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Braunstorfer L, Romanowicz J, Powell AJ, Pattee J, Browne LP, van der Geest RJ, Moghari MH. Non-contrast free-breathing whole-heart 3D cine cardiovascular magnetic resonance with a novel 3D radial leaf trajectory. Magn Reson Imaging 2022; 94:64-72. [PMID: 36122675 DOI: 10.1016/j.mri.2022.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/18/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To develop and validate a non-contrast free-breathing whole-heart 3D cine steady-state free precession (SSFP) sequence with a novel 3D radial leaf trajectory. METHODS We used a respiratory navigator to trigger acquisition of 3D cine data at end-expiration to minimize respiratory motion in our 3D cine SSFP sequence. We developed a novel 3D radial leaf trajectory to reduce gradient jumps and associated eddy-current artifacts. We then reconstructed the 3D cine images with a resolution of 2.0mm3 using an iterative nonlinear optimization algorithm. Prospective validation was performed by comparing ventricular volumetric measurements from a conventional breath-hold 2D cine ventricular short-axis stack against the non-contrast free-breathing whole-heart 3D cine dataset in each patient (n = 13). RESULTS All 3D cine SSFP acquisitions were successful and mean scan time was 07:09 ± 01:31 min. End-diastolic ventricular volumes for left ventricle (LV) and right ventricle (RV) measured from the 3D datasets were smaller than those from 2D (LV: 159.99 ± 42.99 vs. 173.16 ± 47.42; RV: 180.35 ± 46.08 vs. 193.13 ± 49.38; p-value≤0.044; bias<8%), whereas ventricular end-systolic volumes were more comparable (LV: 79.12 ± 26.78 vs. 78.46 ± 25.35; RV: 97.18 ± 32.35 vs. 102.42 ± 32.53; p-value≥0.190, bias<6%). The 3D cine data had a lower subjective image quality score. CONCLUSION Our non-contrast free-breathing whole-heart 3D cine sequence with novel leaf trajectory was robust and yielded smaller ventricular end-diastolic volumes compared to 2D cine imaging. It has the potential to make examinations easier and more comfortable for patients.
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Affiliation(s)
- Lukas Braunstorfer
- Department of Cardiology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Department of Informatics, Technical University of Munich, Munich, BY, Germany.
| | - Jennifer Romanowicz
- Department of Cardiology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Department of Pediatrics, Section of Cardiology, Children's Hospital Colorado, School of Medicine, The University of Colorado, CO, USA
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Jack Pattee
- Department of Biostatistics and Informatics, Colorado School of Public Health, CO, USA
| | - Lorna P Browne
- Department of Radiology, Children's Hospital Colorado, and School of Medicine, The University of Colorado, CO, USA
| | - Rob J van der Geest
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mehdi H Moghari
- Department of Radiology, Children's Hospital Colorado, and School of Medicine, The University of Colorado, CO, USA
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Pednekar AS, Jadhav S, Noel C, Masand P. Free-breathing Cardiorespiratory Synchronized Cine MRI for Assessment of Left and Right Ventricular Volume and Function in Sedated Children and Adolescents with Impaired Breath-holding Capacity. Radiol Cardiothorac Imaging 2019; 1:e180027. [PMID: 33778501 PMCID: PMC7970102 DOI: 10.1148/ryct.2019180027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/28/2019] [Accepted: 04/10/2019] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively compare left ventricular and right ventricular volume, function, and image quality of a free-breathing (FB) cardiorespiratory synchronized balanced steady-state free precession cine MRI sequence with that of a standard of reference breath-hold (BH) technique in sedated children and adolescents who are unable to perform BHs. MATERIALS AND METHODS Cohort 1 included 30 patients able to perform BHs (mean age, 19 years; age range, 9-69 years). Cohort 1 underwent both BH and FB cine short-axis imaging with identical acquisition parameters. Cohort 2 included 63 patients unable to perform BHs (50 sedated patients [mean age, 9 years; age range, 4 months to 28 years], 13 unsedated patients [mean age, 21 years; age range, 8-58 years]). Cohort 2 underwent FB cine imaging in multiple views with spatiotemporal resolution equivalent to BH imaging. Comparative quantitative analysis was performed for left ventricular and right ventricular volumes in cohort 1 and for qualitative image quality scores in all patients. RESULTS Global left ventricular and right ventricular volumetric indexes and image quality scores were comparable between BH and FB sequences in cohort 1. FB image quality was graded as excellent (37 sequences), good (197 sequences), adequate (26 sequences), and suboptimal (three sequences) for 263 cine sequences in cohort 2. In cohort 1, de facto image acquisition time for FB (6.1 minutes ± 1.9 [standard deviation]) was comparable to the equivalent for BH (6.1 minutes ± 2.6) for a stack of 14 sections. CONCLUSION In cohorts of sedated children, adolescents, and young adults unable to perform BHs consistently, left ventricular and right ventricular volumes and function were comparable and image quality was noninferior between FB and standard of reference BH techniques.© RSNA, 2019.
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Affiliation(s)
- Amol S. Pednekar
- From the Edward B. Singleton Department of Pediatric Radiology (A.S.P., S.J., P.M.) and Department of Pediatric Cardiology (C.N.), Texas Children’s Hospital, Mark A. Wallace Tower, 6701 Fannin St, Suite 470, Houston, TX 77030-2399
| | - Siddharth Jadhav
- From the Edward B. Singleton Department of Pediatric Radiology (A.S.P., S.J., P.M.) and Department of Pediatric Cardiology (C.N.), Texas Children’s Hospital, Mark A. Wallace Tower, 6701 Fannin St, Suite 470, Houston, TX 77030-2399
| | - Cory Noel
- From the Edward B. Singleton Department of Pediatric Radiology (A.S.P., S.J., P.M.) and Department of Pediatric Cardiology (C.N.), Texas Children’s Hospital, Mark A. Wallace Tower, 6701 Fannin St, Suite 470, Houston, TX 77030-2399
| | - Prakash Masand
- From the Edward B. Singleton Department of Pediatric Radiology (A.S.P., S.J., P.M.) and Department of Pediatric Cardiology (C.N.), Texas Children’s Hospital, Mark A. Wallace Tower, 6701 Fannin St, Suite 470, Houston, TX 77030-2399
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Pednekar AS, Wang H, Flamm S, Cheong BY, Muthupillai R. Two-center clinical validation and quantitative assessment of respiratory triggered retrospectively cardiac gated balanced-SSFP cine cardiovascular magnetic resonance imaging in adults. J Cardiovasc Magn Reson 2018; 20:44. [PMID: 29950177 PMCID: PMC6022503 DOI: 10.1186/s12968-018-0467-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 05/25/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Breath-hold (BH) requirement remains the limiting factor on the spatio-temporal resolution and coverage of the cine balanced steady-state free precession (bSSFP) cardiovascular magnetic resonance (CMR) imaging. In this prospective two-center clinical trial, we validated the performance of a respiratory triggered (RT) bSSFP cine sequence for evaluation of biventricular function. METHODS Our study included 23 asymptomatic healthy subjects and 60 consecutive patients from Institute A (n = 39) and Institute B (n = 21) referred for a clinically indicated CMR study. We implemented a RT sequence with a respiratory synchronized drive to steady state (SS) of bSSFP signal, before the commencement of image data acquisition with prospective cardiac arrhythmia rejection and retrospectively cardiac gated reconstruction in real-time. Left (LV) and right (RV) ventricular function and LV mass were evaluated by using RT-bSSFP and conventional BH-bSSFP sequences with one cardiac cycle for SS preparation keeping all the imaging parameters identical. The performance of the sequences was evaluated by using quantitative and semi-quantitative metrics. RESULTS Global LV and RV functional parameters and LV mass obtained from the RT-bSSFP and BH-bSSFP sequences were in good agreement. Quantitative metrics designed to capture fluctuation in SS signal intensity showed no significant difference between sequences. In addition, blood-to-myocardial contrast was nearly identical between sequences. The combined clinical score for image quality was excellent or good for 100% of cases with the BH-bSSFP and 83% of cases with the RT-bSSFP sequence. The de facto image acquisition time for RT-bSSFP was statistically significantly longer than that for conventional BH-bSSFP (7.9 ± 3.4 min vs. 5.1 ± 2.6 min). CONCLUSIONS Cine RT-bSSFP is an alternative for evaluating global biventricular function with contrast and spatio-temporal resolutions that are similar to those attained by using the BH-bSSFP sequence, albeit with a modest time penalty and a small reduction in image quality.
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Affiliation(s)
- Amol S Pednekar
- Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite D470.09, Houston, TX 77030-2399 USA
| | - Hui Wang
- Philips Healthcare, Gainesville, FL USA
| | - Scott Flamm
- Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH USA
| | - Benjamin Y. Cheong
- Department of Radiology, Baylor St. Luke’s Medical Center, Houston, TX USA
| | - Raja Muthupillai
- Department of Radiology, Baylor St. Luke’s Medical Center, Houston, TX USA
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Moghari MH, Barthur A, Amaral ME, Geva T, Powell AJ. Free-breathing whole-heart 3D cine magnetic resonance imaging with prospective respiratory motion compensation. Magn Reson Med 2017; 80:181-189. [PMID: 29222852 DOI: 10.1002/mrm.27021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/11/2017] [Accepted: 10/31/2017] [Indexed: 12/27/2022]
Abstract
PURPOSE To develop and validate a new prospective respiratory motion compensation algorithm for free-breathing whole-heart 3D cine steady-state free precession (SSFP) imaging. METHODS In a 3D cine SSFP sequence, 4 excitations per cardiac cycle are re-purposed to prospectively track heart position. Specifically, their 1D image is reconstructed and routed into the scanner's standard diaphragmatic navigator processing system. If all 4 signals are in end-expiration, cine image data from the entire cardiac cycle is accepted for image reconstruction. Prospective validation was carried out in patients (N = 17) by comparing in each a conventional breath-hold 2D cine ventricular short-axis stack and a free-breathing whole-heart 3D cine data set. RESULTS All 3D cine SSFP acquisitions were successful and the mean scan time was 5.9 ± 2.7 min. Left and right ventricular end-diastolic, end-systolic, and stroke volumes by 3D cine SSFP were all larger than those from 2D cine SSFP. This bias was < 6% except for right ventricular end-systolic volume that was 12%. The 3D cine images had a lower ventricular blood-to-myocardium contrast ratio, contrast-to-noise ratio, mass, and subjective quality score. CONCLUSION The novel prospective respiratory motion compensation method for 3D cine SSFP imaging was robust and efficient and yielded slightly larger ventricular volumes and lower mass compared to breath-hold 2D cine imaging. Magn Reson Med 80:181-189, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Mehdi H Moghari
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Ashita Barthur
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Maria E Amaral
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Tal Geva
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Liu J, Feng L, Shen HW, Zhu C, Wang Y, Mukai K, Brooks GC, Ordovas K, Saloner D. Highly-accelerated self-gated free-breathing 3D cardiac cine MRI: validation in assessment of left ventricular function. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 30:337-346. [PMID: 28120280 DOI: 10.1007/s10334-017-0607-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 12/21/2016] [Accepted: 01/03/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This work presents a highly-accelerated, self-gated, free-breathing 3D cardiac cine MRI method for cardiac function assessment. MATERIALS AND METHODS A golden-ratio profile based variable-density, pseudo-random, Cartesian undersampling scheme was implemented for continuous 3D data acquisition. Respiratory self-gating was achieved by deriving motion signal from the acquired MRI data. A multi-coil compressed sensing technique was employed to reconstruct 4D images (3D+time). 3D cardiac cine imaging with self-gating was compared to bellows gating and the clinical standard breath-held 2D cine imaging for evaluation of self-gating accuracy, image quality, and cardiac function in eight volunteers. Reproducibility of 3D imaging was assessed. RESULTS Self-gated 3D imaging provided an image quality score of 3.4 ± 0.7 vs 4.0 ± 0 with the 2D method (p = 0.06). It determined left ventricular end-systolic volume as 42.4 ± 11.5 mL, end-diastolic volume as 111.1 ± 24.7 mL, and ejection fraction as 62.0 ± 3.1%, which were comparable to the 2D method, with bias ± 1.96 × SD of -0.8 ± 7.5 mL (p = 0.90), 2.6 ± 3.3 mL (p = 0.84) and 1.4 ± 6.4% (p = 0.45), respectively. CONCLUSION The proposed 3D cardiac cine imaging method enables reliable respiratory self-gating performance with good reproducibility, and provides comparable image quality and functional measurements to 2D imaging, suggesting that self-gated, free-breathing 3D cardiac cine MRI framework is promising for improved patient comfort and cardiac MRI scan efficiency.
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Affiliation(s)
- Jing Liu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA.
| | - Li Feng
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Hsin-Wei Shen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
| | - Chengcheng Zhu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
| | - Yan Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
| | - Kanae Mukai
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Gabriel C Brooks
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Karen Ordovas
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA.,Radiology Service, VA Medical Center, San Francisco, CA, USA
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Han F, Rapacchi S, Khan S, Ayad I, Salusky I, Gabriel S, Plotnik A, Finn JP, Hu P. Four-dimensional, multiphase, steady-state imaging with contrast enhancement (MUSIC) in the heart: a feasibility study in children. Magn Reson Med 2015; 74:1042-9. [PMID: 25302932 DOI: 10.1002/mrm.25491] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/09/2014] [Accepted: 09/21/2014] [Indexed: 11/11/2022]
Abstract
PURPOSE To develop a technique for high resolution, four-dimensional (4D), multiphase, steady-state imaging with contrast enhancement (MUSIC) in children with complex congenital heart disease. METHODS Eight pediatric patients underwent cardiovascular MRI with controlled mechanical ventilation after ferumoxytol administration. Breath-held contrast-enhanced MRA (CE-MRA) was performed during the first-pass and delayed phases of ferumoxytol, followed by a respiratory gated, 4D MUSIC acquisition during the steady state distribution phase of ferumoxytol. The subjective image quality and image sharpness were evaluated. Assessment of ventricular volumes based on 4D MUSIC was compared with those based on multislice 2D cardiac cine MRI. RESULTS The 4D MUSIC technique provided cardiac-phase-resolved (65-95 ms temporal resolution) and higher spatial resolution (0.6-0.9 mm isotropic) images than previously achievable using first-pass CE-MRA or 2D cardiac cine. When compared with Ferumoxytol-based first-pass CE-MRA, the 4D MUSIC provided sharper images and better definition of the coronary arteries, aortic root, myocardium, and pulmonary trunk (P < 0.05 for all). The ventricular volume measurements were in good agreement between 4D MUSIC and 2D cine (concordance correlation coefficient >0.95). CONCLUSION The 4D MUSIC technique may represent a new paradigm in MR evaluation of cardiovascular anatomy and function in children with complex congenital heart disease.
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Affiliation(s)
- Fei Han
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Stanislas Rapacchi
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Sarah Khan
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Ihab Ayad
- Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Isidro Salusky
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Simon Gabriel
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Adam Plotnik
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - J Paul Finn
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Biomedical Physics Inter-Departmental Graduate Program, University of California, Los Angeles, California, USA
| | - Peng Hu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Biomedical Physics Inter-Departmental Graduate Program, University of California, Los Angeles, California, USA
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Moghari MH, Komarlu R, Annese D, Geva T, Powell AJ. Free-breathing steady-state free precession cine cardiac magnetic resonance with respiratory navigator gating. Magn Reson Med 2014; 73:1555-61. [PMID: 24777586 DOI: 10.1002/mrm.25275] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 04/09/2014] [Accepted: 04/10/2014] [Indexed: 12/23/2022]
Abstract
PURPOSE To develop and validate a respiratory motion compensation method for free-breathing cardiac cine imaging. METHODS A free-breathing navigator-gated cine steady-state free precession acquisition (Cine-Nav) was developed which preserves the equilibrium state of the net magnetization vector, maintains the high spatial and temporal resolutions of standard breath-hold (BH) acquisition, and images entire cardiac cycle. Cine image data is accepted only from cardiac cycles occurring entirely during end-expiration. Prospective validation was performed in 10 patients by obtaining in each three complete ventricular image stacks with different respiratory motion compensation approaches: (1) BH, (2) free-breathing with 3 signal averages (3AVG), and (3) free-breathing with Cine-Nav. RESULTS The subjective image quality score (1 = worst, 4 = best) for Cine-Nav (3.8 ± 0.4) was significantly better than for 3AVG (2.2 ± 0.5, P = 0.002), and similar to BH (4.0 ± 0.0, P = 0.13). The blood-to-myocardium contrast ratio for Cine-Nav (6.3 ± 1.5) was similar to BH (5.9 ± 1.6, P = 0.52) and to 3AVG (5.6 ± 2.5, P = 0.43). There were no significant differences between Cine-Nav and BH for the ventricular volumes and mass. In contrast, there were significant differences between 3AVG and BH in all of these measurements but right ventricular mass. CONCLUSION Free-breathing cine imaging with Cine-Nav yielded comparable image quality and ventricular measurements to BH, and was superior to 3AVG.
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Affiliation(s)
- Mehdi H Moghari
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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