Model checking for trigger loss detection during Doppler ultrasound-guided fetal cardiovascular MRI
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Ultrasound (US) is the state of the art in prenatal diagnosis to depict fetal heart diseases. Cardiovascular magnetic resonance imaging (CMRI) has been proposed as a complementary diagnostic tool. Currently, only trigger-based methods allow the temporal and spatial resolutions necessary to depict the heart over time. Of these methods, only Doppler US (DUS)-based triggering is usable with higher field strengths. DUS is sensitive to motion. This may lead to signal and, ultimately, trigger loss. If too many triggers are lost, the image acquisition is stopped, resulting in a failed imaging sequence. Moreover, losing triggers may prolong image acquisition. Hence, if no actual trigger can be found, injected triggers are added to the signal based on the trigger history.
We use model checking, a technique originating from the computer science domain that formally checks if a model satisfies given requirements, to simultaneously model heart and respiratory motion and to decide whether respiration has a prominent effect on the signal. Using bounds on the physiological parameters and their variability, the method detects when changes in the signal are due to respiration. We use this to decide when to inject a trigger.
In a real-world scenario, we can reduce the number of falsely injected triggers by 94% from more than 87% to less than 5%. On a subset of motion that would allow CMRI, the number can be further reduced to below 0.2%. In a study using simulations with a robot, we show that our method works for different types of motions, motion ranges, starting positions and heartbeat traces.
While DUS is a promising approach for fetal CMRI, correct trigger injection is critical. Our model checking method can reduce the number of wrongly injected triggers substantially, providing a key prerequisite for fast and artifact free CMRI.
KeywordsFetal Heart MRI Cardiovascular Triggering Model checking
Compliance with ethical standard
Conflict of interest
K. Fehrs, F. Kording and C. Ruprecht are the founders of the company northh medical GmbH. The other authors declare that they have no conflict of interest.
For this type of study, formal consent is not required.
- 4.Baier C, Katoen JP (2008) Principles of model checking. The MIT Press, LondonGoogle Scholar
- 5.Cimatti A (2001) Industrial applications of model checking. Springer, Berlin, pp 153–168Google Scholar
- 10.Frauenrath T, Hezel F, Renz W, d’Orth TdG, Dieringer M, von Knobelsdorff-Brenkenhoff F, Prothmann M, Schulz Menger J, Niendorf T (2010) Acoustic cardiac triggering: a practical solution for synchronization and gating of cardiovascular magnetic resonance at 7 Tesla. J Cardiovasc Magn Reson 12:67CrossRefPubMedPubMedCentralGoogle Scholar
- 13.Kording F, Ruprecht C, Schoennagel B, Fehrs K, Yamamura J, Adam G, Goebel J, Nassenstein K, Maderwald S, Quick HH, Kraff O (2017) Doppler ultrasound triggering for cardiac MRI at 7T. Magn Reson Med 74:1291Google Scholar
- 14.Kording F, Tavares de Sousa M, Yamamura J, Kladeck M, Gerhard A, Ruprecht C, Schoennagel B (2016) Funktionelle fetale kardiale MRT Bildgebung basierend auf Doppler-Ultraschall: Erste Erfahrungen. Fortschr Röntgenstr 188(S 01):RK205\_2Google Scholar
- 18.Sievers B, Wiesner M, Kiria N, Speiser U, Schoen S, Strasser RH (2011) Influence of the trigger technique on ventricular function measurements using 3-Tesla magnetic resonance imaging: comparison of ECG versus pulse wave triggering. Acta Radiol (Stockholm, Sweden: 1987) 52(4):385–392Google Scholar
- 20.van Amerom JFP, Lloyd DFA, Price AN, Kuklisova Murgasova M, Aljabar P, Malik SJ, Lohezic M, Rutherford MA, Pushparajah K, Razavi R, Hajnal JV (2018) Fetal cardiac cine imaging using highly accelerated dynamic MRI with retrospective motion correction and outlier rejection. Magn Reson Med 79(1):327–338CrossRefPubMedGoogle Scholar