1
|
Weng AM, Köstler H, Bley TA, Ritter CO. Effect of short-term smoking & L-arginine on coronary endothelial function assessed by cardiac magnetic resonance cold pressor testing: a pilot study. BMC Cardiovasc Disord 2021; 21:237. [PMID: 33980159 PMCID: PMC8114700 DOI: 10.1186/s12872-021-02050-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background The effect of smoking on coronary vasomotion has been investigated in the past with various imaging techniques in both short- and long-term smokers. Additionally, coronary vasomotion has been shown to be normalized in long-term smokers by L-Arginine acting as a substrate for NO synthase, revealing the coronary endothelium as the major site of abnormal vasomotor response. Aim of the prospective cohort study was to investigate coronary vasomotion of young healthy short-term smokers via magnetic resonance cold pressor test with and without the administration of L-Arginine and compare obtained results with the ones from nonsmokers. Methods Myocardial blood flow (MBF) was quantified with first-pass perfusion MRI on a 1.5 T scanner in healthy short-term smokers (N = 10, age: 25.0 ± 2.8 years, 5.0 ± 2.9 pack years) and nonsmokers (N = 10, age: 34.3 ± 13.6) both at rest and during cold pressor test (CPT). Smokers underwent an additional examination after administration of L-Arginine within a median of 7 days of the naïve examination. Results MBF at rest turned out to be 0.77 ± 0.30 (smokers with no L-Arginine; mean ± standard deviation), 0.66 ± 0.21 (smokers L-Arginine) and 0.84 ± 0.08 (nonsmokers). Values under CPT were 1.21 ± 0.42 (smokers no L-Arginine), 1.09 ± 0.35 (smokers L-Arginine) and 1.63 ± 0.33 (nonsmokers). In all groups, MBF was significantly increased under CPT compared to the corresponding rest examination (p < 0.05 in all cases). Additionally, MBF under CPT was significantly different between the smokers and the nonsmokers (p = 0.002). MBF at rest was significantly different between the smokers when L-Arginine was given and the nonsmokers (p = 0.035). Conclusion Short-term smokers showed a reduced response to cold both with and without the administration of L-Arginine. However, absolute MBF values under CPT were lower compared to nonsmokers independently of L-Arginine administration.
Collapse
Affiliation(s)
- Andreas M Weng
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
| | - Herbert Köstler
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Thorsten A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Christian O Ritter
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.,Institute for Diagnostic and Interventional Radiology, University Medicine Goettingen, Goettingen, Germany
| |
Collapse
|
2
|
Weng AM, Wilimsky S, Bender G, Hahner S, Köstler H, Ritter CO. Magnetic resonance cold pressor test to investigate potential endothelial dysfunction in patients suffering from type 1 diabetes. J Magn Reson Imaging 2018; 48:1595-1601. [PMID: 29897641 DOI: 10.1002/jmri.26191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 04/27/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In its course, diabetes impairs microvascular function through endothelial dysfunction. As the response of myocardial perfusion to sympathetic stimulation through cold is modulated by endothelium-related factors, an incipient endothelial dysfunction might be observed noninvasively by investigation of myocardial perfusion with a cold pressor test (CPT). This approach has been used in clinical MRI previously. PURPOSE To assess endothelial function of patients suffering from type 1 diabetes by MR CPT. STUDY TYPE Prospective cohort study. SUBJECTS Twenty type 1 diabetics and 20 healthy volunteers. FIELD STRENGTH/SEQUENCE 3T, dynamic contrast enhanced perfusion (steady-state free precession). ASSESSMENT Absolute quantitative myocardial perfusion values at rest and under CPT. STATISTICAL TESTS Kolmogorov-Smirnov test to determine normal distribution of the results. T-test for independent samples. RESULTS Patients' mean myocardial perfusion was 0.68 cc/g/min at rest and 0.80 cc/g/min during CPT, respective values of 0.81 cc/g/min and 1.36 cc/g/min were found in healthy volunteers. Perfusion values differed significantly for CPT (P < 0.01) but not for resting conditions (P = 0.06). DATA CONCLUSION This study demonstrated that endothelial function might be impaired in type 1 diabetes patients. This fosters the thesis that endothelial function may serve as an early biomarker for coronary artery disease in patients with type 1 diabetes while these patients are still clinically asymptomatic. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;48:1595-1601.
Collapse
Affiliation(s)
- Andreas M Weng
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Germany
| | - Stefan Wilimsky
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Germany.,Department of Diagnostic and Interventional Neuroradiology, University Hospital of Würzburg, Germany
| | - Gwendolyn Bender
- Department of Internal Medicine 1, University Hospital of Würzburg, Germany
| | - Stefanie Hahner
- Department of Internal Medicine 1, University Hospital of Würzburg, Germany
| | - Herbert Köstler
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Germany
| | - Christian O Ritter
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Germany.,Department of Diagnostic and Interventional Radiology, University Medicine Göttingen, Germany
| |
Collapse
|
3
|
Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Quantitative Lung Perfusion Imaging Using the Dual-Bolus Approach. Invest Radiol 2016; 51:186-93. [DOI: 10.1097/rli.0000000000000224] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
4
|
DCE-MRI of the liver: reconstruction of the arterial input function using a low dose pre-bolus contrast injection. PLoS One 2014; 9:e115667. [PMID: 25546176 PMCID: PMC4278725 DOI: 10.1371/journal.pone.0115667] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 11/26/2014] [Indexed: 11/26/2022] Open
Abstract
Purpose To assess the quality of the arterial input function (AIF) reconstructed using a dedicated pre-bolus low-dose contrast material injection imaged with a high temporal resolution and the resulting estimated liver perfusion parameters. Materials and Methods In this IRB–approved prospective study, 24 DCE-MRI examinations were performed in 21 patients with liver disease (M/F 17/4, mean age 56 y). The examination consisted of 1.3 mL and 0.05 mmol/kg of gadobenate dimeglumine for pre-bolus and main bolus acquisitions, respectively. The concentration-curve of the abdominal aorta in the pre-bolus acquisition was used to reconstruct the AIF. AIF quality and shape parameters obtained with pre-bolus and main bolus acquisitions and the resulting estimated hepatic perfusion parameters obtained with a dual-input single compartment model were compared between the 2 methods. Test–retest reproducibility of perfusion parameters were assessed in three patients. Results The quality of the pre-bolus AIF curve was significantly better than that of main bolus AIF. Shape parameters peak concentration, area under the time activity curve of gadolinium contrast at 60 s and upslope of pre-bolus AIF were all significantly higher, while full width at half maximum was significantly lower than shape parameters of main bolus AIF. Improved liver perfusion parameter reproducibility was observed using pre-bolus acquisition [coefficient of variation (CV) of 4.2%–38.7% for pre-bolus vs. 12.1–71.4% for main bolus] with the exception of distribution volume (CV of 23.6% for pre-bolus vs. 15.8% for main bolus). The CVs between pre-bolus and main bolus for the perfusion parameters were lower than 14%. Conclusion The AIF reconstructed with pre-bolus low dose contrast injection displays better quality and shape parameters and enables improved liver perfusion parameter reproducibility, although the resulting liver perfusion parameters demonstrated no clinically significant differences between pre-bolus and main bolus acquisitions.
Collapse
|
5
|
Mitsumori LM, Bhargava P, Essig M, Maki JH. Magnetic resonance imaging using gadolinium-based contrast agents. Top Magn Reson Imaging 2014; 23:51-69. [PMID: 24477166 DOI: 10.1097/rmr.0b013e31829c4686] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The purpose of this article was to review the basic properties of available gadolinium-based magnetic resonance contrast agents, discuss their fundamental differences, and explore common and evolving applications of gadolinium-based magnetic resonance contrast throughout the body excluding the central nervous system. A more specific aim of this article was to explore novel uses of these gadolinium-based contrast agents and applications where a particular agent has been demonstrated to behave differently or be better suited for certain applications than the other contrast agents in this class.
Collapse
|
6
|
Camici PG, d'Amati G, Rimoldi O. Coronary microvascular dysfunction: mechanisms and functional assessment. Nat Rev Cardiol 2014; 12:48-62. [DOI: 10.1038/nrcardio.2014.160] [Citation(s) in RCA: 290] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
7
|
Basha TA, Roujol S, Kissinger KV, Goddu B, Berg S, Manning WJ, Nezafat R. Free-breathing cardiac MR stress perfusion with real-time slice tracking. Magn Reson Med 2014; 72:689-98. [PMID: 24123153 PMCID: PMC3979504 DOI: 10.1002/mrm.24977] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 09/09/2013] [Accepted: 09/11/2013] [Indexed: 12/30/2022]
Abstract
PURPOSE To develop a free-breathing cardiac MR perfusion sequence with slice tracking for use after physical exercise. METHODS We propose to use a leading navigator, placed immediately before each 2D slice acquisition, for tracking the respiratory motion and updating the slice location in real-time. The proposed sequence was used to acquire CMR perfusion datasets in 12 healthy adult subjects and 8 patients. Images were compared with the conventional perfusion (i.e., without slice tracking) results from the same subjects. The location and geometry of the myocardium were quantitatively analyzed, and the perfusion signal curves were calculated from both sequences to show the efficacy of the proposed sequence. RESULTS The proposed sequence was significantly better compared with the conventional perfusion sequence in terms of qualitative image scores. Changes in the myocardial location and geometry decreased by 50% in the slice tracking sequence. Furthermore, the proposed sequence had signal curves that are smoother and less noisy. CONCLUSION The proposed sequence significantly reduces the effect of the respiratory motion on the image acquisition in both rest and stress perfusion scans.
Collapse
Affiliation(s)
- Tamer A. Basha
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Sébastien Roujol
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Kraig V. Kissinger
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Beth Goddu
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Sophie Berg
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Warren J. Manning
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Reza Nezafat
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| |
Collapse
|
8
|
Cookson AN, Lee J, Michler C, Chabiniok R, Hyde E, Nordsletten D, Smith NP. A spatially-distributed computational model to quantify behaviour of contrast agents in MR perfusion imaging. Med Image Anal 2014; 18:1200-16. [PMID: 25103922 PMCID: PMC4156310 DOI: 10.1016/j.media.2014.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 07/07/2014] [Accepted: 07/08/2014] [Indexed: 10/30/2022]
Abstract
Contrast agent enhanced magnetic resonance (MR) perfusion imaging provides an early, non-invasive indication of defects in the coronary circulation. However, the large variation of contrast agent properties, physiological state and imaging protocols means that optimisation of image acquisition is difficult to achieve. This situation motivates the development of a computational framework that, in turn, enables the efficient mapping of this parameter space to provide valuable information for optimisation of perfusion imaging in the clinical context. For this purpose a single-compartment porous medium model of capillary blood flow is developed which is coupled with a scalar transport model, to characterise the behaviour of both blood-pool and freely-diffusive contrast agents characterised by their ability to diffuse through the capillary wall into the extra-cellular space. A parameter space study is performed on the nondimensionalised equations using a 2D model for both healthy and diseased myocardium, examining the sensitivity of system behaviour to Peclet number, Damköhler number (Da), diffusivity ratio and fluid porosity. Assuming a linear MR signal response model, sample concentration time series data are calculated, and the sensitivity of clinically-relevant properties of these signals to the model parameters is quantified. Both upslope and peak values display significant non-monotonic behaviour with regard to the Damköhler number, with these properties showing a high degree of sensitivity in the parameter range relevant to contrast agents currently in use. However, the results suggest that signal upslope is the more robust and discerning metric for perfusion quantification, in particular for correlating with perfusion defect size. Finally, the results were examined in the context of nonlinear signal response, flow quantification via Fermi deconvolution and perfusion reserve index, which demonstrated that there is no single best set of contrast agent parameters, instead the contrast agents should be tailored to the specific imaging protocol and post-processing method to be used.
Collapse
Affiliation(s)
- A N Cookson
- Department of Biomedical Engineering, Division of Imaging Sciences & Biomedical Engineering, St. Thomas' Hospital, King's College London, London SE1 7EH, UK
| | - J Lee
- Department of Biomedical Engineering, Division of Imaging Sciences & Biomedical Engineering, St. Thomas' Hospital, King's College London, London SE1 7EH, UK
| | - C Michler
- Department of Biomedical Engineering, Division of Imaging Sciences & Biomedical Engineering, St. Thomas' Hospital, King's College London, London SE1 7EH, UK
| | - R Chabiniok
- Department of Biomedical Engineering, Division of Imaging Sciences & Biomedical Engineering, St. Thomas' Hospital, King's College London, London SE1 7EH, UK
| | - E Hyde
- Department of Computer Science, University of Oxford, Oxford OX1 3QD, UK
| | - D Nordsletten
- Department of Biomedical Engineering, Division of Imaging Sciences & Biomedical Engineering, St. Thomas' Hospital, King's College London, London SE1 7EH, UK
| | - N P Smith
- Department of Biomedical Engineering, Division of Imaging Sciences & Biomedical Engineering, St. Thomas' Hospital, King's College London, London SE1 7EH, UK.
| |
Collapse
|
9
|
Ritter CO, Wilke A, Wichmann T, Beer M, Hahn D, Köstler H. Comparison of intravascular and extracellular contrast media for absolute quantification of myocardial rest-perfusion using high-resolution MRI. J Magn Reson Imaging 2011; 33:1047-51. [PMID: 21509860 DOI: 10.1002/jmri.22557] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To use the contrast agent gadofosveset for absolute quantification of myocardial perfusion and compare it with gadobenate dimeglumine (Gd-BOPTA) using a high-resolution generalized autocalibrating partially parallel acquisition (GRAPPA) sequence. MATERIALS AND METHODS Ten healthy volunteers were examined twice at two different dates with a first-pass perfusion examination at rest using prebolus technique. We used a 1.5 T scanner and a 32 channel heart-array coil with a steady-state free precession (SSFP) true fast imaging with steady state precession (trueFISP) GRAPPA sequence (acceleration-factor 3). Manual delineation of the myocardial contours was performed and absolute quantification was performed after baseline and contamination correction. At the first appointment, 1cc/4cc of the extracellular contrast agent Gd-BOPTA were administered, on the second date, 1cc/4cc of the blood pool contrast agent (CA) gadofosveset. At each date the examination was repeated after a 15-minute time interval. RESULTS Using gadofosveset perfusion the value (in cc/g/min) at rest was 0.66 ± 0.25 (mean ± standard deviation) for the first, and 0.55 ± 0.24 for the second CA application; for Gd-BOPTA it was 0.62 ± 0.25 and 0.45 ± 0.23. No significant difference was found between the acquired perfusion values. The apparent mean residence time in the myocardium was 23 seconds for gadofosveset and 19.5 seconds for Gd-BOPTA. Neither signal-to-noise ratio (SNR) nor subjectively rated image contrast showed a significant difference. CONCLUSION The application of gadofosveset for an absolute quantification of myocardial perfusion is possible. Yet the acquired perfusion values show no significant differences to those determined with Gd-BOPTA, maintained the same SNR and comparable perfusion values, and did not picture the expected concentration time-course for an intravasal CA in the first pass.
Collapse
Affiliation(s)
- Christian O Ritter
- Institut für Röntgendiagnostik der Universität Würzburg, Würzburg, Germany.
| | | | | | | | | | | |
Collapse
|
10
|
Ritter CO, Kowalski M, Weng AM, Beer M, Hahn D, Köstler H. Quantitative myocardial perfusion imaging with a MR cold pressor test. Magn Reson Med 2011; 67:246-50. [PMID: 21630345 DOI: 10.1002/mrm.22941] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 03/04/2011] [Accepted: 03/07/2011] [Indexed: 01/30/2023]
Abstract
The response of myocardial blood flow to sympathetic stimulation with cold is modulated by endothelium-related factors. As endothelial dysfunction is an early step in patients with coronary artery disease, the aim of this study was to establish a cold pressor test (CPT) setting for quantitative analysis of myocardial perfusion in a MR scanner. First pass perfusion studies were performed in 10 healthy volunteers using a 1.5 T MR scanner with a multislice steady state free precession perfusion trueFISP sequence in prebolus technique (1 cc/4 cc gadobenate dimeglumine). MR-CPT was established using an over head ice-water bath of the left hand. First pass perfusion imaging was started after 1 min to assure an adequate stimulus followed by a second series after 15 min to evaluate the rest perfusion. After motion correction images were segmented with an adapted, automated tool, myocardial contours were determined. Perfusion was quantitatively evaluated after contamination and baseline correction by deconvolution with the arterial input function using an exponential function model as residuum. All data could be evaluated. Mean myocardial perfusion rose from 0.61 ± 0.22 cc/g/min at rest to 1.15 ± 0.34 cc/g/min under CPT. MR myocardial perfusion values show a comparable increase under CPT as published positron emission tomography data. Consequently, CPT for the presence of endothelial dysfunction is feasible in the MR environment.
Collapse
Affiliation(s)
- C O Ritter
- Institute of Radiology, University of Würzburg, Würzburg, Germany.
| | | | | | | | | | | |
Collapse
|
11
|
Evaluation of Gadodiamide Versus Gadobutrol for Contrast-Enhanced MR Imaging in a Rat Brain Glioma Model at 1.5 and 3 T. Invest Radiol 2010; 45:810-8. [DOI: 10.1097/rli.0b013e3181f03d8a] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
12
|
Groothuis JGJ, Kremers FPPJ, Beek AM, Brinckman SL, Tuinenburg AC, Jerosch-Herold M, van Rossum AC, Hofman MBM. Comparison of dual to single contrast bolus magnetic resonance myocardial perfusion imaging for detection of significant coronary artery disease. J Magn Reson Imaging 2010; 32:88-93. [PMID: 20578015 DOI: 10.1002/jmri.22231] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To investigate the incremental diagnostic value of dual-bolus over single-contrast-bolus first pass magnetic resonance myocardial perfusion imaging (MR-MPI) for detection of significant coronary artery disease (CAD). MATERIALS AND METHODS Patients (n = 49) with suspected CAD underwent first pass adenosine stress and rest MR-MPI and invasive coronary angiography (CA). Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) was injected with a prebolus (1 mL) and a large bolus (0.1 mmol/kg). For the single-bolus technique, the arterial input function (AIF) was obtained from the large-contrast bolus. For the dual-bolus technique, the AIF was reconstructed from the prebolus. Absolute myocardial perfusion was calculated by Fermi-model constrained deconvolution. Receiver operating characteristic (ROC) analysis was used to investigate diagnostic accuracy of MR myocardial perfusion imaging for detection of significant CAD on CA at vessel-based analysis. RESULTS The area under the curve (AUC) of the minimal stress perfusion value for the detection of significant CAD using the single-bolus and dual-bolus technique was 0.85 +/- 0.04 (95% confidence interval [CI], 0.77-0.93) and 0.77 +/- 0.05 (95% CI, 0.67-0.86), respectively. CONCLUSION In this study the dual-bolus technique had no incremental diagnostic value over single-bolus technique for detection of significant CAD with the used contrast concentrations.
Collapse
Affiliation(s)
- Jan G J Groothuis
- Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Kim TH, Pack NA, Chen L, DiBella EVR. Quantification of myocardial perfusion using CMR with a radial data acquisition: comparison with a dual-bolus method. J Cardiovasc Magn Reson 2010; 12:45. [PMID: 20653961 PMCID: PMC2920886 DOI: 10.1186/1532-429x-12-45] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Accepted: 07/23/2010] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Quantitative estimates of myocardial perfusion generally require accurate measurement of the arterial input function (AIF). The saturation of signal intensity in the blood that occurs with most doses of contrast agent makes obtaining an accurate AIF challenging. This work seeks to evaluate the performance of a method that uses a radial k-space perfusion sequence and multiple saturation recovery times (SRT) to quantify myocardial perfusion with cardiovascular magnetic resonance (CMR). METHODS Perfusion CMR was performed at 3 Tesla with a saturation recovery radial turboFLASH sequence with 72 rays. Fourteen subjects were given a low dose (0.004 mmol/kg) of dilute (1/5 concentration) contrast agent (Gd-BOPTA) and then a higher non-dilute dose of the same volume (0.02 mmol/kg). AIFs were calculated from the blood signal in three sub-images with differing effective saturation recovery times. The full and sub-images were reconstructed iteratively with a total variation constraint. The images from the full 72 ray data were processed to obtain six tissue enhancement curves in two slices of the left ventricle in each subject. A 2-compartment model was used to determine absolute flows RESULTS The proposed multi-SRT method resulted in AIFs that were similar to those obtained with the dual-bolus method. Myocardial blood flow (MBF) estimates from the dual-bolus and the multi-SRT methods were related by MBFmulti-SRT = 0.85MBFdual-bolus + 0.18 (r = 0.91). CONCLUSIONS The multi-SRT method, which uses a radial k-space perfusion sequence, can be used to obtain an accurate AIF and thus quantify myocardial perfusion for doses of contrast agent that result in a relatively saturated AIF.
Collapse
Affiliation(s)
- Tae Ho Kim
- Utah Center for Advanced Imaging Research, Department of Radiology, 729 Arapeen Dr. University of Utah, Salt Lake City, Utah 84108, USA
- Current Address: Department of Radiation Oncology, Stanford University, Stanford, CA 94305, USA
| | - Nathan A Pack
- Utah Center for Advanced Imaging Research, Department of Radiology, 729 Arapeen Dr. University of Utah, Salt Lake City, Utah 84108, USA
| | - Liyong Chen
- Utah Center for Advanced Imaging Research, Department of Radiology, 729 Arapeen Dr. University of Utah, Salt Lake City, Utah 84108, USA
| | - Edward VR DiBella
- Utah Center for Advanced Imaging Research, Department of Radiology, 729 Arapeen Dr. University of Utah, Salt Lake City, Utah 84108, USA
| |
Collapse
|
14
|
Attenberger UI, Runge VM, Morelli JN, Williams J, Jackson CB, Michaely HJ. Evaluation of gadobutrol, a macrocyclic, nonionic gadolinium chelate in a brain glioma model: comparison with gadoterate meglumine and gadopentetate dimeglumine at 1.5 T, combined with an assessment of field strength dependence, specifically 1.5 versus 3 T. J Magn Reson Imaging 2010; 31:549-55. [PMID: 20187196 DOI: 10.1002/jmri.22089] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To evaluate in a rat brain glioma model intraindividual tumor enhancement at 1.5 T using gadobutrol (Gadovist), a nonionic, macrocyclic chelate currently in clinical trials in the United States, in comparison with both an ionic macrocyclic chelate, gadoterate meglumine (Dotarem), and an ionic linear chelate, gadopentetate dimeglumine (Magnevist), and to compare the degree of tumor enhancement with gadobutrol at 1.5 and 3 T. MATERIALS AND METHODS A total of 24 rats, divided into three groups with n = 8 animals per group, were evaluated. Animals in group 1 received injections of gadobutrol and gadopentetate dimeglumine, whereas those in group 2 received gadobutrol and gadoterate meglumine. Injections were performed in random order and separated by 24 hours. Magnetic resonance imaging (MRI) examinations were performed immediately following each contrast injection with a 1.5 T MR system. Animals in group 3 received gadobutrol injections using the same protocol but with scans performed at 1.5 and 3 T. In all examinations, T1-weighted images were acquired precontrast, 1 minute postcontrast, and at 4 consecutive 2-minute intervals thereafter. A contrast dose of 0.1 mmol/kg was used in all instances. RESULTS In groups 1 and 2, tumor signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were higher for gadobutrol compared to both other agents at each timepoint postcontrast injection. The improvement in tumor CNR with gadobutrol, depending on time, was between 12% and 40% versus gadopentetate dimeglumine, with the difference achieving statistical significance at 7 minutes. The improvement in tumor CNR with gadobutrol, depending on time, was between 15% and 27% versus gadoterate meglumine, with the difference statistically significant at 5 and 9 minutes. In group 3 the improvement in tumor SNR and CNR seen with the increase in field strength from 1.5 to 3 T for gadobutrol was statistically significant at all acquired timepoints (P < 0.002). CNR mean values ranged from 10.4 +/- 2.9 to 24.6 +/- 5.0 at 1.5 T and from 20.5 +/- 5.9 to 47.8 +/- 15.7 at 3 T depending on the timepoint postcontrast. CONCLUSION Consistently greater tumor enhancement was noted at all measured timepoints following contrast injection with gadobutrol compared to both gadopentetate dimeglumine and gadoterate meglumine at 1.5 T. A substantial further improvement in tumor enhancement was noted using gadobutrol at 3 T.
Collapse
Affiliation(s)
- Ulrike I Attenberger
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
| | | | | | | | | | | |
Collapse
|
15
|
Gutberlet M, Geier O, Stäb D, Ritter C, Beer M, Hahn D, Köstler H. SNR-optimized myocardial perfusion imaging using parallel acquisition for effective density-weighted saturation recovery imaging. Magn Reson Imaging 2010; 28:341-50. [DOI: 10.1016/j.mri.2009.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 07/28/2009] [Accepted: 11/26/2009] [Indexed: 11/30/2022]
|
16
|
Camici PG, Rimoldi OE. The Clinical Value of Myocardial Blood Flow Measurement. J Nucl Med 2009; 50:1076-87. [DOI: 10.2967/jnumed.108.054478] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
|