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Tricuspid valve flow measurement using a deep learning framework for automated valve-tracking 2D phase contrast

Lamy, Jérôme ; Gonzales, Ricardo A. ; Xiang, Jie ; Seemann, Felicia ; Huber, Steffen ; Steele, Jeremy ; Wieben, Oliver ; Heiberg, Einar LU orcid and Peters, Dana C. (2024) In Magnetic Resonance in Medicine 92(5). p.1838-1850
Abstract

Purpose: Tricuspid valve flow velocities are challenging to measure with cardiovascular MR, as the rapidly moving valvular plane prohibits direct flow evaluation, but they are vitally important to diastolic function evaluation. We developed an automated valve-tracking 2D method for measuring flow through the dynamic tricuspid valve. Methods: Nine healthy subjects and 2 patients were imaged. The approach uses a previously trained deep learning network, TVnet, to automatically track the tricuspid valve plane from long-axis cine images. Subsequently, the tracking information is used to acquire 2D phase contrast (PC) with a dynamic (moving) acquisition plane that tracks the valve. Direct diastolic net flows evaluated from the dynamic PC... (More)

Purpose: Tricuspid valve flow velocities are challenging to measure with cardiovascular MR, as the rapidly moving valvular plane prohibits direct flow evaluation, but they are vitally important to diastolic function evaluation. We developed an automated valve-tracking 2D method for measuring flow through the dynamic tricuspid valve. Methods: Nine healthy subjects and 2 patients were imaged. The approach uses a previously trained deep learning network, TVnet, to automatically track the tricuspid valve plane from long-axis cine images. Subsequently, the tracking information is used to acquire 2D phase contrast (PC) with a dynamic (moving) acquisition plane that tracks the valve. Direct diastolic net flows evaluated from the dynamic PC sequence were compared with flows from 2D-PC scans acquired in a static slice localized at the end-systolic valve position, and also ventricular stroke volumes (SVs) using both planimetry and 2D PC of the great vessels. Results: The mean tricuspid valve systolic excursion was 17.8 ± 2.5 mm. The 2D valve-tracking PC net diastolic flow showed excellent correlation with SV by right-ventricle planimetry (bias ± 1.96 SD = −0.2 ± 10.4 mL, intraclass correlation coefficient [ICC] = 0.92) and aortic PC (−1.0 ± 13.8 mL, ICC = 0.87). In comparison, static tricuspid valve 2D PC also showed a strong correlation but had greater bias (p = 0.01) versus the right-ventricle SV (10.6 ± 16.1 mL, ICC = 0.61). In most (8 of 9) healthy subjects, trace regurgitation was measured at begin-systole. In one patient, valve-tracking PC displayed a high-velocity jet (380 cm/s) with maximal velocity agreeing with echocardiography. Conclusion: Automated valve-tracking 2D PC is a feasible route toward evaluation of tricuspid regurgitant velocities, potentially solving a major clinical challenge.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
deep learning, phase contrast, regurgitation, slice-following, tricuspid valve
in
Magnetic Resonance in Medicine
volume
92
issue
5
pages
13 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85194834294
  • pmid:38817154
ISSN
0740-3194
DOI
10.1002/mrm.30163
language
English
LU publication?
yes
id
733f9ddf-127b-45f4-84fa-5762ef871ffb
date added to LUP
2024-10-14 15:15:22
date last changed
2025-07-08 13:52:10
@article{733f9ddf-127b-45f4-84fa-5762ef871ffb,
  abstract     = {{<p>Purpose: Tricuspid valve flow velocities are challenging to measure with cardiovascular MR, as the rapidly moving valvular plane prohibits direct flow evaluation, but they are vitally important to diastolic function evaluation. We developed an automated valve-tracking 2D method for measuring flow through the dynamic tricuspid valve. Methods: Nine healthy subjects and 2 patients were imaged. The approach uses a previously trained deep learning network, TVnet, to automatically track the tricuspid valve plane from long-axis cine images. Subsequently, the tracking information is used to acquire 2D phase contrast (PC) with a dynamic (moving) acquisition plane that tracks the valve. Direct diastolic net flows evaluated from the dynamic PC sequence were compared with flows from 2D-PC scans acquired in a static slice localized at the end-systolic valve position, and also ventricular stroke volumes (SVs) using both planimetry and 2D PC of the great vessels. Results: The mean tricuspid valve systolic excursion was 17.8 ± 2.5 mm. The 2D valve-tracking PC net diastolic flow showed excellent correlation with SV by right-ventricle planimetry (bias ± 1.96 SD = −0.2 ± 10.4 mL, intraclass correlation coefficient [ICC] = 0.92) and aortic PC (−1.0 ± 13.8 mL, ICC = 0.87). In comparison, static tricuspid valve 2D PC also showed a strong correlation but had greater bias (p = 0.01) versus the right-ventricle SV (10.6 ± 16.1 mL, ICC = 0.61). In most (8 of 9) healthy subjects, trace regurgitation was measured at begin-systole. In one patient, valve-tracking PC displayed a high-velocity jet (380 cm/s) with maximal velocity agreeing with echocardiography. Conclusion: Automated valve-tracking 2D PC is a feasible route toward evaluation of tricuspid regurgitant velocities, potentially solving a major clinical challenge.</p>}},
  author       = {{Lamy, Jérôme and Gonzales, Ricardo A. and Xiang, Jie and Seemann, Felicia and Huber, Steffen and Steele, Jeremy and Wieben, Oliver and Heiberg, Einar and Peters, Dana C.}},
  issn         = {{0740-3194}},
  keywords     = {{deep learning; phase contrast; regurgitation; slice-following; tricuspid valve}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{1838--1850}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Magnetic Resonance in Medicine}},
  title        = {{Tricuspid valve flow measurement using a deep learning framework for automated valve-tracking 2D phase contrast}},
  url          = {{http://dx.doi.org/10.1002/mrm.30163}},
  doi          = {{10.1002/mrm.30163}},
  volume       = {{92}},
  year         = {{2024}},
}