Motion-robust approach for 4D cardiac MRI using 2D real-time acquisitions and slice-to-volume reconstruction (SVR)

Motivation: 4D cardiac cine is a powerful tool for comprehensive cardiac function assessment. However, current methods are sensitive to breathing patterns, body motion, and arrhythmia, resulting in 10-20% failure rates. Goal(s): To develop a 4D cardiac cine approach requiring no patient corporation, that is robust to breathing patterns, irregular motion, and arrhythmia. Approach: Multi-slice 2D real-time spiral bSSFP with synchronized ECG is acquired in 4 cardiac orientations, followed by slice-to-volume registration, achieving 1mm3 isotropic resolution cardiac cine with 25 cardiac phases. Results: This method provided 4D cardiac cine in 8:47±1:02minutes for volunteers and arrhythmia patients, with ejection fraction highly correlated to breath-held cine (r=0.99). Impact: This approach enables 1 mm3 isotropic 4D cardiac cine with zero patient corporation, within an averaged 8:47±1:02 minutes acquisition. This approach may be beneficial in patients that are non-cooperative, children, and those with irregular breathing and/or arrhythmia.