Generalized super-resolution of 4D Flow MRI : extending capabilities using ensemble learning

Abstract: 4D Flow Magnet Resonance Imaging (4D Flow MRI) is a novel non-invasive technique for imaging of cardiovascular blood flow. However, when utilized as a stand-alone analysis method, 4D Flow MRI has certain limitations including limited spatial resolution and noise artefacts, motivating the application of dedicated post-processing tools. Learning based super-resolution (SR) has here emerged as a promising utility for such work, however, more often than not, these efforts have been constricted to a narrowly defined cardiovascular domain. Rather, there has been limited exploration of how learned super-resolution models perform across \emph{multiple} cardiovascular compartments, with the wide range of hemodynamic compartments covered by the cardiovasculature as an apparent challenge. To address this, we investigate the generalizability of 4D Flow MRI super-resolution using ensemble learning. Our investigation employs ensemble learning techniques, specifically bagging and stacking, with a convolutional neural network (4DFlowNet) serving as the framework for all base learners. To assist in training, synthetic training data was extracted from patient-specific, physics-based velocity fields derived from computational fluid dynamic (CFD) simulations conducted in three key compartments: the aorta, brain and the heart. Varying base and ensemble networks were then trained on pairs of high-resolution and low-resolution synthetic data, with performance quantitatively assessed as a function of cardiovascular domain, and specific architecture. To ensure clinical relevance, we also evaluated model performance on clinically acquired MRI data from the very same three compartments.  We find that ensemble models improve performance, as compared to isolated equivalents. Our ensemble model \textit{Stacking Block-3}, improves in-silico error rate by $16.22$ points across the average domain. Additionally, performance on the aorta, brain and heart improves by $2.66$, $5.81$ and $2.00$ points respectively. Employing both qualitative and quantitative evaluation methods on the in-vivo data, we find that ensemble models produce super-resolved velocity fields that are quantitatively coherent with ground truth reference data and visually pleasing. To conclude, ensemble learning has shown potential in generalizing 4D Flow MRI across multiple cardiovascular compartments.