1
|
Xue H, Brown LA, Nielles-Vallespin S, Plein S, Kellman P. Automatic in-line quantitative myocardial perfusion mapping: Processing algorithm and implementation. Magn Reson Med 2020; 83:712-730. [PMID: 31441550 PMCID: PMC8400845 DOI: 10.1002/mrm.27954] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/27/2019] [Accepted: 07/27/2019] [Indexed: 02/03/2023]
Abstract
PURPOSE Quantitative myocardial perfusion mapping has advantages over qualitative assessment, including the ability to detect global flow reduction. However, it is not clinically available and remains a research tool. Building upon the previously described imaging sequence, this study presents algorithm and implementation of an automated solution for inline perfusion flow mapping with step by step performance characterization. METHODS Proposed workflow consists of motion correction (MOCO), arterial input function blood detection, intensity to gadolinium concentration conversion, and pixel-wise mapping. A distributed kinetics model, blood-tissue exchange model, is implemented, computing pixel-wise maps of myocardial blood flow (mL/min/g), permeability-surface-area product (mL/min/g), blood volume (mL/g), and interstitial volume (mL/g). RESULTS Thirty healthy subjects (11 men; 26.4 ± 10.4 years) were recruited and underwent adenosine stress perfusion cardiovascular MR. Mean MOCO quality score was 3.6 ± 0.4 for stress and 3.7 ± 0.4 for rest. Myocardial Dice similarity coefficients after MOCO were significantly improved (P < 1e-6), 0.87 ± 0.05 for stress and 0.86 ± 0.06 for rest. Arterial input function peak gadolinium concentration was 4.4 ± 1.3 mmol/L at stress and 5.2 ± 1.5 mmol/L at rest. Mean myocardial blood flow at stress and rest were 2.82 ± 0.47 mL/min/g and 0.68 ± 0.16 mL/min/g, respectively. The permeability-surface-area product was 1.32 ± 0.26 mL/min/g at stress and 1.09 ± 0.21 mL/min/g at rest (P < 1e-3). Blood volume was 12.0 ± 0.8 mL/100 g at stress and 9.7 ± 1.0 mL/100 g at rest (P < 1e-9), indicating good adenosine vasodilation response. Interstitial volume was 20.8 ± 2.5 mL/100 g at stress and 20.3 ± 2.9 mL/100 g at rest (P = 0.50). CONCLUSIONS An inline perfusion flow mapping workflow is proposed and demonstrated on normal volunteers. Initial evaluation demonstrates this fully automated solution for the respiratory MOCO, arterial input function left ventricle mask detection, and pixel-wise mapping, from free-breathing myocardial perfusion imaging.
Collapse
Affiliation(s)
- Hui Xue
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Louise A.E. Brown
- Multidisciplinary Cardiovascular Research Centre (MCRC) & Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | | | - Sven Plein
- Multidisciplinary Cardiovascular Research Centre (MCRC) & Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Peter Kellman
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
2
|
Kunze KP, Nekolla SG, Rischpler C, Zhang SH, Hayes C, Langwieser N, Ibrahim T, Laugwitz KL, Schwaiger M. Myocardial perfusion quantification using simultaneously acquired 13 NH 3 -ammonia PET and dynamic contrast-enhanced MRI in patients at rest and stress. Magn Reson Med 2018; 80:2641-2654. [PMID: 29672922 DOI: 10.1002/mrm.27213] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/11/2018] [Accepted: 03/19/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE Systematic differences with respect to myocardial perfusion quantification exist between DCE-MRI and PET. Using the potential of integrated PET/MRI, this study was conceived to compare perfusion quantification on the basis of simultaneously acquired 13 NH3 -ammonia PET and DCE-MRI data in patients at rest and stress. METHODS Twenty-nine patients were examined on a 3T PET/MRI scanner. DCE-MRI was implemented in dual-sequence design and additional T1 mapping for signal normalization. Four different deconvolution methods including a modified version of the Fermi technique were compared against 13 NH3 -ammonia results. RESULTS Cohort-average flow comparison yielded higher resting flows for DCE-MRI than for PET and, therefore, significantly lower DCE-MRI perfusion ratios under the common assumption of equal arterial and tissue hematocrit. Absolute flow values were strongly correlated in both slice-average (R2 = 0.82) and regional (R2 = 0.7) evaluations. Different DCE-MRI deconvolution methods yielded similar flow result with exception of an unconstrained Fermi method exhibiting outliers at high flows when compared with PET. CONCLUSION Thresholds for Ischemia classification may not be directly tradable between PET and MRI flow values. Differences in perfusion ratios between PET and DCE-MRI may be lifted by using stress/rest-specific hematocrit conversion. Proper physiological constraints are advised in model-constrained deconvolution.
Collapse
Affiliation(s)
- Karl P Kunze
- Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany
| | - Stephan G Nekolla
- Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
| | - Christoph Rischpler
- Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
| | | | | | - Nicolas Langwieser
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany.,Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
| | - Tareq Ibrahim
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany.,Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
| | - Karl-Ludwig Laugwitz
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany.,Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
| | - Markus Schwaiger
- Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
| |
Collapse
|
3
|
Wissmann L, Gotschy A, Santelli C, Tezcan KC, Hamada S, Manka R, Kozerke S. Analysis of spatiotemporal fidelity in quantitative 3D first-pass perfusion cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2017; 19:11. [PMID: 28125995 PMCID: PMC5270366 DOI: 10.1186/s12968-017-0324-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whole-heart first-pass perfusion cardiovascular magnetic resonance (CMR) relies on highly accelerated image acquisition. The influence of undersampling on myocardial blood flow (MBF) quantification has not been systematically investigated yet. In the present work, the effect of spatiotemporal scan acceleration on image reconstruction accuracy and MBF error was studied using a numerical phantom and validated in-vivo. METHODS Up to 10-fold scan acceleration using k-t PCA and k-t SPARSE-SENSE was simulated using the MRXCAT CMR numerical phantom framework. Image reconstruction results were compared to ground truth data in the k-f domain by means of modulation transfer function (MTF) analysis. In the x-t domain, errors pertaining to specific features of signal intensity-time curves and MBF values derived using Fermi model deconvolution were analysed. In-vivo first-pass CMR data were acquired in ten healthy volunteers using a dual-sequence approach assessing the arterial input function (AIF) and myocardial enhancement. 10x accelerated 3D k-t PCA and k-t SPARSE-SENSE were compared and related to non-accelerated 2D reference images. RESULTS MTF analysis revealed good recovery of data upon k-t PCA reconstruction at 10x undersampling with some attenuation of higher temporal frequencies. For 10x k-t SPARSE-SENSE the MTF was found to decrease to zero at high spatial frequencies for all temporal frequencies indicating a loss in spatial resolution. Signal intensity-time curve errors were most prominent in AIFs from 10x k-t PCA, thereby emphasizing the need for separate AIF acquisition using a dual-sequence approach. These findings were confirmed by MBF estimation based on AIFs from fully sampled and undersampled simulations. Average in-vivo MBF estimates were in good agreement between both accelerated and the fully sampled methods. Intra-volunteer MBF variation for fully sampled 2D scans was lower compared to 10x k-t PCA and k-t SPARSE-SENSE data. CONCLUSION Quantification of highly undersampled 3D first-pass perfusion CMR yields accurate MBF estimates provided the AIF is obtained using fully sampled or moderately undersampled scans as part of a dual-sequence approach. However, relative to fully sampled 2D perfusion imaging, intra-volunteer variation is increased using 3D approaches prompting for further developments.
Collapse
Affiliation(s)
- Lukas Wissmann
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Alexander Gotschy
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
- Division of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Claudio Santelli
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Kerem Can Tezcan
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Sandra Hamada
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
- Department of Cardiology, RWTH Aachen University, Aachen, Germany
| | - Robert Manka
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
- Division of Imaging Sciences, King’s College London, London, UK
| |
Collapse
|
4
|
Quantitative Perfusion Analysis of First-Pass Contrast Enhancement Kinetics: Application to MRI of Myocardial Perfusion in Coronary Artery Disease. PLoS One 2016; 11:e0162067. [PMID: 27583385 PMCID: PMC5008793 DOI: 10.1371/journal.pone.0162067] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 08/17/2016] [Indexed: 11/22/2022] Open
Abstract
Purpose Perfusion analysis from first-pass contrast enhancement kinetics requires modeling tissue contrast exchange. This study presents a new approach for numerical implementation of the tissue homogeneity model, incorporating flexible distance steps along the capillary (NTHf). Methods The proposed NTHf model considers contrast exchange in fluid packets flowing along the capillary, incorporating flexible distance steps, thus allowing more efficient and stable calculations of the transit of tracer through the tissue. We prospectively studied 8 patients (62 ± 13 years old) with suspected CAD, who underwent first-pass perfusion CMR imaging at rest and stress prior to angiography. Myocardial blood flow (MBF) and myocardial perfusion reserve index (MPRI) were estimated using both the NTHf and the conventional adiabatic approximation of the TH models. Coronary artery lesions detected at angiography were clinically assigned to one of three categories of stenosis severity (‘insignificant’, ‘mild to moderate’ and ‘severe’) and related to corresponding myocardial territories. Results The mean MBF (ml/g/min) at rest/stress and MPRI were 0.80 ± 0.33/1.25 ± 0.45 and 1.68 ± 0.54 in the insignificant regions, 0.74 ± 0.21/1.09 ± 0.28 and 1.54 ± 0.46 in the mild to moderate regions, and 0.79 ± 0.28/0.63 ± 0.34 and 0.85 ± 0.48 in the severe regions, respectively. The correlation coefficients of MBFs at rest/stress and MPRI between the NTHf and AATH models were r = 0.97/0.93 and r = 0.91, respectively. Conclusions The proposed NTHf model allows efficient quantitative analysis of the transit of tracer through tissue, particularly at higher flow. Results of initial application to MRI of myocardial perfusion in CAD are encouraging.
Collapse
|
5
|
Kunze KP, Rischpler C, Hayes C, Ibrahim T, Laugwitz KL, Haase A, Schwaiger M, Nekolla SG. Measurement of extracellular volume and transit time heterogeneity using contrast-enhanced myocardial perfusion MRI in patients after acute myocardial infarction. Magn Reson Med 2016; 77:2320-2330. [PMID: 27364875 DOI: 10.1002/mrm.26320] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 05/17/2016] [Accepted: 05/31/2016] [Indexed: 12/20/2022]
Abstract
PURPOSE To assess the ability of dynamic contrast-enhanced myocardial perfusion MRI to measure extracellular volume (ECV) and to investigate the possibility of estimating capillary transit time heterogeneity (CTH) in patients after myocardial infarction and successful revascularization. METHODS Twenty-four perfusion data sets were acquired on a 3 Tesla positron emission tomography (PET)/MRI scanner. Three perfusion models of different complexity were implemented in a hierarchical fashion with an Akaike information criterion being used to determine the number of fit parameters supported by the data. Results were compared sector-wise to ECV from an equilibrium T1 mapping method (modified look-locker inversion recovery (MOLLI)). RESULTS ECV derived from the perfusion analysis correlated well with equilibrium measurements (R² = 0.76). Estimation of CTH was supported in 16% of sectors (mostly remote). Inclusion of a nonzero CTH parameter usually led to lower estimates of first-pass extraction and slightly higher estimates of blood volume and flow. Estimation of the capillary permeability-surface area product was feasible in 81% of sectors. CONCLUSION Transit time heterogeneity has a measurable effect on the kinetic analysis of myocardial perfusion MRI data, and Gd-DTPA extravasation in the myocardium is usually not flow-limited in infarct-related pathology. Measurement of myocardial ECV using perfusion imaging could provide a scan-time efficient alternative to methods based on T1 mapping. Magn Reson Med 77:2320-2330, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
Collapse
Affiliation(s)
- Karl P Kunze
- Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany
| | - Christoph Rischpler
- Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
| | | | - Tareq Ibrahim
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany.,Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
| | - Karl-Ludwig Laugwitz
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany.,Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
| | - Axel Haase
- Zentralinstitut für Medizintechnik (IMETUM) der TU München, Garching, Germany
| | - Markus Schwaiger
- Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
| | - Stephan G Nekolla
- Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
| |
Collapse
|
6
|
Wissmann L, Niemann M, Gotschy A, Manka R, Kozerke S. Quantitative three-dimensional myocardial perfusion cardiovascular magnetic resonance with accurate two-dimensional arterial input function assessment. J Cardiovasc Magn Reson 2015; 17:108. [PMID: 26637221 PMCID: PMC4669617 DOI: 10.1186/s12968-015-0212-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 11/24/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Quantification of myocardial perfusion from first-pass cardiovascular magnetic resonance (CMR) images at high contrast agent (CA) dose requires separate acquisition of blood pool and myocardial tissue enhancement. In this study, a dual-sequence approach interleaving 2D imaging of the arterial input function with high-resolution 3D imaging for myocardial perfusion assessment is presented and validated for low and high CA dose. METHODS A dual-sequence approach interleaving 2D imaging of the aortic root and 3D imaging of the whole left ventricle using highly accelerated k-t PCA was implemented. Rest perfusion imaging was performed in ten healthy volunteers after administration of a Gadolinium-based CA at low (0.025 mmol/kg b.w.) and high dose (0.1 mmol/kg b.w.). Arterial input functions extracted from the 2D and 3D images were analysed for both doses. Myocardial contrast-to-noise ratios (CNR) were compared across volunteers and doses. Variations of myocardial perfusion estimates between volunteers and across myocardial territories were studied. RESULTS High CA dose imaging resulted in strong non-linearity of the arterial input function in the 3D images at peak CA concentration, which was avoided when the input function was derived from the 2D images. Myocardial CNR was significantly increased at high dose compared to low dose, with a 2.6-fold mean CNR gain. Most robust myocardial blood flow estimation was achieved using the arterial input function extracted from the 2D image at high CA dose. In this case, myocardial blood flow estimates varied by 24% between volunteers and by 20% between myocardial territories when analysed on a per-volunteer basis. CONCLUSION Interleaving 2D imaging for arterial input function assessment enables robust quantitative 3D myocardial perfusion imaging at high CA dose.
Collapse
Affiliation(s)
- Lukas Wissmann
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
| | - Markus Niemann
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
- Clinic of Cardiology, University Hospital Zurich, Zurich, Switzerland.
- Furtwangen University, Faculty Mechanical and Medical Engineering, Villingen-Schwenningen, Germany.
| | - Alexander Gotschy
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
- Clinic of Cardiology, University Hospital Zurich, Zurich, Switzerland.
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland.
| | - Robert Manka
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
- Clinic of Cardiology, University Hospital Zurich, Zurich, Switzerland.
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.
- Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
| |
Collapse
|
7
|
Hong K, Jeong EK, Wall TS, Drakos SG, Kim D. Wideband arrhythmia-Insensitive-rapid (AIR) pulse sequence for cardiac T1 mapping without image artifacts induced by an implantable-cardioverter-defibrillator. Magn Reson Med 2015; 74:336-45. [PMID: 25975192 DOI: 10.1002/mrm.25712] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/06/2015] [Accepted: 03/06/2015] [Indexed: 01/05/2023]
Abstract
PURPOSE To develop and evaluate a wideband arrhythmia-insensitive-rapid (AIR) pulse sequence for cardiac T1 mapping without image artifacts induced by implantable-cardioverter-defibrillator (ICD). METHODS We developed a wideband AIR pulse sequence by incorporating a saturation pulse with wide frequency bandwidth (8.9 kHz) to achieve uniform T1 weighting in the heart with ICD. We tested the performance of original and "wideband" AIR cardiac T1 mapping pulse sequences in phantom and human experiments at 1.5 Tesla. RESULTS In five phantoms representing native myocardium and blood and postcontrast blood/tissue T1 values, compared with the control T1 values measured with an inversion-recovery pulse sequence without ICD, T1 values measured with original AIR with ICD were considerably lower (absolute percent error > 29%), whereas T1 values measured with wideband AIR with ICD were similar (absolute percent error < 5%). Similarly, in 11 human subjects, compared with the control T1 values measured with original AIR without ICD, T1 measured with original AIR with ICD was significantly lower (absolute percent error > 10.1%), whereas T1 measured with wideband AIR with ICD was similar (absolute percent error < 2.0%). CONCLUSION This study demonstrates the feasibility of a wideband pulse sequence for cardiac T1 mapping without significant image artifacts induced by ICD.
Collapse
Affiliation(s)
- KyungPyo Hong
- Department of Bioengineering, University of Utah, Salt Lake City, Utah, USA.,UCAIR, Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Eun-Kee Jeong
- UCAIR, Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - T Scott Wall
- Division of Cardiology, Internal Medicine, University of Utah, Salt Lake, Utah, USA
| | - Stavros G Drakos
- Division of Cardiology, Internal Medicine, University of Utah, Salt Lake, Utah, USA
| | - Daniel Kim
- UCAIR, Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
8
|
Mendes J, Parker DL, McNally S, DiBella E, Bolster BD, Treiman GS. Three-dimensional dynamic contrast enhanced imaging of the carotid artery with direct arterial input function measurement. Magn Reson Med 2013; 72:816-22. [PMID: 24375566 DOI: 10.1002/mrm.24993] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 09/17/2013] [Accepted: 09/18/2013] [Indexed: 12/26/2022]
Abstract
PURPOSE Kinetic analysis using dynamic contrast enhanced MRI to assess neovascularization of carotid plaque requires images with high spatial and temporal resolution. This work demonstrates a new three-dimensional (3D) dynamic contrast enhanced imaging sequence, which directly measures the arterial input function with high temporal resolution yet maintains the high spatial resolution required to identify areas of increased adventitial neovascularity. THEORY AND METHODS The sequence consists of multiple rapid acquisitions of a saturation prepared dynamic 3D gradient recalled echo (GRE) sequence temporally interleaved with multiple acquisitions of a 2D slice. The saturation recovery time was adjusted to maintain signal linearity with the very different contrast agent concentrations in the 2D slice and 3D volume. The K(trans) maps were obtained from the 3D dynamic contrast measurements while the 2D slice was used to obtain the arterial input function. Calibration and dynamic studies are presented. RESULTS For contrast agent concentrations up to 5 mM, a saturation recovery time for the 2D slice of 20 ms resulted in less than a 10% deviation from the desired linear response of signal intensity with contrast agent concentration. The corresponding saturation recovery time of 83 ms for the 3D volume maintained less than a 10% deviation from the linear response up to contrast agent concentrations of 2 mM while a contrast agent concentration of 5 mM had almost a 30% deviation. There was a significant improvement in signal attenuation (9 ± 3% versus 23 ± 5% at 40 cm/s) when flow compensation was added to the slice select gradients. For patient studies, volume transfer and plasma fraction maps were calculated with data from the proposed sequence. CONCLUSION This work demonstrated a novel sequence for 3D dynamic contrast enhanced imaging with a simultaneously acquired 2D slice that directly measures the arterial input function with high temporal resolution. Acquisition parameters can be adjusted to accommodate the full range of contrast agent concentration values to be encountered and the kinetic parameters obtained were consistent with expected values.
Collapse
Affiliation(s)
- Jason Mendes
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | | | | | | | | | | |
Collapse
|
9
|
Dacher JN, Lefebvre V, Dubourg B, Deux JF, Caudron J. Is it possible to do without the study of myocardial perfusion in 2013? Diagn Interv Imaging 2013; 94:1337-44. [PMID: 23849751 DOI: 10.1016/j.diii.2013.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The analysis of myocardial perfusion is a key step in the cardiac MRI examination. In routine work, this exploration carried out at rest is based on the qualitative first pass study of gadolinium with an ECG-triggered saturation recovery bFFE sequence. In view of recent knowledge, the analysis of the myocardial perfusion under vasodilator stress may be carried out by scintigraphy or MRI, the latter benefiting from the absence of exposure to ionizing rays and a lower cost. Besides coronary disease, the perfusion sequence provides a rich semiology to compare with the clinics and the data from other sequences. Arterial Spin Labeling (ASL) is an alternative technique used in the animal to quantify myocardial perfusion.
Collapse
Affiliation(s)
- J-N Dacher
- Radiodiagnostic et Imagerie Médicale (Imagerie Cardiaque Non Invasive), CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France; Inserm U1096, UFR Médecine Pharmacie, 22, boulevard Gambetta, 76183 Rouen cedex 1, France.
| | | | | | | | | |
Collapse
|
10
|
Pop M, Ghugre NR, Ramanan V, Morikawa L, Stanisz G, Dick AJ, Wright GA. Quantification of fibrosis in infarcted swine hearts byex vivolate gadolinium-enhancement and diffusion-weighted MRI methods. Phys Med Biol 2013; 58:5009-28. [DOI: 10.1088/0031-9155/58/15/5009] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
11
|
Calcagno C, Robson PM, Ramachandran S, Mani V, Kotys-Traughber M, Cham M, Fischer SE, Fayad ZA. SHILO, a novel dual imaging approach for simultaneous HI-/LOw temporal (Low-/Hi-spatial) resolution imaging for vascular dynamic contrast enhanced cardiovascular magnetic resonance: numerical simulations and feasibility in the carotid arteries. J Cardiovasc Magn Reson 2013; 15:42. [PMID: 23706156 PMCID: PMC3668185 DOI: 10.1186/1532-429x-15-42] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 04/23/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dynamic contrast enhanced (DCE) cardiovascular magnetic resonance (CMR) is increasingly used to quantify microvessels and permeability in atherosclerosis. Accurate quantification depends on reliable sampling of both vessel wall (VW) uptake and contrast agent dynamic in the blood plasma (the so called arterial input function, AIF). This poses specific challenges in terms of spatial/temporal resolution and matched dynamic MR signal range, which are suboptimal in current vascular DCE-CMR protocols. In this study we describe a novel dual-imaging approach, which allows acquiring simultaneously AIF and VW images using different spatial/temporal resolution and optimizes imaging parameters for the two compartments. We refer to this new acquisition as SHILO, Simultaneous HI-/LOw-temporal (low-/hi-spatial) resolution DCE-imaging. METHODS In SHILO, the acquisition of low spatial resolution single-shot AIF images is interleaved with segments of higher spatial resolution images of the VW. This allows sampling the AIF and VW with different spatial/temporal resolution and acquisition parameters, at independent spatial locations. We show the adequacy of this temporal sampling scheme by using numerical simulations. Following, we validate the MR signal of SHILO against a standard 2D spoiled gradient recalled echo (SPGR) acquisition with in vitro and in vivo experiments. Finally, we show feasibility of using SHILO imaging in subjects with carotid atherosclerosis. RESULTS Our simulations confirmed the superiority of the SHILO temporal sampling scheme over conventional strategies that sample AIF and tissue curves at the same time resolution. Both the median relative errors and standard deviation of absolute parameter values were lower for the SHILO than for conventional sampling schemes. We showed equivalency of the SHILO signal and conventional 2D SPGR imaging, using both in vitro phantom experiments (R2 =0.99) and in vivo acquisitions (R2 =0.95). Finally, we showed feasibility of using the newly developed SHILO sequence to acquire DCE-CMR data in subjects with carotid atherosclerosis to calculate plaque perfusion indices. CONCLUSIONS We successfully demonstrate the feasibility of using the newly developed SHILO dual-imaging technique for simultaneous AIF and VW imaging in DCE-CMR of atherosclerosis. Our initial results are promising and warrant further investigation of this technique in wider studies measuring kinetic parameters of plaque neovascularization with validation against gold standard techniques.
Collapse
Affiliation(s)
- Claudia Calcagno
- Translational and Molecular Imaging Institute, Imaging Science Laboratories, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY 10029, USA
- Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Philip M Robson
- Translational and Molecular Imaging Institute, Imaging Science Laboratories, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY 10029, USA
- Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Sarayu Ramachandran
- Translational and Molecular Imaging Institute, Imaging Science Laboratories, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY 10029, USA
- Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Venkatesh Mani
- Translational and Molecular Imaging Institute, Imaging Science Laboratories, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY 10029, USA
- Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | | | - Matthew Cham
- Translational and Molecular Imaging Institute, Imaging Science Laboratories, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY 10029, USA
- Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Stefan E Fischer
- MR Clinical Science, Philips Healthcare, 595 Miner Road, Cleveland, OH 44143, USA
| | - Zahi A Fayad
- Translational and Molecular Imaging Institute, Imaging Science Laboratories, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY 10029, USA
- Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| |
Collapse
|
12
|
Fluckiger JU, Benefield BC, Harris KR, Lee DC. Absolute quantification of myocardial blood flow with constrained estimation of the arterial input function. J Magn Reson Imaging 2013; 38:603-9. [PMID: 23371884 DOI: 10.1002/jmri.24025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 12/07/2012] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To evaluate the performance of the constrained alternating minimization with model (CAMM) method for estimating the input function from the myocardial tissue curves. MATERIALS AND METHODS Myocardial perfusion imaging was performed on seven canine models of coronary artery disease in 15 imaging sessions. In each session, stress was induced with intravenous infusion of adenosine and a variable occluder created coronary artery stenosis. A dual bolus protocol was used for each acquisition, and input functions were then estimated using the CAMM method with data acquired from the high dose scan following each imaging session. For each acquisition, myocardial blood flow was measured by injected microspheres. RESULTS The dual bolus and CAMM-derived flows were not significantly different (P = 0.18), and the correlation between the two methods was high (r = 0.97). The correlation between the dual bolus and CAMM methods and microsphere measurements was lower than that for the two MR methods (r = 0.53; r = 0.43, respectively). CONCLUSION The CAMM method presented here shows promise in estimating myocardial blood flow in patients with coronary artery disease at stress with a single injection and without any specialized acquisitions. Further work is needed to validate the approach in a clinical setting.
Collapse
Affiliation(s)
- Jacob U Fluckiger
- Department of Radiology, Northwestern University, Chicago, Illinois, USA.
| | | | | | | |
Collapse
|
13
|
Fitts M, Breton E, Kholmovski EG, Dosdall DJ, Vijayakumar S, Hong KP, Ranjan R, Marrouche NF, Axel L, Kim D. Arrhythmia insensitive rapid cardiac T1 mapping pulse sequence. Magn Reson Med 2012; 70:1274-82. [PMID: 23280998 DOI: 10.1002/mrm.24586] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 11/11/2012] [Accepted: 11/13/2012] [Indexed: 12/12/2022]
Abstract
PURPOSE To develop an arrhythmia-insensitive rapid (AIR) cardiac T1 mapping pulse sequence for quantification of diffuse fibrosis. METHODS An arrhythmia-insensitive cardiac T1 mapping pulse sequence was developed based on saturation recovery T1 weighting, which is inherently insensitive to heart rate and rhythm, and two single-shot balanced steady-state free precession image acquisitions with centric k-space ordering, where T1 calculation is inherently insensitive to T2 effects. Its performance against conventional cardiac T1 mapping based on inversion recovery (i.e., MOLLI) is compared. Phantom experiments (T1 ranging from 535 to 2123 ms) were performed with heart rate and rhythm simulated at 60 and 120 beats per minute (bpm) and arrhythmia using an external triggering device. Ten human subjects and 17 large animals were scanned precontrast and 5, 10, and 15 min after contrast agent administration. RESULTS Compared with the reference T1 mapping, AIR yielded lower normalized root-mean-square error than MOLLI (8% vs. 3%, respectively, at 60 bpm, 28% vs. 3%, respectively, at 120 bpm, and 22% vs. 3%, respectively, at arrhythmia). In vivo studies showed that T1 measurements made by MOLLI and AIR were strongly correlated (r = 0.99) but in poor agreement (mean difference = 161.8 ms, upper and lower 95% limits of agreements = 347.5 ms and -24.0 ms). CONCLUSION Our AIR pulse sequence may be clinically useful for assessment of diffuse myocardial fibrosis in patients.
Collapse
Affiliation(s)
- Michelle Fitts
- Department of Bioengineering, University of Utah, Salt Lake City, Utah, USA; CARMA Center, University of Utah, Salt Lake City, Utah, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
The Potential of Magnetic Particle Imaging in the Competitive Environment of Cardiac Diagnostics. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/978-3-642-24133-8_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
|