Manifold-based respiratory phase estimation enables motion and distortion correction of free-breathing cardiac diffusion tensor MRI.

Purpose: For in vivo cardiac DTI, breathing motion and B ₀ field inhomogeneities produce misalignment and geometric distortion in diffusion-weighted (DW) images acquired with conventional single-shot EPI. We propose using a dimensionality reduction method to retrospectively estimate the respiratory phase of DW images and facilitate both distortion correction (DisCo) and motion compensation.
Methods: Free-breathing electrocardiogram-triggered whole left-ventricular cardiac DTI using a second-order motion-compensated spin echo EPI sequence and alternating directionality of phase encoding blips was performed on 11 healthy volunteers. The respiratory phase of each DW image was estimated after projecting the DW images into a 2D space with Laplacian eigenmaps. DisCo and motion compensation were applied to the respiratory sorted DW images. The results were compared against conventional breath-held T ₂ half-Fourier single shot turbo spin echo. Cardiac DTI parameters including fractional anisotropy, mean diffusivity, and helix angle transmurality were compared with and without DisCo.
Results: The left-ventricular geometries after DisCo and motion compensation resulted in significantly improved alignment of DW images with T ₂ reference. DisCo reduced the distance between the left-ventricular contours by 13.2% ± 19.2%, P < .05 (2.0 ± 0.4 for DisCo and 2.4 ± 0.5 mm for uncorrected). DisCo DTI parameter maps yielded no significant differences (mean diffusivity: 1.55 ± 0.13 × 10 ^-3 mm ² /s and 1.53 ± 0.13 × 10 ^-3 mm ² /s, P = .09; fractional anisotropy: 0.375 ± 0.041 and 0.379 ± 0.045, P = .11; helix angle transmurality: 1.00% ± 0.10°/% and 0.99% ± 0.12°/%, P = .44), although the orientation of individual tensors differed.
Conclusion: Retrospective respiratory phase estimation with LE-based DisCo and motion compensation in free-breathing cardiac DTI resulting in significantly reduced geometric distortion and improved alignment within and across slices.
(© 2021 International Society for Magnetic Resonance in Medicine.)