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Eck BL, Seiberlich N, Flamm SD, Hamilton JI, Suresh A, Kumar Y, Hanna M, Houston A, Tew D, Tang WHW, Kwon DH. Characterization of cardiac amyloidosis using cardiac magnetic resonance fingerprinting. Int J Cardiol 2022; 351:107-110. [PMID: 34963645 PMCID: PMC8857016 DOI: 10.1016/j.ijcard.2021.12.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/26/2021] [Accepted: 12/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiac amyloidosis (CA) is an infiltrative cardiomyopathy with poor prognosis absent appropriate treatment. Elevated native myocardial T1 and T2 have been reported for CA, and tissue characterization by cardiac MRI may expedite diagnosis and treatment. Cardiac Magnetic Resonance Fingerprinting (cMRF) has the potential to enable tissue characterization for CA through rapid, simultaneous T1 and T2 mapping. Furthermore, cMRF signal timecourses may provide additional information beyond myocardial T1 and T2. METHODS Nine CA patients and five controls were scanned at 3 T using a prospectively gated cMRF acquisition. Two cMRF-based analysis approaches were examined: (1) relaxometric-based linear discriminant analysis (LDA) using native T1 and T2, and (2) signal timecourse-based LDA. The Fisher coefficient was used to compare the separability of patient and control groups from both approaches. Leave-two-out cross-validation was employed to evaluate the classification error rates of both approaches. RESULTS Elevated myocardial T1 and T2 was observed in patients vs controls (T1: 1395 ± 121 vs 1240 ± 36.4 ms, p < 0.05; T2: 36.8 ± 3.3 vs 31.8 ± 2.6 ms, p < 0.05). LDA scores were elevated in patients for relaxometric-based LDA (0.56 ± 0.28 vs 0.18 ± 0.13, p < 0.05) and timecourse-based LDA (0.97 ± 0.02 vs 0.02 ± 0.02, p < 0.05). The Fisher coefficient was greater for timecourse-based LDA (60.8) vs relaxometric-based LDA (1.6). Classification error rates were lower for timecourse-based LDA vs relaxometric-based LDA (12.6 ± 24.3 vs 22.5 ± 30.1%, p < 0.05). CONCLUSIONS These findings suggest that cMRF may be a valuable technique for the detection and characterization of CA. Analysis of cMRF signal timecourse data may improve tissue characterization as compared to analysis of native T1 and T2 alone.
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Affiliation(s)
- Brendan L Eck
- Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
| | - Nicole Seiberlich
- Department of Radiology, Department of Biomedical Engineering, University of Michigan, 1150 West Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Scott D Flamm
- Imaging Institute, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Jesse I Hamilton
- Department of Radiology, Department of Biomedical Engineering, University of Michigan, 1150 West Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Abhilash Suresh
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Yash Kumar
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Mazen Hanna
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Angel Houston
- Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Derrek Tew
- Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - W H Wilson Tang
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Deborah H Kwon
- Imaging Institute, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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Weingärtner S, Desmond KL, Obuchowski NA, Baessler B, Zhang Y, Biondetti E, Ma D, Golay X, Boss MA, Gunter JL, Keenan KE, Hernando D. Development, validation, qualification, and dissemination of quantitative MR methods: Overview and recommendations by the ISMRM quantitative MR study group. Magn Reson Med 2021; 87:1184-1206. [PMID: 34825741 DOI: 10.1002/mrm.29084] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/20/2021] [Accepted: 10/27/2021] [Indexed: 12/26/2022]
Abstract
On behalf of the International Society for Magnetic Resonance in Medicine (ISMRM) Quantitative MR Study Group, this article provides an overview of considerations for the development, validation, qualification, and dissemination of quantitative MR (qMR) methods. This process is framed in terms of two central technical performance properties, i.e., bias and precision. Although qMR is confounded by undesired effects, methods with low bias and high precision can be iteratively developed and validated. For illustration, two distinct qMR methods are discussed throughout the manuscript: quantification of liver proton-density fat fraction, and cardiac T1 . These examples demonstrate the expansion of qMR methods from research centers toward widespread clinical dissemination. The overall goal of this article is to provide trainees, researchers, and clinicians with essential guidelines for the development and validation of qMR methods, as well as an understanding of necessary steps and potential pitfalls for the dissemination of quantitative MR in research and in the clinic.
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Affiliation(s)
- Sebastian Weingärtner
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Kimberly L Desmond
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nancy A Obuchowski
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bettina Baessler
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Yuxin Zhang
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Emma Biondetti
- Department of Neuroscience, Imaging and Clinical Sciences, D'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Dan Ma
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Xavier Golay
- Brain Repair & Rehabilitation, Institute of Neurology, University College London, United Kingdom.,Gold Standard Phantoms Limited, Rochester, United Kingdom
| | - Michael A Boss
- Center for Research and Innovation, American College of Radiology, Philadelphia, Pennsylvania, USA
| | | | - Kathryn E Keenan
- National Institute of Standards and Technology, Boulder, Colorado, USA
| | - Diego Hernando
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Magat J, Fouillet A, Constantin M, Haliot K, Naulin J, El Hamrani D, Benoist D, Charron S, Walton R, Bernus O, Quesson B. 3D magnetization transfer (MT) for the visualization of cardiac free-running Purkinje fibers: an ex vivo proof of concept. MAGMA (NEW YORK, N.Y.) 2021; 34:605-618. [PMID: 33484367 PMCID: PMC8338918 DOI: 10.1007/s10334-020-00905-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/02/2020] [Accepted: 12/22/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES We investigate the possibility to exploit high-field MRI to acquire 3D images of Purkinje network which plays a crucial role in cardiac function. Since Purkinje fibers (PF) have a distinct cellular structure and are surrounded by connective tissue, we investigated conventional contrast mechanisms along with the magnetization transfer (MT) imaging technique to improve image contrast between ventricular structures of differing macromolecular content. METHODS Three fixed porcine ventricular samples were used with free-running PFs on the endocardium. T1, T2*, T2, and M0 were evaluated on 2D slices for each sample at 9.4 T. MT parameters were optimized using hard pulses with different amplitudes, offset frequencies and durations. The cardiac structure was assessed through 2D and 3D T1w images with isotropic resolutions of 150 µm. Histology, immunofluorescence, and qPCR were performed to analyze collagen contents of cardiac tissue and PF. RESULTS An MT preparation module of 350 ms duration inserted into the sequence with a B1 = 10 µT and frequency offset = 3000 Hz showed the best contrast, approximately 0.4 between PFs and myocardium. Magnetization transfer ratio (MTR) appeared higher in the cardiac tissue (MTR = 44.7 ± 3.5%) than in the PFs (MTR = 25.2 ± 6.3%). DISCUSSION MT significantly improves contrast between PFs and ventricular myocardium and appears promising for imaging the 3D architecture of the Purkinje network.
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Affiliation(s)
- Julie Magat
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France.
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France.
| | - Arnaud Fouillet
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France
| | - Marion Constantin
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France
| | - Kylian Haliot
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France
| | - Jérôme Naulin
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France
| | - Dounia El Hamrani
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France
| | - David Benoist
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France
| | - Sabine Charron
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France
| | - Richard Walton
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France
| | - Olivier Bernus
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France
| | - Bruno Quesson
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Hopital Xavier Arnozan, Avenue du Haut Lévêque, 33604, Pessac cedex, France
- Centre de Recherche Cardio-Thoracique de Bordeaux Inserm, U1045, Université de Bordeaux, 33000, Bordeaux, France
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López K, Neji R, Bustin A, Rashid I, Hajhosseiny R, Malik SJ, Teixeira RPAG, Razavi R, Prieto C, Roujol S, Botnar RM. Quantitative magnetization transfer imaging for non-contrast enhanced detection of myocardial fibrosis. Magn Reson Med 2020; 85:2069-2083. [PMID: 33201524 DOI: 10.1002/mrm.28577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 09/10/2020] [Accepted: 10/09/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE To develop a novel gadolinium-free model-based quantitative magnetization transfer (qMT) technique to assess macromolecular changes associated with myocardial fibrosis. METHODS The proposed sequence consists of a two-dimensional breath-held dual shot interleaved acquisition of five MT-weighted (MTw) spoiled gradient echo images, with variable MT flip angles (FAs) and off-resonance frequencies. A two-pool exchange model and dictionary matching were used to quantify the pool size ratio (PSR) and bound pool T2 relaxation ( T 2 B ). The signal model was developed and validated using 25 MTw images on a bovine serum albumin (BSA) phantom and in vivo human thigh muscle. A protocol with five MTw images was optimized for single breath-hold cardiac qMT imaging. The proposed sequence was tested in 10 healthy subjects and 5 patients with myocardial fibrosis and compared to late gadolinium enhancement (LGE). RESULTS PSR values in the BSA phantom were within the confidence interval of previously reported values (concentration 10% BSA = 5.9 ± 0.1%, 15% BSA = 9.4 ± 0.2%). PSR and T 2 B in thigh muscle were also in agreement with literature (PSR = 10.9 ± 0.3%, T 2 B = 6.4 ± 0.4 us). In 10 healthy subjects, global left ventricular PSR was 4.30 ± 0.65%. In patients, PSR was reduced in areas associated with LGE (remote: 4.68 ± 0.70% vs. fibrotic: 3.12 ± 0.78 %, n = 5, P < .002). CONCLUSION In vivo model-based qMT mapping of the heart was performed for the first time, with promising results for non-contrast enhanced assessment of myocardial fibrosis.
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Affiliation(s)
- Karina López
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,MR Research Collaboration, Siemens Healthcare Limited, Frimley, UK
| | - Aurelien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Imran Rashid
- 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
| | - Shaihan J Malik
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Rui Pedro A G Teixeira
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Sébastien Roujol
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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