Project Summary Parent Award: MRI guidance of cardiac catheterization provides a non-ionizing alternative to X-ray fluoroscopy and can improve soft tissue contrast. Recent advances have increased the availability of MRI-safe devices, but clinical use remains limited due to the relatively poor image quality of single-shot, real-time MRI. In this research, we propose to develop a novel, multi-beat data acquisition and image analysis approach to improve anatomic image quality and device visualization, which we test in silico, in vitro, and in vivo. Supplement: This supplement extends the multi-beat approach being developed in the parent award by incorporating inline assessment of image quality to the framework and supports the training and development of a bioengineering graduate student (who is also part of the physician-scientist MD/PhD training program). Early work by the applicant has demonstrated that we can quickly score image quality with respect to number of k-space samples available for image reconstruction and the presence of cardiac and respiratory motion artifacts. However, we have yet to combine this finding with the multi-beat approach described in the parent award. Therefore, in this supplement, we propose to validate our image quality scoring, incorporate image quality metrics into our multi-beat imaging, and test the utility in patients. The use of image quality as a metric for closed-loop control is expected to make our multi-beat imaging more robust and more adaptive to patient-specific differences and changes over time. In addition to this new research direction, the supplement outlines tailored training for a promising MD/PhD student who is joining the principal investigators laboratory. Together, they have developed a set of training activities which will enable him to thrive at the interface of cardiology, radiology, and bioengineering. The ongoing collaboration with pediatric cardiologists developed by the parent award is the perfect setting for him to develop an interdisciplinary training. He will have the ability to shadow clinical care of patients and take part in multidisciplinary patient discussions. In addition, support for his scientific publishing and conference presentations will provide him with the networking, publication, and training experiences he needs to continue to work in this translational field.