Cardiac and respiratory motion extraction for MRI using Pilot Tone-a patient study

Background:The Pilot Tone (PT) technology allows contactless monitoring of physiological motion during the MRI scan. Several studies have shown that both respiratory and cardiac motion can be extracted from the PT signal successfully. However, most of these studies were performed in healthy volunteers. In this study, we seek to evaluate the accuracy and reliability of the cardiac and respiratory signals extracted from PT in patients clinically referred for cardiovascular MRI (CMR). Methods: Twenty-three patients were included in this study, each scanned under free-breathing conditions using a balanced steady-state free-precession real-time (RT) cine sequence on a 1.5T scanner. The PT signal was generated by a built-in PT transmitter integrated within the body array coil. For comparison, ECG and BioMatrix (BM) respiratory sensor signals were also synchronously recorded. To assess the performances of PT, ECG, and BM, cardiac and respiratory signals extracted from the RT cine images were used as the ground truth. Results: The respiratory motion extracted from PT correlated positively with the image-derived respiratory signal in all cases and showed a stronger correlation (absolute coefficient: 0.95-0.09) than BM (0.72-0.24). For the cardiac signal, the precision of PT-based triggers (standard deviation of PT trigger locations relative to ECG triggers) ranged from 6.6 to 81.2 ms (median 19.5 ms). Overall, the performance of PT-based trigger extraction was comparable to that of ECG. Conclusions: This study demonstrates the potential of PT to monitor both respiratory and cardiac motion in patients clinically referred for CMR.