Automatic Selection of Mask and Arterial Phase Images for Temporally-Resolved MR Digital Subtraction Angiography
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1 Automatic Selection of Mask and Arterial Phase Images for Temporally-Resolved MR Digital Subtraction Angiography 21 May 2002, ISMRM 2002 Junhwan Kim, Martin R. Prince, Ramin Zabih,, Jeff Bezanson, Richard Watts, Hale Erel,, Yi Wang Department of Radiology Weil Medical College of Cornell University
2 2D Projection MRA: 5 ml Gd Raw image Complex subtraction Left Right Coronal T1
3 2D Projection MRA: + complex subtraction Ankles Knee
4 Time-resolved background-subtracted CEMRA Time-resolved image gives too many images Surgeon prefers one image that shows everything Our goal: Create a single best subtraction image by combining best mask and best arterial phase images
5 Coronal spoiled gradient echo sequence parameters TR/TE/flip angle = 10/2/60 degrees Slab thickness = 7-10 cm Field-of-view = 30cm Matrix = 256x192 Bandwidth = 16 khz The imaging time 1.95 seconds per acquisition repeat the acquisition 35 times total of 67 seconds
6 Major challenges Identify the contrast bolus arrival Avoid motion corrupted images Tedious manual procedure
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8 Major challenges Identify the contrast bolus arrival Avoid motion corrupted images Tedious manual procedure Issues Quantify image quality Select the mask and arterial phase images based on image quality
9 Subtracted Image Quality Evaluation Two basic criteria Bright foreground (i.e. artery) Dark background Quality = avg(artery) avg(background) Problem: How to determine whether each pixel is in artery or background We need assumptions! Artery is thin and vertically oriented Artery width is typically 1-5 mm
10 Artery-Background Classification
11 Artery-Background Classification A A pixel is in the artery If the pixel ranks in brightness between 1 st and 2 nd of 128 pixels in the scan line. A pixel is in the background If the pixel ranks in brightness between 11 th and 128 th of 128 pixels in the scan line. Unclassified Otherwise
12 Select mask and arterial phase Contrast arrival detection Best mask / arterial phase pair selection Best mask set / arterial phase set selection
13 Contrast Arrival Detection
14 Best mask / arterial phase pair selection arterial 1 arterial 2 arterial 3 arterial 4 arterial 5 arterial 6 arterial 7 arterial 8 masks 1 masks 2 masks 3 masks 4 masks 5
15 Best mask set / arterial phase set selection arterials 1 arterials 2 arterials 3 arterials 4 arterials 5 arterials 6 arterials 7 arterials 8 masks 1 masks 2 masks 3 masks 4 masks 5
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17 Patients Period: Sep 11, 2000 to Nov 25, 2000 Demography 26 males aged (mean 70) years 19 females aged (mean 68) years. The primary indications claudication (n=23) limb threatening ischemia (n=11) aneurysm (n=7) post-bypass graft (n=3) dissection (n=1). Approved by our Institutional Review Board.
18 Image evaluation Blind test by two radiologists (MRP, HE) Auto >> Manual Auto > Manual Auto Manual Auto < Manual Auto << Manual Statistical analysis Paired signed-rank Wilcoxon test
19 Image Quality Comparison Radiologist 1 Radiologist 2 Total Auto >> Manual Auto > Manual Auto Manual Auto < Manual Auto << Manual p value
20 Automatic wins Automatic Manual Better geniculate arteries Auto > Manual (both readers)
21 Automatic wins Automatic Manual More details of distal arteries but more background veins in the left leg Auto > Manual (reader 1) and Auto >> Manual (reader 2)
22 Trade-off Automatic Manual Reduction in background motion artifacts More details in distal left leg Auto < Manual (both readers)
23 Trade-off Automatic Manual More details of distal arteries but more background veins in the left leg Slightly better proximal arteries Auto < Manual (reader 1) and Auto Manual (reader 2)
24 Trade-off Automatic Manual Better distal tibial arteries and the right popliteal artery Better detail of the left popliteal artery Auto > Manual (reader 1) and Auto Manual (reader 2)
25 Manual wins Automatic Manual Enhanced bony structure Auto << Manual (both readers)
26 Contribution Automatic image post-processing processing technique Simple yet effective Daily use PC version coming soon! Special thanks to Younga Kim: Slide preparation All of you
27 Automatic Selection of Mask and Arterial Phase Images for Temporally-Resolved MR Digital Subtraction Angiography 21 May 2002, ISMRM 2002 Junhwan Kim, Martin R. Prince, Ramin Zabih,, Jeff Bezanson, Richard Watts, Hale Erel,, Yi Wang Department of Radiology Weil Medical College of Cornell University
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