Purpose: The aim of this study is to evaluate a deep variational network, FlowVN, for the reconstruction of heavily undersampled 4D Flow MRI across multiple sites.
Methods: FlowVN was trained on fully sampled 4D Flow MRI datasets of healthy volunteers from one site. The model was tested on retrospective undersampled data (R = 6-22) of six normal volunteers from the same site and six from another site, prospectively undersampled data (R = 12.4-13.8) of six healthy volunteers from the second site and six patients with aortic stenosis from first Site. Performance was evaluated using nRMSE, relative and angular error, average and maximum velocity, flow rate, volumetric flow, and turbulent kinetic energy (TKE), with a Wilcoxon signed-rank test to assess the difference from ground truth.
Results: FlowVN showed minimal sensitivity to the number of training datasets and performed well even when trained on a single dataset. FlowVN also demonstrated good generalizability across sites. No significant difference in average and maximum velocity was observed up to R = 16. Total TKE was preserved up to R = 10 in the normal volunteers, but was well preserved even at higher acceleration factors in the aortic stenosis patients. Flow volumes through the ascending and descending aorta were well preserved for all acceleration factors, although ascending aorta flow volumes for data from one site were significantly different from ground truth for AF > 16.
Conclusion: FlowVN accurately reconstructs highly undersampled 4D Flow MRI from multiple sites using a model trained on a single dataset, maintaining excellent quantitative image quality even at very high acceleration factors.
Keywords: cardiac MRI; deep learning; flow; image reconstruction; turbulent kinetic energy; variational networks.
© 2026 The Author(s). Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.