Free-breathing Motion-Informed Locally Low-Rank Quantitative 3D Myocardial Perfusion Imaging

Purpose To propose respiratory motion-informed locally low-rank reconstruction (MI-LLR) for robust free-breathing single-bolus quantitative 3D myocardial perfusion CMR imaging. Simulation and in-vivo results are compared to locally low-rank (LLR) and compressed sensing reconstructions (CS) for reference. Methods Data were acquired using a 3D Cartesian pseudo-spiral in-out k-t undersampling scheme (R = 10) and reconstructed using MI-LLR, which encompasses two stages. In the first stage, approximate displacement fields are derived from an initial LLR reconstruction to feed a motion-compensated reference system to a second reconstruction stage, which reduces the rank of the inverse problem. For comparison, data were also reconstructed with LLR and frame-by-frame CS using wavelets as sparsifying transform (l1$ {\ell}_1 $-wavelet). Reconstruction accuracy relative to ground truth was assessed using synthetic data for realistic ranges of breathing motion, heart rates, and SNRs. In-vivo experiments were conducted in healthy subjects at rest and during adenosine stress. Myocardial blood flow (MBF) maps were derived using a Fermi model. Results Improved uniformity of MBF maps with reduced local variations was achieved with MI-LLR. For rest and stress, intra-volunteer variation of absolute and relative MBF was lower in MI-LLR (+/- 0.17 mL/g/min [26%] and +/- 1.07 mL/g/min [33%]) versus LLR (+/- 0.19 mL/g/min [28%] and +/- 1.22 mL/g/min [36%]) and versus l1$ {\ell}_1 $-wavelet (+/- 1.17 mL/g/min [113%] and +/- 6.87 mL/g/min [115%]). At rest, intra-subject MBF variation was reduced significantly with MI-LLR. Conclusion The combination of pseudo-spiral Cartesian undersampling and dual-stage MI-LLR reconstruction improves free-breathing quantitative 3D myocardial perfusion CMR imaging under rest and stress condition.