Free-running fat-suppressed radial whole-heart 4D flow using OptiPulse

Motivation: Free-running radial 4D flow has been shown to enable accurate whole-heart quantification and visualization of hemodynamics. However, unsuppressed fat signal can lead to artifacts, which may compromise image quality and cause errors in flow quantification. Goal(s): Our study therefore aims to reduce fat signal in radial 4D flow MRI. Approach: We integrated a novel b-splines iteratively optimized water-excitation RF pulse generated with a previously described framework (OptiPulse) into a radial 4D flow sequence to suppress the signal from fat. Results: We successfully integrated OptiPulse in radial 4D flow to suppress fat signal and demonstrated comparable quantitative flow assessment to non-fat-suppressed 4D flow. Impact: The integration of b-splines iteratively optimized water-excitation RF pulses (OptiPulse) into a free-running radial whole-heart 4D flow sequence leads to significantly reduced fat-signal in a promising step towards more robust hemodynamic assessment in patients with large amounts of adipose tissue.