Deep Learning-based Prediction of Intra-Cardiac Blood Flow in Long-axis Cine Magnetic Resonance Imaging

Purpose: We aimed to design and evaluate a deep learning-based method to automatically predict the time-varying in-plane blood flow velocity within the cardiac cavities in long-axis cine MRI, validated against 4D flow. Methods: A convolutional neural network (CNN) was implemented, taking cine MRI as the input and the in-plane velocity derived from the 4D flow acquisition as the ground truth. The method was evaluated using velocity vector end-point error (EPE) and angle error. Additionally, the E/A ratio and diastolic function classification derived from the predicted velocities were compared to those derived from the 4D flow. Results: For intra-cardiac pixels with a velocity >5 cm/s, our method achieved an EPE of 8.65 cm/s, angle errorof 41.27°. For pixels with a velocity >25 cm/s, the angle error significantly reduced to 19.26°. Although the averaged blood flow velocity prediction was under-estimated by 26.69%, the high correlation (PCC=0.95) of global time-varying velocity and the visual evaluation demonstrate a good agreement between our prediction and 4D flow data. The E/A ratio was derived with minimal bias, but with considerable mean absolute error of 0.39 and wide limits of agreement. The diastolic function classification showed a high accuracy of 88.1%. Conclusions: Using a deep learning-based algorithm, intra-cardiac blood flow velocities can be predicted from long-axis cine MRI with high correlation with 4D flow derived velocities. Visualization of the derived velocities provides adjunct functional information and may potentially be used to derive the E/A ratio from conventional CMR exams.