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J Magn Reson Imaging. Author manuscript; available in PMC 2016 October 01.
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Published in final edited form as:

J Magn Reson Imaging. 2015 October ; 42(4): 887–901. doi:10.1002/jmri.24850.

Motion Artefacts in MRI: a Complex Problem with Many Partial

Solutions
Maxim Zaitsev, Ph.D1,*, Julian. Maclaren, Ph.D1,2, and Michael Herbst, Ph.D1,3
1Department of Radiology, University Medical Centre Freiburg, Freiburg, Germany
2Department of Radiology, Stanford University, Stanford, USA
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3University of Hawaii, Department of Medicine, John A. Burns School of Medicine, Honolulu, USA

Abstract
Subject motion during magnetic resonance imaging (MRI) has been problematic since its
introduction as a clinical imaging modality. While sensitivity to particle motion or blood flow can
be used to provide useful image contrast, bulk motion presents a considerable problem in the
majority of clinical applications. It is one of the most frequent sources of artefacts. Over 30 years
of research have produced numerous methods to mitigate or correct for motion artefacts, but no
single method can be applied in all imaging situations. Instead, a ‘toolbox’ of methods exists,
where each tool is suitable for some tasks, but not for others. This article reviews the origins of
motion artefacts and presents current mitigation and correction methods. In some imaging
situations, the currently available motion correction tools are highly effective; in other cases,
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appropriate tools still need to be developed. It seems likely that this multifaceted approach will be
what eventually solves the motion sensitivity problem in MRI, rather than a single solution that is
effective in all situations. This review places a strong emphasis on explaining the physics behind
the occurrence of such artefacts, with the aim of aiding artefact detection and mitigation in
particular clinical situations.

Keywords
motion correction; motion prevention; motion artefact; MRI; review

INTRODUCTION
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Compared to other imaging modalities, such as ultrasound or computed tomography, MRI

has always been particularly sensitive to subject motion. This is primarily due to the
prolonged time required for most MR imaging sequences to collect sufficient data to form
an image. This is far longer than the timescale of most types of physiological motion,
including involuntary movements, cardiac and respiratory motion, gastrointestinal

*
Corresponding author: Maxim Zaitsev, Department of Radiology - Medical Physics, University Medical Centre Freiburg, Breisacher
Str. 60a, 79106, Freiburg, Germany., Phone: +49 761 27074120, Fax: +49 761 27093790, [email protected].
There are no financial interests or commercial products associated with the presented material.
 Zaitsev et al. Page 2

peristalsis, vessel pulsation, and blood and CSF flow. The effects of motion have been well
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known since the early days of MRI and include blurring and ghosting in the image (1, 2).

Recent technological improvements have improved the situation in some cases, but have
exacerbated it in others. On one hand, incremental performance gains in hardware (e.g.
higher performance gradients) have enabled faster imaging, as have breakthroughs such as
parallel imaging. Faster imaging means that some scans can be performed in a shorter time,
leading to a smaller chance of involuntarily subject motion. On the other hand, hardware
improvements have improved the achievable resolution and signal-to-noise ratio (SNR), and
the sensitivity to motion has therefore increased. Stronger gradients also mean greater phase
accumulation for moving spins. Higher main field strengths and stronger gradients also
mean that a typical MR scan is generally louder than it was in the early days of MRI, which
reduces the chance of infants sleeping through the procedure. This is particularly true for
diffusion-weighted or diffusion tensor imaging, as was reviewed recently by Le Bihan (3).
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At present, there is no sign that the problem of subject motion during MRI examinations will
be resolved through hardware improvements. The potential of accelerated imaging seems to
be increasingly limited by biologic constraints: peripheral nerve stimulation limits gradient
switching speeds; specific adsorption rate (SAR) limits the use of RF excitation pulses; and
T1 and T2 relaxation times constrain the sequence repetition and echo times, depending on
the required contrast.

Furthermore, it seems increasingly likely that there is not, and will not be, a single
methodological solution to the problem of motion in MRI; rather, a toolbox of solutions
exists. The choice of which tool to apply depends on the task at hand, namely, the imaging
situation and type of motion in question. Some prevention or correction techniques are
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highly effective in particular circumstances, but useless in others. Other techniques are
relatively general, but are not completely effective. It is therefore extremely important to
recognize and understand motion artefacts in order to identify the physical cause of the
problem in a particular clinical situation and use the best possible tool for the problem.

In this review, we first examine the physical origins of motion artefacts and then summarize
the main motion prevention and correction tools currently in use or in development. Our aim
is to provide a condensed guide to the function, application and limitations of these methods.

PHYSICAL PRINCIPLES BEHIND MOTION ARTEFACTS

The appearance of motion artefacts in an image is a result of a complicated interaction
between the image structure, the type of motion, the specifics of the MR pulse sequence and
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the k-space acquisition strategy. In this section we briefly revisit the most important physical
mechanisms affecting the appearance of motion artefacts.

K-space and the image acquisition process

Spatial encoding in MRI is an intrinsically slow and sequential process. For the appreciation
of the effect of motion on MR images it is important to realize that the data acquisition

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occurs not directly in image space, as is the case in photography, but rather in frequency or
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Fourier space, which is commonly termed ‘k-space’.

K-space corresponds to the spectrum of the spatial frequencies of the imaged object and
depending on the imaging situation can be two- or three-dimensional. Spatial frequency
spectra of objects with small number of contrast features and with smooth intensity
variations are predominantly defined by the components close to the k-space origin. Objects
or organs with sharp high-contrast edges contain a significant spectral density at the k-space
periphery. The majority of biological samples show very local spectral density in k-space
centred around k=0. Some organs and tissues, such as brain cortex, have a fractal-like nature
(4) and therefore show a slower decay of spectral density in k-space.

To understand the properties of k-space and its relation to image/object space, it is important
to develop an intuition regarding the local and global properties of these two spaces. This
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topic is reviewed in detail by Paschal and Morris (5). K-space describes the object using a
set of global planar waves. Every sample in k-space describes the contribution of the wave
with a corresponding frequency to the entire image. Therefore a change in a single sample in
k-space affects theoretically the entire image. Similarly, a change in the intensity of a single
pixel (e.g. in a dynamic process) generally affects all k-space samples. However, when such
change can be allocated to a larger cluster of pixels, predominantly the centre of k-space is
affected. The latter phenomenon is the basis of a range of data-sharing techniques, which
achieve a higher apparent temporal resolution in dynamic imaging by updating the central
region of k-space more frequently (6-9).

Different strategies to populate k-space with measured data are termed “k-space sampling
trajectories” or “k-space trajectories”. The most common and clinically relevant approach
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collects data on a rectilinear grid in k-space (so-called ‘Cartesian’ sampling), because it

allows for a computationally efficient image reconstruction using the fast Fourier transform
(FFT). Even though we primarily consider the Cartesian sampling strategy, it is necessary to
distinguish between the multitude of k-space trajectories, which differ from each other in the
way and the order the nodes of this rectilinear 2D or 3D k-space grids are visited. Other
popular data acquisition schemes include radial (5, 10), PROPELLER (11) and spirals (12).

Typical motion-induced deterioration effects observed in MR images consist of a

combination of the following basic effects:

• Blurring of sharp contrast or object edges (intuitively similar to photography)

• Ghosting (both coherent and incoherent) originating from moving structures

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• Signal loss due to spin dephasing or undesired magnetization evolution

• Appearance of undesired strong signals

The first two points are related to the signal readout process, whereas the latter two are
related to the signal generation and contrast preparation within the pulse sequence. Here we
refer to ghosting as a partial or complete replication of the object or structure along the
phase-encoding dimension, or along multiple phase-encoding dimensions for 3D imaging.
Periodic motion synchronized with the k-space acquisition results in a coherent ghosting

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with the number of replicas corresponding to the frequency of k-space modulation: two
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ghosts result if every second line is altered, four if every fourth, etc. Deviations from perfect
periodicity in k-space result in incoherent ghosting, appearing as multiple overlapped
replicas, and sometimes seen as stripes in the phase-encoding dimension.

The main cause of readout-related motion artefacts is the inconsistency between the various
portions of the k-space data used for the image reconstruction or between the data and the
signal model assumed in the reconstruction. Simple reconstruction using an inverse FFT
(iFFT) assumes the object has remained stationary during the time the k-space data were
sampled. A violation of this assumption results in artefacts.

To demonstrate possible motion artefact appearance we have simulated a range of motions

and k-space reordering schemes. Figure 1a shows the digital phantom used based on the
Shepp-Logan phantom with altered intensities and a grid of small objects added. Figures 1b-
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d demonstrate the range of simulated motions (continuous rotation to 10°, continuous

translations by 10 pixels in vertical and horizontal directions (Figs. 1b-d, respectively) and a
periodic sinusoidal oscillation in the horizontal direction with the same amplitude (not
shown). To provide a reference of image quality, a photography-like image acquisition has
been simulated, averaging the motion in image space (Figs. 1e-1h). It is noteworthy that the
image 1h appears more blurred than 1g, because for periodic motion the object spends more
time in proximity of the terminal positions.

It is common knowledge in the imaging community that MRI is particularly sensitive to

motion. However, in the case of slow continuous drifts and sequential k-space ordering,
Fourier acquisition is actually significantly less motion-sensitive than a corresponding
“photographic” image taken with the same “exposure time” (Fig s 1i-1k). Periodic motion
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however produces very strong ghosting (Fig. 1l). In the case of interleaved multishot k-space
ordering, even slow continuous drifts produce significant ghosting (Figures 1m-1o). Note
that ghosting reduces for the periodic motion in Figure 1p in comparison to Figure 1l
because the interleaved acquisition scheme traverses k-space faster, which reduces the
number of full oscillations effectively seen in the complete k-space data set. If the
interleaving scheme is synchronized with the underlying periodic motion, the artefacts
reduce further to the level comparable with that in Figure 1k. This phenomenon is often
exploited in cardiac imaging and is discussed in more detail below. Plots of the motion as a
function of k-space position for the representative images in Fig. 1 are presented in Fig. 2.

Although slow continuous motions do occur in clinical settings, for example due to the
gradual relaxation of the neck muscles in head imaging, they only strongly affect sequences
relying on interleaved k-space acquisitions, e.g. T2-weigted TSE/FSE (Turbo/Fast Spin
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Echo) imaging. In addition to periodic processes (e.g. breathing, cardiac motion, blood
pulsation and tremors), sudden position changes, for example due to swallowing in head
imaging or insufficient breath hold capability in abdominal scanning are the effects that
often lead to artefacts. The effect of sudden motion on the Fourier acquisition is visualized
in Figure 3. Here, single 10° rotation events have been simulated, with the motion occurring
at different time points, leading to varying proportions of k-space data that are inconsistent.
Figures 3a-3d and Figures 3e-3h assume linear and interleaved k-space ordering,

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respectively. In both cases 12.5% (1/8th) of the inconsistent k-space data result in a
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negligible effect; however, image quality deteriorates much faster for the interleaved
acquisition. Centric k-space reordering demonstrates even higher resistance against artefacts
(Figures 3i-3l).

The following conclusions can be drawn from these simulations:

1. MRI with a sequential k-space ordering is fairly insensitive to slow continuous

motion;

2. motion as a function of k-space position is the most relevant parameter for the
appearance of artefacts;

3. it is important where in k-space fast motion occurs, as data corruption near the
centre of k-space produces stronger artefacts than data corruption near the k-space
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periphery;

4. repeated modulation in k-space amplifies artefacts and should be avoided.

Types of motion
The different types of motion relevant for in vivo MRI can be loosely separated into the
following categories: rigid body motion, elastic motion and flow.

Rigid body motion, or ‘bulk motion’, includes one-dimensional translations (requiring a

single parameter for its mathematical representation), multi-dimensional translations
(requiring several parameters), or completely unconstrained rigid motion (requiring six
parameters). For example, diaphragm motion is sometimes approximated using a one-
dimensional translation, but involuntary head motion normally requires six degrees of
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freedom, comprising three translations and three rotations.

Elastic motion typically includes stretching, compression and shearing along three axes, in
addition to rigid body motion. It requires 12 degrees of freedom for its complete
representation. Elastic motion is observed in the abdomen, where various locations
experience different displacements and deformations. Flow can in some cases be assumed to
be one-dimensional, for example for laminar blood flow in small or medium-sized vessels or
CSF flow in the cervical spine. It then requires only a single parameter (velocity) for its
complete representation. More complex flow is observed in the heart and aorta. This
requires a two- or three-dimensional velocity vector field for its complete description.

The most complete description is provided by the displacement field, which consists of the
trajectories of each particle within the object as a function of time. Although being
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complete, the displacement field is often not measurable with sufficient precision. Luckily,
for the vast majority of practical situations this description is too detailed. Physical,
mechanical and physiologic constraints placed on the human body (e.g. incompressibility of
liquids and a majority of tissues, presence of bones and joints, etc.) allow for a drastic
reduction of the number of parameters required for the description of motion.

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Data corruption mechanisms

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Several physical mechanisms contribute to the appearance of the motion artefacts. The most
important and relevant for in vivo MRI are the following:

• Incorrect phase accumulation due to tissue motion during the periods in the pulse
sequence where gradients are switched on. MRI relies on the ability to create
gradient echoes, and typically assumes that tissues are stationary during imaging.
As seen in Fig. 4, spins moving in the direction of the gradient acquire additional
phase. If this phase varies for different phase-encoding steps, inconsistencies in k-
space arise;

• The so-called excitation history effect appears when slice-selective RF pulses are
used for excitation, saturation or refocusing. As seen in Fig. 5, out-of-plane motion
between such pulses affects the desired evolution of the signal and typically results
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in generation of signals that are too strong or too weak, or causes alternations in
image contrast. For multi-shot imaging this results in magnitude inconsistencies in
k-space;

• Motion of the tissues and body parts often affects magnetic fields used in MRI. The
B0 field within the imaging volume changes significantly if the orientation of the
body part changes but may also be affected by motion of relatively distant body
parts due to long-ranging magnetic susceptibility effects (13, 14). Both transmit and
receive B1 fields may also change depending on the body position or due to the
motion of the surface coils themselves.

• Rotations during the k-space data acquisition process in multi-shot imaging

produces inconsistencies between the effective readout directions for different k-
space lines (see Fig. 6). Even if the true motion during the acquisition is known and
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compensated for, the resulting k-space is not sampled homogeneously, which may
result in ghosting or streaking artefacts.

• Cardiac or respiratory motion leads to so-called ‘physiologic noise’ in fMRI.

Because the fMRI signal is very small (15), any other dynamic changes caused by,
for example, periodic blood flow, appears as a confounding factor in the analysis.
The situation is further exacerbated by the realively low temporal resolution of
typical fMRI acquisitions leading to a spectral aliasing of the physiologic signals.

Data inconsistencies between k-space lines or segments in multi-shot imaging typically

result in ghosting or blurring. Most of the above mechanisms may also affect the contrast
preparation modules (e.g. diffusion weighting or inversion) and thus generate undesired
contrast variations without visible ghosting artefacts. This occurs particularly in single-shot
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imaging.

ARTEFACT MITIGATION STRATEGIES

As discussed above, there are many types of motion and many possible mechanisms for data
corruption resulting from each motion type. It follows, therefore, that many different
strategies have been developed to address these challenges. In the following, we categorize

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these methods into three distinct groups: motion prevention, artefact reduction and motion
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correction (Table 1).

Motion prevention is the most obvious method of suppressing motion artefacts. If motion
can be avoided, then the effects discussed early in the review are prevented and other, more
complex, strategies become redundant. Unfortunately, preventing motion is not always
practical and so artefact reduction or motion correction strategies must often be employed.
Artefact reduction is defined in this review as acquisition strategies that reduce artefacts in
the resulting image or replace them with those with a less dramatic appearance, when
compared to standard Cartesian acquisition methods. Motion correction, on the other hand,
normally involves the explicit estimation and compensation of motion. Combinations of all
three methods are possible, just as multiple tools may be used together in a complementary
fashion in the toolbox analogy mentioned above.
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Motion prevention
Prevention is the most commonly attempted approach to avoid motion artefacts in clinical
MRI. The main prevention tools available are briefly summarized here.

For young children, training with a mock MRI is useful to avoid bulk motion by reducing
anxiety. However, this method is not widely available and is not particularly cost effective.
In infants, imaging can be timed after feeding to take advantage of sleeping. Babies can be
well wrapped, which also encourages sleeping. Foam restraints or special inflatable devices
are in common use, the latter particularly in the case of infants. However, these methods are
only partially effective. Nevertheless, Windram et al. have recently reported failure-free
imaging of 20 young patients with a congenital heart disease using the feed-and-sleep
technique (16).
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Moderate sedation, or in some cases, general anaesthesia, is often employed (17, 18) when
imaging young children. Surprisingly enough, sedation is not always effective, with
occurrence of motion artefacts in about 12% of cases (17) and an increased prevalence of
failures in older children. According to (17), general anaesthesia is more reliable, as it has a
much lower incidence of motion artefacts (about 0.7%) but is associated with much greater
costs (in part due to the requirement of a presence of an anaesthetist), more severe side
effects and greater health risks.

In the early days of MRI, bite bars mounted on head coils (19, 20) were deemed an effective
means of avoiding head motion. However, due to their cumbersome set up and significant
discomfort, these approaches have not found wide acceptance in clinical practice. The same
applies to other immobilizing systems, such as a personalized plaster cast head holder (21).
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Vacuum immobilizer cushions, which are available from several suppliers, address the set-
up issues, but, in the experience of the authors, are perceived as very uncomfortable after a
time period of 10 to 30 minutes.

In the case of abdomen or cardiac imaging, breath-holding is an obvious, and effective,

methods of suppressing motion artefacts due to breathing (see Chapter 12.3 in (22)). Breath-
holding, however, restricts scan duration severely (between 10 and 20 seconds in clinical

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settings), which in turn limits the image quality, resolution and coverage. Image quality is
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further restricted by the quality of breath-hold (e.g. presence of drifts or tremour). To

overcome time limitations multiple breath-holds are often employed despite limitations
associated with breathing hysteresis and limited reproducibility of breath-hold positions.

Artefact reduction
The basic remedial approaches and tools to reduce motion artefacts were devised about 30
years ago, in the early days of MRI. A 1986 review article by Bellon (23), lists strategies
such as shortening imaging time, optimizing the phase encoding direction and ordering, and
reducing flow sensitivity. These basic approaches remain valid to date, but new ways of
achieving the same goals have appeared. Therefore, for the sake of completeness, we review
the current artefact reduction strategies below.
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Faster imaging—In analogy to photography, shortening the image acquisition time below
the typical time scale of motion is the most straightforward approach to reduce motion
artefacts. The wider availability of fast imaging techniques is largely responsible for the
improvements seen in MRI with regard to the immunity to motion, rather than the more
complicated motion correction techniques discussed below. In the case of spontaneous
movements, shorter scan times mean that the patient is less likely to become uncomfortable
and move. In the case of cardiac or breathing motion, fast sequences acquire more data
within a single period. An early example of fast gradient echo imaging is the FLASH (fast
low-angle shot) sequence (24), which uses low-angle excitation and spoils transverse
magnetization between TRs. Progress in gradient hardware has resulted in the wide
availability of fully-refocused gradient echo sequences (25) (so-called balanced steady-state
free precession, bSSFP). For the same reason, echo planar imaging (EPI) (26), which was
initially deemed barely feasible, has became a workhorse in functional neuroimaging. T2-
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weighed imaging has became clinically feasible due to the adoption of the echo-train
principles (27), but still remains too slow for certain applications, such as breathhold
abdominal imaging. In such cases a single-shot fast spin-echo (a.k.a. HASTE) is often
employed as a means of freezing motion at expense of a moderate loss in spatial resolution.

Parallel imaging (28-30) has revolutionized many MRI applications by shortening

acquisition times, typically by a factor of 2 to 3. More recently, these approaches have been
extended to acceleration in two encoding dimensions (31, 32) leading to even higher gains
for 3D imaging or novel approaches, such as simultaneous multi-slice imaging (33). The
introduction of compressed sensing MRI (34) in 2007 has provided a further tool for
acceleration of MRI acquisitions and has paved a way to new motion-compensated
applications (35).
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Fast imaging, however, compared to the standard counterpart, frequently represents a

compromise between the acquisition time and other confounding issues. Single-shot imaging
typically has a limited spatial resolution. EPI suffers from geometric distortions and
chemical-shift artefacts. Parallel imaging methods rely on the accuracy of the coil
calibration data and may result in new types of artefacts if motion happens during the
acquisition of the reference data (36-38). Compressed sensing is often criticized for the

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introduction of the new types of artefacts (e.g. patchiness, synthetic appearance), which may
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mask important anatomic features in some cases (39).

Gradient moment nulling—Gradient moment nulling is a widely used method to reduce

artefacts produced by objects or tissues moving with a near-constant velocity. It is
particularly useful for the suppression of flow-related artefacts. The method attempts to
minimize the phase shifts acquired by both stationary and moving spins at the echo time.
Without gradient moment nulling (Fig. 7a), stationary spins are refocused, but spins moving
along the direction of the applied gradient are not. With gradient moment nulling (Fig. 7b),
both stationary spins, and spins moving with a constant velocity, are refocused.
Mathematically this is equivalent to minimizing both the 0th gradient moment (area under
the gradient waveform) and the 1st gradient moment at the echo time. The gradient moment
nulling condition is exactly or approximately fulfilled for a range of multi-echo imaging
sequences (40) such as multi-gradient echo or turbo spin echo, but only for even echoes
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within the echo train. This phenomenon is termed “even echo refocusing” in the literature.

Incorporation of gradient moment nulling almost always slows down the sequence as it
requires additional gradient lobes to be added. Currently the majority of scanner vendors
provide this feature for one or several encoding dimensions as an option amongst the
sequence parameters, typically referred to as “flow compensation”.

Motion insensitive sequences—Imaging methods relying on spiral or radial encoding

strategies are often more motion-tolerant than Cartesian sequences, in that the motion
artefacts have a more benign appearance in the images (41). The reason for this is that these
strategies typically oversample the centre of k-space, which either smears out the artefacts,
due to the inherent averaging (41-44) or may further be employed for more advanced
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correction in post-processing (45-49). Furthermore, if the readout starts at or close to the

centre of k-space, it is easier to achieve gradient moment nulling, which reduces phase
errors between the shots.

Phase reordering—The order of acquisition of k-space lines can make a substantial

difference to the appearance and severity of motion artefacts when imaging a moving object.
Changing the ordering to minimize artefacts is particularly common to prevent artefacts
from respiratory motion. An early example of this is respiratory-ordered phase encoding
(ROPE) (50), where neighbouring lines in k-space are acquired at points in the respiratory
waveform that are also close together. This minimizes side lobe peaks in the point-spread
function (PSF), which reduces ghosting. Such techniques are often generally referred to as
‘respiratory compensation’. A major advantage of respiratory compensation over respiratory
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gating is a much shorter scan time.

Respiratory compensation requires information about motion caused by the patient

breathing. Typically, respiratory bellows are used to obtain a waveform that gives
information about the patient’s chest position via measurement of the movement of air in the
bellows. It is important that the bellows are correctly attached in order to measure the full
range of respiratory motion. MR navigators that track breathing motion are also often used
as a source of information for the phase reordering (51).

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Spatial saturation bands—Movement of parts of the anatomy (e.g. blood flow from
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arteries, breathing motion in abdominal imaging, etc.) can generate motion artefacts that
overlay the organ of interest (52, 53). Spatial saturation bands can be used to suppress signal
from such moving tissue. To achieve this, one or more spatially selective 90° RF pulses are
applied prior to the actual excitation pulse. The transverse magnetization is then dephased
by spoiler gradients. Moving spins from the saturated region are therefore prevented from
contributing to artefacts in the imaged volume. However, the additional RF pulses lead to an
increase in SAR and measurement time – clinically, this results in a decreased number of
slices for a given TR.

Triggering and Gating—Patient motion resulting from physiologic effects such as

heartbeat or breathing is generally periodic. This is an advantage for motion correction, as
MR data acquisition can be timed to the different points within the cardiac cycle (54) or
breathing position (55).
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There are two general approaches to enforce consistency of the data acquired in presence of
(quasi-) periodic motion. Data can either be collected at the same point in the cycle
(triggering) or acquired continuously and then reordered retrospectively (gating). Triggering
is often easier to implement and it has the advantage of a more precise synchronization with
the underlying motion. On the other hand triggering by necessity introduces a delay, which
both disrupts the signal steady state and misses some part of the dynamic cycle in
applications like cardiac cine imaging. Gating is free of these shortcomings, but it has to
sacrifice some scanning efficiency and allow for a certain degree of redundancy to ensure
that sufficient data are available for retrospective image reconstruction.

Both triggering and gating rely on an additional signal or several signals correlated to the
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physiologic motion in question. For cardiac imaging, electrodes are normally placed on the
subject’s chest to record the electrocardiogram (ECG). This has the drawback of slower
patient workflow and has some safety implications (56). At higher field strengths (3T and
above) the quality of the ECG trace may be reduced substantially, so it is therefore
important to optimize the placement of the EEC electrodes and leads (57). Another
possibility is to use a pulse oximeter, typically attached to subject’s finger. However,
peripheral signals are less sharp and precise and are more suitable for gating because of the
delay associated with a limited velocity of the pulse wave in the human body. Respiratory
gating and triggering can rely on respiration sensors, such as belts or bellows typically
affixed to the subject’s chest or belly, as discussed above. However, the reliability of such
devices and the relation to the breathing-induced motion of the internal abdomen organs are
substantially lower than in the case of cardiac motion. Therefore MR navigators following
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the position of the diaphragm or directly the organ of interest are often preferred. Navigators
are discussed in more detail in a separate section below. Another popular approach acquires
one or several non-encoded samples following the RF excitation. This is commonly referred
to as FID-gating or self-gating (58, 59).

Generic limitations to both triggering and gating arise from the violation of the two basic
assumptions behind these techniques: periodicity of the disturbing motion and stationarity of
the imaged object or organ. Therefore cardiac MR imaging in patients with arrhythmia

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remains challenging. In paediatrics both breathing and heartbeat may be very irregular,
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which limits the achievable image quality severely. Also in adults free-breathing exams fail
sporadically, due to breathing position drifts and changes in breathing patterns. Imaging of
fast non-stationary and irreproducible events, such those observed in cardiac perfusion is an
area of active research (e.g. (60)).

Motion correction
MR Navigators—MR navigator methods acquire the required position information during
an imaging sequence using the MR scanner itself ((61-63). This is achieved by frequently
playing out ultra-short (on the order of milliseconds) navigator sequences during the
imaging process. These navigator sequences allow for determination of the object’s position
by comparing each acquired navigator signal to a reference.

Generally, navigators can be separated into two categories: those that work in k-space and
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those that work in image-space. They can be further classified in terms of their
dimensionality: 1D, 2D, or 3D. Since any additional information encoded by the navigator
comes at a cost of increased acquisition and processing times, and increased complexity,
navigators are typically simplified to an extent acceptable for the target application.
Therefore, 1D and 2D navigators are popular especially in abdominal and cardiac imaging to
correct for breathing motion, by tracking the position of the diaphragm (64, 65). In brain
imaging, 2D navigators allow for a correction of rigid body motion in the navigator plane
(66-69). In DWI even the smallest movements caused by brain pulsation can lead to phase
changes due to the strong gradients used for diffusion weighting. Variations of the image
phase leads to substantial image artefacts in multishot-DWI. MR-navigators measuring the
image phase after diffusion weighting (in 2D) allow the correction of these phase
instabilities (70, 71).
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3D navigators allow for the correction of patient motion in up to 6 degrees of freedom (66,
72-74). They also require substantial time to be available in the host sequence, on the order
of hundreds of milliseconds. This time is available in many sequences, due to contrast
preparation or recovery delays; therefore, 3D navigators have become increasingly popular,
especially in brain structural imaging. Spectroscopic acquisitions offer even more ‘empty
space’ within the sequence, which is sufficient to acquire several navigator echoes, or even
specialized shim navigators to correct for shim alterations due to motion (75, 76). Recently,
substantially faster 3D navigators, relying on parallel imaging or multiband excitation (33),
have been presented at various conferences and workshops.

To improve the accuracy of the navigation sequence, and to reduce interference with the
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imaging process, it is possible to use additional spatial-frequency-tuned markers (77),

miniature radio-frequency probes (78, 79), or signals of the endogenous fat (80, 81).
However, many of these methods were so far restricted to 1D (80) and 2D (77, 81), and are
generally only used in research applications.

An alternative to the navigator methodology is self-navigated methods, which allow the

determination of motion from the MR imaging data themselves (45-47, 49, 58). All of these
methods are very specific to a particular imaging scheme and are often limited to 2D

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 Zaitsev et al. Page 12

acquisitions. One popular variant of self-navigated sequences is PROPELLER, which is

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discussed in detail in the next section. Self-navigation methods can also be extended to 3D,
for example in conjunction with a three dimensional radial imaging scheme (48).

Navigator information can be used either retrospectively to correct the acquired imaging
data (82), or prospectively to adapt the imaging scan to the patient’s position. Note that for
prospective motion correction, motion parameters need to be extracted from the navigator
data in real time. Advantages and disadvantages of both prospective and retrospective
approaches are discussed below.

A detailed overview of different navigator approaches can be found in Chapter 12.2 of

Bernstein (22).

PROPELLER—The acronym ‘PROPELLER’ is an abbreviation for ‘periodically rotated

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overlapping parallel lines with enhanced reconstruction’ (11). PROPELLER imaging, and
all its variants, follow a strategy similar to that of radial imaging. However, instead of
acquiring the data projection-by-projection, strips of several parallel k-space lines are
collected. This can be realized using different readout strategies like RARE (83), EPI(84,
85), or GRASE (84). This strip is rotated around the k-space origin in the subsequent
acquisition cycles until a disc of k-space is filled.

This sampling scheme provides substantially reduced motion sensitivity due to the strong
oversampling of the k-space centre and its radial character. In addition, during the
reconstruction the robustness to motion can be further improved (86). Low-resolution
images reconstructed from single blades can be used to quantify in-plane translations and
correct for the resulting inconsistencies between the blades prior to the final image
reconstruction. Additionally, the central disc of k-space - which is acquired by all strips -
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can be used to detect and correct in plane rotations of the single k-space strips. By cross-
correlating the central disc of the corrected strips, through-plane motion can be detected.
Such motion cannot be corrected for retrospectively; however, by introducing factor that
puts less weight on corrupted blades, the influence of through-plane motion can be reduced.

The PROPELLER sampling strategy can be combined with undersampling techniques (87).
It can also be used to introduce diffusion weighting to the RARE readout module (88),
which was shown to be of interest for DTI at high fields(89).

The PROPELLER methodology has been shown to be a very useful tool in clinical settings
(90) and is available on the majority of imaging platforms (under different names).
Drawbacks of PROPELLER are the increased image acquisition time, due to the strong
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oversampling around the k-space centre, the limitation to 2D imaging and a limited
robustness against through-plane motions.

Prospective correction—Prospective motion correction is an intuitive approach where

the relative spatial position and orientation between scanning coordinates and the object of
interest is kept constant. For the correction of head motion, a rigid object is assumed,
moving in 6 degrees-of-freedom. If the position and orientation of such an object can be
measured in real time, the magnetic gradients, RF pulses, and receiver frequency and phase

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 Zaitsev et al. Page 13

can be adjusted accordingly. Rotations of the object require a rotation of the encoding
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gradients; translations require a change of transmit and receive frequency and phase (91).

In the case of head motion, head pose can be measured using MR navigators, working either
in image space (e.g. PROMO (92, 93), PACE (94)), or k-space (e.g. cloverleaf, spherical or
orbital navigators (66, 67, 73)). Alternatively, an external tracking device can be used,
including stereo camera systems (95), miniature RF probes (78, 79, 96), in-bore camera
systems (97-99), or ultrasound systems (100). Navigators need to be compatible with the
sequence timing and typically have a low temporal sample rate. On the other hand, external
tracking typically requires an MR compatible design and accurate calibration to the scanner
coordinate system. Furthermore, the majority of the external approaches require a tracking
device to be mounted on the subject, which is a concern for routine applications.

The topic of prospective motion correction has gained popularity in the last few years
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resulting in numerous new applications including fMRI (101, 102), DWI (103, 104), and
spectroscopy (105-107). Although it is an extremely promising approach for neuroimaging,
it does have some limitations, including practical considerations (e.g., marker fixation for
external tracking systems) and uncorrectable effects (e.g., motion-related B0 distortions
(108)). Covering this topic in detail is beyond the scope of this paper; interested readers are
referred to a recent review article (109).

Post-processing techniques & retrospective correction—While prospective

correction methods aim at maintaining data quality during the acquisition, retrospective
techniques attempt to improve data consistency afterwards, by modifying the collected data
or the reconstruction model. This can be done by either including the exact knowledge about
the motion during the scan (e.g. using navigator data) or with iterative algorithms (e.g.
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optimizing image entropy, gradient entropy or other measures of artefacts (110-112)).

The basic idea behind these methods is to undo the motion-related changes occurring to the
MR data. For rigid body motion these are described according to the Fourier theorems: a
translation of the object leads to a phase ramp in the acquired k-space, an object rotation
corresponds to a rotation of k-space (113). While translations are relatively easy to correct
by applying a phase change to the acquired data, the correction of rotations requires the use
of non-Cartesian reconstruction methods (114,115) and includes some sophisticated
algorithms (116-119) which are computationally intensive.

In 3D imaging, arbitrary rigid body motion can be corrected, as long as the acquired signals
are only damaged but not lost (e.g. there are no signal dropouts due to intra-voxel
dephasing). For 2D imaging these correction methods are limited to in-plane motion, as
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through-plane motion during the scan results in inconsistencies, which cannot be corrected.

Elastic motion remains a major challenge for both prospective and retrospective correction
approaches. Especially in abdominal and cardiac MRI, the complexity of the underlying
motion restricts the current concepts to a combination of gating/triggering followed by a
correction of affine motion within the gating window (60, 120).

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 Zaitsev et al. Page 14

An alternative approach to retrospectively improve the quality of datasets which are only
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partially affected by motion is described in (121). By discarding motion corrupted data and
filling the resulting parts of k-space using parallel imaging techniques, the quality of the
reconstructed images could be increased at a cost of SNR and possibly some residual
blurring.

By including a general description of motion into the MR signal equation (122) using
measured or estimated displacement fields (123) free-breathing cardiac imaging has been
demonstrated. Recently this approach has been extended to incorporate compressed sensing
methodology (35). Unfortunately such retrospective image reconstruction methods are
extremely computation-intensive, which presently restricts their clinical acceptance.

CONCLUSIONS
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Due to peculiarities of the image acquisition process in MRI, motion causes a varying range
of artefacts, including blurring, ghosting, signal dropouts and unwanted signal enhancement.
The large variety of image contrasts and k-space sampling methods in MRI causes these
artefacts to appear differently from scan to scan. This, coupled with a large range of motion
types that occur in vivo, means that there is no single motion correction tool that can be
applied to every motion problem. Instead, there is a toolbox of techniques, where different
tools are applicable in particular situations. In some cases, powerful tools are already
available; in other cases, tools still need to be developed. Nonetheless, it is likely that
developing dedicated tools for specific situations will be what eventually solves the motion
problem in MRI, rather than a single approach that solves all problems.

Acknowledgments
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Grant support:

NIH grant numbers 1R01 DA021146, 2R01 DA021146, 5R01 EB011654 and 5R21 EB017616 Alexander von
Humboldt foundation

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Fig. 1.
(a) Original FFT reconstruction without motion, (b-d) sum of first and last source images to
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show the range of simulated motions for (b) continuous monotonic rotation to the total angle
of 10°, (c) continuous vertical translation and (d) continuous horizontal translation (in both
cases 10 pixels for a matrix of 256×256). Periodic horizontal translation has the same
amplitude and is not shown. Images (e-h) demonstrate the results of averaging the motion as
would correspond to photography with an equivalently long exposure time; (e) rotation, (f)
vertical translation, (g) horizontal translation and (h) periodic horizontal translation. Note
the loss of detail and edge information due to the motion blur and the enhanced blurring in

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(h) due to the fact that with sinusoidal motion the object spends more time close to the
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terminal positions. Images (i-l) show simulated MRI acquisitions with linear k-space
ordering. Images (m-p) show simulated two-shot interleaved MRI acquisitions. Plots of the
motion as a function of k-space position for the representative images are presented in Fig.
2.
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Fig. 2.
Effective translation (as a fraction of the FOV) as a function of the k-space position for (a)
Fig. 1j and 1k, (b) Fig. 1l, (c) Fig. 1n and 1o and (d) Fig. 1p. As seen, if the external
disturbance oscillates as a function of k-space position, e g. in cases (b), (c) and (d),
ghosting will result (see corresponding images in Fig. 1). Reduced ghosting in Fig. 1p can
be explained by the effective reduced frequency of oscillation of the position as a function of
the k-space coordinate (compare plots (b) and (d)). Plots of rotations are omitted due to their
similar appearance.
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Fig. 3.
Simulations of a single sudden orientation change during the k-space acquisition for
different k-space acquisition strategies and different amounts of inconsistent k-space data.
For a linear k-space ordering, images reconstructed from datasets containing (a) 12.5%, (b)
25%, (c) 37.5% and (d) 50% inconsistent data have been simulated. Hardly any artefacts are
visible if the corruption occurs outside of the ½ of the maximum k-space distance to the
centre. Similar conclusions follow for the two-shot interleaved k-space acquisitions with (e)
12.5%, (f) 25%, (g) 37.5% and (h) 50% of inconsistent data. Images (i-l) present a similar
simulation for the centric reordering with (i) 50% of inconsistent with respect to the k-space
centre data, (j) 62.5%, (k) 75% and (l) 87.5%, respectively. The precise threshold at which
visually detectable artefacts start to appear strongly depends on the image, primarily on the
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presence of small high-contrast features, but the overall tendency is that below a certain
distance from the k-space centre a single motion event produces only negligible artefacts.

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Fig. 4.
Velocity effects on the phase of MR signals. Stationary spins can be refocused with a pair of
gradient pulses of equal area and opposite polarity, which is a basis of gradient echo. Spins
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moving along the gradient direction acquire additional phase due to the fact that dephasing
and refocusing occur at different physical locations where the same gradient indices
different frequency shifts, leading to different amounts of the phase acquired during
dephasing and refocusing periods. Greyed segments on the corresponding phase circles
mark the amount of phase acquired by the moving spins during the last gradient pulse.

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Fig. 5.
Excitation history effects visualized for a 3-pulse MR pulse sequence. In the case of no
motion, regions excited by all three pulses overlap resulting in the desired signal evolution.
The respective brain regions are marked using half-transparent bands with the colour of the
corresponding slice-selective RF pulse. Overlap of red and green results in light brown.
When light brown is followed by an overlap with blue, a grey colour results, which indicates
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the desired spin evolution. In the case of motion, (rotation after the first pulse, followed by a
combination of rotation and translation after the second pulse, original position is shown as
dotted line) the grey region corresponding to the desired spin evolution is substantially
reduced, while coloured regions with undesired signal evolution appear. Therefore desired
signals are decreased, and undesired signals are produced, resulting in artefacts, such as
ghosting or signal disturbances. The unwanted signals may also cancel some of the desired
signals, causing signal voids.
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Fig. 6.
The effect of rotations on the k-space sample locations in object coordinates. In the absence
of rotations (a) the k-space samples are arranged on a uniform grid fulfilling the Nyquist
criterion. Rotation of the object during the image acquisition rotates the spatial frequency
components associated with the object with respect to the encoding gradients, which
effectively redistributes the samples in k-space (b). This leads the sampling density in some
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areas of k-space to fall below the Nyquist criterion and results in streaking and ghosting
artefacts in the images, which are difficult to correct for in reconstruction even if the motion
is known.
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Fig. 7.
The effect of linear motion on the phase acquired by the spins under the action of the
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encoding gradients (frequency encoding in this example). A bipolar gradient (a) refocuses
the stationary spins at the moment when the net area under the gradient arrives to zero. This
is because the phase accrual in this case is proportional to a product of the gradient
amplitude and the time duration. Contrary to that, the phase acquired by a spin moving along
the gradient direction is proportional to the gradient amplitude, duration and the
displacement of the spin. Because the displacement under the continuous motion is
proportional to the time, the phase shows a quadratic dependency on time. Therefore, a
bipolar gradient fails to refocus moving spins. Consequently, such spins will be poorly

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located and a motion artefact will be seen in vascular structures and moving fluids. It is
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possible to account for the quadratic behaviour of the phase by introducing a third gradient
lobe, as shown in (b). Here, in order to keep the polarity of the frequency encoding gradient
the sign of the two preceding lobes has been adjusted. The gradient area ratio of 1:-2:1 does
not induce additional dephasing for the stationary spins and allows for refocusing the spins
moving with a constant velocity. Other gradient schemes are possible taking into account
gradient amplitude and slew rate limits, but velocity compensation always increases the
minimal echo time.
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Table 1

Common notion artefact mitigation strategies

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Motion prevention Artefact reduction Motion correction

Training Faster imaging Navigators
Distraction Insensitive sequences Self-navigated trajectories (PROPELLER and alike)
Feed and wrap (for babies) Gradient moment nulling
Foam restraints Saturation bands Prospective correction
Sedation Triggering and gating Retrospective correction
Bitebars/head holders Phase reordering
Breathhold
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