited training set conditions. With this approach we investigate the variability in annotations from multiple raters and show that our automatic segmentations (Dice of 0.86 for anterior and 0.83 for posterior placentas) achieve human-level performance as compared to intra- and inter-observer variability. Lastly, our approach can deliver whole placenta segmentation using a multi-view US acquisition pipeline consisting of three stages: multi-probe image acquisition, image fusion and image segmentation. This results in high quality segmentation of larger structures such as the placenta in US with reduced image artifacts which are beyond the field-of-view of single probes., Comment: 21 pages (18 + appendix), 13 figures (9 + appendix)

Purpose: This work proposes a novel RF pulse design for parallel transmit (pTx) systems to obtain uniform saturation of semisolid magnetization for Magnetization Transfer (MT) contrast in the presence of transmit field ($B_1^+$) inhomogeneities. The semisolid magnetization is usually modeled as being purely longitudinal, with the applied $B_1^+$ field saturating but not rotating its magnetization, thus standard pTx pulse design methods do not apply. Theory and Methods: Pulse design for Saturation Homogeneity (PUSH) optimizes pTx RF pulses by considering uniformity of root-mean squared $B_1^+$, $B_1^{rms}$, which relates to the rate of semisolid saturation. Here we considered designs consisting of a small number of spatially non-selective sub-pulses optimized over either a single 2D plane or 3D. Simulations and in vivo experiments on a 7T Terra system with an 8-TX Nova head coil in 5 subjects were carried out to study the homogenization of $B_1^{rms}$ and of the MT contrast by acquiring MT ratio maps. Results: Simulations and in vivo experiments showed up to 6 and 2 times more uniform $B_1^{rms}$ compared to circular polarized (CP) mode for 2D and 3D optimizations, respectively. This translated into 4 and 1.25 times more uniform MT contrast, consistently for all subjects, where 2 sub-pulses were enough for the implementation and coil used. Conclusion: The proposed PUSH method obtains more uniform and higher MT contrast than CP mode within the same SAR budget., Comment: 18 pages, 9 figures. Code available at: https://github.com/mriphysics/PUSH

Magnetic resonance imaging of whole fetal body and placenta is limited by different sources of motion affecting the womb. Usual scanning techniques employ single-shot multi-slice sequences where anatomical information in different slices may be subject to different deformations, contrast variations or artifacts. Volumetric reconstruction formulations have been proposed to correct for these factors, but they must accommodate a non-homogeneous and non-isotropic sampling, so regularization becomes necessary. Thus, in this paper we propose a deep generative prior for robust volumetric reconstructions integrated with a diffeomorphic volume to slice registration method. Experiments are performed to validate our contributions and compare with a state of the art method in a cohort of $72$ fetal datasets in the range of $20-36$ weeks gestational age. Results suggest improved image resolution and more accurate prediction of gestational age at scan when comparing to a state of the art reconstruction method. In addition, gestational age prediction results from our volumetric reconstructions compare favourably with existing brain-based approaches, with boosted accuracy when integrating information of organs other than the brain. Namely, a mean absolute error of $0.618$ weeks ($R^2=0.958$) is achieved when combining fetal brain and trunk information., Comment: 23 pages, 15 figures, 1 table

Purpose: Magnetization transfer (MT) and inhomogeneous MT (ihMT) contrasts are used in MRI to provide information about macromolecular tissue content. In particular, MT is sensitive to macromolecules and ihMT appears to be specific to myelinated tissue. This study proposes a technique to characterize MT and ihMT properties from a single acquisition, producing both semiquantitative contrast ratios, and quantitative parameter maps. Theory and Methods: Building upon previous work that uses multiband radiofrequency (RF) pulses to efficiently generate ihMT contrast, we propose a cyclic-steady-state approach that cycles between multiband and single-band pulses to boost the achieved contrast. Resultant time-variable signals are reminiscent of a magnetic resonance fingerprinting (MRF) acquisition, except that the signal fluctuations are entirely mediated by magnetization transfer effects. A dictionary-based low-rank inversion method is used to reconstruct the resulting images and to produce both semiquantitative MT ratio (MTR) and ihMT ratio (ihMTR) maps, as well as quantitative parameter estimates corresponding to an ihMT tissue model. Results: Phantom and in vivo brain data acquired at 1.5T demonstrate the expected contrast trends, with ihMTR maps showing contrast more specific to white matter (WM), as has been reported by others. Quantitative estimation of semisolid fraction and dipolar T1 was also possible and yielded measurements consistent with literature values in the brain. Conclusions: By cycling between multiband and single-band pulses, an entirely magnetization transfer mediated 'fingerprinting' method was demonstrated. This proof-of-concept approach can be used to generate semiquantitative maps and quantitatively estimate some macromolecular specific tissue parameters., Comment: 34 Pages and 15 Figures (Including Supporting Information), Submitted to Magnetic Resonance in Medicine (MRM). Updated to include link to final published article

Purpose: To introduce a novel deep learning based approach for fast and high-quality dynamic multi-coil MR reconstruction by learning a complementary time-frequency domain network that exploits spatio-temporal correlations simultaneously from complementary domains. Theory and Methods: Dynamic parallel MR image reconstruction is formulated as a multi-variable minimisation problem, where the data is regularised in combined temporal Fourier and spatial (x-f) domain as well as in spatio-temporal image (x-t) domain. An iterative algorithm based on variable splitting technique is derived, which alternates among signal de-aliasing steps in x-f and x-t spaces, a closed-form point-wise data consistency step and a weighted coupling step. The iterative model is embedded into a deep recurrent neural network which learns to recover the image via exploiting spatio-temporal redundancies in complementary domains. Results: Experiments were performed on two datasets of highly undersampled multi-coil short-axis cardiac cine MRI scans. Results demonstrate that our proposed method outperforms the current state-of-the-art approaches both quantitatively and qualitatively. The proposed model can also generalise well to data acquired from a different scanner and data with pathologies that were not seen in the training set. Conclusion: The work shows the benefit of reconstructing dynamic parallel MRI in complementary time-frequency domains with deep neural networks. The method can effectively and robustly reconstruct high-quality images from highly undersampled dynamic multi-coil data ($16 \times$ and $24 \times$ yielding 15s and 10s scan times respectively) with fast reconstruction speed (2.8s). This could potentially facilitate achieving fast single-breath-hold clinical 2D cardiac cine imaging., Comment: Accepted by Magnetic Resonance in Medicine

Transducers with larger aperture size are desirable in ultrasound imaging to improve resolution and image quality. A coherent multi-transducer ultrasound imaging system (CoMTUS) enables an extended effective aperture through coherent combination of multiple transducers. In this study, the discontinuous extended aperture created by CoMTUS and its performance for deep imaging and through layered-media are investigated by both simulations and experiments. Typical image quality metrics - resolution, contrast and contrast-to-noise ratio - are evaluated and compared with a standard single probe imaging system. Results suggest that, the image performance of CoMTUS depends on the relative spatial location of the arrays. The resulting effective aperture significantly improves resolution, while the separation between the arrays may degrade contrast. For a limited gap in the effective aperture (less than few centimetres), CoMTUS provides benefits to image quality compared to standard single probe imaging system. Overall, CoMTUS shows higher sensitivity and reduced loss of resolution with imaging depth. In general, CoMTUS imaging performance was unaffected when imaging through a layered-medium with different speed of sound values and resolution improved up to 80% at large imaging depths., Comment: 12 pages, 16 figures

Tracking microsctructural changes in the developing brain relies on accurate inter-subject image registration. However, most methods rely on either structural or diffusion data to learn the spatial correspondences between two or more images, without taking into account the complementary information provided by using both. Here we propose a deep learning registration framework which combines the structural information provided by T2-weighted (T2w) images with the rich microstructural information offered by diffusion tensor imaging (DTI) scans. We perform a leave-one-out cross-validation study where we compare the performance of our multi-modality registration model with a baseline model trained on structural data only, in terms of Dice scores and differences in fractional anisotropy (FA) maps. Our results show that in terms of average Dice scores our model performs better in subcortical regions when compared to using structural data only. Moreover, average sum-of-squared differences between warped and fixed FA maps show that our proposed model performs better at aligning the diffusion data.

This study presents a comparison of quantitative MRI methods based on an efficiency metric that quantifies their intrinsic ability to extract information about tissue parameters. Under a regime of unbiased parameter estimates, an intrinsic efficiency metric $\eta$ was derived for fully-sampled experiments which can be used to both optimize and compare sequences. Here we optimize and compare several steady-state and transient gradient-echo based qMRI methods, such as magnetic resonance fingerprinting (MRF), for joint T1 and T2 mapping. The impact of undersampling was also evaluated, assuming incoherent aliasing that is treated as noise by parameter estimation. In-vivo validation of the efficiency metric was also performed. Transient methods such as MRF can be up to 3.5 times more efficient than steady-state methods, when spatial undersampling is ignored. If incoherent aliasing is treated as noise during least-squares parameter estimation, the efficiency is reduced in proportion to the SNR of the data, with reduction factors of 5 often seen for practical SNR levels. In-vivo validation showed a very good agreement between the theoretical and experimentally predicted efficiency. This work presents and validates an efficiency metric to optimize and compare the performance of qMRI methods. Transient methods were found to be intrinsically more efficient than steady-state methods, however the effect of spatial undersampling can significantly erode this advantage., Comment: Submitted to Physics in Medicine and Biology

Purpose: To enable rigid-body motion tolerant parallel volumetric magnetic resonance imaging by retrospective head motion correction on a variety of spatio-temporal scales and imaging sequences. Theory and methods: Tolerance against rigid-body motion is based on distributed and incoherent sampling orders for boosting a joint retrospective motion estimation and reconstruction framework. Motion resilience stems from the encoding redundancy in the data, as generally provided by the coil array. Hence, it does not require external sensors, navigators or training data, so the methodology is readily applicable to sequences using 3D encodings. Results: Simulations are performed showing full inter-shot corrections for usual levels of in-vivo motion, large number of shots, standard levels of noise and moderate acceleration factors. Feasibility of inter- and intra-shot corrections is shown under controlled motion in-vivo. Practical efficacy is illustrated by high quality results in most corrupted of 208 volumes from a series of 26 clinical pediatric examinations collected using standard protocols. Conclusion: The proposed framework addresses the rigid motion problem in volumetric anatomical brain scans with sufficient encoding redundancy which has enabled reliable pediatric examinations without sedation., Comment: 22 pages, 9 figures, 1 table, accepted in Magnetic Resonance in Medicine

We present simple reconstruction networks for multi-coil data by extending deep cascade of CNN's and exploiting the data consistency layer. In particular, we propose two variants, where one is inspired by POCSENSE and the other is calibration-less. We show that the proposed approaches are competitive relative to the state of the art both quantitatively and qualitatively., Comment: Presented at ISMRM 27th Annual Meeting & Exhibition (Abstract #4663)

AUTOMAP is a promising generalized reconstruction approach, however, it is not scalable and hence the practicality is limited. We present dAUTOMAP, a novel way for decomposing the domain transformation of AUTOMAP, making the model scale linearly. We show dAUTOMAP outperforms AUTOMAP with significantly fewer parameters., Comment: Presented at ISMRM 27th Annual Meeting & Exhibition (Abstract #658)

Accurately estimating and correcting the motion artifacts are crucial for 3D image reconstruction of the abdominal and in-utero magnetic resonance imaging (MRI). The state-of-art methods are based on slice-to-volume registration (SVR) where multiple 2D image stacks are acquired in three orthogonal orientations. In this work, we present a novel reconstruction pipeline that only needs one orientation of 2D MRI scans and can reconstruct the full high-resolution image without masking or registration steps. The framework consists of two main stages: the respiratory motion estimation using a self-supervised recurrent neural network, which learns the respiratory signals that are naturally embedded in the asymmetry relationship of the neighborhood slices and cluster them according to a respiratory state. Then, we train a 3D deconvolutional network for super-resolution (SR) reconstruction of the sparsely selected 2D images using integrated reconstruction and total variation loss. We evaluate the classification accuracy on 5 simulated images and compare our results with the SVR method in adult abdominal and in-utero MRI scans. The results show that the proposed pipeline can accurately estimate the respiratory state and reconstruct 4D SR volumes with better or similar performance to the 3D SVR pipeline with less than 20\% sparsely selected slices. The method has great potential to transform the 4D abdominal and in-utero MRI in clinical practice., Comment: Accepted by MICCAI 2019 workshop on Machine Learning for Medical Image Reconstruction

In in-utero MRI, motion correction for fetal body and placenta poses a particular challenge due to the presence of local non-rigid transformations of organs caused by bending and stretching. The existing slice-to-volume registration (SVR) reconstruction methods are widely employed for motion correction of fetal brain that undergoes only rigid transformation. However, for reconstruction of fetal body and placenta, rigid registration cannot resolve the issue of misregistrations due to deformable motion, resulting in degradation of features in the reconstructed volume. We propose a Deformable SVR (DSVR), a novel approach for non-rigid motion correction of fetal MRI based on a hierarchical deformable SVR scheme to allow high resolution reconstruction of the fetal body and placenta. Additionally, a robust scheme for structure-based rejection of outliers minimises the impact of registration errors. The improved performance of DSVR in comparison to SVR and patch-to-volume registration (PVR) methods is quantitatively demonstrated in simulated experiments and 20 fetal MRI datasets from 28-31 weeks gestational age (GA) range with varying degree of motion corruption. In addition, we present qualitative evaluation of 100 fetal body cases from 20-34 weeks GA range.

Purpose: To study placental function - both perfusion and an oxygenation surrogate (T2*)-simultaneously and quantitatively in-vivo. Methods: 15 pregnant women were scanned on a 3T MR scanner. For perfusion measurements, a velocity selective arterial spin labelling preparation module was placed before a multi-echo gradient echo EPI readout to integrate T2* and perfusion measurements in one joint perfusion-oxygenation (PERFOX) acquisition. Joint motion correction and quantification were performed to evaluate changes in T2* and perfusion over GA. Results: The optimised integrated PERFOX protocol and post-processing allowed successful visualization and quantification of perfusion and T2* in all subjects. Areas of high T2* and high perfusion appear to correspond to placental sub-units and show a systematic offset in location along the maternal-fetal axis. The areas of highest perfusion are consistently closer to the maternal basal plate and the areas of highest T2* closer to the fetal chorionic plate. Quantitative results show a strong negative correlation of gestational age with T2* and weak negative correlation with perfusion. Conclusion: A strength of the joint sequence is that it provides truly simultaneous and co-registered estimates of local T2* and perfusion, however, to achieve this, the time per slice is prolonged compared to a perfusion only scan which can potentially limit coverage. The achieved interlocking can be particularly useful when quantifying transient physiological effects such as uterine contractions. PERFOX opens a new avenue to elucidate the relationship between maternal supply and oxygen uptake, both of which are central to placental function and dysfunction.

In utero diffusion MRI provides unique opportunities to non-invasively study the microstructure of tissue during fetal development. A wide range of developmental processes, such as the growth of white matter tracts in the brain, the maturation of placental villous trees, or the fibres in the fetal heart remain to be studied and understood in detail. Advances in fetal interventions and surgery furthermore increase the need for ever more precise antenatal diagnosis from fetal MRI. However, the specific properties of the in utero environment, such as fetal and maternal motion, increased field-of-view, tissue interfaces and safety considerations, are significant challenges for most MRI techniques, and particularly for diffusion. Recent years have seen major improvements, driven by the development of bespoke techniques adapted to these specific challenges in both acquisition and processing. Fetal diffusion MRI, an emerging research tool, is now adding valuable novel information for both research and clinical questions. This paper will highlight specific challenges, outline strategies to target them, and discuss two main applications: fetal brain connectomics and placental maturation.

Diffusion MRI offers a unique probe into neural microstructure and connectivity in the developing brain. However, analysis of neonatal brain imaging data is complicated by inevitable subject motion, leading to a series of scattered slices that need to be aligned within and across diffusion-weighted contrasts. Here, we develop a reconstruction method for scattered slice multi-shell high angular resolution diffusion imaging (HARDI) data, jointly estimating an uncorrupted data representation and motion parameters at the slice or multiband excitation level. The reconstruction relies on data-driven representation of multi-shell HARDI data using a bespoke spherical harmonics and radial decomposition (SHARD), which avoids imposing model assumptions, thus facilitating to compare various microstructure imaging methods in the reconstructed output. Furthermore, the proposed framework integrates slice-level outlier rejection, distortion correction, and slice profile correction. We evaluate the method in the neonatal cohort of the developing Human Connectome Project (650 scans). Validation experiments demonstrate accurate slice-level motion correction across the age range and across the range of motion in the population. Results in the neonatal data show successful reconstruction even in severely motion-corrupted subjects. In addition, we illustrate how local tissue modelling can extract advanced microstructure features such as orientation distribution functions from the motion-corrected reconstructions., Comment: revision. 15 pages, 10 figures, 2 tables

An extended aperture has the potential to greatly improve ultrasound imaging performance. This work extends the effective aperture size by coherently compounding the received radio frequency data from multiple transducers. A framework is developed in which an ultrasound imaging system consisting of $N$ synchronized matrix arrays, each with partly shared field of view, take turns to transmit plane waves. Only one individual transducer transmits at each time while all $N$ transducers simultaneously receive. The subwavelength localization accuracy required to combine information from multiple transducers is achieved without the use of any external tracking device. The method developed in this study is based on the study of the backscattered echoes received by the same transducer and resulting from a targeted scatterer point in the medium insonated by the multiple ultrasound probes of the system. The current transducer locations along with the speed of sound in the medium are deduced by optimizing the cross-correlation between these echoes. The method is demonstrated experimentally in 2-D using ultrasound point and anechoic lesion phantoms and a first demonstration of a free-hand experiment is also shown. Results demonstrate that the coherent multi-transducer imaging has the potential to improve ultrasound image quality, improving resolution and target detectability. Lateral resolution, contrast and contrast-to-noise ratio improved from 0.67 mm, -6.708 dB and 0.702, respectively, when using a single probe, to 0.18 mm, -7.251 dB and 0.721 in the coherent multi-transducer imaging case.

We look into the robustness of deep learning based MRI reconstruction when tested on unseen contrasts and organs. We then propose to generalize the network by training with large publicly-available natural image datasets with synthesized phase information to achieve high cross-domain reconstruction performance which is competitive with domain-specific training. To explain its generalization mechanism, we have also analyzed patch sets for different training datasets., Comment: Accepted for ISBI2019 as a 1-page abstract