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Yang Y, Hair J, Yerly J, Piccini D, Di Sopra L, Bustin A, Prsa M, Si-Mohamed S, Stuber M, Oshinski JN. Quiescent frame, contrast-enhanced coronary magnetic resonance angiography reconstructed using limited number of physiologic frames from 5D free-running acquisitions. Magn Reson Imaging 2024; 113:110209. [PMID: 38972471 PMCID: PMC11390311 DOI: 10.1016/j.mri.2024.07.008] [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: 04/25/2024] [Revised: 06/12/2024] [Accepted: 07/03/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND 5D, free-running imaging resolves sets of 3D whole-heart images in both cardiac and respiratory dimensions. In an application such as coronary imaging when a single, static image is of interest, computationally expensive offline iterative reconstruction is still needed to compute the multiple 3D datasets. PURPOSE Evaluate how the number of physiologic bins included in the reconstruction affects the computational cost and resulting image quality of a single, static volume reconstruction. STUDY TYPE Retrospective. SUBJECTS 15 pediatric patients following Ferumoxytol infusion (4 mg/kg). FIELD STRENGTH/SEQUENCE 1.5 T/Ungated 5D free-running GRE sequence. ASSESSMENT The raw data of each subject were binned and reconstructed into a 5D (x-y-z-cardiac-respiratory) images. 1, 3, 5, 7, and 9 bins adjacent to both sides of the retrospectively determined cardiac resting phase and 1, 3 bins adjacent to the end-expiration phase are used for limited frame reconstructions. The static volume within each limited reconstruction was compared with the corresponding full 5D reconstruction using the structural similarity index measure (SSIM). A non-linear regression model was used to fit SSIM with the percentage of data used compared to full reconstruction (% data). A linear regression model was used to fit computation time with % raw data used. Coronary artery sharpness is measured on each limited reconstructed images to determine the minimal number of cardiac and respiratory bins needed to preserve image quality. STATISTICAL TESTS The coefficient of determination (R2) is computed for each regression model. RESULTS The % of data used in the reconstruction was linearly related to the computational time (R2 = 0.99). The SSIM of the static image from the limited reconstructions is non-linearly related with the % of data used (R2 = 0.80). Over the 15 patients, the model showed SSIM of 0.9 with 18% of data, and SSIM of 0.96 with 30% of data. The coronary artery sharpness of images reconstructed using no less than 5 cardiac and all respiratory phases is not significantly different from the full reconstructed images using all cardiac and respiratory bins. DATA CONCLUSION Reconstruction using only a limited number of acquired physiological states can linearly reduce the computational cost while preserving similarity to the full reconstruction image. It is suggested to use no less than 5 cardiac and all respiratory phases in the limited reconstruction to best preserve the original quality seen on the full reconstructed images.
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Affiliation(s)
- Yitong Yang
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Jackson Hair
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Center for Biomedical Imaging, Lausanne, Switzerland
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland
| | - Lorenzo Di Sopra
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Center for Biomedical Imaging, Lausanne, Switzerland
| | - Aurelien Bustin
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Center for Biomedical Imaging, Lausanne, Switzerland
| | - Milan Prsa
- Department of Interventional Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Salim Si-Mohamed
- Department of Radiology, University of Claude Bernard Lyon 1., Lyon, France
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Center for Biomedical Imaging, Lausanne, Switzerland
| | - John N Oshinski
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States; Department of Radiology, Emory University School of Medicine, Atlanta, GA, United States.
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Wu X, Yue X, Peng P, Tan X, Huang F, Cai L, Li L, He S, Zhang X, Liu P, Sun J. Accelerated 3D whole-heart non-contrast-enhanced mDIXON coronary MR angiography using deep learning-constrained compressed sensing reconstruction. Insights Imaging 2024; 15:224. [PMID: 39298070 DOI: 10.1186/s13244-024-01797-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 08/21/2024] [Indexed: 09/21/2024] Open
Abstract
OBJECTIVES To investigate the feasibility of a deep learning-constrained compressed sensing (DL-CS) method in non-contrast-enhanced modified DIXON (mDIXON) coronary magnetic resonance angiography (MRA) and compare its diagnostic accuracy using coronary CT angiography (CCTA) as a reference standard. METHODS Ninety-nine participants were prospectively recruited for this study. Thirty healthy subjects (age range: 20-65 years; 50% female) underwent three non-contrast mDIXON-based coronary MRA sequences including DL-CS, CS, and conventional sequences. The three groups were compared based on the scan time, subjective image quality score, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The remaining 69 patients suspected of coronary artery disease (CAD) (age range: 39-83 years; 51% female) underwent the DL-CS coronary MRA and its diagnostic performance was compared with that of CCTA. RESULTS The scan time for the DL-CS and CS sequences was notably shorter than that of the conventional sequence (9.6 ± 3.1 min vs 10.0 ± 3.4 min vs 13.0 ± 4.9 min; p < 0.001). The DL-CS sequence obtained the highest image quality score, mean SNR, and CNR compared to CS and conventional methods (all p < 0.001). Compared to CCTA, the accuracy, sensitivity, and specificity of DL-CS mDIXON coronary MRA per patient were 84.1%, 92.0%, and 79.5%; those per vessel were 90.3%, 82.6%, and 92.5%; and those per segment were 98.0%, 85.1%, and 98.0%, respectively. CONCLUSION The DL-CS mDIXON coronary MRA provided superior image quality and short scan time for visualizing coronary arteries in healthy individuals and demonstrated high diagnostic value compared to CCTA in CAD patients. CRITICAL RELEVANCE STATEMENT DL-CS resulted in improved image quality with an acceptable scan time, and demonstrated excellent diagnostic performance compared to CCTA, which could be an alternative to enhance the workflow of coronary MRA. KEY POINTS Current coronary MRA techniques are limited by scan time and the need for noise reduction. DL-CS reduced the scan time in coronary MR angiography. Deep learning achieved the highest image quality among the three methods. Deep learning-based coronary MR angiography demonstrated high performance compared to CT angiography.
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Affiliation(s)
- Xi Wu
- Department of Radiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Xun Yue
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Pengfei Peng
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xianzheng Tan
- Department of Radiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Feng Huang
- Department of Radiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Lei Cai
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lei Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Shuai He
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | | | - Peng Liu
- Department of Radiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
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Wood G, Hajhosseiny R, Pedersen AU, Littlewood S, Hansen TJ, Neji R, Kunze KP, Wetzl J, Nørgaard BL, Jensen JM, Maeng M, Madsen PL, Vejlstrup N, Prieto C, Botnar RM, Kim WY. iNav-based, Automated Coronary Magnetic Resonance Angiography for the Detection of Coronary Artery Stenosis (iNav-AUTO CMRA). J Cardiovasc Magn Reson 2024:101097. [PMID: 39293786 DOI: 10.1016/j.jocmr.2024.101097] [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: 01/18/2024] [Revised: 08/23/2024] [Accepted: 09/10/2024] [Indexed: 09/20/2024] Open
Abstract
BACKGROUND Coronary computed tomography angiography (CCTA) is recommended as the first line diagnostic imaging modality in low to intermediate risk individuals suspected of stable coronary artery disease (CAD). However, CCTA exposes patients to ionising radiation and potentially nephrotoxic contrast agents. Invasive coronary angiography (ICA) is the gold-standard investigation to guide coronary revascularisation strategy, however, invasive procedures incur an inherent risk to the patient. Coronary magnetic resonance angiography (Coronary MRA) avoids these issues. Nevertheless, clinical implementation is currently limited due to extended scanning durations, inconsistent image quality, and consequent lack of diagnostic accuracy. Several technical Coronary MRA innovations including advanced respiratory motion correction with 100% scan efficiency (no data rejection), fast image acquisition with motion-corrected undersampled image reconstruction and deep-learning (DL)-based automated planning have been implemented and now await clinical validation in multi-centre trials. METHODS The objective of the iNav-AUTO CMRA prospective multi-centre study is to evaluate the diagnostic accuracy of a newly developed, state-of-the-art, standardised, and automated Coronary MRA framework compared to CCTA in 230 patients undergoing clinical investigation for CAD. The study protocol mandates the administration of oral beta-blockers to decrease heart rate to below 60bpm and the use of sublingual nitroglycerine spray to induce vasodilation. Additionally, the study incorporates the utilisation of standardised postprocessing with sliding-thin-slab multiplanar reformatting, in combination with evaluation of the source images, to optimize the visualisation of coronary artery stenosis. DISCUSSION If proven effective, Coronary MRA could provide a non-invasive, needle-free, yet also clinically viable, alternative to CCTA. TRIAL REGISTRATION This study is registered at clinicaltrials.gov (NCT05473117).
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Affiliation(s)
- Gregory Wood
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Reza Hajhosseiny
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Alexandra Uglebjerg Pedersen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Simon Littlewood
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Tina Juul Hansen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Karl P Kunze
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; MR Research Collaborations, Siemens Healthcare Limited, Camberley, UK
| | - Jens Wetzl
- Magnetic Resonance, Siemens Healthcare GmbH, Erlangen, Germany
| | - Bjarne Linde Nørgaard
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jesper Møller Jensen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Michael Maeng
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Per Lav Madsen
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital; Department of Clinical Medicine, University of Copenhagen, Herlev, Herlev, Denmark; The August Krogh Institute (NEXS), University of Copenhagen
| | - Niels Vejlstrup
- Department of Cardiology, University Hospital Copenhagen - Rigshospitalet, Copenhagen, Denmark
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Escuela de Ingeniería and Instituto de Ingeniería Biológica y Médica, 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, United Kingdom; BHF Centre of Research Excellence, Cardiovascular Division, King's College London, London, UK; Escuela de Ingeniería and Instituto de Ingeniería Biológica y Médica, Pontificia Universidad Católica de Chile, Santiago, Chile; Millenium Institute for Intelligent Healthcare Engineering, Santiago, Chile; Institute for Advanced Study, Technical University of Munich, Lichtenbergstrasse 2 a, D-85748 Garching, Germany.
| | - Won Yong Kim
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Bottardi A, Prado GFA, Lunardi M, Fezzi S, Pesarini G, Tavella D, Scarsini R, Ribichini F. Clinical Updates in Coronary Artery Disease: A Comprehensive Review. J Clin Med 2024; 13:4600. [PMID: 39200741 PMCID: PMC11354290 DOI: 10.3390/jcm13164600] [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: 05/29/2024] [Revised: 07/05/2024] [Accepted: 07/26/2024] [Indexed: 09/02/2024] Open
Abstract
Despite significant goals achieved in diagnosis and treatment in recent decades, coronary artery disease (CAD) remains a high mortality entity and continues to pose substantial challenges to healthcare systems globally. After the latest guidelines, novel data have emerged and have not been yet considered for routine practice. The scope of this review is to go beyond the guidelines, providing insights into the most recent clinical updates in CAD, focusing on non-invasive diagnostic techniques, risk stratification, medical management and interventional therapies in the acute and stable scenarios. Highlighting and synthesizing the latest developments in these areas, this review aims to contribute to the understanding and management of CAD helping healthcare providers worldwide.
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Affiliation(s)
- Andrea Bottardi
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
| | - Guy F. A. Prado
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
- Department of Clinical and Molecular Medicine, Sapienza University, 00185 Rome, Italy
| | - Mattia Lunardi
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Simone Fezzi
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
| | - Gabriele Pesarini
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
| | - Domenico Tavella
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
| | - Roberto Scarsini
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
| | - Flavio Ribichini
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
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Ota H, Morita Y, Vucevic D, Higuchi S, Takagi H, Kutsuna H, Yamashita Y, Kim P, Miyazaki M. Motion robust coronary MR angiography using zigzag centric ky-kz trajectory and high-resolution deep learning reconstruction. MAGMA (NEW YORK, N.Y.) 2024:10.1007/s10334-024-01172-9. [PMID: 38916681 DOI: 10.1007/s10334-024-01172-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/28/2024] [Accepted: 05/27/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE To develop a new MR coronary angiography (MRCA) technique by employing a zigzag fan-shaped centric ky-kz k-space trajectory combined with high-resolution deep learning reconstruction (HR-DLR). METHODS All imaging data were acquired from 12 healthy subjects and 2 patients using two clinical 3-T MR imagers, with institutional review board approval. Ten healthy subjects underwent both standard 3D fast gradient echo (sFGE) and centric ky-kz k-space trajectory FGE (cFGE) acquisitions to compare the scan time and image quality. Quantitative measures were also performed for signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) as well as sharpness of the vessel. Furthermore, the feasibility of the proposed cFGE sequence was assessed in two patients. For assessing the feasibility of the centric ky-kz trajectory, the navigator-echo window of a 30-mm threshold was applied in cFGE, whereas sFGE was applied using a standard 5-mm threshold. Image quality of MRCA using cFGE with HR-DLR and sFGE without HR-DLR was scored in a 5-point scale (non-diagnostic = 1, fair = 2, moderate = 3, good = 4, and excellent = 5). Image evaluation of cFGE, applying HR-DLR, was compared with sFGE without HR-DLR. Friedman test, Wilcoxon signed-rank test, or paired t tests were performed for the comparison of related variables. RESULTS The actual MRCA scan time of cFGE with a 30-mm threshold was acquired in less than 5 min, achieving nearly 100% efficiency, showcasing its expeditious and robustness. In contrast, sFGE was acquired with a 5-mm threshold and had an average scan time of approximately 15 min. Overall image quality for MRCA was scored 3.3 for sFGE and 2.7 for cFGE without HR-DLR but increased to 3.6 for cFGE with HR-DLR and (p < 0.05). The clinical result of patients obtained within 5 min showed good quality images in both patients, even with a stent, without artifacts. Quantitative measures of SNR, CNR, and sharpness of vessel presented higher in cFGE with HR-DLR. CONCLUSION Our findings demonstrate a robust, time-efficient solution for high-quality MRCA, enhancing patient comfort and increasing clinical throughput.
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Affiliation(s)
- Hideki Ota
- Department of Advanced Radiological Imaging Collaborative Research, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Yoshiaki Morita
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Diana Vucevic
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Satoshi Higuchi
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Hidenobu Takagi
- Department of Advanced Radiological Imaging Collaborative Research, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | | | | | - Paul Kim
- Department of Cardiology, University of California, San Diego, La Jolla, CA, USA
| | - Mitsue Miyazaki
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA.
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Takahashi J, Machida Y, Fukuzawa K, Tsuji Y, Ohmoto-Sekine Y. Denoising parameter dependence of coronary artery depictability in compressed sensing magnetic resonance angiography. Radiol Phys Technol 2024; 17:375-388. [PMID: 38461220 DOI: 10.1007/s12194-024-00787-w] [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: 03/14/2023] [Revised: 01/26/2024] [Accepted: 01/27/2024] [Indexed: 03/11/2024]
Abstract
Using numerical indices and visual evaluation, we evaluated the dependence of coronary-artery depictability on the denoising parameter in compressed sensing magnetic resonance angiography (CS-MRA). This study was conducted to clarify the acceleration factor (AF) and denoising factor (DF) dependence of CS-MRA image quality. Vascular phantoms and clinical images were acquired using three-dimensional CS-MRA on a clinical 1.5 T system. For the phantom measurements, we compared the full width at half maximum (FWHM), sharpness, and contrast ratio of the vascular profile curves for various AFs and DFs. In the clinical cases, the FWHM, sharpness, contrast ratio, signal-to-noise ratio, noise level values, and visual evaluation results were compared for various DFs. Phantom image analyses demonstrated that the respective measurements of the FWHM, sharpness, and contrast ratios did not significantly change with an increase in AF. The FWHM and sharpness measurements slightly changed with the DF level. However, the contrast ratio tended to increase with an increase in the DF level. In the clinical cases, the FWHM and sharpness showed no significant differences, even when the DF level was changed. However, the contrast ratio tended to decrease as the DF level increased. When the DF levels of the clinical cases increased, the background signals of the myocardium, fat, and noise levels decreased. We investigated the dependence of the coronary-artery depictability on AF and DF using CS-MRA. Analysis of the coronary-artery profile curves indicated that a better image quality was achieved with a stronger DF on coronary CS-MRA.
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Affiliation(s)
- Junji Takahashi
- Department of Radiological Technology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
- Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Yoshio Machida
- Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Kei Fukuzawa
- Department of Radiological Technology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Yoshinori Tsuji
- Department of Radiological Technology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Yuki Ohmoto-Sekine
- Health Management Center, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
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Yu A, Gao H, Ma Y, Li J, Zhang H. Feasibility study of the multishot gradient-echo planar imaging sequence in non-enhanced and free-breathing whole-heart magnetic resonance coronary angiography. Clin Radiol 2024; 79:e539-e545. [PMID: 38160106 DOI: 10.1016/j.crad.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 11/22/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
AIM To investigate the feasibility of non-enhanced and free-breathing whole-heart magnetic resonance coronary angiography (MRCA) using multishot gradient-echo planar imaging (MSG-EPI). MATERIALS AND METHODS In total, 29 healthy volunteers were recruited for free-breathing whole-heart MRCA acquisition using the MSG-EPI sequence and fast gradient echo (GRE) sequence. After the examination, the actual scanning times, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the left main (LM) coronary artery, subjective quality scores for each segment, and evaluable length of the coronary artery were recorded and statistically analysed. RESULTS There was no significant difference between the SNRLM of the MSG-EPI sequence and fast GRE sequence (p=0.130), but the CNRLM of the MSG-EPI sequence was higher (p=0.001). The subjective quality score of the mid- and distal left anterior descending branch as well as the distal circumflex branch of the coronary artery in the MSG-EPI sequence was higher than that in the fast GRE sequence (p=0.003, 0.001, and 0.003, respectively). The evaluable length of the left anterior descending branch and the circumflex branch was better using the MSG-EPI sequence than that of the fast GRE sequence (p=0.015 and < 0.001, respectively). Moreover, the scanning time of the MSG-EPI sequence was 54.5% less than that of the fast GRE sequence (p<0.001). CONCLUSION The MSG-EPI sequence improves the subjective and objective image quality of MRCA as well as reduces the scanning time.
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Affiliation(s)
- A Yu
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China
| | - H Gao
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China
| | - Y Ma
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China
| | - J Li
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China
| | - H Zhang
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China.
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Hövels-Gürich HH, Lebherz C, Dettori R, Pütz A, Racolta A, Linden K, Kirschfink A, Altiok E, Rüffer A, Marx N, Herberg U, Frick M. Coronary coding in dTGA pre- and post-ASO-verification and necessary corrections following adult CMR. EUROPEAN HEART JOURNAL. IMAGING METHODS AND PRACTICE 2024; 2:qyae055. [PMID: 39224101 PMCID: PMC11367965 DOI: 10.1093/ehjimp/qyae055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/30/2024] [Indexed: 09/04/2024]
Abstract
Aims In adult patients with transposition of the great arteries (dTGA) after arterial switch operation (ASO), the coronary artery circulation after neonatal surgical transfer remains a major culprit for long-term sequelae, including myocardial ischaemia and sudden cardiac death. As coronary imaging in paediatric age is often incomplete and classification mainly relies on the surgeon's description in the operation report, we intended to develop a systematic, understandable pattern of the coronary status for each young patient, combining unambiguous coding with non-invasive imaging. Methods and results The monocentric prospective study evaluated 89 young adults (mean 23 years) after ASO for dTGA including cardiac magnetic resonance (CMR) coronary angiography. Following 'The Leiden Convention coronary coding system', we describe the systematic transformation process and provide a graphical illustration considering surgical and imaging views for the six main coronary types, followed by a comparison with adult CMR. Discordance between surgeon's and CMR classification is evaluated.In seven (7.9%) patients, a discordance between the surgeon's post-operative and the CMR classification was found; therefore, the initial classification had to be corrected according to adult CMR. Three cases (3.4%) with particularly challenging coronary variants (intramural and interarterial course, functional common ostium) are presented. Conclusion Considering the risks of a possible neonatal coronary misclassification and of increasing additional acquired coronary artery disease with age, reliable cooperation between surgeons, cardiologists, and imaging specialists must be ensured. Therefore, after completion of growth, a systematic pattern of the coronary artery status, combining unambiguous coding with CMR imaging, should be established for each patient.
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Affiliation(s)
- Hedwig H Hövels-Gürich
- Department of Paediatric Cardiology and Congenital Heart Defects, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
- Superregional Centre for Adults with Congenital Heart Disease, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Corinna Lebherz
- Superregional Centre for Adults with Congenital Heart Disease, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Rosalia Dettori
- Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Andreas Pütz
- Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Anca Racolta
- Department of Paediatric Cardiology and Congenital Heart Defects, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
- Superregional Centre for Adults with Congenital Heart Disease, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Katharina Linden
- Department of Paediatric Cardiology and Congenital Heart Defects, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
- Superregional Centre for Adults with Congenital Heart Disease, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Annemarie Kirschfink
- Superregional Centre for Adults with Congenital Heart Disease, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Ertunc Altiok
- Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - André Rüffer
- Superregional Centre for Adults with Congenital Heart Disease, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
- Department of Cardiac Surgery for Congential Heart Defects, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Nikolaus Marx
- Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Ulrike Herberg
- Department of Paediatric Cardiology and Congenital Heart Defects, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
- Superregional Centre for Adults with Congenital Heart Disease, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Michael Frick
- Superregional Centre for Adults with Congenital Heart Disease, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital, RWTH Aachen University, Pauwelsstr. 30, D-52074 Aachen, Germany
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9
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Tang H, Li HK, Yang CF, Dillenseger JL, Coatrieux G, Feng J, Zhou SJ, Chen Y. A multiple catheter tips tracking method in X-ray fluoroscopy images by a new lightweight segmentation network and Bayesian filtering. Int J Med Robot 2023; 19:e2569. [PMID: 37634070 DOI: 10.1002/rcs.2569] [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: 06/14/2023] [Revised: 07/29/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023]
Abstract
During percutaneous coronary intervention, the guiding catheter plays an important role. Tracking the catheter tip placed at the coronary ostium in the X-ray fluoroscopy sequence can obtain image displacement information caused by the heart beating, which can help dynamic coronary roadmap overlap on X-ray fluoroscopy images. Due to a low exposure dose, the X-ray fluoroscopy is noisy and low contrast, which causes some difficulties in tracking. In this paper, we developed a new catheter tip tracking framework. First, a lightweight efficient catheter tip segmentation network is proposed and boosted by a self-distillation training mechanism. Then, the Bayesian filtering post-processing method is used to consider the sequence information to refine the single image segmentation results. By separating the segmentation results into several groups based on connectivity, our framework can track multiple catheter tips. The proposed tracking framework is validated on a clinical X-ray sequence dataset.
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Affiliation(s)
- Hui Tang
- School of Computer Science and Engineering, Southeast University, Nanjing, China
- The Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, School of Computer Science and Engineering, Southeast University, Nanjing, China
- Key Laboratory of New Generation Artificial Intelligence Technology and Its Interdisciplinary Applications (Southeast University), Ministry of Education, Beijing, China
| | - Hao Kai Li
- School of Computer Science and Engineering, Southeast University, Nanjing, China
| | - Chun Feng Yang
- School of Computer Science and Engineering, Southeast University, Nanjing, China
- The Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, School of Computer Science and Engineering, Southeast University, Nanjing, China
- Key Laboratory of New Generation Artificial Intelligence Technology and Its Interdisciplinary Applications (Southeast University), Ministry of Education, Beijing, China
| | - Jean-Louis Dillenseger
- Centre de Recherche en Information Biomédicale Sino-Francais, INSERM, University of Rennes 1, Rennes, France
- Univ Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | | | - Juan Feng
- Shanghai United Imaging Company, Shanghai, China
| | - Shou Jun Zhou
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yang Chen
- School of Computer Science and Engineering, Southeast University, Nanjing, China
- The Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, School of Computer Science and Engineering, Southeast University, Nanjing, China
- Key Laboratory of New Generation Artificial Intelligence Technology and Its Interdisciplinary Applications (Southeast University), Ministry of Education, Beijing, China
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10
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Swoboda PP, Matthews GD, Garg P, Plein S, Greenwood JP. Comparison of Stress-Rest and Stress-LGE Analysis Strategy in Patients Undergoing Stress Perfusion Cardiovascular Magnetic Resonance. Circ Cardiovasc Imaging 2023; 16:e014765. [PMID: 38054378 PMCID: PMC7615405 DOI: 10.1161/circimaging.123.014765] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/02/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Stress perfusion cardiovascular magnetic resonance can be performed without rest perfusion for the quantification of ischemia burden. However, the optimal method of analysis is uncertain. METHODS We identified 666 patients from CE-MARC (Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease) with complete stress perfusion, rest perfusion, late gadolinium enhancement (LGE), and quantitative coronary angiography data. For each segment of the 16-segment model, perfusion was visually graded during stress and rest imaging, with infarct transmurality assessed from LGE imaging. In the stress-LGE analysis, a segment was defined as ischemic if it had a subendocardial perfusion defect with no infarction. Rest perfusion was not used in this analysis. We compared the diagnostic accuracy of stress-LGE analysis against quantitative coronary angiography and the stress-rest method validated in the original CE-MARC analysis. The diagnostic accuracy of the stress-LGE method was evaluated with different thresholds of infarct transmurality used to define whether an infarcted segment had peri-infarct ischemia. RESULTS The optimal stress-LGE analysis classified all segments with a stress perfusion defect as ischemic unless they had >75% infarct transmurality (area under the curve, 0.843; sensitivity, 75.6%; specificity, 93.1%; P<0.001). This analysis method has superior diagnostic accuracy to the stress-rest method (area under the curve, 0.834; sensitivity, 73.6%; specificity, 93.1%; P<0.001, P value for difference=0.02). Patients were followed-up for median 6.5 years for major adverse cardiovascular events, with the presence of inducible ischemia by either the stress-LGE or stress-rest analysis being similar and strongly predictive (hazard ratio, 2.65; P<0.001, for both). CONCLUSIONS In this analysis of CE-MARC, the optimum definition of inducible ischemia was the presence of a stress-induced perfusion defect without transmural infarction. This definition improved the diagnostic accuracy compared with the stress-rest analysis validated in the original study. The absence of ischemia by either analysis strategy conferred a favorable long-term prognosis.
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Affiliation(s)
- Peter P. Swoboda
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Gareth D.K. Matthews
- Department of Cardiovascular and Metabolic Health, Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Pankaj Garg
- Department of Cardiovascular and Metabolic Health, Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Sven Plein
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - John P. Greenwood
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
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11
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Lu H, Zhao S, Tian D, Chen Y, Ma J, Ge M, Zeng M, Jin H. A clinical strategy to improve the diagnostic performance of 3T non-contrast coronary MRA and noninvasively evaluate coronary distensibility: combination of diastole and systole imaging. J Cardiovasc Magn Reson 2023; 25:67. [PMID: 37993897 PMCID: PMC10666457 DOI: 10.1186/s12968-023-00982-5] [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: 04/28/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The clinical application of coronary MR angiography (MRA) combining diastole and systole imaging has never been described comprehensively in coronary artery disease (CAD) patients. We aimed to design an optimal non-contrast coronary MRA scan protocol combining diastolic and systolic imaging and to (1) evaluate its diagnostic performance for detecting significant coronary stenosis; (2) evaluate the feasibility of this protocol to noninvasively measure the coronary distensibility index (CDI). METHODS From June 2021 to May 2022, 33 healthy volunteers and 91 suspected CAD patients scheduled for X-ray coronary angiography (CAG) were prospectively enrolled. 3T non-contrast water-fat coronary MRA was carried out twice at diastole and systole. Significant coronary stenosis was defined as a luminal diameter reduction of ≥ 50% using CAG as the reference and was evaluated as follows: (1) by coronary MRA in diastole alone; (2) by coronary MRA in systole alone; (3) by combined coronary MRA in diastole and systole. According to CAG, the patients were divided into significant CAD patients and non-significant CAD patients. The difference in CDI among participants was evaluated. RESULTS Combined coronary MRA was completed in 31 volunteers and 76 patients. The per-patient sensitivity, specificity, and accuracy of combined coronary MRA were 97.5%, 83.3%, and 90.8%, respectively. Compared with single diastolic mode, combined coronary MRA showed equally high sensitivity but improved specificity on a per-patient basis (83.3% vs. 63.9%, adjusted P = 0.013). The CDI tested by coronary MRA decreased incrementally from healthy volunteers to non-significant and significant CAD patients. CONCLUSION Compared with single-phase mode, 3 T non-contrast combined coronary MRA significantly improved specificity and may have potential to be a simple noninvasive method to measure CDI.
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Affiliation(s)
- Hongfei Lu
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Shihai Zhao
- Department of Radiology, Zhongshan Hospital (Minhang Meilong Branch), Fudan University and Shanghai Geriatric Medical Center, Shanghai, 200237, China
| | - Di Tian
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Yinyin Chen
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Jianying Ma
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Meiying Ge
- Department of Radiology, Zhongshan Hospital (Minhang Meilong Branch), Fudan University and Shanghai Geriatric Medical Center, Shanghai, 200237, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Shanghai, 200032, China.
- Department of Radiology, Zhongshan Hospital (Minhang Meilong Branch), Fudan University and Shanghai Geriatric Medical Center, Shanghai, 200237, China.
| | - Hang Jin
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Shanghai, 200032, China.
- Department of Radiology, Zhongshan Hospital (Minhang Meilong Branch), Fudan University and Shanghai Geriatric Medical Center, Shanghai, 200237, China.
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12
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Wu X, Tang L, Li W, He S, Yue X, Peng P, Wu T, Zhang X, Wu Z, He Y, Chen Y, Huang J, Sun J. Feasibility of accelerated non-contrast-enhanced whole-heart bSSFP coronary MR angiography by deep learning-constrained compressed sensing. Eur Radiol 2023; 33:8180-8190. [PMID: 37209126 DOI: 10.1007/s00330-023-09740-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/14/2023] [Accepted: 03/26/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To examine a compressed sensing artificial intelligence (CSAI) framework to accelerate image acquisition in non-contrast-enhanced whole-heart bSSFP coronary magnetic resonance (MR) angiography. METHODS Thirty healthy volunteers and 20 patients with suspected coronary artery disease (CAD) scheduled for coronary computed tomography angiography (CCTA) were enrolled. Non-contrast-enhanced coronary MR angiography was performed with CSAI, compressed sensing (CS), and sensitivity encoding (SENSE) methods in healthy participants and with CSAI in patients. Acquisition time, subjective image quality score, and objective image quality measurement (blood pool homogeneity, signal-to-noise ratio [SNR], and contrast-to-noise ratio [CNR]) were compared among the three protocols. The diagnostic performance of CASI coronary MR angiography for predicting significant stenosis (≥ 50% diameter stenosis) on CCTA was evaluated. The Friedman test was performed to compare the three protocols. RESULTS Acquisition time was significantly shorter in the CSAI and CS groups than in the SENSE group (10.2 ± 3.2 min vs. 10.9 ± 2.9 min vs. 13.0 ± 4.1 min, p < 0.001). However, the CSAI approach had the highest image quality scores, blood pool homogeneity, mean SNR value, and mean CNR value (all p < 0.001) compared with the CS and SENSE approaches. The sensitivity, specificity, and accuracy of CSAI coronary MR angiography per patient were 87.5% (7/8), 91.7% (11/12), and 90.0% (18/20); those per vessel were 81.8% (9/11), 93.9% (46/49), and 91.7% (55/60); and those per segment were 84.6% (11/13), 98.0% (244/249), and 97.3% (255/262), respectively. CONCLUSIONS CSAI yielded superior image quality within a clinically feasible acquisition time in healthy participants and patients with suspected CAD. CLINICAL RELEVANCE STATEMENT The non-invasive and radiation-free CSAI framework could be a promising tool for rapid screening and comprehensive examination of the coronary vasculature in patients with suspected CAD. KEY POINTS • This prospective study showed that CSAI enables a reduction in acquisition time by 22% with superior diagnostic image quality compared with the SENSE protocol. • CSAI replaces the wavelet transform with a CNN as a sparsifying transform in the CS algorithm, achieving high coronary MR image quality with reduced noise. • CSAI achieved per-patient sensitivity of 87.5% (7/8) and specificity of 91.7% (11/12) respectively for detecting significant coronary stenosis.
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Affiliation(s)
- Xi Wu
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Lu Tang
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
| | - Wanjiang Li
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
| | - Shuai He
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
| | - Xun Yue
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Pengfei Peng
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
| | - Tao Wu
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
| | - Xiaoyong Zhang
- Clinical Science, Philips Healthcare, Chengdu, 610041, Sichuan, China
| | - Zhigang Wu
- Clinical Science, Philips Healthcare, Chengdu, 610041, Sichuan, China
| | - Yong He
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Juan Huang
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China.
| | - Jiayu Sun
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China.
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13
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Mézquita AJV, Biavati F, Falk V, Alkadhi H, Hajhosseiny R, Maurovich-Horvat P, Manka R, Kozerke S, Stuber M, Derlin T, Channon KM, Išgum I, Coenen A, Foellmer B, Dey D, Volleberg RHJA, Meinel FG, Dweck MR, Piek JJ, van de Hoef T, Landmesser U, Guagliumi G, Giannopoulos AA, Botnar RM, Khamis R, Williams MC, Newby DE, Dewey M. Clinical quantitative coronary artery stenosis and coronary atherosclerosis imaging: a Consensus Statement from the Quantitative Cardiovascular Imaging Study Group. Nat Rev Cardiol 2023; 20:696-714. [PMID: 37277608 DOI: 10.1038/s41569-023-00880-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 06/07/2023]
Abstract
The detection and characterization of coronary artery stenosis and atherosclerosis using imaging tools are key for clinical decision-making in patients with known or suspected coronary artery disease. In this regard, imaging-based quantification can be improved by choosing the most appropriate imaging modality for diagnosis, treatment and procedural planning. In this Consensus Statement, we provide clinical consensus recommendations on the optimal use of different imaging techniques in various patient populations and describe the advances in imaging technology. Clinical consensus recommendations on the appropriateness of each imaging technique for direct coronary artery visualization were derived through a three-step, real-time Delphi process that took place before, during and after the Second International Quantitative Cardiovascular Imaging Meeting in September 2022. According to the Delphi survey answers, CT is the method of choice to rule out obstructive stenosis in patients with an intermediate pre-test probability of coronary artery disease and enables quantitative assessment of coronary plaque with respect to dimensions, composition, location and related risk of future cardiovascular events, whereas MRI facilitates the visualization of coronary plaque and can be used in experienced centres as a radiation-free, second-line option for non-invasive coronary angiography. PET has the greatest potential for quantifying inflammation in coronary plaque but SPECT currently has a limited role in clinical coronary artery stenosis and atherosclerosis imaging. Invasive coronary angiography is the reference standard for stenosis assessment but cannot characterize coronary plaques. Finally, intravascular ultrasonography and optical coherence tomography are the most important invasive imaging modalities for the identification of plaques at high risk of rupture. The recommendations made in this Consensus Statement will help clinicians to choose the most appropriate imaging modality on the basis of the specific clinical scenario, individual patient characteristics and the availability of each imaging modality.
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Affiliation(s)
| | - Federico Biavati
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Volkmar Falk
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research) Partner Site, Berlin, Germany
- Department of Health Science and Technology, ETH Zurich, Zurich, Switzerland
| | - Hatem Alkadhi
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - 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
| | - Pál Maurovich-Horvat
- Department of Radiology, Medical Imaging Center, Semmelweis University, Budapest, Hungary
| | - Robert Manka
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, ETH Zurich, University of Zurich, Zurich, Switzerland
| | - Matthias Stuber
- Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Keith M Channon
- Radcliffe Department of Medicine, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - Ivana Išgum
- Department of Biomedical Engineering and Physics, Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Adriaan Coenen
- Department of Radiology, Erasmus University, Rotterdam, Netherlands
| | - Bernhard Foellmer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Damini Dey
- Departments of Biomedical Sciences and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Rick H J A Volleberg
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Felix G Meinel
- Department of Radiology, University Medical Centre Rostock, Rostock, Germany
| | - Marc R Dweck
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Jan J Piek
- Department of Clinical and Experimental Cardiology and Cardiovascular Sciences, Amsterdam UMC, Heart Center, University of Amsterdam, Amsterdam, Netherlands
| | - Tim van de Hoef
- Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Ulf Landmesser
- DZHK (German Centre for Cardiovascular Research) Partner Site, Berlin, Germany
- Department of Cardiology, Deutsches Herzzentrum der Charité (DHZC), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Giulio Guagliumi
- Division of Cardiology, IRCCS Galeazzi Sant'Ambrogio Hospital, Milan, Italy
| | - Andreas A Giannopoulos
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile
| | - Ramzi Khamis
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - David E Newby
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Marc Dewey
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research) Partner Site, Berlin, Germany.
- Deutsches Herzzentrum der Charité (DHZC), Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Berlin Institute of Health, Campus Charité Mitte, Berlin, Germany.
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14
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Zhao SH, Guo WF, Yao ZF, Yang S, Yun H, Chen YY, Han TT, Zhou XY, Fu CX, Zeng MS, Li CG, Pan CZ, Jin H. Fully automated pixel-wise quantitative CMR-myocardial perfusion with CMR-coronary angiography to detect hemodynamically significant coronary artery disease. Eur Radiol 2023; 33:7238-7249. [PMID: 37145148 DOI: 10.1007/s00330-023-09689-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVES We applied a fully automated pixel-wise post-processing framework to evaluate fully quantitative cardiovascular magnetic resonance myocardial perfusion imaging (CMR-MPI). In addition, we aimed to evaluate the additive value of coronary magnetic resonance angiography (CMRA) to the diagnostic performance of fully automated pixel-wise quantitative CMR-MPI for detecting hemodynamically significant coronary artery disease (CAD). METHODS A total of 109 patients with suspected CAD were prospectively enrolled and underwent stress and rest CMR-MPI, CMRA, invasive coronary angiography (ICA), and fractional flow reserve (FFR). CMRA was acquired between stress and rest CMR-MPI acquisition, without any additional contrast agent. Finally, CMR-MPI quantification was analyzed by a fully automated pixel-wise post-processing framework. RESULTS Of the 109 patients, 42 patients had hemodynamically significant CAD (FFR ≤ 0.80 or luminal stenosis ≥ 90% on ICA) and 67 patients had hemodynamically non-significant CAD (FFR ˃ 0.80 or luminal stenosis < 30% on ICA) were enrolled. On the per-territory analysis, patients with hemodynamically significant CAD had higher myocardial blood flow (MBF) at rest, lower MBF under stress, and lower myocardial perfusion reserve (MPR) than patients with hemodynamically non-significant CAD (p < 0.001). The area under the receiver operating characteristic curve of MPR (0.93) was significantly larger than those of stress and rest MBF, visual assessment of CMR-MPI, and CMRA (p < 0.05), but similar to that of the integration of CMR-MPI with CMRA (0.90). CONCLUSIONS Fully automated pixel-wise quantitative CMR-MPI can accurately detect hemodynamically significant CAD, but the integration of CMRA obtained between stress and rest CMR-MPI acquisition did not provide significantly additive value. KEY POINTS • Full quantification of stress and rest cardiovascular magnetic resonance myocardial perfusion imaging can be postprocessed fully automatically, generating pixel-wise myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) maps. • Fully quantitative MPR provided higher diagnostic performance for detecting hemodynamically significant coronary artery disease, compared with stress and rest MBF, qualitative assessment, and coronary magnetic resonance angiography (CMRA). • The integration of CMRA and MPR did not significantly improve the diagnostic performance of MPR alone.
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Affiliation(s)
- Shi-Hai Zhao
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Wei-Feng Guo
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Zhi-Feng Yao
- Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Shan Yang
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Hong Yun
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Yin-Yin Chen
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Tong-Tong Han
- Circle Cardiovascular Imaging, Calgary, Alberta, Canada
| | - Xiao-Yue Zhou
- MR Collaboration, Siemens Healthineers Ltd., Shanghai, China
| | - Cai-Xia Fu
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Meng-Su Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.
- Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China.
| | - Chen-Guang Li
- Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
| | - Cui-Zhen Pan
- Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hang Jin
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.
- Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China.
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Tian D, Sun Y, Guo JJ, Zhao SH, Lu HF, Chen YY, Ge MY, Zeng MS, Jin H. 3.0 T unenhanced Dixon water-fat separation whole-heart coronary magnetic resonance angiography: compressed-sensing sensitivity encoding imaging versus conventional 2D sensitivity encoding imaging. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:1775-1784. [PMID: 37428247 DOI: 10.1007/s10554-023-02878-y] [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: 11/04/2022] [Accepted: 05/16/2023] [Indexed: 07/11/2023]
Abstract
This study was aimed to investigate 3.0 T unenhanced Dixon water-fat whole-heart CMRA (coronary magnetic resonance angiography) using compressed-sensing sensitivity encoding (CS-SENSE) and conventional sensitivity encoding (SENSE) in vitro and in vivo. The key parameters of CS-SENSE and conventional 1D/2D SENSE were compared in vitro phantom study. In vivo study, fifty patients with suspected coronary artery disease (CAD) completed unenhanced Dixon water-fat whole-heart CMRA at 3.0 T using both CS-SENSE and conventional 2D SENSE methods. We compared mean acquisition time, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and the diagnostic accuracy between two techniques. In vitro study, CS-SENSE achieved better effectiveness between higher SNR/CNR and shorter scan times using the appropriate acceleration factor compared with conventional 2D SENSE. In vivo study, CS-SENSE CMRA had better performance than 2D SENSE in terms of the mean acquisition time, SNR and CNR (7.4 ± 3.2 min vs. 8.3 ± 3.4 min, P = 0.001; SNR: 115.5 ± 35.4 vs. 103.3 ± 32.2; CNR: 101.1 ± 33.2 vs. 90.6 ± 30.1, P < 0.001 for both). The diagnostic accuracy between CS-SENSE and 2D SENSE had no significant difference on a patient-based analysis (sensitivity: 97.3% vs. 91.9%; specificity: 76.9% vs. 61.5%; accuracy: 92.0% vs. 84.0%; P > 0.05 for each). Unenhanced CS-SENSE Dixon water-fat separation whole-heart CMRA at 3.0 T can improve the SNR and CNR, shorten the acquisition time while providing equally satisfactory image quality and diagnostic accuracy compared with 2D SENSE CMRA.
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Affiliation(s)
- Di Tian
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Yi Sun
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Jia-Jun Guo
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Shi-Hai Zhao
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Hong-Fei Lu
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Yin-Yin Chen
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Mei-Ying Ge
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China.
| | - Meng-Su Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Hang Jin
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China.
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Ma Y, Wang S, Hua Y, Ma R, Song T, Xue Z, Cao H, Guan H. Perceptual Data Augmentation for Biomedical Coronary Vessel Segmentation. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2023; 20:2494-2505. [PMID: 35786559 DOI: 10.1109/tcbb.2022.3188148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sufficient annotated data is critical to the success of deep learning methods. Annotating for vessel segmentation in X-ray coronary angiograms is extremely difficult because of the small and complex structures to be processed. Although unsupervised domain adaptation methods can be utilized to alleviate the annotation burden by using data in other domains, e.g., eye fundus images, these methods cannot perform well due to the characteristic of medical images. Data augmentation can help improve the similarity of source domain and target domain in unsupervised domain adaptation tasks. Existing data augmentation methods play a limited role in improving domain adaptation performance, especially for special medical image segmentation tasks. In this paper, we propose an effective perceptual data augmentation method to improve the similarity between eye fundus images and coronary angiograms by synthesizing virtual samples. Auto Foreground Augment method is designed to search for geometric transformations that improve the similarity between foreground vessels of eye fundus images and coronary angiograms. The Haar Wavelet-Based Perceptual Similarity Index is utilized to guide the synthesis of virtual samples in foreground and background mixup. Extensive experiments show that our data augmentation method can synthesize high-quality virtual samples and thus improve the domain adaptation performance. To our best knowledge, this is the first work to apply perceptual data augmentation to vessel segmentation in coronary angiograms.
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Dong Z, Si G, Zhu X, Li C, Hua R, Teng J, Zhang W, Xu L, Qian W, Liu B, Wang J, Wang T, Tang Y, Zhao Y, Gong X, Tao Z, Xu Z, Li Y, Chen B, Kong X, Xu Y, Gu N, Li C. Diagnostic Performance and Safety of a Novel Ferumoxytol-Enhanced Coronary Magnetic Resonance Angiography. Circ Cardiovasc Imaging 2023; 16:580-590. [PMID: 37463240 DOI: 10.1161/circimaging.123.015404] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/13/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Currently, noninvasive arteriography for the diagnosis of coronary artery disease is clinically limited to the computed tomography scanning, where patients have to be exposed to the radiation and risks associated with iodinated contrast. We aimed to investigate the diagnostic performance and safety of a novel ferumoxytol-enhanced coronary magnetic resonance angiography (CMRA) in patients with suspected coronary artery disease. METHODS Thirty patients, 19 males, with a median age of 63 years old, and 17 with renal insufficiency, who were scheduled for invasive coronary angiography, were enrolled. Ferumoxytol was administered intravenously with a dose of 3 mg/kg during CMRA. Images were acquired with an ECG-triggered, navigator-gated, inversion recovery-prepared 3D fast low-angle shot sequence, and the image quality was assessed by a 4-point scale. Eighteen-segment coronary artery model was adopted to evaluate the visibility of the coronary arteries, and the image quality and stenosis were evaluated in nine segments. The diagnostic performance of CMRA is described as sensitivity, specificity, positive and negative predictive values, and accuracy with the invasive coronary angiography results as reference. The patients' vital signs were monitored during CMRA, and their hepatic and renal functions were followed up for 3 months to evaluate the safety of ferumoxytol. RESULTS Two hundred fifty-two of the 270 study segments were identified by CMRA, and their quality score reached 3.6±0.7. Referring to the invasive coronary angiography results, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ferumoxytol-enhanced CMRA reached 100.0%, 66.7%, 92.3%, 100.0%, and 93.3% respectively in patient-based analysis; 91.4%, 90.9%, 86.5%, 94.3%, and 91.1%, respectively in vessel-based analysis; and 92.3%, 96.7%, 83.7%, 98.6%, and 96.0%, respectively in segment-based analysis. No ferumoxytol-related adverse event was observed during the 3-month follow-up. CONCLUSIONS Ferumoxytol-enhanced CMRA demonstrated good diagnostic performance and excellent safety in the diagnosis of significant coronary stenosis, providing an alternative to coronary computed tomography angiography for the diagnosis of coronary artery disease. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT05032937.
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Affiliation(s)
- Zhou Dong
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Guangxiang Si
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, Southeast University, Nanjing, China (G.S., N.G.)
| | - Xiaomei Zhu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (X.Z., L.X., W.Q., B.L., J.W., Y.X.)
| | - Chen Li
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Rui Hua
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Jianzhen Teng
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Wenhao Zhang
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Lulu Xu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (X.Z., L.X., W.Q., B.L., J.W., Y.X.)
| | - Wen Qian
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (X.Z., L.X., W.Q., B.L., J.W., Y.X.)
| | - Bo Liu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (X.Z., L.X., W.Q., B.L., J.W., Y.X.)
| | - Jun Wang
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (X.Z., L.X., W.Q., B.L., J.W., Y.X.)
| | - Tong Wang
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Yingdan Tang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, No. 101 Longmian Avenue, Nanjing, China (Y.T., Y.Z.)
| | - Yang Zhao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, No. 101 Longmian Avenue, Nanjing, China (Y.T., Y.Z.)
| | - Xiaoxuan Gong
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Zhiwen Tao
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Zhihui Xu
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Yong Li
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Bo Chen
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Xiangqing Kong
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
| | - Yi Xu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (X.Z., L.X., W.Q., B.L., J.W., Y.X.)
| | - Ning Gu
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
- Medical School, Nanjing University, Nanjing, Jiangsu, China (N.G.)
| | - Chunjian Li
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (Z.D., C.L., R.H., J.T., W.Z., T.W., X.G., Z.T., Z.X., Y.L., B.C., X.K., C.L.)
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Kato S, Azuma M, Nakayama N, Fukui K, Ito M, Saito N, Horita N, Utsunomiya D. Diagnostic accuracy of whole heart coronary magnetic resonance angiography: a systematic review and meta-analysis. J Cardiovasc Magn Reson 2023; 25:36. [PMID: 37357310 PMCID: PMC10291762 DOI: 10.1186/s12968-023-00949-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND The purpose of this meta-analysis was to comprehensively investigate the diagnostic ability of 1.5 T and 3.0 T whole heart coronary angiography (WHCA) to detect significant coronary artery disease (CAD) on X-ray coronary angiography. METHODS A literature search of electronic databases, including PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE, was performed to retrieve and integrate articles showing significant CAD detectability of 1.5 and 3.0 T WHCA. RESULTS Data from 1899 patients from 34 studies were included in the meta-analysis. 1.5 T WHCA had a summary area under ROC of 0.88 in the patient-based analysis, 0.90 in the vessel-based analysis, and 0.92 in the segment-based analysis. These values for 3.0 T WHCA were 0.94, 0.95, 0.96, respectively. Contrast-enhanced 3.0 T WHCA had significantly higher specificity than non-contrast-enhanced 1.5 T WHCA on a patient-based analysis (0.87, 95% CI 0.80-0.92 vs. 0.74, 95% CI 0.64-0.82, P = 0.02). There were no differences in diagnostic performance on a patient-based analysis by use of vasodilators, beta-blockers or between Asian and Western countries. CONCLUSIONS The diagnostic performance of WHCA was deemed satisfactory, with contrast-enhanced 3.0 T WHCA exhibiting higher specificity compared to non-contrast-enhanced 1.5 T WHCA in a patient-based analysis. There were no significant differences in diagnostic performance on a patient-based analysis in terms of vasodilator or beta-blocker use, nor between Asian and Western countries. However, further large-scale multicentre studies are crucial for the widespread global adoption of WHCA.
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Affiliation(s)
- Shingo Kato
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Mai Azuma
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Naoki Nakayama
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Kazuki Fukui
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Masanori Ito
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Naka Saito
- Department of Clinical Laboratory, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Shen Q, Lin C, Yao Q, Wang J, Zhou J, He L, Chen G, Hu X. Addition of gadolinium contrast to three-dimensional SSFP MR sequences improves the visibility of coronary artery anatomy in young children. Front Pediatr 2023; 11:1159347. [PMID: 37215588 PMCID: PMC10196256 DOI: 10.3389/fped.2023.1159347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/12/2023] [Indexed: 05/24/2023] Open
Abstract
Objective This study aims to compare the value of a gadolinium contrast-enhanced 1.5-T three-dimensional (3D) steady-state free precession (SSFP) sequence with that of a noncontrast 3D SSFP sequence for magnetic resonance coronary angiography in a pediatric population. Materials and methods Seventy-nine patients from 1 month to 18 years old participated in this study. A 3D SSFP coronary MRA at 1.5-T was applied before and after gadolinium-diethylenetriaminepentaaceticacid (DTPA) injection. The detection rates of coronary arteries and side branches were assessed by McNemar's χ2 test. The image quality, vessel length, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the coronary arteries were analyzed by the Wilcoxon signed-rank test. The intra- and interobserver agreements were evaluated with a weighted kappa test or an intraclass correlation efficient test. Results A contrast-enhanced scan detected more coronary arteries than a noncontrast-enhanced scan in patients under 2 years old (P < 0.05). The SSFP sequence with contrast media detected more coronary artery side branches in patients younger than 5 years (P < 0.05). The image quality of all the coronary arteries was better after the injection of gadolinium-DTPA in children younger than 2 years (P < 0.05) but not significantly improved in children older than 2 years (P > 0.05). The contrast-enhanced 3D SSFP protocol detected longer lengths for the left anterior descending coronary artery in children younger than 2 years and the left circumflex coronary artery (LCX) in children younger than 5 years (P < 0.05). SNR and CNR of all the coronary arteries in children younger than 5 years and the LCX and right coronary artery in children older than 5 years enhanced after the injection of gadolinium-DTPA (P < 0.05). The intra- and interobserver agreements were high (0.803-0.998) for image quality, length, SNR, and CNR of the coronary arteries in both pre- and postcontrast groups. Conclusion The use of gadolinium contrast in combination with the 3D SSFP sequence is necessary for coronary imaging in children under 2 years of age and may be helpful in children between 2 and 5 years. Coronary artery visualization is not significantly improved in children older than 5 years.
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Affiliation(s)
- Quanli Shen
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
| | - Chengxiang Lin
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
| | - Qiong Yao
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
| | - Junbo Wang
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
| | - Jian Zhou
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
| | - Lan He
- Heart Centre, Children’s Hospital of Fudan University, Shanghai, China
| | - Gang Chen
- Heart Centre, Children’s Hospital of Fudan University, Shanghai, China
| | - Xihong Hu
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
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Koundinyan SP, Baron CA, Malavé MO, Ong F, Addy NO, Cheng JY, Yang PC, Hu BS, Nishimura DG. High-resolution, respiratory-resolved coronary MRA using a Phyllotaxis-reordered variable-density 3D cones trajectory. Magn Reson Imaging 2023; 98:140-148. [PMID: 36646397 PMCID: PMC9991864 DOI: 10.1016/j.mri.2023.01.008] [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: 11/08/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
PURPOSE To develop a respiratory-resolved motion-compensation method for free-breathing, high-resolution coronary magnetic resonance angiography (CMRA) using a 3D cones trajectory. METHODS To achieve respiratory-resolved 0.98 mm resolution images in a clinically relevant scan time, we undersample the imaging data with a variable-density 3D cones trajectory. For retrospective motion compensation, translational estimates from 3D image-based navigators (3D iNAVs) are used to bin the imaging data into four phases from end-expiration to end-inspiration. To ensure pseudo-random undersampling within each respiratory phase, we devise a phyllotaxis readout ordering scheme mindful of eddy current artifacts in steady state free precession imaging. Following binning, residual 3D translational motion within each phase is computed using the 3D iNAVs and corrected for in the imaging data. The noise-like aliasing characteristic of the combined phyllotaxis and cones sampling pattern is leveraged in a compressed sensing reconstruction with spatial and temporal regularization to reduce aliasing in each of the respiratory phases. RESULTS In initial studies of six subjects, respiratory motion compensation using the proposed method yields improved image quality compared to non-respiratory-resolved approaches with no motion correction and with 3D translational correction. Qualitative assessment by two cardiologists and quantitative evaluation with the image edge profile acutance metric indicate the superior sharpness of coronary segments reconstructed with the proposed method (P < 0.01). CONCLUSION We have demonstrated a new method for free-breathing, high-resolution CMRA based on a variable-density 3D cones trajectory with modified phyllotaxis ordering and respiratory-resolved motion compensation with 3D iNAVs.
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Affiliation(s)
| | - Corey A Baron
- Medical Biophysics, Western University, London, Ontario, Canada
| | - Mario O Malavé
- Electrical Engineering, Stanford University, Stanford, CA, United States
| | - Frank Ong
- Electrical Engineering, Stanford University, Stanford, CA, United States
| | - Nii Okai Addy
- Electrical Engineering, Stanford University, Stanford, CA, United States
| | - Joseph Y Cheng
- Electrical Engineering, Stanford University, Stanford, CA, United States; Radiology, Stanford University, Stanford, CA, United States
| | - Phillip C Yang
- Cardiovascular Medicine, Stanford University, Stanford, CA, United States
| | - Bob S Hu
- Electrical Engineering, Stanford University, Stanford, CA, United States; Cardiology, Palo Alto Medical Foundation, Palo Alto, CA, United States
| | - Dwight G Nishimura
- Electrical Engineering, Stanford University, Stanford, CA, United States.
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Zhang Y, Zhang X, Jiang Y, Yang P, Hu X, Peng B, Yue X, Li Y, Ma P, Yuan Y, Yu Y, Liu B, Li X. 3D whole-heart noncontrast coronary MR angiography based on compressed SENSE technology: a comparative study of conventional SENSE sequence and coronary computed tomography angiography. Insights Imaging 2023; 14:35. [PMID: 36790611 PMCID: PMC9931966 DOI: 10.1186/s13244-023-01378-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/20/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE The relatively long scan time has hampered the clinical use of whole-heart noncontrast coronary magnetic resonance angiography (NCMRA). The compressed sensitivity encoding (SENSE) technique, also known as the CS technique, has been found to improve scan times. This study aimed to identify the optimal CS acceleration factor for NCMRA. METHODS Thirty-six participants underwent four NCMRA sequences: three sequences using the CS technique with acceleration factors of 4, 5, and 6, and one sequence using the conventional SENSE technique with the acceleration factor of 2. Coronary computed tomography angiography (CCTA) was considered as a reference sequence. The acquisition times of the four NCMRA sequences were assessed. The correlation and agreement between the visible vessel lengths obtained via CCTA and NCMRA were also assessed. The image quality scores and contrast ratio (CR) of eight coronary artery segments from the four NCMRA sequences were quantitatively evaluated. RESULTS The mean acquisition time of the conventional SENSE was 343 s, while that of CS4, CS5, and CS6 was 269, 215, and 190 s, respectively. The visible vessel length from the CS4 sequence showed good correlation and agreement with CCTA. The image quality score and CR from the CS4 sequence were not statistically significantly different from those in the other groups (p > 0.05). Moreover, the image score and CR showed a decreasing trend with the increase in the CS factor. CONCLUSIONS The CS technique could significantly shorten the acquisition time of NCMRA. The CS sequence with an acceleration factor of 4 was generally acceptable for NCMRA in clinical settings to balance the image quality and acquisition time.
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Affiliation(s)
- Yang Zhang
- grid.412679.f0000 0004 1771 3402Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, 230032 Anhui Province China ,Department of Radiology, Fuyang People’s Hospital, Fuyang, 236015 Anhui Province China
| | - Xinna Zhang
- grid.412679.f0000 0004 1771 3402Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, 230032 Anhui Province China
| | - Yuqi Jiang
- grid.186775.a0000 0000 9490 772XDepartment of Radiology, Fuyang Hospital of Anhui Medical University, Fuyang, 236000 Anhui China
| | - Panpan Yang
- grid.186775.a0000 0000 9490 772XDepartment of Radiology, Fuyang Hospital of Anhui Medical University, Fuyang, 236000 Anhui China
| | - Xiankuo Hu
- Department of Radiology, Fuyang People’s Hospital, Fuyang, 236015 Anhui Province China
| | - Bin Peng
- Department of Radiology, Fuyang People’s Hospital, Fuyang, 236015 Anhui Province China
| | | | - Yuanyuan Li
- Department of Radiology, Fuyang People’s Hospital, Fuyang, 236015 Anhui Province China
| | - Peiqi Ma
- Department of Radiology, Fuyang People’s Hospital, Fuyang, 236015 Anhui Province China
| | - Yushan Yuan
- Department of Radiology, Fuyang People’s Hospital, Fuyang, 236015 Anhui Province China
| | - Yongqiang Yu
- grid.412679.f0000 0004 1771 3402Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, 230032 Anhui Province China
| | - Bin Liu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, 230032, Anhui Province, China.
| | - Xiaohu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, 230032, Anhui Province, China. .,Department of Radiology, Fuyang Hospital of Anhui Medical University, Fuyang, 236000, Anhui, China.
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Ansari U, Janssen S, Baumann S, Borggrefe M, Waldeck S, Schönberg S, Papavassiliu T, Overhoff D. Sparse 3D contrast-enhanced whole-heart imaging for coronary artery evaluation. Herz 2023; 48:55-63. [PMID: 35006290 PMCID: PMC9892157 DOI: 10.1007/s00059-021-05091-6] [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: 10/01/2021] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND We investigated the feasibility of evaluating coronary arteries with a contrast-enhanced (CE) self-navigated sparse isotropic 3D whole heart T1-weighted magnetic resonance imaging (MRI) study sequence. METHODS A total of 22 consecutive patients underwent coronary angiography and/or cardiac computed tomography (CT) including cardiac MRI. The image quality was evaluated on a 3-point Likert scale. Inter-reader variability for image quality was analyzed with Cohen's kappa for the main coronary segments (left circumflex [LCX], left anterior descending [LAD], right coronary artery [RCA]) and the left main trunk (LMT). RESULTS Inter-reader agreement for image quality of the coronary tree ranged from substantial to perfect, with a Cohen's kappa of 0.722 (RCAmid) to 1 (LCXprox). The LMT had the best image quality. Image quality of the proximal vessel segments differed significantly from the mid- and distal segments (RCAprox vs. RCAdist, p < 0.05). The LCX segments showed no significant difference in image quality along the vessel length (LCXprox vs. LCXdist, p = n.s.). The mean acquisition time for the study sequence was 553 s (±46 s). CONCLUSION Coronary imaging with a sparse 3D whole-heart sequence is feasible in a reasonable amount of time producing good-quality imaging. Image quality was poorer in distal coronary segments and along the entire course of the LCX.
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Affiliation(s)
- Uzair Ansari
- grid.7700.00000 0001 2190 4373First Department of Medicine, University Medical Center Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany ,European Center for AngioScience (ECAS), Mannheim, Germany ,DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Sonja Janssen
- grid.7700.00000 0001 2190 4373Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Stefan Baumann
- grid.7700.00000 0001 2190 4373First Department of Medicine, University Medical Center Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany ,European Center for AngioScience (ECAS), Mannheim, Germany ,DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Martin Borggrefe
- grid.7700.00000 0001 2190 4373First Department of Medicine, University Medical Center Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany ,European Center for AngioScience (ECAS), Mannheim, Germany ,DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Stephan Waldeck
- Department of Radiology and Neuroradiology, Bundeswehr Central Hospital Koblenz, Koblenz, Germany
| | - Stefan Schönberg
- grid.7700.00000 0001 2190 4373Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Theano Papavassiliu
- grid.7700.00000 0001 2190 4373First Department of Medicine, University Medical Center Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany ,European Center for AngioScience (ECAS), Mannheim, Germany ,DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Daniel Overhoff
- grid.7700.00000 0001 2190 4373Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
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23
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Auriau J, Belhadjer Z, Panaioli E, Derridj N, Jais JP, Gaudin R, Raimondi F, Bonnet D, Legendre A. Exercise electrocardiogram for risk-based screening of severe residual coronary lesion in children after coronary surgery. Arch Cardiovasc Dis 2022; 115:656-663. [PMID: 36372663 DOI: 10.1016/j.acvd.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 09/22/2022] [Accepted: 10/03/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Residual severe coronary artery (CA) lesion (SCL) in children after cardiac surgery involving the CA is a major concern. AIM To evaluate the value of exercise electrocardiogram (eECG) for risk-based screening of SCL. METHODS We analysed 135 maximal eECG from 115 children (mean age 13.6±3.7 years) who underwent concomitant CA imaging. SCL was defined as a stenosis exceeding 50%. RESULTS Underlying congenital heart diseases were transposition of the great arteries (TGA) (n = 116), CA pathway anomaly (n = 13) and left CA from the pulmonary artery (n = 6). Eleven SCLs were identified in 10 patients, of which 3 had a known untreated non-severe lesion and 4 had no lesions on previous imaging. In multivariable analysis, risks markers for SCL were effort chest pain (OR: 4.72, 95% CI: 1.23-18.17; P=0.024), intramural pathway (OR: 4.37, 95% CI: 1.14-16.81; P=0.032). Yacoubs C-type CA was added as a risk marker for patients with TGA (P=0.0009). All patients with SCL had a positive eECG (sensitivity: 100%, 95% CI: 72-100). Specificity was 81% (95% CI: 73-87). In the low-risk group (0 risk markers), 3/95 patients had SCL (3%), and the post-test probability of SCL with positive eECG (PPr+) was 15% (95% CI: 8-21). In the high-risk group (≥1 risk marker) comprising 8/40 SCLs (20%), PPr+ was 53% (95% CI: 35-67). CONCLUSIONS Most SCL tended to develop gradually, years after surgery. Provided it is near maximal, a negative eECG appears sufficient to exclude SCL. In the high-risk group, PPr+ exceeded 50%.
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Affiliation(s)
- Johanne Auriau
- M3C-Necker-Enfants malades, AP-HP Paris, 75015 Paris, France
| | - Zahra Belhadjer
- M3C-Necker-Enfants malades, AP-HP Paris, 75015 Paris, France
| | - Elena Panaioli
- M3C-Necker-Enfants malades, Radiology Department, hôpital universitaire Necker enfants malades, AP-HP, 75015 Paris, France
| | - Neil Derridj
- M3C-Necker-Enfants malades, AP-HP Paris, 75015 Paris, France
| | - Jean-Philippe Jais
- Biostatistics Unit, hôpital universitaire Necker-Enfants malades, AP-HP, Inserm U1163, Institut Imagine, Laboratory of Human Genetics of Infectious Diseases, Necker Branch, University of Paris, 75015 Paris, France
| | - Regis Gaudin
- M3C-Necker-Enfants malades, AP-HP Paris, 75015 Paris, France
| | - Francesca Raimondi
- M3C-Necker-Enfants malades, AP-HP, University of Paris, 75015 Paris, France
| | - Damien Bonnet
- M3C-Necker-Enfants malades, AP-HP, University of Paris, 75015 Paris, France
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24
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Noguchi T, Ota H, Matsumoto N, Morita Y, Oshita A, Kawasaki E, Kawasaki T, Moriwaki K, Kato S, Fukui K, Hoshi T, Watabe H, Kanaya T, Asaumi Y, Kataoka Y, Otsuka F, Takagi K, Yoneda S, Sawada K, Iwai T, Matama H, Honda S, Fujino M, Miura H, Nishimura K, Takase K. Clinical impact of cardiac magnetic resonance in patients with suspected coronary artery disease associated with chronic kidney disease (AQUAMARINE-CKD study): study protocol for a randomized controlled trial. Trials 2022; 23:904. [PMID: 36280852 PMCID: PMC9590223 DOI: 10.1186/s13063-022-06820-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/05/2022] [Indexed: 11/25/2022] Open
Abstract
Background Although screening for coronary artery disease (CAD) using computed tomography coronary angiography in patients with stable chest pain has been reported to be beneficial, patients with chronic kidney disease (CKD) might have limited benefit due to complications of contrast agent nephropathy and decreased diagnostic accuracy as a result of coronary artery calcifications. Cardiac magnetic resonance (CMR) has emerged as a novel imaging modality for detecting coronary stenosis and high-risk coronary plaques without contrast media that is not affected by coronary artery calcification. However, the clinical use of this technology has not been robustly evaluated. Methods AQUAMARINE-CKD is an open parallel-group prospective multicenter randomized controlled trial of 524 patients with CKD at high risk for CAD estimated based on risk factor categories for a Japanese urban population (Suita score) recruited from 6 institutions. Participants will be randomized 1:1 to receive a CMR examination that includes non-contrast T1-weighted imaging and coronary magnetic angiography (CMR group) or standard examinations that include stress myocardial scintigraphy (control group). Randomization will be conducted using a web-based system. The primary outcome is a composite of cardiovascular events at 1 year after study examinations: all-cause death, death from CAD, nonfatal myocardial infarction, nonfatal ischemic stroke, and ischemia-driven unplanned coronary intervention (percutaneous coronary intervention or coronary bypass surgery). Discussion If the combination of T1-weighted imaging and coronary magnetic angiography contributes to the risk assessment of CAD in patients with CKD, this study will have major clinical implications for the management of patients with CKD at high risk for CAD. Trial registration Japan Registry of Clinical Trials (jRCT) 1,052,210,075. Registered on September 10, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06820-w.
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Affiliation(s)
- Teruo Noguchi
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Hideki Ota
- grid.412757.20000 0004 0641 778XDepartment of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Naoya Matsumoto
- grid.260969.20000 0001 2149 8846Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Nihon University Hospital, 1-6 Kanda-surugadai, Chiyoda-ku, Tokyo, 101-8309 Japan
| | - Yoshiaki Morita
- grid.410796.d0000 0004 0378 8307Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, 564-8565 Japan
| | - Akira Oshita
- Department of Cardiology, Ehime Prefectural Imabari Hospital, 4-5-5 Ishiicho, Imabari, 794-0006 Japan
| | - Eiji Kawasaki
- grid.415758.aDepartment of Diabetes and Endocrinology, Shin-Koga Hospital, 120 Tenjin-cho, Kurume, 830-8577 Japan
| | - Tomohiro Kawasaki
- grid.415758.aCardiovascular and Heart Rhythm Center, Shin-Koga Hospital, 120 Tenjin-cho, Kurume, 830-8577 Japan
| | - Kensuke Moriwaki
- grid.262576.20000 0000 8863 9909Comprehensive Unit for Health Economic Evidence Review and Decision Support, Research Organization of Science and Technology, Ritsumeikan University, Kyoto, 604-8520 Japan
| | - Shingo Kato
- grid.419708.30000 0004 1775 0430Department of Cardiovascular Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, 236-0051 Japan
| | - Kazuki Fukui
- grid.419708.30000 0004 1775 0430Department of Cardiovascular Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, 236-0051 Japan
| | - Tomoya Hoshi
- grid.20515.330000 0001 2369 4728Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, 305-8576 Japan
| | - Hiroaki Watabe
- grid.20515.330000 0001 2369 4728Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, 305-8576 Japan
| | - Tomoaki Kanaya
- grid.470088.3Department of Cardiovascular Medicine, Dokkyo Medical University Hospital, 880 kitakobayashi, Mibu, Tochigi, 321-0293 Japan
| | - Yasuhide Asaumi
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Yu Kataoka
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Fumiyuki Otsuka
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Kensuke Takagi
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Shuichi Yoneda
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Kenichiro Sawada
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Takamasa Iwai
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Hideo Matama
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Satoshi Honda
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Masashi Fujino
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Hiroyuki Miura
- grid.410796.d0000 0004 0378 8307Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, Suita, 564-8565 Japan
| | - Kunihiro Nishimura
- grid.410796.d0000 0004 0378 8307Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, 564-8565 Japan
| | - Kei Takase
- grid.69566.3a0000 0001 2248 6943Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan
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25
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Ranjan P, Ro R, Lerakis S. Multislice Computed Tomography (MSCT) and Cardiovascular Magnetic Resonance (CMR) Imaging for Coronary and Structural Heart Disease. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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26
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Litmanovich D, Hurwitz Koweek LM, Ghoshhajra BB, Agarwal PP, Bourque JM, Brown RKJ, Davis AM, Fuss C, Johri AM, Kligerman SJ, Malik SB, Maroules CD, Meyersohn NM, Vasu S, Villines TC, Abbara S. ACR Appropriateness Criteria® Chronic Chest Pain-High Probability of Coronary Artery Disease: 2021 Update. J Am Coll Radiol 2022; 19:S1-S18. [PMID: 35550795 DOI: 10.1016/j.jacr.2022.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/19/2022] [Indexed: 10/18/2022]
Abstract
Management of patients with chronic chest pain in the setting of high probability of coronary artery disease (CAD) relies heavily on imaging for determining or excluding presence and severity of myocardial ischemia, hibernation, scarring, and/or the presence, site, and severity of obstructive coronary lesions, as well as course of management and long-term prognosis. In patients with no known ischemic heart disease, imaging is valuable in determining and documenting the presence, extent, and severity of obstructive coronary narrowing and presence of myocardial ischemia. In patients with known ischemic heart disease, imaging findings are important in determining the management of patients with chronic myocardial ischemia and can serve as a decision-making tool for medical therapy, angioplasty, stenting, or surgery. This document summarizes the recent growing body of evidence on various imaging tests and makes recommendations for imaging based on the available data and expert opinion. This document is focused on epicardial CAD and does not discuss the microvascular disease as the cause for CAD. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Diana Litmanovich
- Harvard Medical School, Boston, Massachusetts; and Chief, Cardiothoracic imaging Section, Beth Israel Deaconess Medical Center.
| | - Lynne M Hurwitz Koweek
- Panel Chair, Duke University Medical Center, Durham, North Carolina; Panel Chair ACR AUG committee
| | - Brian B Ghoshhajra
- Panel Vice-Chair, Division Chief, Cardiovascular Imaging, Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Prachi P Agarwal
- Division Director of Cardiothoracic Radiology and Co-Director of Congenital Cardiovascular MR Imaging, University of Michigan, Ann Arbor, Michigan
| | - Jamieson M Bourque
- Medical Director of Nuclear Cardiology and the Stress Laboratory, University of Virginia Health System, Charlottesville, Virginia; Nuclear cardiology expert
| | - Richard K J Brown
- University of Michigan Health System, Ann Arbor, Michigan; and Vice Chair of Clinical Operations, Department of Radiology and Imaging Sciences, University of Utah
| | - Andrew M Davis
- The University of Chicago Medical Center, Chicago, Illinois; American College of Physicians; and Associate Vice-Chair for Quality, Department of Medicine, University of Chicago
| | - Cristina Fuss
- Oregon Health & Science University, Portland, Oregon; SCCT Member of the Board; Section Chief Cardiothoracic Imaging Department of Diagnostic Radiology, Oregon Health & Science University; ABR OLA Cardiac Committee; and NASCI Program Vice-Chair
| | - Amer M Johri
- Queen's University, Kingston, Ontario, Canada; Cardiology Expert; and ASE Board Member
| | | | - Sachin B Malik
- Division Chief Thoracic and Cardiovascular Imaging, Director of Cardiac MRI, Director of MRI, VA Palo Alto Health Care System, Palo Alto, California and Stanford University, Stanford, California
| | | | - Nandini M Meyersohn
- Fellowship Program Director, Massachusetts General Hospital, Boston, Massachusetts
| | - Sujethra Vasu
- Director, Cardiac MRI and Cardiac CT, Wake Forest University Health Sciences, Winston Salem, North Carolina; Society for Cardiovascular Magnetic Resonance
| | - Todd C Villines
- University of Virginia Health Center, Charlottesville, Virginia; Society of Cardiovascular Computed Tomography
| | - Suhny Abbara
- Specialty Chair, UT Southwestern Medical Center, Dallas, Texas
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27
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Nazir MS, Bustin A, Hajhosseiny R, Yazdani M, Ryan M, Vergani V, Neji R, Kunze KP, Nicol E, Masci PG, Perera D, Plein S, Chiribiri A, Botnar R, Prieto C. High-resolution non-contrast free-breathing coronary cardiovascular magnetic resonance angiography for detection of coronary artery disease: validation against invasive coronary angiography. J Cardiovasc Magn Reson 2022; 24:26. [PMID: 35399091 PMCID: PMC8996676 DOI: 10.1186/s12968-022-00858-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/24/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Coronary artery disease (CAD) is the single most common cause of death worldwide. Recent technological developments with coronary cardiovascular magnetic resonance angiography (CCMRA) allow high-resolution free-breathing imaging of the coronary arteries at submillimeter resolution without contrast in a predictable scan time of ~ 10 min. The objective of this study was to determine the diagnostic accuracy of high-resolution CCMRA for CAD detection against the gold standard of invasive coronary angiography (ICA). METHODS Forty-five patients (15 female, 62 ± 10 years) with suspected CAD underwent sub-millimeter-resolution (0.6 mm3) non-contrast CCMRA at 1.5T in this prospective clinical study from 2019-2020. Prior to CCMR, patients were given an intravenous beta blockers to optimize heart rate control and sublingual glyceryl trinitrate to promote coronary vasodilation. Obstructive CAD was defined by lesions with ≥ 50% stenosis by quantitative coronary angiography on ICA. RESULTS The mean duration of image acquisition was 10.4 ± 2.1 min. On a per patient analysis, the sensitivity, specificity, positive predictive value and negative predictive value (95% confidence intervals) were 95% (75-100), 54% (36-71), 60% (42-75) and 93% (70-100), respectively. On a per vessel analysis the sensitivity, specificity, positive predictive value and negative predictive value (95% confidence intervals) were 80% (63-91), 83% (77-88), 49% (36-63) and 95% (90-98), respectively. CONCLUSION As an important step towards clinical translation, we demonstrated a good diagnostic accuracy for CAD detection using high-resolution CCMRA, with high sensitivity and negative predictive value. The positive predictive value is moderate, and combination with CMR stress perfusion may improve the diagnostic accuracy. Future multicenter evaluation is now required.
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Affiliation(s)
- Muhummad Sohaib Nazir
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK.
| | - Aurélien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
| | - Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
| | - Momina Yazdani
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
| | - Matthew Ryan
- British Heart Foundation Centre of Excellence and National Institute for Health Research Biomedical Research Centre at the School of Cardiovascular Medicine and Sciences, Kings College London, London, UK
| | - Vittoria Vergani
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
| | - Karl P Kunze
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
| | - Edward Nicol
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
- Royal Brompton Hospital, Guy's and St Thomas Hospital NHS Trust, London, UK
| | - Pier Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
| | - Divaka Perera
- British Heart Foundation Centre of Excellence and National Institute for Health Research Biomedical Research Centre at the School of Cardiovascular Medicine and Sciences, Kings College London, London, UK
| | - Sven Plein
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
- Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Amedeo Chiribiri
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
| | - René Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SW1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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28
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Unenhanced Whole-Heart Coronary MRA: Prospective Intraindividual Comparison of 1.5-T SSFP and 3-T Dixon Water-Fat Separation GRE Methods Using Coronary Angiography as Reference. AJR Am J Roentgenol 2022; 219:199-211. [PMID: 35293232 DOI: 10.2214/ajr.21.27292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Coronary MRA is commonly performed at 1.5 T using SSFP acquisitions. Coronary MRA at 3 T is limited using SSFP due to impaired fat suppression and has been investigated typically using contrast-enhanced techniques. A Dixon fat-water separation gradient-recalled echo (GRE) method may enable high-quality unenhanced 3-T coronary MRA. Objective: To compare 1.5-T SSFP and 3-T Dixon water-fat separation GRE methods for unenhanced whole-heart coronary MRA in patients with suspected coronary artery disease (CAD). Methods: This prospective study included 44 patients (27 men, 17 women; mean age 59±8 years) with intermediate-to-high risk of CAD who underwent both 1.5-T SSFP and 3-T Dixon GRE coronary MRA examinations before coronary angiography (CAG). Two radiologists independently assessed coronary arteries in terms of subjective image quality (1-5 scale; 5=highest image quality), number of visible segments, apparent contrast-to-noise ratio (CNR; vs myocardium)), and presence of significant stenoses. Methods were compared using readers' mean values for apparent CNR and consensus interpretations for other measures. CAG served as reference standard for presence of stenoses. Results: Interobserver agreement expressed as kappa was 0.85 for image quality, 0.85 for segment visibility, and 0.83 for stenosis, and expressed as intraclass correlation coefficient was 0.92 for apparent CNR. Mean overall image quality score was 4.0±1.1 for 3-T Dixon GRE versus 3.0±1.2 for 1.5-T SSFP. Percentage of visible segments for 3-T Dixon GRE versus 1.5-T SSFP was 96.7% versus 88.9% for all segments, 96.9% versus 90.1% for distal segments, and 93.1% versus 77.2% for branch segments. Mean overall apparent CNR was 93.2±29.2 for 3-T Dixon GRE versus 80.8±27.9 for 1.5-T SSFP. 3-T Dixon GRE, compared with 1.5-T SSFP, showed higher sensitivity and specificity in per-vessel analysis (87.9% vs 77.3%; 83.3% vs 60.6%), per-segment analysis (84.6% vs 74.8%, 90.9% vs 79.6%), and per-segment analysis of distal and branch segments (89.7% vs 75.9%, 89.7% vs 73.7%). Conclusion: For unenhanced coronary MRA, 3-T unenhanced Dixon GRE had better image quality and diagnostic performance than 1.5-T SSFP, particularly for distal and branch segments. Clinical Impact: The 3-T Dixon GRE technique may be preferred to the current clinical standard of 1.5-T SSFP for unenhanced coronary MRA.
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29
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Pulipati VP, Alenghat FJ. The impact of lipid-lowering medications on coronary artery plaque characteristics. Am J Prev Cardiol 2021; 8:100294. [PMID: 34877559 PMCID: PMC8627965 DOI: 10.1016/j.ajpc.2021.100294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/29/2021] [Accepted: 11/06/2021] [Indexed: 11/28/2022] Open
Abstract
Atherosclerosis is the predominant cause of coronary artery disease. The last several decades have witnessed significant advances in lipid-lowering therapies, which comprise a central component of atherosclerotic cardiovascular disease prevention. In addition to cardiovascular risk reduction with dyslipidemia management, some lipid-based therapies show promise at the level of the atherosclerotic plaque itself through mechanisms governing lipid accumulation, plaque stability, local inflammation, endothelial dysfunction, and thrombogenicity. The capacity of lipid-lowering therapies to modify atherosclerotic plaque burden, size, composition, and vulnerability should correlate with their ability to reduce disease progression. This review discusses plaque characteristics, diagnostic modalities to evaluate these characteristics, and how they are altered by current and emerging lipid-lowering therapies, all in human coronary artery disease.
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Affiliation(s)
- Vishnu Priya Pulipati
- Section of Cardiology, University of Chicago Medicine, 5841 S. Maryland Avenue, MC 6080, Chicago, IL 60637, United States
| | - Francis J. Alenghat
- Section of Cardiology, University of Chicago Medicine, 5841 S. Maryland Avenue, MC 6080, Chicago, IL 60637, United States
- Pritzker School of Medicine, University of Chicago, Chicago, United States
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30
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Kersten J, Eberhardt N, Prasad V, Keßler M, Markovic S, Mörike J, Nita N, Stephan T, Tadic M, Tesfay T, Rottbauer W, Buckert D. Non-invasive Imaging in Patients With Chronic Total Occlusions of the Coronary Arteries-What Does the Interventionalist Need for Success? Front Cardiovasc Med 2021; 8:713625. [PMID: 34527713 PMCID: PMC8435679 DOI: 10.3389/fcvm.2021.713625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/06/2021] [Indexed: 10/26/2022] Open
Abstract
Chronic total occlusion (CTO) of coronary arteries is a common finding in patients with known or suspected coronary artery disease (CAD). Although tremendous advances have been made in the interventional treatment of CTOs over the past decade, correct patient selection remains an important parameter for achieving optimal results. Non-invasive imaging can make a valuable contribution. Ischemia and viability, two major factors in this regard, can be displayed using echocardiography, single-photon emission tomography, positron emission tomography, computed tomography, and cardiac magnetic resonance imaging. Each has its own strengths and weaknesses. Although most have been studied in patients with CAD in general, there is an increasing number of studies with positive preselectional factors for patients with CTOs. The aim of this review is to provide a structured overview of the current state of pre-interventional imaging for CTOs.
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Affiliation(s)
- Johannes Kersten
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Nina Eberhardt
- Department for Nuclear Medicine, University of Ulm, Ulm, Germany
| | - Vikas Prasad
- Department for Nuclear Medicine, University of Ulm, Ulm, Germany
| | - Mirjam Keßler
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Sinisa Markovic
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Johannes Mörike
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Nicoleta Nita
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Tilman Stephan
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Marijana Tadic
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Temsgen Tesfay
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | | | - Dominik Buckert
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
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Hajhosseiny R, Munoz C, Cruz G, Khamis R, Kim WY, Prieto C, Botnar RM. Coronary Magnetic Resonance Angiography in Chronic Coronary Syndromes. Front Cardiovasc Med 2021; 8:682924. [PMID: 34485397 PMCID: PMC8416045 DOI: 10.3389/fcvm.2021.682924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/23/2021] [Indexed: 01/14/2023] Open
Abstract
Cardiovascular disease is the leading cause of mortality worldwide, with atherosclerotic coronary artery disease (CAD) accounting for the majority of cases. X-ray coronary angiography and computed tomography coronary angiography (CCTA) are the imaging modalities of choice for the assessment of CAD. However, the use of ionising radiation and iodinated contrast agents remain drawbacks. There is therefore a clinical need for an alternative modality for the early identification and longitudinal monitoring of CAD without these associated drawbacks. Coronary magnetic resonance angiography (CMRA) could be a potential alternative for the detection and monitoring of coronary arterial stenosis, without exposing patients to ionising radiation or iodinated contrast agents. Further advantages include its versatility, excellent soft tissue characterisation and suitability for repeat imaging. Despite the early promise of CMRA, widespread clinical utilisation remains limited due to long and unpredictable scan times, onerous scan planning, lower spatial resolution, as well as motion related image quality degradation. The past decade has brought about a resurgence in CMRA technology, with significant leaps in image acceleration, respiratory and cardiac motion estimation and advanced motion corrected or motion-resolved image reconstruction. With the advent of artificial intelligence, great advances are also seen in deep learning-based motion estimation, undersampled and super-resolution reconstruction promising further improvements of CMRA. This has enabled high spatial resolution (1 mm isotropic), 3D whole heart CMRA in a clinically feasible and reliable acquisition time of under 10 min. Furthermore, latest super-resolution image reconstruction approaches which are currently under evaluation promise acquisitions as short as 1 min. In this review, we will explore the recent technological advances that are designed to bring CMRA closer to clinical reality.
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Affiliation(s)
- Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Camila Munoz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Ramzi Khamis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Won Yong Kim
- Department of Cardiology and Institute of Clinical Medicine, Aarhus University Hospital, Skejby, Denmark
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - René M. Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Instituto de Ingeniería Biologica y Medica, Pontificia Universidad Catolica de Chile, Santiago, Chile
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32
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Han T, Ai D, An R, Fan J, Song H, Wang Y, Yang J. Ordered multi-path propagation for vessel centerline extraction. Phys Med Biol 2021; 66. [PMID: 34157702 DOI: 10.1088/1361-6560/ac0d8e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/22/2021] [Indexed: 11/12/2022]
Abstract
Vessel centerline extraction from x-ray angiography images is essential for vessel structure analysis in the diagnosis of coronary artery disease. However, complete and continuous centerline extraction remains a challenging task due to image noise, poor contrast, and complexity of vessel structure. Thus, an iterative multi-path search framework for automatic vessel centerline extraction is proposed. First, the seed points of the vessel structure are detected and sorted by confidence. With the ordered seed points, multi-bifurcation centerline is searched through multi-path propagation of wavefront and accumulated voting. Finally, the centerline is further extended piecewise by wavefront propagation on the basis of keypoint detection. The latter two steps are performed alternately to obtain the final centerline result. The proposed method is qualitatively and quantitatively evaluated on 1260 synthetic images and 50 clinical angiography images. The results demonstrate that our method has a highF1score of 87.8% ± 2.7% for the angiography images and achieves accurate and continuous results of vessel centerline extraction.
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Affiliation(s)
- Tao Han
- Laboratory of Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Danni Ai
- Laboratory of Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Ruirui An
- Laboratory of Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Jingfan Fan
- Laboratory of Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Hong Song
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Yining Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People's Republic of China
| | - Jian Yang
- Laboratory of Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, People's Republic of China
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Lu H, Zhao S, Tian D, Yang S, Ma J, Chen Y, Ge M, Zeng M, Jin H. Clinical Application of Non-Contrast-Enhanced Dixon Water-Fat Separation Compressed SENSE Whole-Heart Coronary MR Angiography at 3.0 T With and Without Nitroglycerin. J Magn Reson Imaging 2021; 55:579-591. [PMID: 34254384 DOI: 10.1002/jmri.27829] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND 3.0 T non-contrast-enhanced nitroglycerin (NTG)-assisted whole-heart coronary magnetic resonance angiography (MRA) employing Dixon water-fat separation and compressed SENSE (CS-SENSE) acceleration is a promising method for diagnosing coronary artery disease (CAD). PURPOSE To evaluate the diagnostic performance of this technique for detecting clinically-relevant (≥50% diameter reducing) CAD and to evaluate the difference in NTG-induced coronary vasodilation between patients with and without clinically-relevant CAD. STUDY TYPE Prospective. POPULATION Sixty-six patients with suspected CAD. FIELD STRENGTH/SEQUENCE 3.0 T; CSSENSE, Dixon water-fat separation, three-dimensional segmented turbo field gradient-echo sequence for whole-heart coronary MRA. ASSESSMENT Overall image quality of coronary MRA was calculated on the basis of all visible coronary segments. The diagnostic performance of coronary MRA for detecting a ≥50% reduction in coronary artery diameter with and without NTG was compared using X-ray coronary angiography (CAG) as the reference. According to CAG, patients were divided into a non-clinically-relevant CAD group and clinically-relevant CAD group, and the difference in NTG-induced vasodilation between the groups was evaluated. STATISTICAL TESTS Unpaired/paired Student's t-test, Mann-Whitney U test, paired Wilcoxon signed-rank test, χ2 test, McNemar test. A two-tailed P value <0.05 was considered significant. RESULTS Overall image quality was increased significantly in the coronary MRA images after NTG. The diagnostic performance of the non-NTG vs. NTG-assisted coronary MRA was as follows on a per-patient basis: sensitivity 94.3% vs. 94.3%, specificity 64.5% vs. 83.9%, positive predictive value 75.0% vs. 86.8%, negative predictive value 90.9% vs. 92.9%, and accuracy 80.3% vs. 89.4%, respectively. NTG-induced vasodilation was significantly lower in the clinically-relevant CAD group than in the non-clinically-relevant CAD group (13.7 ± 8.1% vs. 24.1 ± 16.3%). DATA CONCLUSION Non-contrast Dixon water-fat separation CS-SENSE coronary MRA at 3.0 T can noninvasively detect clinically-relevant CAD and sublingual NTG improved performance. Combining pre- and post-NTG coronary MRA may provide a simple noninvasive and nonionizing test to evaluate coronary vasodilation function. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Hongfei Lu
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Shihai Zhao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Di Tian
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Shan Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Jianying Ma
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yinyin Chen
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Meiying Ge
- Department of Radiology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
| | - Hang Jin
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai, China
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Guo B, Li Z, Tu P, Tang H, Tu Y. Molecular Imaging and Non-molecular Imaging of Atherosclerotic Plaque Thrombosis. Front Cardiovasc Med 2021; 8:692915. [PMID: 34291095 PMCID: PMC8286992 DOI: 10.3389/fcvm.2021.692915] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/08/2021] [Indexed: 12/11/2022] Open
Abstract
Thrombosis in the context of atherosclerosis typically results in life-threatening consequences, including acute coronary events and ischemic stroke. As such, early detection and treatment of thrombosis in atherosclerosis patients is essential. Clinical diagnosis of thrombosis in these patients is typically based upon a combination of imaging approaches. However, conventional imaging modalities primarily focus on assessing the anatomical structure and physiological function, severely constraining their ability to detect early thrombus formation or the processes underlying such pathology. Recently, however, novel molecular and non-molecular imaging strategies have been developed to assess thrombus composition and activity at the molecular and cellular levels more accurately. These approaches have been successfully used to markedly reduce rates of atherothrombotic events in patients suffering from acute coronary syndrome (ACS) by facilitating simultaneous diagnosis and personalized treatment of thrombosis. Moreover, these modalities allow monitoring of plaque condition for preventing plaque rupture and associated adverse cardiovascular events in such patients. Sustained developments in molecular and non-molecular imaging technologies have enabled the increasingly specific and sensitive diagnosis of atherothrombosis in animal studies and clinical settings, making these technologies invaluable to patients' health in the future. In the present review, we discuss current progress regarding the non-molecular and molecular imaging of thrombosis in different animal studies and atherosclerotic patients.
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Affiliation(s)
- Bingchen Guo
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhaoyue Li
- Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Peiyang Tu
- College of Clinical Medicine, Hubei University of Science and Technology, Xianning, China
| | - Hao Tang
- Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yingfeng Tu
- Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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35
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Omisore OM, Duan W, Du W, Zheng Y, Akinyemi T, Al-Handerish Y, Li W, Liu Y, Xiong J, Wang L. Automatic tool segmentation and tracking during robotic intravascular catheterization for cardiac interventions. Quant Imaging Med Surg 2021; 11:2688-2710. [PMID: 34079734 DOI: 10.21037/qims-20-1119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Cardiovascular diseases resulting from aneurism, thrombosis, and atherosclerosis in the cardiovascular system are major causes of global mortality. Recent treatment methods have been based on catheterization of flexible endovascular tools with imaging guidance. While advances in robotic intravascular catheterization have led to modeling tool navigation approaches with data sensing and feedback, proper adaptation of image-based guidance for robotic navigation requires the development of sensitive segmentation and tracking models without specificity loss. Several methods have been developed to tackle non-uniform illumination, low contrast; however, presence of untargeted body organs commonly found in X-ray frames taken during angiography procedures still presents some major issues to be solved. Methods In this study, a segmentation method was developed for automatic detection and tracking of guidewire pixels in X-ray angiograms. Image frames were acquired during robotic intravascular catheterization for cardiac interventions. For segmentation, multiscale enhancement filtering was applied on preprocessed X-ray angiograms, while morphological operations and filters were applied to refine the frames for pixel intensity adjustment and vesselness measurement. Minima and maxima extrema of the pixels were obtained to detect guidewire pixels in the X-ray frames. Lastly, morphological operation was applied for guidewire pixel connectivity and tracking in segmented pixels. Method validation was performed on 12 X-ray angiogram sequences which were acquired during in vivo intravascular catheterization trials in rabbits. Results The study outcomes showed that an overall accuracy of 0.995±0.001 was achieved for segmentation. Tracking performance was characterized with displacement and orientation errors observed as 1.938±2.429 mm and 0.039±0.040°, respectively. Evaluation studies performed against 9 existing methods revealed that this proposed method provides more accurate segmentation with 0.753±0.074 area under curve. Simultaneously, high tracking accuracy of 0.995±0.001 with low displacement and orientation errors of 1.938±2.429 mm and 0.039±0.040°, respectively, were achieved. Also, the method demonstrated higher sensitivity and specificity values compared to the 9 existing methods, with a relatively faster exaction time. Conclusions The proposed method has the capability to enhance robotic intravascular catheterization during percutaneous coronary interventions (PCIs). Thus, interventionists can be provided with better tool tracking and visualization systems while also reducing their exposure to operational hazards during intravascular catheterization for cardiac interventions.
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Affiliation(s)
- Olatunji Mumini Omisore
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,CAS Key Laboratory for Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Wenke Duan
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,CAS Key Laboratory for Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Wenjing Du
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,CAS Key Laboratory for Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yuhong Zheng
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Toluwanimi Akinyemi
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Yousef Al-Handerish
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Wanghongbo Li
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yong Liu
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Jing Xiong
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Lei Wang
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,CAS Key Laboratory for Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Tang S, Zhang G, Chen Z, Liu X, He L. Application of prospective ECG-gated multiphase scanning for coronary CT in children with different heart rates. Jpn J Radiol 2021; 39:946-955. [PMID: 34046853 DOI: 10.1007/s11604-021-01133-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND To investigate the application of prospective ECG-gated multiphase scanning in coronary CT imaging in children with different heart rates. METHODS In the control group, 160 children aged 2-4 years who underwent a coronary CT examination in our hospital from May 2016 to December 2017 were retrospectively selected. They were divided into five subgroups according to their heart rate frequency: 75-85 beats/min, 86-95 beats/min, 96-105 beats/min, and 106-120 beats/min. There were 40 children in each subgroup. Each child was treated with retrospective ECG-gated scanning technology. Six groups of phase images were reconstructed: 40%, 45%, 50%, 70%, 75% and 80%. The optimal phase was selected for coronary artery reconstruction. In the study group, 240 children aged 2-4 years who underwent coronary artery CT examination in our hospital from January 2018 to May 2019 were prospectively selected and divided into five subgroups according to the heart rate frequency: 75-85 beats/min, 86-95 beats/min, 96-105 beats/min, and 106-120 beats/min. There were 60 children in each subgroup. A prospective ECG-gated multiphase scanning technique was used to reconstruct 70%, 75% and 80% phase images in the subgroups with heart rates < 85/min. In the remaining subgroups, 40%, 45% and 50% phase images were reconstructed, and the optimal phase was selected for coronary artery reconstruction. The scanning parameters, dosage of contrast medium and injection mode of contrast medium were the same in both groups. The radiation dose and image quality of the coronary artery were compared between the two groups at the same heart rate. RESULTS When comparing the two groups at the same heart rate, the radiation dose in the study group was 72% lower than that in the control group (P < 0.05). There was no significant difference in coronary artery image quality between the two groups at the optimal phase (P > 0.05). CONCLUSIONS Applying prospective ECG-gated multiphase scanning technology to children's coronary CT imaging can significantly reduce the scanning radiation dose without affecting the quality of the coronary artery image.
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Affiliation(s)
- Shilong Tang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
| | - Guanping Zhang
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Zhuo Chen
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xianfan Liu
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ling He
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.
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Hajhosseiny R, Rashid I, Bustin A, Munoz C, Cruz G, Nazir MS, Grigoryan K, Ismail TF, Preston R, Neji R, Kunze K, Razavi R, Chiribiri A, Masci PG, Rajani R, Prieto C, Botnar RM. Clinical comparison of sub-mm high-resolution non-contrast coronary CMR angiography against coronary CT angiography in patients with low-intermediate risk of coronary artery disease: a single center trial. J Cardiovasc Magn Reson 2021; 23:57. [PMID: 33993890 PMCID: PMC8127202 DOI: 10.1186/s12968-021-00758-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 04/06/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The widespread clinical application of coronary cardiovascular magnetic resonance (CMR) angiography (CMRA) for the assessment of coronary artery disease (CAD) remains limited due to low scan efficiency leading to prolonged and unpredictable acquisition times; low spatial-resolution; and residual respiratory motion artefacts resulting in limited image quality. To overcome these limitations, we have integrated highly undersampled acquisitions with image-based navigators and non-rigid motion correction to enable high resolution (sub-1 mm3) free-breathing, contrast-free 3D whole-heart coronary CMRA with 100% respiratory scan efficiency in a clinically feasible and predictable acquisition time. OBJECTIVES To evaluate the diagnostic performance of this coronary CMRA framework against coronary computed tomography angiography (CTA) in patients with suspected CAD. METHODS Consecutive patients (n = 50) with suspected CAD were examined on a 1.5T CMR scanner. We compared the diagnostic accuracy of coronary CMRA against coronary CTA for detecting a ≥ 50% reduction in luminal diameter. RESULTS The 50 recruited patients (55 ± 9 years, 33 male) completed coronary CMRA in 10.7 ± 1.4 min. Twelve (24%) had significant CAD on coronary CTA. Coronary CMRA obtained diagnostic image quality in 95% of all, 97% of proximal, 97% of middle and 90% of distal coronary segments. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were: per patient (100%, 74%, 55%, 100% and 80%), per vessel (81%, 88%, 46%, 97% and 88%) and per segment (76%, 95%, 44%, 99% and 94%) respectively. CONCLUSIONS The high diagnostic image quality and diagnostic performance of coronary CMRA compared against coronary CTA demonstrates the potential of coronary CMRA as a robust and safe non-invasive alternative for excluding significant disease in patients at low-intermediate risk of CAD.
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Affiliation(s)
- Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK.
| | - Imran Rashid
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Aurélien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Camila Munoz
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Muhummad Sohaib Nazir
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Karine Grigoryan
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Tevfik F Ismail
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Rebecca Preston
- Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
| | - Karl Kunze
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Amedeo Chiribiri
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Pier Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Ronak Rajani
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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38
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Nakamura S, Ishida M, Nakata K, Ichikawa Y, Takase S, Takafuji M, Ito H, Nakamori S, Kurita T, Dohi K, Sakuma H. Long-term prognostic value of whole-heart coronary magnetic resonance angiography. J Cardiovasc Magn Reson 2021; 23:56. [PMID: 33993891 PMCID: PMC8127259 DOI: 10.1186/s12968-021-00749-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/18/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Coronary magnetic resonance angiography (CMRA) allows non-ionizing visualization of luminal narrowing in coronary artery disease (CAD). Although a prior study showed the usefulness of CMRA for risk stratification in short-term follow-up, the long-term prognostic value of CMRA remains unclear. The purpose of this study was to evaluate the long-term prognostic value of CMRA. METHODS A total of 506 patients without history of myocardial infarction or prior coronary artery revascularization underwent free-breathing whole-heart CMRA between 2009 and 2015. Images were acquired using a 1.5 T or 3 T scanner and visually evaluated as the consensus decisions of two observers. Obstructive CAD on CMRA was defined as luminal narrowing of ≥ 50% in at least one coronary artery. Major adverse cardiac events (MACE) comprised cardiac death, nonfatal myocardial infarction, and unstable angina. RESULTS Obstructive CAD on CMRA was observed in 214 patients (42%). During follow-up (median, 5.6 years), 31 MACE occurred. Kaplan-Meier curve analysis revealed a significant difference in event-free survival between patients with and without obstructive CAD for MACE (log-rank, p = 0.003) and cardiac death (p = 0.012). Annualized event rates for MACE in patients with no obstructive CAD, 1-vessel disease, 2-vessel disease, and left-main or 3-vessel disease were 0.6%, 1.5%, 2.3%, and 3.6%, respectively (log-rank, p = 0.003). Cox proportional hazard regression analysis showed that, among obstructive CAD on CMRA and clinical risk factors (age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of CAD), obstructive CAD and diabetes were significant predictors of MACE (hazard ratios, 2.9 [p = 0.005] and 2.2 [p = 0.034], respectively). In multivariate analysis, obstructive CAD remained an independent predictor (adjusted hazard ratio, 2.6 [p = 0.010]) after adjusting for diabetes. Addition of obstructive CAD to clinical risk factors significantly increased the global chi-square result from 8.3 to 13.8 (p = 0.022). CONCLUSIONS In long-term follow-up, free breathing whole heart CMRA allows non-invasive risk stratification for MACE and cardiac death and provides incremental prognostic value over conventional risk factors in patients without a history of myocardial infarction or prior coronary artery revascularization. The presence and severity of obstructive CAD detected by CMRA were associated with worse prognosis. Importantly, patients without obstructive CAD on CMRA displayed favorable prognosis.
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Affiliation(s)
- Satoshi Nakamura
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Masaki Ishida
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Kei Nakata
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Yasutaka Ichikawa
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Shinichi Takase
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Masafumi Takafuji
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Haruno Ito
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Shiro Nakamori
- Department of Cardiology and Nephrology, Mie University Hospital, Tsu, Mie, Japan
| | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Hospital, Tsu, Mie, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Hospital, Tsu, Mie, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
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39
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Miyoshi T, Honda T, Shinozuka F, Sadamoto K, Yamaguchi O. Efficacy of Magnetic Resonance Coronary Angiography. Circ J 2021; 85:401. [PMID: 33627541 DOI: 10.1253/circj.cj-20-1261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Toru Miyoshi
- Department of Cardiology, Sadamoto Hospital.,Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine
| | | | - Fuminori Shinozuka
- Department of Cardiology, Sadamoto Hospital.,Department of Neurosurgery, Sadamoto Hospital
| | | | - Osamu Yamaguchi
- Department of Cardiology, Sadamoto Hospital.,Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine
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40
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Zahergivar A, Kocher M, Waltz J, Kabakus I, Chamberlin J, Akkaya S, Agha AM, Schoepf UJ, Burt JR. The diagnostic value of non-contrast magnetic resonance coronary angiography in the assessment of coronary artery disease: A systematic review and meta-analysis. Heliyon 2021; 7:e06386. [PMID: 33817362 PMCID: PMC8010401 DOI: 10.1016/j.heliyon.2021.e06386] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/28/2020] [Accepted: 02/24/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose The current literature reports a wide range of diagnostic accuracy of non-contrast magnetic resonance coronary angiography (NC-MRCA) for the assessment of coronary artery disease (CAD). We aimed to compare the clinical effectiveness of NC-MRCA with that of invasive coronary angiography (ICA) in patients with suspected CAD using a systematic review and meta-analysis. Methods Two investigators independently extracted 36 published manuscripts between 2010 and 2019. Databases including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane were searched using pre-established keywords. Analysis of the data followed the PRISMA statement for reporting systematic reviews and meta-analyses and primary analysis followed the Mantel-Hansel methodology. Correctness of classification for detecting coronary artery stenosis ≥50% (CAS) was measured using ICA as the gold standard. Results A total of five studies met inclusion criteria, with a total of 417 patients and 2883 coronary segments. The pooled per patient sensitivity and specificity of NC-MRCA for CAS in suspected patients was 90.3% (95% CI 85.6–95.1%) and 77.9% (95% CI 69.5–86.3%). Pooled per vessel assessment of NC- MRCA revealed a sensitivity of 83.7% (95%CI 79.7–87.8%) and specificity of 90.0% (95%CI 86.7–93.4%). Per-segment assessment of NC-MRCA showed a pooled sensitivity of 81.6% (95% CI 76.8–86.4) and specificity of 97.0% (95% CI 95.5–98.5). Mild to moderate heterogeneity was noted in most diagnostic parameters with larger heterogeneity noted in the per-segment analyses. There was less heterogeneity in sensitivity and NPV than specificity and PPV. Conclusion According to this meta-analysis, non-contrast coronary MRA resulted in adequate screening in patients with suspected CAD with high sensitivity and specificity. This result was true for per-patient, per-vessel, and per-segment assessment.
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Affiliation(s)
- Aryan Zahergivar
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Madison Kocher
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Jeffrey Waltz
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Ismail Kabakus
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Jordan Chamberlin
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Selcuk Akkaya
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Ali M Agha
- Department of Internal Medicine, Division of Cardiology, Baylor College of Medicine, Houston, TX, USA
| | - U Joseph Schoepf
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Jeremy R Burt
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
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41
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Pontone G, Di Cesare E, Castelletti S, De Cobelli F, De Lazzari M, Esposito A, Focardi M, Di Renzi P, Indolfi C, Lanzillo C, Lovato L, Maestrini V, Mercuro G, Natale L, Mantini C, Polizzi A, Rabbat M, Secchi F, Secinaro A, Aquaro GD, Barison A, Francone M. Appropriate use criteria for cardiovascular magnetic resonance imaging (CMR): SIC-SIRM position paper part 1 (ischemic and congenital heart diseases, cardio-oncology, cardiac masses and heart transplant). LA RADIOLOGIA MEDICA 2021; 126:365-379. [PMID: 33629237 PMCID: PMC7937599 DOI: 10.1007/s11547-020-01332-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/22/2020] [Indexed: 01/02/2023]
Abstract
Cardiac magnetic resonance (CMR) has emerged as new mainstream technique for the evaluation of patients with cardiac diseases, providing unique information to support clinical decision-making. This document has been developed by a joined group of experts of the Italian Society of Cardiology and Italian society of Radiology and aims to produce an updated consensus statement about the current state of technology and clinical applications of CMR. The writing committee consisted of members and experts of both societies who worked jointly to develop a more integrated approach in the field of cardiac radiology. Part 1 of the document will cover ischemic heart disease, congenital heart disease, cardio-oncology, cardiac masses and heart transplant.
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Affiliation(s)
| | - Ernesto Di Cesare
- Department of Life, Healt and Enviromental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Silvia Castelletti
- Center for the Cardiac Arrhythmias of Genetic Origin, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Francesco De Cobelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Manuel De Lazzari
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Antonio Esposito
- Center for the Cardiac Arrhythmias of Genetic Origin, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Marta Focardi
- Department of Cardiology, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Paolo Di Renzi
- U.O.C. Radiologia, Ospedale "San Giovanni Calibita" Fatebenefratelli - Isola Tiberina, Rome, Italy
| | - Ciro Indolfi
- Division of Cardiology, University Magna Graecia, Italy and Mediterranea Cardiocentro, Naples, Italy
| | | | - Luigi Lovato
- Cardiovascular Radiology Unit, Department of Imaging S.Orsola, Malpighi University Hospital, Bologna, Italy
| | - Viviana Maestrini
- Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luigi Natale
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology - Diagnostic Imaging Area, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Universita ` Cattolica del Sacro Cuore, Rome, Italy
| | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Aldo Polizzi
- Unit of Radiodiagnostics II, University Hospital "Policlinico-Vittorio Emanuele", Catania, Italy
| | - Mark Rabbat
- Loyola University of Chicago, Chicago, USA
- Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - Francesco Secchi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Aurelio Secinaro
- Advanced Cardiovascular Imaging Unit, Department of Imaging, Bambino Gesù Children's Hospital, Rome, Italy
| | | | | | - Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.
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42
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Miller T, Chin MS, Gharagouzloo C, Aghayev A, Zheng S, Kwong R, Memon AA, Siedlecki AM. Ferumoxytol-Enhanced Coronary Magnetic Resonance Angiography Compared to Invasive Coronary Angiography for Detection of Epicardial Coronary Artery Disease. Kidney Med 2021; 3:139-141. [PMID: 33604543 PMCID: PMC7873820 DOI: 10.1016/j.xkme.2020.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Mathew S Chin
- Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA
| | | | - Ayaz Aghayev
- Department of Medicine, Kaiser Permanente, Oakland, CA.,Department of Radiology, Brigham and Women's Hospital, Boston, MA
| | - Sijie Zheng
- Division of Cardiology, Brigham and Women's Hospital, Boston, MA
| | - Raymond Kwong
- Division of Cardiology, Brigham and Women's Hospital, Boston, MA
| | - Aliza Anwar Memon
- Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA
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43
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Yamagishi M, Tamaki N, Akasaka T, Ikeda T, Ueshima K, Uemura S, Otsuji Y, Kihara Y, Kimura K, Kimura T, Kusama Y, Kumita S, Sakuma H, Jinzaki M, Daida H, Takeishi Y, Tada H, Chikamori T, Tsujita K, Teraoka K, Nakajima K, Nakata T, Nakatani S, Nogami A, Node K, Nohara A, Hirayama A, Funabashi N, Miura M, Mochizuki T, Yokoi H, Yoshioka K, Watanabe M, Asanuma T, Ishikawa Y, Ohara T, Kaikita K, Kasai T, Kato E, Kamiyama H, Kawashiri M, Kiso K, Kitagawa K, Kido T, Kinoshita T, Kiriyama T, Kume T, Kurata A, Kurisu S, Kosuge M, Kodani E, Sato A, Shiono Y, Shiomi H, Taki J, Takeuchi M, Tanaka A, Tanaka N, Tanaka R, Nakahashi T, Nakahara T, Nomura A, Hashimoto A, Hayashi K, Higashi M, Hiro T, Fukamachi D, Matsuo H, Matsumoto N, Miyauchi K, Miyagawa M, Yamada Y, Yoshinaga K, Wada H, Watanabe T, Ozaki Y, Kohsaka S, Shimizu W, Yasuda S, Yoshino H. JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases. Circ J 2021; 85:402-572. [PMID: 33597320 DOI: 10.1253/circj.cj-19-1131] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine Graduate School
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Graduate School
| | - Kenji Ueshima
- Center for Accessing Early Promising Treatment, Kyoto University Hospital
| | - Shiro Uemura
- Department of Cardiology, Kawasaki Medical School
| | - Yutaka Otsuji
- Second Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School
| | | | | | - Hajime Sakuma
- Department of Radiology, Mie University Graduate School
| | | | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School
| | | | - Hiroshi Tada
- Department of Cardiovascular Medicine, University of Fukui
| | | | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | | | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa Universtiy
| | | | - Satoshi Nakatani
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Atsushi Nohara
- Division of Clinical Genetics, Ishikawa Prefectural Central Hospital
| | | | | | - Masaru Miura
- Department of Cardiology, Tokyo Metropolitan Children's Medical Center
| | | | | | | | - Masafumi Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University
| | - Toshihiko Asanuma
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School
| | - Yuichi Ishikawa
- Department of Pediatric Cardiology, Fukuoka Children's Hospital
| | - Takahiro Ohara
- Division of Community Medicine, Tohoku Medical and Pharmaceutical University
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Tokuo Kasai
- Department of Cardiology, Uonuma Kinen Hospital
| | - Eri Kato
- Department of Cardiovascular Medicine, Department of Clinical Laboratory, Kyoto University Hospital
| | | | - Masaaki Kawashiri
- Department of Cardiovascular and Internal Medicine, Kanazawa University
| | - Keisuke Kiso
- Department of Diagnostic Radiology, Tohoku University Hospital
| | - Kakuya Kitagawa
- Department of Advanced Diagnostic Imaging, Mie University Graduate School
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School
| | | | | | | | - Akira Kurata
- Department of Radiology, Ehime University Graduate School
| | - Satoshi Kurisu
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center
| | - Eitaro Kodani
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama Nagayama Hospital
| | - Akira Sato
- Department of Cardiology, University of Tsukuba
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Kyoto University Graduate School
| | - Junichi Taki
- Department of Nuclear Medicine, Kanazawa University
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, Hospital of the University of Occupational and Environmental Health, Japan
| | | | - Nobuhiro Tanaka
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center
| | - Ryoichi Tanaka
- Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University
| | | | | | - Akihiro Nomura
- Innovative Clinical Research Center, Kanazawa University Hospital
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Hospital
| | - Masahiro Higashi
- Department of Radiology, National Hospital Organization Osaka National Hospital
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University
| | | | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Naoya Matsumoto
- Division of Cardiology, Department of Medicine, Nihon University
| | | | | | | | - Keiichiro Yoshinaga
- Department of Diagnostic and Therapeutic Nuclear Medicine, Molecular Imaging at the National Institute of Radiological Sciences
| | - Hideki Wada
- Department of Cardiology, Juntendo University Shizuoka Hospital
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University
| | - Yukio Ozaki
- Department of Cardiology, Fujita Medical University
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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44
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Self-navigated versus navigator-gated 3D MRI sequence for non-enhanced aortic root measurement in transcatheter aortic valve implantation. Eur J Radiol 2021; 137:109573. [PMID: 33578090 DOI: 10.1016/j.ejrad.2021.109573] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/27/2020] [Accepted: 01/22/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To prospectively compare image-quality, reliability and graft sizing of a prototype self-navigated and a navigator-gated non-contrast three dimensional (3D) whole-heart magnetic-resonance-angiography (MRA) sequence with computed-tomography-angiography (CTA) for planning transcatheter-aortic-valve-implantation (TAVI). METHODS Self- and navigator-gated 1.5 T MRA were performed in 27 patients (aged 83 ± 5 years, 41 % male) for aortic root sizing and coronary ostia height measurements; 15 (56 %) patients underwent additional CTA. Subjective-image quality was graded on a 4-point Likert scale, objective MRA image-quality was assessed by signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Continuous MRA and CTA measurements were analyzed with regression and Bland-Altman analysis, valve sizing by kappa statistics. RESULTS Median image-quality as rated by two observers was 1.5 [interquartile range (IQR) 1-3] for self-navigated MRA and 1 [IQR 1-2] for navigator-gated MRA (p = 0.059). SNR and CNR were comparable between MRA sequences (p = 0.471 and 0.445, respectively). Acquisition time was shorter for self-navigated MRA compared to navigator-gated MRA (5.5 ± 1 min vs, 6.5 ± 2 min, p = 0.029). Inter-observer correlation of aortic root measurements was high to very high for both self- and navigator-gated MRA (r = 0.75 to 0.94 and r = 0.85 to 0.96, respectively, all p < 0.0001). Theoretical prosthetic valve sizing of self-navigated MRA and CTA was equivalent (κ = 1). However, in four patients (15 %) one coronary ostium each (right coronary artery 3, left main artery 1) was not clearly definable on self-navigated MRA. CONCLUSION Self-navigated MRA enables aortic annulus TAVI measurements without significant difference to navigator-gated MRA at shortened acquisition time. Prosthesis sizing by self-navigated MRA measurements is equivalent to navigator-gated MRA and CTA-based choice.
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45
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Noncontrast Magnetic Resonance Angiography in the Era of Nephrogenic Systemic Fibrosis and Gadolinium Deposition. J Comput Assist Tomogr 2021; 45:37-51. [PMID: 32976265 DOI: 10.1097/rct.0000000000001074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
ABSTRACT Gadolinium-based contrast agents for clinical magnetic resonance imaging are overall safe. However, the discovery of nephrogenic systemic fibrosis in patients with severe renal impairment and gadolinium deposition in patients receiving contrast have generated developments in contrast-free imaging of the vasculature, that is, noncontrast magnetic resonance angiography. This article presents an update on noncontrast magnetic resonance angiography techniques, with comparison to other imaging alternatives. Potential benefits and challenges to implementation, and evidence to date for various clinical applications are discussed.
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46
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Mantella LE, Liblik K, Johri AM. Vascular imaging of atherosclerosis: Strengths and weaknesses. Atherosclerosis 2021; 319:42-50. [PMID: 33476943 DOI: 10.1016/j.atherosclerosis.2020.12.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 12/16/2022]
Abstract
Atherosclerosis is an inflammatory disease that can lead to several complications such as ischemic heart disease, stroke, and peripheral vascular disease. Therefore, researchers and clinicians rely heavily on the use of imaging modalities to identify, and more recently, quantify the burden of atherosclerosis in the aorta, carotid arteries, coronary arteries, and peripheral vasculature. These imaging techniques vary in invasiveness, cost, resolution, radiation exposure, and presence of artifacts. Consequently, a detailed understanding of the risks and benefits of each technique is crucial prior to their introduction into routine cardiovascular screening. Additionally, recent research in the field of microvascular imaging has proven to be important in the field of atherosclerosis. Using techniques such as contrast-enhanced ultrasound and superb microvascular imaging, researchers have been able to detect blood vessels within a plaque lesion that may contribute to vulnerability and rupture. This paper will review the strengths and weaknesses of the various imaging techniques used to measure atherosclerotic burden. Furthermore, it will discuss the future of advanced imaging modalities as potential biomarkers for atherosclerosis.
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Affiliation(s)
- Laura E Mantella
- Department of Biomedical and Molecular Sciences, Queen's University, 18 Stuart Street, K7L 3N6, Kingston, ON, Canada
| | - Kiera Liblik
- Department of Medicine, Cardiovascular Imaging Network at Queen's University, 76 Stuart Street, K7L 2V7, Kingston, ON, Canada
| | - Amer M Johri
- Department of Biomedical and Molecular Sciences, Queen's University, 18 Stuart Street, K7L 3N6, Kingston, ON, Canada; Department of Medicine, Cardiovascular Imaging Network at Queen's University, 76 Stuart Street, K7L 2V7, Kingston, ON, Canada.
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47
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Jiang Z, Ou C, Qian Y, Rehan R, Yong A. Coronary vessel segmentation using multiresolution and multiscale deep learning. INFORMATICS IN MEDICINE UNLOCKED 2021. [DOI: 10.1016/j.imu.2021.100602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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48
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Hajhosseiny R, Bustin A, Munoz C, Rashid I, Cruz G, Manning WJ, Prieto C, Botnar RM. Coronary Magnetic Resonance Angiography: Technical Innovations Leading Us to the Promised Land? JACC Cardiovasc Imaging 2020; 13:2653-2672. [PMID: 32199836 DOI: 10.1016/j.jcmg.2020.01.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 01/03/2020] [Accepted: 01/08/2020] [Indexed: 02/07/2023]
Abstract
Coronary artery disease remains the leading cause of cardiovascular morbidity and mortality. Invasive X-ray angiography and coronary computed tomography angiography are established gold standards for coronary luminography. However, they expose patients to invasive complications, ionizing radiation, and iodinated contrast agents. Among a number of imaging modalities, coronary cardiovascular magnetic resonance (CMR) angiography may be used in some cases as an alternative for the detection and monitoring of coronary arterial stenosis, with advantages including its versatility, excellent soft tissue characterization, and avoidance of ionizing radiation and iodinated contrast agents. In this review, we explore the recent advances in motion correction, image acceleration, and reconstruction technologies that are bringing coronary CMR angiography closer to widespread clinical implementation.
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Affiliation(s)
- Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; National Heart and Lung Institute, Imperial College London, London, United Kingdom.
| | - Aurelien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Camila Munoz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Imran Rashid
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Warren J Manning
- Department of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
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Impairment of right ventricular strain evaluated by cardiovascular magnetic resonance feature tracking in patients with interstitial lung disease. Int J Cardiovasc Imaging 2020; 37:1073-1083. [PMID: 33113068 DOI: 10.1007/s10554-020-02079-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/19/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The aims of this study were to investigate the relationship between pulmonary hypertension (PH) and right ventricular (RV) strain, and to evaluate the prognostic value of RV strain by cardiac magnetic resonance (CMR) feature tracking for patients with interstitial lung disease (ILD). METHODS A total of seventy ILD patients (mean age: 71 ± 8 years, 39 [56%] males) who underwent CMR and right heart catheterization (RHC) were studied. Using a 1.5T magnetic resonance (MR) scanner, steady-state free precession cine MR images encompassing the RV were acquired in all patients and 20 control subjects. RV longitudinal strain were calculated with a feature tracking algorithm. PH was defined as a mean pulmonary artery pressure of more than 20 mmHg at rest and a pulmonary vascular resistance ≥3 Woods unit. RESULTS The RV longitudinal strain was significantly impaired in the ILD patients with PH (n=18) than ILD patients without PH (n=52) (-13.3 ± 5.4% vs. -16.9±5.4%, p=0.048). The RV longitudinal strain differed significantly between the ILD patients without PH and the controls (n=20) (-16.9 ± 5.4% vs. -20.8 ± 6.2%, p=0.002). Five of 70 (7%) patients died within one-year after CMR scan. Area under receiver operating characteristics curve for predicting death was 0.900 (95%CI: 0.800 to 1.000) for RV strain, 0.643 (95%CI: 0.454 to 0.832) for RVEF. CONCLUSIONS Presence of PH was associated with impairment of RV strain, and RV strain could predict short-term mortality in patients with ILD. RV strain by feature tracking might be useful as a non-invasive prognostic marker for patients with ILD.
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Collet C, Conte E, Mushtaq S, Brouwers S, Shinke T, Coskun AU, Pu Z, Hakim D, Stone PH, Andreini D. Reviewing imaging modalities for the assessment of plaque erosion. Atherosclerosis 2020; 318:52-59. [PMID: 33129585 DOI: 10.1016/j.atherosclerosis.2020.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/17/2020] [Accepted: 10/08/2020] [Indexed: 12/22/2022]
Abstract
Plaque rupture followed by intracoronary thrombus formation is recognized as the most common pathophysiological mechanism in acute coronary syndromes (ACS). The second most common underlying substrate for ACS is plaque erosion whose hallmark is thrombus formation without cap disruption. Invasive and non-invasive methods have emerged as a promising tool for evaluation of plaque features that either predict or detect plaque erosion. Optical coherence tomography (OCT), high-definition intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS), and near-infrared autofluorescence (NIRF) have been used to study plaque erosion. The detection of plaque erosion in the clinical setting, mainly facilitated by OCT, has shed light upon the complex pathophysiology underlying ACS not related to plaque rupture. Coronary computed tomography angiography (CCTA), which is to date the most commonly used non-invasive technique for coronary plaque evaluation, may also have a role in the evaluation of patients predisposed to erosion. Also, computational models enabling quantification of endothelial shear stress may pave the way to new research in coronary plaque pathophysiology. This review focuses on the recent imaging techniques for the evaluation of plaque erosion including invasive and non-invasive assessment.
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Affiliation(s)
- Carlos Collet
- Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium
| | - Edoardo Conte
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Saima Mushtaq
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Sofie Brouwers
- Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium; Experimental Pharmacology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Toshiro Shinke
- Division of Cardiology, Department of Medicine, Showa University School of Medicine, Japan
| | | | - Zhongyue Pu
- Cardiovascular Division, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Diaa Hakim
- Cardiovascular Division, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
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