@phdthesis{Martens2020,
  author    = {Martens, Johannes},
  title     = {Development of an In-Silico Model of the Arterial Epicardial Vasculature},
  doi       = {10.25972/OPUS-18247},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-182478},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {In dynamic CE MR perfusion imaging the passage of an intravenously injected CA bolus through tissue is monitored to assess the myocardial pefusion state. To enable this, knowledge of the shape of CA wash-in through upstream epicardial vessels is required, the so-called AIF. For technical reasons this cannot be quantified directly in the supplying vessels and is thus measured in the left ventricle, which introduces the risk of systematic errors in quantification of MBF due to bolus dispersion in coronary vessels. This means occuring CA dispersion must be accounted in the quantification process in order to produce reliable and reproducible results. In order to do this, CFD simulations are performed to analyze and approximate these errors and deepen insights and knowledge gained from previous CFD analyses on both idealized as well as realistic and pathologically altered 3D geometries. In a first step, several different procedures and approaches are undertaken in order to accelerate the performed workflow, however, maintaining a sufficient degree of numerical accuracy. In the end, the implementation of these steps makes the analysis of the cardiovascular 3D model of unprecedented detail including vessels at pre-arteriolar level feasible at all. The findings of the Navier-Stokes simulations are thus validated with regard to different aspects of cardiac blood flow. These include the distribution of VBF into the different myocardial regions, the areals, which can be associated to the large coronary arteries as well as the fragmentation of VBF into vessels of different diameters. The subsequently performed CA transport simulations yield results on the one hand confirming previous studies. On the other hand, interesting additional knowledge about the behavior of CA dispersion in coronary arteries is obtained both regarding travelled distance as well as vessel diameters. The relative dispersion of the so-called vascular transport function, a characterizing feature of vascular networks, shows a linear decrease with vessel diameter. This results in asymptotically decreased additional dispersion of the CA time curve towards smaller and more distal vessels. Nonetheless, perfusion quantification errors are subject to strong regional variability and reach an average value of \$(-28\pm16)\$ \\% at rest across the whole myocardium. Depending on the distance from the inlet and the considered coronary tree, MBF errors up to 62 \\% are observed.},
  subject      = {Computerunterst{\"u}tztes Verfahren},
  language  = {en}
}
@phdthesis{Eirich2022,
  author    = {Eirich, Philipp},
  title     = {Accelerated non-Cartesian cardiovascular MR Imaging at 3T and 7T},
  doi       = {10.25972/OPUS-25397},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-253974},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {In this work, accelerated non-Cartesian Magnetic Resonance Imaging (MRI) methods were established and applied to cardiovascular imaging (CMR) at different magnetic field strengths (3T and 7T). To enable rapid data acquisition, highly efficient spiral k-space trajectories were created. In addition, hybrid sampling patterns such as the twisting radial lines (TWIRL) k-space trajectory were studied. Imperfections of the dynamic gradient system of a MR scanner result in k-space sampling errors. Ultimately, these errors can lead to image artifacts in non-Cartesian acquisitions. Among other reasons such as an increased reconstruction complexity, they cause the lack of spiral sequences in clinical routine compared to standard Cartesian imaging. Therefore, the Gradient System Transfer Functions (GSTFs) of both scanners were determined and used for k-space trajectory correction in post-correction as well as in terms of a pre-emphasis. The GSTF pre-emphasis was implemented as a fully automatic procedure, which enabled a precise correction of arbitrary gradient waveforms for double-oblique slice orientations. Consequently, artifacts due to trajectory errors could be mitigated, which resulted in high image quality in non-Cartesian MRI. Additionally, the GSTF correction was validated by measuring pre-emphasized spiral gradient outputs, which showed high agreement with the theoretical gradient waveforms. Furthermore, it could be demonstrated that the performance of the GSTF correction is superior to a simple delay compensation approach. The developed pulse sequences were applied to gated as well as real-time CMR. Special focus lied on the implementation of a spiral imaging protocol to resolve the beating heart of animals and humans in real time and free breathing. In order to achieve real-time CMR with high spatiotemporal resolution, k-space undersampling was performed. For this reason, efficient sampling strategies were developed with the aim to facilitate compressed sensing (CS) during image reconstruction. The applied CS approach successfully removed aliasing artifacts and yielded high-resolution cardiac image series. Image reconstruction was performed offline in all cases such that the images were not available immediately after acquisition at the scanner. Spiral real-time CMR could be performed in free breathing, which led to an acquisition time of less than 1 minute for a whole short-axis stack. At 3T, the results were compared to the gold standard of electrocardiogram-gated Cartesian CMR in breath hold, which revealed similar values for important cardiovascular functional and volumetric parameters. This paves the way to an application of the developed framework in clinical routine of CMR. In addition, the spiral real-time protocol was transferred to swallowing and speech imaging at 3T, and first images were presented. The results were of high quality and confirm the straightforward utilization of the spiral sequence in other fields of MRI. In general, the GSTF correction yielded high-quality images at both field strengths, 3T and 7T. Off-resonance related blurring was mitigated by applying non-Cartesian readout gradients of short duration. At 7T, however, B1-inhomogeneity led to image artifacts in some cases. All in all, this work demonstrated great advances in accelerating the MRI process by combining efficient, undersampled non-Cartesian k-space coverage with CS reconstruction. Trajectory correction using the GSTF can be implemented at any scanner model and enables non-Cartesian imaging with high image quality. Especially MRI of dynamic processes greatly benefits from the presented rapid imaging approaches.},
  subject      = {Kernspintomografie},
  language  = {en}
}
@phdthesis{Richter2021,
  author    = {Richter, Julian Alexander J{\"u}rgen},
  title     = {Wave-CAIPI for Accelerated Dynamic MRI of the Thorax},
  doi       = {10.25972/OPUS-23207},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232071},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {In summary, the wave-CAIPI k-space trajectory presents an efficient sampling strategy for accelerated MR acquisitions. Using wave-CAIPI in parallel imaging reconstructions leads to a reduced noise level in the reconstructed images, compared to the Cartesian standard trajectory. This effect could be quantified by means of noise and SNR calculations. An SNR gain can be traded for a reduced scan time, i.e., additional undersampling, or for an enhanced image quality, keeping scan time constant. Acceleration of MR imaging is especially important in dynamic applications, since these examinations are inherently time-consuming. The impact of wave-CAIPI sampling on image quality and its potential for scan time reduction was investigated for two dynamic applications: self-gated dynamic 3D lung MRI during free breathing and cardiac 4D flow MRI. Dynamic 3D Lung MRI By employing wave-CAIPI sampling in self-gated, free-breathing dynamic 3D lung MRI for the purpose of radiotherapy treatment planning, the image quality of accelerated scans could be enhanced. Volunteer examinations were used to quantify image quality by means of similarity between accelerated and reference images. To this end, the normalized mutual information and the root-mean-square error were chosen as quantitative image similarity measures. The wave-CAIPI sampling was shown to exhibit superior quality, especially for short scan times. The values of the normalized mutual information were (10.2 +- 7.3)\% higher in the wave-CAIPI case -- the root-mean-square error was (18.9 +- 13.2)\% lower on average. SNR calculations suggest an average SNR benefit of around 14\% for the wave-CAIPI, compared to Cartesian sampling. Resolution of the lung in 8 breathing states can be achieved in only 2 minutes. By using the wave-CAIPI k-space trajectory, precise tumor delineation and assessment of respiration-induced displacement is facilitated. Cardiac 4D Flow MRI In 4D flow MRI, acceleration of the image acquisition is essential to incorporate the corresponding scan protocols into clinical routine. In this work, a retrospective 6-fold acceleration of the image acquisition was realized. Cartesian and wave-CAIPI 4D flow examinations of healthy volunteers were used to quantify uncertainties in flow parameters for the respective sampling schemes. By employing wave-CAIPI sampling, the estimated errors in flow parameters in 6-fold accelerated scans could be reduced by up to 55\%. Noise calculations showed that the noise level in 6-fold accelerated 4D flow acquisitions with wave-CAIPI is 43\% lower, compared to Cartesian sampling. Comparisons between Cartesian and wave-CAIPI 4D flow examinations with a prospective acceleration factor R=2 revealed small, but partly statistically significant discrepancies. Differences between 2-fold and 6-fold accelerated wave-CAIPI scans are comparable to the differences between Cartesian and wave-CAIPI examinations at R=2. Wave-CAIPI 4D flow acquisitions of the aorta could be performed with an average, simulated scan time of under 4 minutes, with reduced uncertainties in flow parameters. Important visualizations of hemodynamic flow patterns in the aorta were only slightly affected by undersampling in the wave-CAIPI case, whereas for Cartesian sampling, considerable discrepancies were observed.},
  subject      = {Magnetresonanztomographie},
  language  = {en}
}
@phdthesis{Lohr2021,
  author    = {Lohr, David},
  title     = {Functional and Structural Characterization of the Myocardium},
  doi       = {10.25972/OPUS-23448},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234486},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Clinical practice in CMR with respect to cardiovascular disease is currently focused on tissue characterization, and cardiac function, in particular. In recent years MRI based diffusion tensor imaging (DTI) has been shown to enable the assessment of microstructure based on the analysis of Brownian motion of water molecules in anisotropic tissue, such as the myocardium. With respect to both functional and structural imaging, 7T MRI may increase SNR, providing access to information beyond the reach of clinically applied field strengths. To date, cardiac 7T MRI is still a research modality that is only starting to develop towards clinical application. In this thesis we primarily aimed to advance methods of ultrahigh field CMR using the latest 7T technology and its application towards the functional and structural characterization of the myocardium. Regarding the assessment of myocardial microstructure at 7T, feasibility of ex vivo DTI of large animal hearts was demonstrated. In such hearts a custom sequence implemented for in vivo DTI was evaluated and fixation induced alterations of derived diffusion metrics and tissue properties were assessed. Results enable comparison of prior and future ex vivo DTI studies and provide information on measurement parameters at 7T. Translating developed methodology to preclinical studies of mouse hearts, ex vivo DTI provided highly sensitive surrogates for microstructural remodeling in response to subendocardial damage. In such cases echocardiography measurements revealed mild diastolic dysfunction and impaired longitudinal deformation, linking disease induced structural and functional alterations. Complementary DTI and echocardiography data also improved our understanding of structure-function interactions in cases of loss of contractile myofiber tracts, replacement fibrosis, and LV systolic failure. Regarding the functional characterization of the myocardium at 7T, sequence protocols were expanded towards a dedicated 7T routine protocol, encompassing accurate cardiac planning and the assessment of cardiac function via cine imaging in humans. This assessment requires segmentation of myocardial contours. For that, artificial intelligence (AI) was developed and trained, enabling rapid automatic generation of cardiac segmentation in clinical data. Using transfer learning, AI models were adapted to cine data acquired using the latest generation 7T system. Methodology for AI based segmentation was translated to cardiac pathology, where automatic segmentation of scar tissue, edema and healthy myocardium was achieved. Developed radiofrequency hardware facilitates translational studies at 7T, providing controlled conditions for future method development towards cardiac 7T MRI in humans. In this thesis the latest 7T technology, cardiac DTI, and AI were used to advance methods of ultrahigh field CMR. In the long run, obtained results contribute to diagnostic methods that may facilitate early detection and risk stratification in cardiovascular disease.},
  subject      = {Diffusionsgewichtete Magnetresonanztomografie},
  language  = {en}
}
@phdthesis{Hock2024,
  author    = {Hock, Michael},
  title     = {Methods for Homogenization of Spatio-Temporal B\(_0\) Magnetic Field Variations in Cardiac MRI at Ultra-High Field Strength},
  doi       = {10.25972/OPUS-34821},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-348213},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {Cardiovascular disease is one of the leading causes of death worldwide and, so far, echocardiography, nuclear cardiology, and catheterization are the gold standard techniques used for its detection. Cardiac magnetic resonance (CMR) can replace the invasive imaging modalities and provide a "one-stop shop" characterization of the cardiovascular system by measuring myocardial tissue structure, function and perfusion of the heart, as well as anatomy of and flow in the coronary arteries. In contrast to standard clinical magnetic resonance imaging (MRI) scanners, which are often operated at a field strength of 1.5 or 3 Tesla (T), a higher resolution and subsequent cardiac parameter quantification could potentially be achieved at ultra-high field, i.e., 7 T and above. Unique insights into the pathophysiology of the heart are expected from ultra-high field MRI, which offers enhanced image quality in combination with novel contrast mechanisms, but suffers from spatio-temporal B0 magnetic field variations. Due to the resulting spatial misregistration and intra-voxel dephasing, these B0-field inhomogeneities generate a variety of undesired image artifacts, e.g., artificial image deformation. The resulting macroscopic field gradients lead to signal loss, because the effective transverse relaxation time T2* is shortened. This affects the accuracy of T2* measurements, which are essential for myocardial tissue characterization. When steady state free precession-based pulse sequences are employed for image acquisition, certain off-resonance frequencies cause signal voids. These banding artifacts complicate the proper marking of the myocardium and, subsequently, systematic errors in cardiac function measurements are inevitable. Clinical MR scanners are equipped with basic shim systems to correct for occurring B0-field inhomogeneities and resulting image artifacts, however, these are not sufficient for the advanced measurement techniques employed for ultra-high field MRI of the heart. Therefore, this work focused on the development of advanced B0 shimming strategies for CMR imaging applications to correct the spatio-temporal B0 field variations present in the human heart at 7 T. A novel cardiac phase-specific shimming (CPSS) technique was set up, which featured a triggered B0 map acquisition, anatomy-matched selection of the shim-region-of-interest (SROI), and calibration-based B0 field modeling. The influence of technical limitations on the overall spherical harmonics (SH) shim was analyzed. Moreover, benefits as well as pitfalls of dynamic shimming were debated in this study. An advanced B0 shimming strategy was set up and applied in vivo, which was the first implementation of a heart-specific shimming approach in human UHF MRI at the time. The spatial B0-field patterns which were measured in the heart throughout this study contained localized spots of strong inhomogeneities. They fluctuated over the cardiac cycle in both size and strength, and were ideally addressed using anatomy-matched SROIs. Creating a correcting magnetic field with one shim coil, however, generated eddy currents in the surrounding conducting structures and a resulting additional, unintended magnetic field. Taking these shim-to-shim interactions into account via calibration, it was demonstrated for the first time that the non-standard 3rd-order SH terms enhanced B0-field homogeneity in the human heart. However, they were attended by challenges for the shim system hardware employed in the presented work, which was indicated by the currents required to generate the optimal 3rd-order SH terms exceeding the dynamic range of the corresponding shim coils. To facilitate dynamic shimming updated over the cardiac cycle for cine imaging, the benefit of adjusting the oscillating CPSS currents was found to be vital. The first in vivo application of the novel advanced B0 shimming strategy mostly matched the simulations. The presented technical developments are a basic requirement to quantitative and functional CMR imaging of the human heart at 7 T. They pave the way for numerous clinical studies about cardiac diseases, and continuative research on dedicated cardiac B0 shimming, e.g., adapted passive shimming and multi-coil technologies.},
  subject      = {Kernspintomografie},
  language  = {en}
}