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Dunn A, Wagner S, Sussman D. Scoping review of magnetic resonance motion imaging phantoms. MAGMA (NEW YORK, N.Y.) 2024:10.1007/s10334-024-01164-9. [PMID: 38739218 DOI: 10.1007/s10334-024-01164-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/28/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024]
Abstract
To review and analyze the currently available MRI motion phantoms. Publications were collected from the Toronto Metropolitan University Library, PubMed, and IEEE Xplore. Phantoms were categorized based on the motions they generated: linear/cartesian, cardiac-dilative, lung-dilative, rotational, deformation or rolling. Metrics were extracted from each publication to assess the motion mechanisms, construction methods, as well as phantom validation. A total of 60 publications were reviewed, identifying 48 unique motion phantoms. Translational movement was the most common movement (used in 38% of phantoms), followed by cardiac-dilative (27%) movement and rotational movement (23%). The average degrees of freedom for all phantoms were determined to be 1.42. Motion phantom publications lack quantification of their impact on signal-to-noise ratio through standardized testing. At present, there is a lack of phantoms that are designed for multi-role as many currently have few degrees of freedom.
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Affiliation(s)
- Alexander Dunn
- Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST) at Toronto Metropolitan University and St. Michael's Hospital, Toronto, Canada
| | - Sophie Wagner
- Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST) at Toronto Metropolitan University and St. Michael's Hospital, Toronto, Canada
| | - Dafna Sussman
- Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, Canada.
- Institute for Biomedical Engineering, Science and Technology (iBEST) at Toronto Metropolitan University and St. Michael's Hospital, Toronto, Canada.
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada.
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Ferumoxytol-Enhanced Cardiac Magnetic Resonance Angiography and 4D Flow: Safety and Utility in Pediatric and Adult Congenital Heart Disease. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121810. [PMID: 36553257 PMCID: PMC9777095 DOI: 10.3390/children9121810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/31/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022]
Abstract
Cardiac magnetic resonance imaging and angiography have a crucial role in the diagnostic evaluation and follow up of pediatric and adult patients with congenital heart disease. Although much of the information required of advanced imaging studies can be provided by standard gadolinium-enhanced magnetic resonance imaging, the limitations of precise bolus timing, long scan duration, complex imaging protocols, and the need to image small structures limit more widespread use of this modality. Recent experience with off-label diagnostic use of ferumoxytol has helped to mitigate some of these barriers. Approved by the U.S. FDA for intravenous treatment of anemia, ferumoxytol is an ultrasmall superparamagnetic iron oxide nanoparticle that has a long blood pool residence time and high relaxivity. Once metabolized by macrophages, the iron core is incorporated into the reticuloendothelial system. In this work, we aim to summarize the evolution of ferumoxytol-enhanced cardiovascular magnetic resonance imaging and angiography and highlight its many applications for congenital heart disease.
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Bonanno G, Weiss RG, Piccini D, Yerly J, Soleimani S, Pan L, Bi X, Hays AG, Stuber M, Schär M. Volumetric coronary endothelial function assessment: a feasibility study exploiting stack-of-stars 3D cine MRI and image-based respiratory self-gating. NMR IN BIOMEDICINE 2021; 34:e4589. [PMID: 34291517 PMCID: PMC8969584 DOI: 10.1002/nbm.4589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
Abnormal coronary endothelial function (CEF), manifesting as depressed vasoreactive responses to endothelial-specific stressors, occurs early in atherosclerosis, independently predicts cardiovascular events, and responds to cardioprotective interventions. CEF is spatially heterogeneous along a coronary artery in patients with atherosclerosis, and thus recently developed and tested non-invasive 2D MRI techniques to measure CEF may not capture the extent of changes in CEF in a given coronary artery. The purpose of this study was to develop and test the first volumetric coronary 3D MRI cine method for assessing CEF along the proximal and mid-coronary arteries with isotropic spatial resolution and in free-breathing. This approach, called 3D-Stars, combines a 6 min continuous, untriggered golden-angle stack-of-stars acquisition with a novel image-based respiratory self-gating method and cardiac and respiratory motion-resolved reconstruction. The proposed respiratory self-gating method agreed well with respiratory bellows and center-of-k-space methods. In healthy subjects, 3D-Stars vessel sharpness was non-significantly different from that by conventional 2D radial in proximal segments, albeit lower in mid-portions. Importantly, 3D-Stars detected normal vasodilatation of the right coronary artery in response to endothelial-dependent isometric handgrip stress in healthy subjects. Coronary artery cross-sectional areas measured using 3D-Stars were similar to those from 2D radial MRI when similar thresholding was used. In conclusion, 3D-Stars offers good image quality and shows feasibility for non-invasively studying vasoreactivity-related lumen area changes along the proximal coronary artery in 3D during free-breathing.
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Affiliation(s)
- Gabriele Bonanno
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA
| | - Robert G. Weiss
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA
| | - Davide Piccini
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), University Hospital of Lausanne, Lausanne, Switzerland
| | - Sahar Soleimani
- Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA
| | - Li Pan
- Siemens Medical Solutions USA, Inc, Baltimore, MD, USA
| | - Xiaoming Bi
- Siemens Medical Solutions USA, Inc, Los Angeles, CA, USA
| | - Allison G Hays
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Matthias Stuber
- Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), University Hospital of Lausanne, Lausanne, Switzerland
| | - Michael Schär
- Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA
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Reduced-iodine-dose dual-energy coronary CT angiography: qualitative and quantitative comparison between virtual monochromatic and polychromatic CT images. Eur Radiol 2021; 31:7132-7142. [PMID: 33740093 PMCID: PMC8379124 DOI: 10.1007/s00330-021-07809-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/06/2021] [Accepted: 02/17/2021] [Indexed: 12/29/2022]
Abstract
Objectives To quantitatively evaluate the impact of virtual monochromatic images (VMI) on reduced-iodine-dose dual-energy coronary computed tomography angiography (CCTA) in terms of coronary lumen segmentation in vitro, and secondly to assess the image quality in vivo, compared with conventional CT obtained with regular iodine dose. Materials and methods A phantom simulating regular and reduced iodine injection was used to determine the accuracy and precision of lumen area segmentation for various VMI energy levels. We retrospectively included 203 patients from December 2017 to August 2018 (mean age, 51.7 ± 16.8 years) who underwent CCTA using either standard (group A, n = 103) or reduced (group B, n = 100) iodine doses. Conventional images (group A) were qualitatively and quantitatively compared with 55-keV VMI (group B). We recorded the location of venous catheters. Results In vitro, VMI outperformed conventional CT, with a segmentation accuracy of 0.998 vs. 1.684 mm2, respectively (p < 0.001), and a precision of 0.982 vs. 1.229 mm2, respectively (p < 0.001), in simulated overweight adult subjects. In vivo, the rate of diagnostic CCTA in groups A and B was 88.4% (n = 91/103) vs. 89% (n = 89/100), respectively, and noninferiority of protocol B was inferred. Contrast-to-noise ratios (CNR) of lumen versus fat and muscle were higher in group B (p < 0.001) and comparable for lumen versus calcium (p = 0.423). Venous catheters were more often placed on the forearm or hand in group B (p < 0.001). Conclusion In vitro, low-keV VMI improve vessel area segmentation. In vivo, low-keV VMI allows for a 40% iodine dose and injection rate reduction while maintaining diagnostic image quality and improves the CNR between lumen versus fat and muscle. Key Points • Dual-energy coronary CT angiography is becoming increasingly available and might help improve patient management. • Compared with regular-iodine-dose coronary CT angiography, reduced-iodine-dose dual-energy CT with low-keV monochromatic image reconstructions performed better in phantom-based vessel cross-sectional segmentation and proved to be noninferior in vivo. • Patients receiving reduced-iodine-dose dual-energy coronary CT angiography often had the venous catheter placed on the forearm or wrist without compromising image quality. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-07809-w.
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Zwingli G, Yerly J, Mivelaz Y, Stoppa-Vaucher S, Dwyer AA, Pitteloud N, Stuber M, Hauschild M. Non-invasive assessment of coronary endothelial function in children and adolescents with type 1 diabetes mellitus using isometric handgrip exercise-MRI: A feasibility study. PLoS One 2020; 15:e0228569. [PMID: 32053613 PMCID: PMC7018029 DOI: 10.1371/journal.pone.0228569] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/19/2020] [Indexed: 01/02/2023] Open
Abstract
Background Type 1 diabetes mellitus (T1DM) in children and adolescents is associated with significant cardiovascular morbidity and mortality. Early detection of vascular dysfunction is key to patient management yet current assessment techniques are invasive and not suitable for pediatric patient populations. A novel approach using isometric handgrip exercise during magnetic resonance imaging (IHE-MRI) has recently been developed to evaluate coronary endothelial function non-invasively in adults. This project aimed to assess endothelium-dependent coronary arterial response to IHE-MRI in children with T1DM and in age matched healthy controls. Materials and methods Healthy volunteers and children with T1DM (>5 years) were recruited. IHE-MRI cross-sectional coronary artery area measurements were recorded at rest and under stress. Carotid intima media thickness (CIMT) and aortic pulse wave velocity (PWV) were assessed for comparison. Student’s t-tests were used to compare results between groups. Results and discussion Seven children with T1DM (3 female, median 14.8 years, mean 14.8 ± 1.9 years) and 16 healthy controls (7 female, median 14.8 years, mean 14.2 ± 2.4 years) participated. A significant increase in stress-induced cross-sectional coronary area was measured in controls (5.4 mm2 at rest to 6.39 mm2 under stress, 18.8 ± 10.7%, p = 0.0004). In contrast, mean area change in patients with T1DM was not significant (7.17 mm2 at rest to 7.59 mm2 under stress, 10.5% ± 28.1%, p = n.s.). There was no significant difference in the results for neither PWV nor CIMT between patients and controls, (5.3±1.5 m/s vs.4.8±0.7 m/s and 0.4±0.03mm vs.0.46 mm ± 0.03 respectively, both p = n.s.). Conclusions Our pilot study demonstrates the feasibility of using a totally non-invasive IHE-MRI technique in children and adolescents with and without T1DM. Preliminary results suggest a blunted endothelium-dependent coronary vasomotor function in children with T1DM (>5 years). Better knowledge and new methodologies may improve surveillance and care for T1DM patients to reduce cardiovascular morbidity and mortality.
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Affiliation(s)
- Gaëtan Zwingli
- Lausanne University (UNIL), Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Radiology, Lausanne University Hospital (CHUV), Center for Biomedical Imaging, Lausanne, Switzerland
| | - Yvan Mivelaz
- Pediatric Cardiology Unit, Service of Pediatrics, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Sophie Stoppa-Vaucher
- Department of Pediatrics, Hôpital Neuchâtelois, Neuchâtel, Switzerland
- Pediatric Endocrinology, Diabetology and Obesity Unit, Service of Pediatrics, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Andrew A. Dwyer
- Boston College, William F.Connell School of Nursing, Chestnut Hill, MA, United States of America
| | - Nelly Pitteloud
- Pediatric Endocrinology, Diabetology and Obesity Unit, Service of Pediatrics, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Matthias Stuber
- Department of Radiology, Lausanne University Hospital (CHUV), Center for Biomedical Imaging, Lausanne, Switzerland
| | - Michael Hauschild
- Pediatric Endocrinology, Diabetology and Obesity Unit, Service of Pediatrics, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- * E-mail:
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Yerly J, Becce F, van Heeswijk RB, Verdun FR, Gubian D, Meuli R, Stuber M. In vitro optimization and comparison of CT angiography versus radial cardiovascular magnetic resonance for the quantification of cross-sectional areas and coronary endothelial function. J Cardiovasc Magn Reson 2019; 21:11. [PMID: 30728035 PMCID: PMC6366062 DOI: 10.1186/s12968-019-0521-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/14/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Our objectives were first to determine the optimal coronary computed tomography angiography (CTA) protocol for the quantification and detection of simulated coronary artery cross-sectional area (CSA) differences in vitro, and secondly to quantitatively compare the performance of the optimized CTA protocol with a previously validated radial coronary cardiovascular magnetic resonance (CMR) technique. METHODS 256-multidetector CTA and radial coronary CMR were used to obtain images of a custom in vitro resolution phantom simulating a range of physiological responses of coronary arteries to stress. CSAs were automatically quantified and compared with known nominal values to determine the accuracy, precision, signal-to-noise ratio (SNR), and circularity of CSA measurements, as well as the limit of detection (LOD) of CSA differences. Various iodine concentrations, radiation dose levels, tube potentials, and iterative image reconstruction algorithms (ASiR-V) were investigated to determine the optimal CTA protocol. The performance of the optimized CTA protocol was then compared with a radial coronary CMR method previously developed for endothelial function assessment under both static and moving conditions. RESULTS The iodine concentration, dose level, tube potential, and reconstruction algorithm all had significant effects (all p < 0.001) on the accuracy, precision, LOD, SNR, and circularity of CSA measurements with CTA. The best precision, LOD, SNR, and circularity with CTA were achieved with 6% iodine, 20 mGy, 100 kVp, and 90% ASiR-V. Compared with the optimized CTA protocol under static conditions, radial coronary CMR was less accurate (- 0.91 ± 0.13 mm2 vs. -0.35 ± 0.04 mm2, p < 0.001), but more precise (0.08 ± 0.02 mm2 vs. 0.21 ± 0.02 mm2, p < 0.001), and enabled the detection of significantly smaller CSA differences (0.16 ± 0.06 mm2 vs. 0.52 ± 0.04 mm2; p < 0.001; corresponding to CSA percentage differences of 2.3 ± 0.8% vs. 7.4 ± 0.6% for a 3-mm baseline diameter). The same results held true under moving conditions as CSA measurements with CMR were less affected by motion. CONCLUSIONS Radial coronary CMR was more precise and outperformed CTA for the specific task of detecting small CSA differences in vitro, and was able to reliably identify CSA changes an order of magnitude smaller than those reported for healthy physiological vasomotor responses of proximal coronary arteries. However, CTA yielded more accurate CSA measurements, which may prove useful in other clinical scenarios, such as coronary artery stenosis assessment.
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Affiliation(s)
- Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV and UNIL), Rue du Bugnon 46, Lausanne, 1011 VD Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV and UNIL), Rue du Bugnon 46, Lausanne, 1011 VD Switzerland
| | - Ruud B. van Heeswijk
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV and UNIL), Rue du Bugnon 46, Lausanne, 1011 VD Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Francis R. Verdun
- Institute of Radiation Physics, Lausanne University Hospital (CHUV and UNIL), Lausanne, Switzerland
| | - Danilo Gubian
- Direction des Constructions, Ingénierie, Technique et Sécurité (CIT-S), Lausanne University Hospital (CHUV and UNIL), Lausanne, Switzerland
| | - Reto Meuli
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV and UNIL), Rue du Bugnon 46, Lausanne, 1011 VD Switzerland
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV and UNIL), Rue du Bugnon 46, Lausanne, 1011 VD Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
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Schär M, Soleimanifard S, Bonanno G, Yerly J, Hays AG, Weiss RG. Precision and accuracy of cross-sectional area measurements used to measure coronary endothelial function with spiral MRI. Magn Reson Med 2019; 81:291-302. [PMID: 30024061 PMCID: PMC6258280 DOI: 10.1002/mrm.27384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/25/2018] [Accepted: 05/09/2018] [Indexed: 01/22/2023]
Abstract
PURPOSE Coronary endothelial function (CEF) reflects vascular health and conventional invasive CEF measures predict cardiovascular events. MRI can now noninvasively measure CEF by quantifying coronary artery cross-sectional area changes in response to isometric handgrip exercise, an endothelial-dependent stressor. Area changes (10 to 20% in healthy; 2 to -12% in impaired vessels) are only a few imaging voxels because of MRI's limited spatial resolution. Here, with numerical simulations and phantom studies, we test whether Fourier interpolation enables sub-pixel area measurement precision and determine the smallest detectable area change using spiral MRI. METHODS In vivo coronary SNR with the currently used CEF protocol at 3T was measured in 7 subjects for subsequent in vitro work. Area measurements of circular vessels were simulated by varying partial volume, vessel diameter, voxel size, SNR, and Fourier interpolation factor. A phantom with precision-drilled holes (diameters 3-3.42 mm) was imaged 10 times with the current CEF protocol (voxel size, Δx = 0.89 mm) and a high-resolution protocol (Δx = 0.6 mm) to determine precision, accuracy, and the smallest detectable area changes. RESULTS In vivo coronary SNR ranged from 30-76. Eight-fold Fourier interpolation improved area measurement precision by a factor 6.5 and 4.9 in the simulations and phantom scans, respectively. The current CEF protocol can detect mean area changes of 4-5% for SNR above 30, and 3-3.5% for SNR above 40 with a higher-resolution protocol. CONCLUSION Current CEF spiral MRI with in vivo SNR allows detection of a 4-5% area change and Fourier interpolation improves precision several-fold to sub-voxel dimensions.
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Affiliation(s)
- Michael Schär
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sahar Soleimanifard
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Gabriele Bonanno
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jérôme Yerly
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Allison G. Hays
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Robert G. Weiss
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
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