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Craft J, Weber J, Li Y, Cheng JY, Diaz N, Kunze KP, Schmidt M, Grgas M, Weber S, Tang J, Parikh R, Onuegbu A, Yamashita AM, Haag E, Fuentes D, Czipo M, Neji R, Espada CB, Figueroa L, Rothbaum JA, Fujikura K, Bano R, Khalique OK, Prieto C, Botnar RM. Inversion recovery and saturation recovery pulmonary vein MR angiography using an image based navigator fluoro trigger and variable-density 3D cartesian sampling with spiral-like order. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024; 40:1363-1376. [PMID: 38676848 DOI: 10.1007/s10554-024-03111-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/07/2024] [Indexed: 04/29/2024]
Abstract
Contrast enhanced pulmonary vein magnetic resonance angiography (PV CE-MRA) has value in atrial ablation pre-procedural planning. We aimed to provide high fidelity, ECG gated PV CE-MRA accelerated by variable density Cartesian sampling (VD-CASPR) with image navigator (iNAV) respiratory motion correction acquired in under 4 min. We describe its use in part during the global iodinated contrast shortage. VD-CASPR/iNAV framework was applied to ECG-gated inversion and saturation recovery gradient recalled echo PV CE-MRA in 65 patients (66 exams) using .15 mmol/kg Gadobutrol. Image quality was assessed by three physicians, and anatomical segmentation quality by two technologists. Left atrial SNR and left atrial/myocardial CNR were measured. 12 patients had CTA within 6 months of MRA. Two readers assessed PV ostial measurements versus CTA for intermodality/interobserver agreement. Inter-rater/intermodality reliability, reproducibility of ostial measurements, SNR/CNR, image, and anatomical segmentation quality was compared. The mean acquisition time was 3.58 ± 0.60 min. Of 35 PV pre-ablation datasets (34 patients), mean anatomical segmentation quality score was 3.66 ± 0.54 and 3.63 ± 0.55 as rated by technologists 1 and 2, respectively (p = 0.7113). Good/excellent anatomical segmentation quality (grade 3/4) was seen in 97% of exams. Each rated one exam as moderate quality (grade 2). 95% received a majority image quality score of good/excellent by three physicians. Ostial PV measurements correlated moderate to excellently with CTA (ICCs range 0.52-0.86). No difference in SNR was observed between IR and SR. High quality PV CE-MRA is possible in under 4 min using iNAV bolus timing/motion correction and VD-CASPR.
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Affiliation(s)
- Jason Craft
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA.
| | - Jonathan Weber
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Yulee Li
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Joshua Y Cheng
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Nancy Diaz
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Karl P Kunze
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, UK
| | | | - Marie Grgas
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Suzanne Weber
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - John Tang
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Roosha Parikh
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Afiachukwu Onuegbu
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Ann-Marie Yamashita
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Elizabeth Haag
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | | | | | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Cristian B Espada
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Leana Figueroa
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Jonathan A Rothbaum
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Kana Fujikura
- Division of Cardiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Ruqiyya Bano
- Department of Nephrology and Hypertension, Stony Brook University Hospital, New York, NY, 11794, USA
| | - Omar K Khalique
- Division of Cardiovascular Imaging, DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, 101 Northern Blvd, Greenvale, NY, 11548, USA
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rene M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Institute of Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
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Guglielmo M, Rier S, Zan GD, Krafft AJ, Schmidt M, Kunze KP, Botnar RM, Prieto C, van der Heijden J, Van Driel V, Ramanna H, van der Harst P, van der Bilt I. Cardiac magnetic resonance for early atrial lesion visualization post atrial fibrillation radiofrequency catheter ablation. J Cardiovasc Electrophysiol 2024; 35:258-266. [PMID: 38065834 DOI: 10.1111/jce.16152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/01/2023] [Accepted: 11/27/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Incomplete atrial lesions resulting in pulmonary vein-left atrium reconnection after pulmonary vein antrum isolation (PVAI), are related to atrial fibrillation (AF) recurrence. Unfortunately, during the PVAI procedure, fluoroscopy and electroanatomic mapping cannot accurately determine the location and size of the ablation lesions in the atrial wall and this can result in incomplete PVAI lesions (PVAI-L) after radiofrequency catheter ablation (RFCA). AIM We seek to evaluate whether cardiac magnetic resonance (CMR), immediately after RFCA of AF, can identify PVAI-L by characterizing the left atrial tissue. METHODS Ten patients (63.1 ± 5.7 years old, 80% male) receiving a RFCA for paroxysmal AF underwent a CMR before (<1 week) and after (<1 h) the PVAI. Two-dimensional dark-blood T2-weighted short tau inversion recovery (DB-STIR), Three-dimensional inversion-recovery prepared long inversion time (3D-TWILITE) and three-dimensional late gadolinium enhancement (3D-LGE) images were performed to visualize PVAI-L. RESULTS The PVAI-L was visible in 10 patients (100%) using 3D-TWILITE and 3D-LGE. Conversely, On DB-STIR, the ablation core of the PAVI-L could not be identified because of a diffuse high signal of the atrial wall post-PVAI. Microvascular obstruction was identified in 7 (70%) patients using 3D-LGE. CONCLUSION CMR can visualize PVAI-L immediately after the RFCA of AF even without the use of contrast agents. Future studies are needed to understand if the use of CMR for PVAI-L detection after RFCA can improve the results of ablation procedures.
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Affiliation(s)
- Marco Guglielmo
- Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, Utrecht University, Utrecht, The Netherlands
- Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Sophie Rier
- Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Giulia De Zan
- Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, Utrecht University, Utrecht, The Netherlands
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | | | - Karl P Kunze
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, UK
- King's College London, London, UK
| | - Rene M Botnar
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, UK
- King's College London, London, UK
| | - Claudia Prieto
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, UK
- King's College London, London, UK
| | | | - Vincent Van Driel
- Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Hemanth Ramanna
- Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Pim van der Harst
- Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Ivo van der Bilt
- Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, Utrecht University, Utrecht, The Netherlands
- Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands
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Fotaki A, Pushparajah K, Rush C, Munoz C, Velasco C, Neji R, Kunze KP, Botnar RM, Prieto C. Highly efficient free-breathing 3D whole-heart imaging in 3-min: single center study in adults with congenital heart disease. J Cardiovasc Magn Reson 2023; 26:100008. [PMID: 38194762 PMCID: PMC11211218 DOI: 10.1016/j.jocmr.2023.100008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/10/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Three dimensional, whole-heart (3DWH) MRI is an established non-invasive imaging modality in patients with congenital heart disease (CHD) for the diagnosis of cardiovascular morphology and for clinical decision making. Current techniques utilise diaphragmatic navigation (dNAV) for respiratory motion correction and gating and are frequently limited by long acquisition times. This study proposes and evaluates the diagnostic performance of a respiratory gating-free framework, which considers respiratory image-based navigation (iNAV), and highly accelerated variable density Cartesian sampling in concert with non-rigid motion correction and low-rank patch-based denoising (iNAV-3DWH-PROST). The method is compared to the clinical dNAV-3DWH sequence in adult patients with CHD. METHODS In this prospective single center study, adult patients with CHD who underwent the clinical dNAV-3DWH MRI were also scanned with the iNAV-3DWH-PROST. Diagnostic confidence (4-point Likert scale) and diagnostic accuracy for common cardiovascular lesions was assessed by three readers. Scan times and diagnostic confidence were compared using the Wilcoxon-signed rank test. Co-axial vascular dimensions at three anatomic landmarks were measured, and agreement between the research and the corresponding clinical sequence was assessed with Bland-Altman analysis. RESULTS The study included 60 participants (mean age ± [SD]: 33 ± 14 years; 36 men). The mean acquisition time of iNAV-3DWH-PROST was significantly lower compared with the conventional clinical sequence (3.1 ± 0.9 min vs 13.9 ± 3.9 min, p < 0.0001). Diagnostic confidence was higher for the iNAV-3DWH-PROST sequence compared with the clinical sequence (3.9 ± 0.2 vs 3.4 ± 0.8, p < 0.001), however there was no significant difference in diagnostic accuracy. Narrow limits of agreement and mean bias less than 0.08 cm were found between the research and the clinical vascular measurements. CONCLUSIONS The iNAV-3DWH-PROST framework provides efficient, high quality and robust 3D whole-heart imaging in significantly shorter scan time compared to the standard clinical sequence.
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Affiliation(s)
- Anastasia Fotaki
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
| | - Kuberan Pushparajah
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Christopher Rush
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Camila Munoz
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom
| | - Carlos Velasco
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom
| | - Radhouene Neji
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom
| | - Karl P Kunze
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom
| | - René M Botnar
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile; Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile; Institute for Advanced Study, Technical University of Munich, Lichtenbergstrasse 2 a, D-85748 Garching, Germany
| | - Claudia Prieto
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, SE1 7EH London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile
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Gertz RJ, Wagner A, Sokolowski M, Lennartz S, Gietzen C, Grunz JP, Goertz L, Kaya K, ten Freyhaus H, Persigehl T, Bunck AC, Doerner J, Naehle CP, Maintz D, Weiss K, Katemann C, Pennig L. Compressed SENSE accelerated 3D single-breath-hold late gadolinium enhancement cardiovascular magnetic resonance with isotropic resolution: clinical evaluation. Front Cardiovasc Med 2023; 10:1305649. [PMID: 38099228 PMCID: PMC10720442 DOI: 10.3389/fcvm.2023.1305649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/17/2023] [Indexed: 12/17/2023] Open
Abstract
Aim The purpose of this study was to investigate the clinical application of Compressed SENSE accelerated single-breath-hold LGE with 3D isotropic resolution compared to conventional LGE imaging acquired in multiple breath-holds. Material & Methods This was a retrospective, single-center study including 105 examinations of 101 patients (48.2 ± 16.8 years, 47 females). All patients underwent conventional breath-hold and 3D single-breath-hold (0.96 × 0.96 × 1.1 mm3 reconstructed voxel size, Compressed SENSE factor 6.5) LGE sequences at 1.5 T in clinical routine for the evaluation of ischemic or non-ischemic cardiomyopathies. Two radiologists independently evaluated the left ventricle (LV) for the presence of hyperenhancing lesions in each sequence, including localization and transmural extent, while assessing their scar edge sharpness (SES). Confidence of LGE assessment, image quality (IQ), and artifacts were also rated. The impact of LV ejection fraction (LVEF), heart rate, body mass index (BMI), and gender as possible confounders on IQ, artifacts, and confidence of LGE assessment was evaluated employing ordinal logistic regression analysis. Results Using 3D single-breath-hold LGE readers detected more hyperenhancing lesions compared to conventional breath-hold LGE (n = 246 vs. n = 216 of 1,785 analyzed segments, 13.8% vs. 12.1%; p < 0.0001), pronounced at subendocardial, midmyocardial, and subepicardial localizations and for 1%-50% of transmural extent. SES was rated superior in 3D single-breath-hold LGE (4.1 ± 0.8 vs. 3.3 ± 0.8; p < 0.001). 3D single-breath-hold LGE yielded more artifacts (3.8 ± 1.0 vs. 4.0 ± 3.8; p = 0.002) whereas IQ (4.1 ± 1.0 vs. 4.2 ± 0.9; p = 0.122) and confidence of LGE assessment (4.3 ± 0.9 vs. 4.3 ± 0.8; p = 0.374) were comparable between both techniques. Female gender negatively influenced artifacts in 3D single-breath-hold LGE (p = 0.0028) while increased heart rate led to decreased IQ in conventional breath-hold LGE (p = 0.0029). Conclusions In clinical routine, Compressed SENSE accelerated 3D single-breath-hold LGE yields image quality and confidence of LGE assessment comparable to conventional breath-hold LGE while providing improved delineation of smaller LGE lesions with superior scar edge sharpness. Given the fast acquisition of 3D single-breath-hold LGE, the technique holds potential to drastically reduce the examination time of CMR.
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Affiliation(s)
- Roman Johannes Gertz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anton Wagner
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute for Diagnostic and Interventional Radiology, Krankenhaus der Augustinerinnen, Cologne, Germany
| | - Marcel Sokolowski
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Simon Lennartz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Carsten Gietzen
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Lukas Goertz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Kenan Kaya
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Henrik ten Freyhaus
- Department III of Internal Medicine, Heart Center, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Alexander Christian Bunck
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jonas Doerner
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Kontraste Radiologie-Praxis Köln West, Cologne, Germany
| | - Claas Philip Naehle
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Radiologische Allianz Hamburg, Hamburg, Germany
| | - David Maintz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | | | - Lenhard Pennig
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Wood G, Pedersen AU, Kunze KP, Neji R, Hajhosseiny R, Wetzl J, Yoon SS, Schmidt M, Nørgaard BL, Prieto C, Botnar RM, Kim WY. Automated detection of cardiac rest period for trigger delay calculation for image-based navigator coronary magnetic resonance angiography. J Cardiovasc Magn Reson 2023; 25:52. [PMID: 37779192 PMCID: PMC10544388 DOI: 10.1186/s12968-023-00962-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/12/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Coronary magnetic resonance angiography (coronary MRA) is increasingly being considered as a clinically viable method to investigate coronary artery disease (CAD). Accurate determination of the trigger delay to place the acquisition window within the quiescent part of the cardiac cycle is critical for coronary MRA in order to reduce cardiac motion. This is currently reliant on operator-led decision making, which can negatively affect consistency of scan acquisition. Recently developed deep learning (DL) derived software may overcome these issues by automation of cardiac rest period detection. METHODS Thirty individuals (female, n = 10) were investigated using a 0.9 mm isotropic image-navigator (iNAV)-based motion-corrected coronary MRA sequence. Each individual was scanned three times utilising different strategies for determination of the optimal trigger delay: (1) the DL software, (2) an experienced operator decision, and (3) a previously utilised formula for determining the trigger delay. Methodologies were compared using custom-made analysis software to assess visible coronary vessel length and coronary vessel sharpness for the entire vessel length and the first 4 cm of each vessel. RESULTS There was no difference in image quality between any of the methodologies for determination of the optimal trigger delay, as assessed by visible coronary vessel length, coronary vessel sharpness for each entire vessel and vessel sharpness for the first 4 cm of the left mainstem, left anterior descending or right coronary arteries. However, vessel length of the left circumflex was slightly greater using the formula method. The time taken to calculate the trigger delay was significantly lower for the DL-method as compared to the operator-led approach (106 ± 38.0 s vs 168 ± 39.2 s, p < 0.01, 95% CI of difference 25.5-98.1 s). CONCLUSIONS Deep learning-derived automated software can effectively and efficiently determine the optimal trigger delay for acquisition of coronary MRA and thus may simplify workflow and improve reproducibility.
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Affiliation(s)
- Gregory Wood
- Department of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Alexandra Uglebjerg Pedersen
- Department of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Karl P Kunze
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, UK
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Radhouene Neji
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, UK
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Jens Wetzl
- Cardiovascular MR Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Seung Su Yoon
- Cardiovascular MR Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Michaela Schmidt
- Cardiovascular MR Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Bjarne Linde Nørgaard
- Department of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millenium Institute for Intelligent Healthcare Engineering, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
- Instituto de Ingeniería Biológica y Médica, Pontificia Universidad Católica de Chile, Santiago, Chile
- Institute for Advanced Study, Technical University of Munich, Garching, Germany
- Millenium Institute for Intelligent Healthcare Engineering, Santiago, Chile
| | - Won Yong Kim
- Department of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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CMRSegTools: An open-source software enabling reproducible research in segmentation of acute myocardial infarct in CMR images. PLoS One 2022; 17:e0274491. [PMID: 36099286 PMCID: PMC9469999 DOI: 10.1371/journal.pone.0274491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/29/2022] [Indexed: 12/19/2022] Open
Abstract
In the last decade, a large number of clinical trials have been deployed using Cardiac Magnetic Resonance (CMR) to evaluate cardioprotective strategies aiming at reducing the irreversible myocardial damage at the time of reperfusion. In these studies, segmentation and quantification of myocardial infarct lesion are often performed with a commercial software or an in-house closed-source code development thus creating a barrier for reproducible research. This paper introduces CMRSegTools: an open-source application software designed for the segmentation and quantification of myocardial infarct lesion enabling full access to state-of-the-art segmentation methods and parameters, easy integration of new algorithms and standardised results sharing. This post-processing tool has been implemented as a plug-in for the OsiriX/Horos DICOM viewer leveraging its database management functionalities and user interaction features to provide a bespoke tool for the analysis of cardiac MR images on large clinical cohorts. CMRSegTools includes, among others, user-assisted segmentation of the left-ventricle, semi- and automatic lesion segmentation methods, advanced statistical analysis and visualisation based on the American Heart Association 17-segment model. New segmentation methods can be integrated into the plug-in by developing components based on image processing and visualisation libraries such as ITK and VTK in C++ programming language. CMRSegTools allows the creation of training and testing data sets (labeled features such as lesion, microvascular obstruction and remote ROI) for supervised Machine Learning methods, and enables the comparative assessment of lesion segmentation methods via a single and integrated platform. The plug-in has been successfully used by several CMR imaging studies.
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