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Monteuuis D, Bouzerar R, Dantoing C, Poujol J, Bohbot Y, Renard C. Prospective Comparison of Free-Breathing Accelerated Cine Deep Learning Reconstruction Versus Standard Breath-Hold Cardiac MRI Sequences in Patients With Ischemic Heart Disease. AJR Am J Roentgenol 2024; 222:e2330272. [PMID: 38323784 DOI: 10.2214/ajr.23.30272] [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] [Indexed: 02/08/2024]
Abstract
BACKGROUND. Cine cardiac MRI sequences require repeated breath-holds, which can be difficult for patients with ischemic heart disease (IHD). OBJECTIVE. The purpose of the study was to compare a free-breathing accelerated cine sequence using deep learning (DL) reconstruction and a standard breath-hold cine sequence in terms of image quality and left ventricular (LV) measurements in patients with IHD undergoing cardiac MRI. METHODS. This prospective study included patients undergoing 1.5- or 3-T cardiac MRI for evaluation of IHD between March 15, 2023, and June 21, 2023. Examinations included an investigational free-breathing cine short-axis sequence with DL reconstruction (hereafter, cine-DL sequence). Two radiologists (reader 1 [R1] and reader 2 [R2]), in blinded fashion, independently assessed left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and subjective image quality for the cine-DL sequence and a standard breath-hold balanced SSFP sequence; R1 assessed artifacts. RESULTS. The analysis included 26 patients (mean age, 64.3 ± 11.7 [SD] years; 14 men, 12 women). Acquisition was shorter for the cine-DL sequence than the standard sequence (mean ± SD, 0.6 ± 0.1 vs 2.4 ± 0.6 minutes; p < .001). The cine-DL sequence, in comparison with the standard sequence, showed no significant difference for LVEF for R1 (mean ± SD, 51.7% ± 14.3% vs 51.3% ± 14.7%; p = .56) or R2 (53.4% ± 14.9% vs 52.8% ± 14.6%; p = .53); significantly greater LVEDV for R2 (mean ± SD, 171.9 ± 51.9 vs 160.6 ± 49.4 mL; p = .01) but not R1 (171.8 ± 53.7 vs 165.5 ± 52.4 mL; p = .16); and no significant difference in LVESV for R1 (mean ± SD, 88.1 ± 49.3 vs 86.0 ± 50.5 mL; p = .45) or R2 (85.2 ± 48.1 vs 81.3 ± 48.2 mL; p = .10). The mean bias between the cine-DL and standard sequences by LV measurement was as follows: LVEF, 0.4% for R1 and 0.7% for R2; LVEDV, 6.3 mL for R1 and 11.3 mL for R2; and LVESV, 2.1 mL for R1 and 3.9 mL for R2. Subjective image quality was better for cine-DL sequence than the standard sequence for R1 (mean ± SD, 2.3 ± 0.5 vs 1.9 ± 0.8; p = .02) and R2 (2.2 ± 0.4 vs 1.9 ± 0.7; p = .02). R1 reported no significant difference between the cine-DL and standard sequences for off-resonance artifacts (3.8% vs 23.1% examinations; p = .10) and parallel imaging artifacts (3.8% vs 19.2%; p = .19); blurring artifacts were more frequent for the cine-DL sequence than the standard sequence (42.3% vs 7.7% examinations; p = .008). CONCLUSION. A free-breathing cine-DL sequence, in comparison with a standard breath-hold cine sequence, showed very small bias for LVEF measurements and better subjective quality. The cine-DL sequence yielded greater LV volumes than the standard sequence. CLINICAL IMPACT. A free-breathing cine-DL sequence may yield reliable LVEF measurements in patients with IHD unable to repeatedly breath-hold. TRIAL REGISTRATION. ClinicalTrials.gov NCT05105984.
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Affiliation(s)
- David Monteuuis
- Department of Radiology, Amiens University Hospital, 1 Rond-Point du Professeur Christian Cabrol, Amiens 80054 Cedex 01, France
| | - Roger Bouzerar
- Biophysics and Image Processing Unit, Amiens University Hospital, Amiens, France
| | - Charlotte Dantoing
- Department of Radiology, Amiens University Hospital, 1 Rond-Point du Professeur Christian Cabrol, Amiens 80054 Cedex 01, France
| | | | - Yohann Bohbot
- Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Cédric Renard
- Department of Radiology, Amiens University Hospital, 1 Rond-Point du Professeur Christian Cabrol, Amiens 80054 Cedex 01, France
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Longère B, Allard PE, Gkizas CV, Coisne A, Hennicaux J, Simeone A, Schmidt M, Forman C, Toupin S, Montaigne D, Pontana F. Compressed Sensing Real-Time Cine Reduces CMR Arrhythmia-Related Artifacts. J Clin Med 2021; 10:jcm10153274. [PMID: 34362058 PMCID: PMC8348071 DOI: 10.3390/jcm10153274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 01/07/2023] Open
Abstract
Background and objective: Cardiac magnetic resonance (CMR) is a key tool for cardiac work-up. However, arrhythmia can be responsible for arrhythmia-related artifacts (ARA) and increased scan time using segmented sequences. The aim of this study is to evaluate the effect of cardiac arrhythmia on image quality in a comparison of a compressed sensing real-time (CSrt) cine sequence with the reference prospectively gated segmented balanced steady-state free precession (Cineref) technique regarding ARA. Methods: A total of 71 consecutive adult patients (41 males; mean age = 59.5 ± 20.1 years (95% CI: 54.7–64.2 years)) referred for CMR examination with concomitant irregular heart rate (defined by an RR interval coefficient of variation >10%) during scanning were prospectively enrolled. For each patient, two cine sequences were systematically acquired: first, the reference prospectively triggered multi-breath-hold Cineref sequence including a short-axis stack, one four-chamber slice, and a couple of two-chamber slices; second, an additional single breath-hold CSrt sequence providing the same slices as the reference technique. Two radiologists independently assessed ARA and image quality (overall, acquisition, and edge sharpness) for both techniques. Results: The mean heart rate was 71.8 ± 19.0 (SD) beat per minute (bpm) (95% CI: 67.4–76.3 bpm) and its coefficient of variation was 25.0 ± 9.4 (SD) % (95% CI: 22.8–27.2%). Acquisition was significantly faster with CSrt than with Cineref (Cineref: 556.7 ± 145.4 (SD) s (95% CI: 496.7–616.7 s); CSrt: 23.9 ± 7.9 (SD) s (95% CI: 20.6–27.1 s); p < 0.0001). A total of 599 pairs of cine slices were evaluated (median: 8 (range: 6–14) slices per patient). The mean proportion of ARA-impaired slices per patient was 85.9 ± 22.7 (SD) % using Cineref, but this was figure was zero using CSrt (p < 0.0001). The European CMR registry artifact score was lower with CSrt (median: 1 (range: 0–5)) than with Cineref (median: 3 (range: 0–3); p < 0.0001). Subjective image quality was higher in CSrt than in Cineref (median: 3 (range: 1–3) versus 2 (range: 1–4), respectively; p < 0.0001). In line, edge sharpness was higher on CSrt cine than on Cineref images (0.054 ± 0.016 pixel−1 (95% CI: 0.050–0.057 pixel−1) versus 0.042 ± 0.022 pixel−1 (95% CI: 0.037–0.047 pixel−1), respectively; p = 0.0001). Conclusion: Compressed sensing real-time cine drastically reduces arrhythmia-related artifacts and thus improves cine image quality in patients with arrhythmia.
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Affiliation(s)
- Benjamin Longère
- University of Lille, Inserm, CHU Lille, Institut Pasteur Lille, U1011—European Genomic Institute for Diabetes (EGID), F-59000 Lille, France; (A.C.); (D.M.); (F.P.)
- Correspondence:
| | - Paul-Edouard Allard
- CHU Lille, Department of Cardiovascular Radiology, F-59000 Lille, France; (P.-E.A.); (C.V.G.); (J.H.); (A.S.)
| | - Christos V Gkizas
- CHU Lille, Department of Cardiovascular Radiology, F-59000 Lille, France; (P.-E.A.); (C.V.G.); (J.H.); (A.S.)
| | - Augustin Coisne
- University of Lille, Inserm, CHU Lille, Institut Pasteur Lille, U1011—European Genomic Institute for Diabetes (EGID), F-59000 Lille, France; (A.C.); (D.M.); (F.P.)
| | - Justin Hennicaux
- CHU Lille, Department of Cardiovascular Radiology, F-59000 Lille, France; (P.-E.A.); (C.V.G.); (J.H.); (A.S.)
| | - Arianna Simeone
- CHU Lille, Department of Cardiovascular Radiology, F-59000 Lille, France; (P.-E.A.); (C.V.G.); (J.H.); (A.S.)
| | - Michaela Schmidt
- MR Product Innovation and Definition, Magnetic Resonance, Siemens Healthcare GmbH, 91052 Erlangen, Germany; (M.S.); (C.F.)
| | - Christoph Forman
- MR Product Innovation and Definition, Magnetic Resonance, Siemens Healthcare GmbH, 91052 Erlangen, Germany; (M.S.); (C.F.)
| | - Solenn Toupin
- Scientific Partnerships, Siemens Healthcare France, 93200 Saint-Denis, France;
| | - David Montaigne
- University of Lille, Inserm, CHU Lille, Institut Pasteur Lille, U1011—European Genomic Institute for Diabetes (EGID), F-59000 Lille, France; (A.C.); (D.M.); (F.P.)
| | - François Pontana
- University of Lille, Inserm, CHU Lille, Institut Pasteur Lille, U1011—European Genomic Institute for Diabetes (EGID), F-59000 Lille, France; (A.C.); (D.M.); (F.P.)
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60-S Retrogated Compressed Sensing 2D Cine of the Heart: Sharper Borders and Accurate Quantification. J Clin Med 2021; 10:jcm10112417. [PMID: 34072464 PMCID: PMC8199407 DOI: 10.3390/jcm10112417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/28/2022] Open
Abstract
Background and objective: Real-time compressed sensing cine (CSrt) provides reliable quantification for both ventricles but may alter image quality. The aim of this study was to assess image quality and the accuracy of left (LV) and right ventricular (RV) volumes, ejection fraction and mass quantifications based on a retrogated segmented compressed sensing 2D cine sequence (CSrg). Methods: Thirty patients were enrolled. Each patient underwent the reference retrogated segmented steady-state free precession cine sequence (SSFPref), the real-time CSrt cine and the segmented retrogated prototype CSrg sequence providing the same slices. Functional parameters quantification and image quality rating were performed on SSFPref and CSrg images sets. The edge sharpness, which is an estimate of the edge spread function, was assessed for the three sequences. Results: The mean scan time was: SSFPref = 485.4 ± 83.3 (SD) s (95% CI: 454.3–516.5) and CSrg = 58.3 ± 15.1 (SD) s (95% CI: 53.7–64.2) (p < 0.0001). CSrg subjective image quality score (median: 4; range: 2–4) was higher than the one provided by CSrt (median: 3; range: 2–4; p = 0.0008) and not different from SSFPref overall quality score (median: 4; range: 2–4; p = 0.31). CSrg provided similar LV and RV functional parameters to those assessed with SSFPref (p > 0.05). Edge sharpness was significantly better with CSrg (0.083 ± 0.013 (SD) pixel−1; 95% CI: 0.078–0.087) than with CSrt (0.070 ± 0.011 (SD) pixel−1; 95% CI: 0.066–0.074; p = 0.0004) and not different from the reference technique (0.075 ± 0.016 (SD) pixel−1; 95% CI: 0.069–0.081; p = 0.0516). Conclusions: CSrg cine provides in one minute an accurate quantification of LV and RV functional parameters without compromising subjective and objective image quality.
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Goyal A. Image-based clustering and connected component labeling for rapid automated left and right ventricular endocardial volume extraction and segmentation in full cardiac cycle multi-frame MRI images of cardiac patients. Med Biol Eng Comput 2019; 57:1213-1228. [PMID: 30690663 DOI: 10.1007/s11517-019-01952-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
A rapid method for left and right ventricular endocardial volume segmentation and clinical cardiac parameter calculation from MRI images of cardiac patients is presented. The clinical motivation is providing cardiologists a tool for assessing the cardiac function in a patient through the left ventricular endocardial volume's ejection fraction. A new method combining adapted fuzzy membership-based c-means pixel clustering and connected regions component labeling is used for automatic segmentation of the left and right ventricular endocardial volumes. This proposed pixel clustering with labeling approach avoids manual initialization or user intervention and does not require specifying the region of interest. This method fully automatically extracts the left and right ventricular endocardial volumes and avoids manual tracing on all MRI image frames in the complete cardiac cycle from systole to diastole. The average computational processing time per frame is 0.6 s, making it much more efficient than deformable methods, which need several iterations for the evolution of the snake or contour. Accuracy of the automated method presented herein was validated against manual tracing-based extraction, performed with the guidance of cardiac experts, on several MRI frames. Dice coefficients between the proposed automatic versus manual traced ventricular endocardial volume segmentations were observed to be 0.9781 ± 0.0070 (for left ventricular endocardial volume) and 0.9819 ± 0.0058 (for right ventricular endocardial volume), and the Pearson correlation coefficients were observed to be 0.9655 ± 0.0206 (for left ventricular endocardial volume) and 0.9870 ± 0.0131 (for right ventricular endocardial volume). Graphical abstract The left ventricular endocardial volume segmentation methodology illustrated as a series of algorithms.
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Affiliation(s)
- Ayush Goyal
- Department of Electrical Engineering and Computer Science, Frank H. Dotterweich College of Engineering, Texas A&M University - Kingsville, MSC 192, 700 University Blvd., Kingsville, TX, 78363-8202, USA.
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Diagnostic Value of Three-Dimensional Contrast-Enhanced Echocardiography for Left Ventricular Volume and Ejection Fraction Measurement in Patients With Poor Acoustic Windows: A Comparison of Echocardiography and Magnetic Resonance Imaging. J Am Soc Echocardiogr 2014; 27:1029-40. [DOI: 10.1016/j.echo.2014.06.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Indexed: 11/23/2022]
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Delattre BMA, Van De Ville D, Braunersreuther V, Pellieux C, Hyacinthe JN, Lerch R, Mach F, Vallée JP. High Time-Resolved Cardiac Functional Imaging Using Temporal Regularization for Small Animal on a Clinical 3T Scanner. IEEE Trans Biomed Eng 2012; 59:929-35. [DOI: 10.1109/tbme.2011.2174363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Daire JL, Jacob JP, Hyacinthe JN, Croisille P, Montet-Abou K, Richter S, Botsikas D, Lepetit-Coiffé M, Morel D, Vallée JP. Cine and tagged cardiovascular magnetic resonance imaging in normal rat at 1.5 T: a rest and stress study. J Cardiovasc Magn Reson 2008; 10:48. [PMID: 18980685 PMCID: PMC2590601 DOI: 10.1186/1532-429x-10-48] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2008] [Accepted: 11/03/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to measure regional contractile function in the normal rat using cardiac cine and tagged cardiovascular magnetic resonance (CMR) during incremental low doses of dobutamine and at rest. METHODS Five rats were investigated for invasive left ventricle pressure measurements and five additional rats were imaged on a clinical 1.5 T MR system using a cine sequence (11-20 phases per cycle, 0.28/0.28/2 mm) and a C-SPAMM tag sequence (18-25 phases per cycle, 0.63/1.79/3 mm, tag spacing 1.25 mm). For each slice, wall thickening (WT) and circumferential strains (CS) were calculated at rest and at stress (2.5, 5 and 10 microg/min/kg of dobutamine). RESULTS Good cine and tagged images were obtained in all the rats even at higher heart rate (300-440 bpm). Ejection fraction and left ventricular (LV) end-systolic volume showed significant changes after each dobutamine perfusion dose (p < 0.001). Tagged CMR had the capacity to resolve the CS transmural gradient and showed a significant increase of both WT and CS at stress compared to rest. Intra and interobserver study showed less variability for the tagged technique. In rats in which a LV catheter was placed, dobutamine produced a significant increase of heart rate, LV dP/dtmax and LV pressure significantly already at the lowest infusion dose. CONCLUSION Robust cardiac cine and tagging CMR measurements can be obtained in the rat under incremental dobutamine stress using a clinical 1.5 T MR scanner.
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Affiliation(s)
- Jean-Luc Daire
- Radiology Department, Faculty of Medicine, University of Geneva and Geneva University Hospital, CH-1211 Geneva 14, Switzerland
| | - Jean-Pascal Jacob
- Radiology Department, Faculty of Medicine, University of Geneva and Geneva University Hospital, CH-1211 Geneva 14, Switzerland
| | - Jean-Noel Hyacinthe
- Radiology Department, Faculty of Medicine, University of Geneva and Geneva University Hospital, CH-1211 Geneva 14, Switzerland
| | - Pierre Croisille
- Radiology Department, Hopital L. Pradel, CREATIS UMR CNRS 5515 & INSERM U630 UCB, Lyon I, France
| | - Karin Montet-Abou
- Radiology Department, Faculty of Medicine, University of Geneva and Geneva University Hospital, CH-1211 Geneva 14, Switzerland
| | - Sophie Richter
- Radiology Department, Faculty of Medicine, University of Geneva and Geneva University Hospital, CH-1211 Geneva 14, Switzerland
| | - Diomidis Botsikas
- Radiology Department, Faculty of Medicine, University of Geneva and Geneva University Hospital, CH-1211 Geneva 14, Switzerland
| | - Matthieu Lepetit-Coiffé
- Radiology Department, Faculty of Medicine, University of Geneva and Geneva University Hospital, CH-1211 Geneva 14, Switzerland
| | - Denis Morel
- Anesthesiology, Pharmacology and Intensive Care Department, Faculty of Medicine, University of Geneva and Geneva University Hospitals, CH-1211, Geneva 14, Switzerland
| | - Jean-Paul Vallée
- Radiology Department, Faculty of Medicine, University of Geneva and Geneva University Hospital, CH-1211 Geneva 14, Switzerland
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Montet-Abou K, Daire JL, Ivancevic MK, Hyacinthe JN, Nguyen D, Jorge-Costa M, Morel DR, Vallée JP. Optimization of cardiac cine in the rat on a clinical 1.5-T MR system. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2006; 19:144-51. [PMID: 16865385 DOI: 10.1007/s10334-006-0037-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2005] [Revised: 06/09/2006] [Accepted: 06/12/2006] [Indexed: 11/30/2022]
Abstract
OBJECT The overall goal was to study cardiovascular function in small animals using a clinical 1.5-T MR scanner optimizing a fast gradient-echo cine sequence to obtain high spatial and temporal resolution. MATERIALS AND METHODS Normal rat hearts (n = 9) were imaged using a 1.5-T MR scanner with a spiral fast gradient-echo (fast field echo for Philips scanners) sequence, three Cartesian fast gradient-echo (turbo field echo for Philips scanners) sequences with different in-plane resolution, and with and without flow compensation and half-Fourier acquisition. The hearts of four rats were then excised and left-ventricle mass was weighed. Inter- and intra-observer variability analysis was performed for magnetic resonance imaging (MRI) measurements. RESULTS Half-Fourier acquisition with flow compensation gave the best sequence in terms of image quality, spatial as well as temporal resolution, and suppression of flow artifact. Ejection fraction was 71 +/- 4% with less than 5% inter- and intra-observer variability. A good correlation was found between MRI-calculated left-ventricular mass and wet weight. CONCLUSIONS Using optimized sequences on a clinical 1.5-T MR scanner can provide accurate quantification of cardiac function in small animals and can promote cardiovascular research on small animals at 1.5-T.
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Affiliation(s)
- K Montet-Abou
- Radiology and Medical Informatics Department, Digital Imaging Unit (UIN), Geneva University Hospital, 1211 Geneva 14, Switzerland.
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O'Regan DP, Schmitz SA. Establishing a clinical cardiac MRI service. Clin Radiol 2006; 61:211-24. [PMID: 16488203 DOI: 10.1016/j.crad.2005.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2005] [Revised: 10/27/2005] [Accepted: 10/29/2005] [Indexed: 10/25/2022]
Abstract
After several years of research development cardiovascular MRI has evolved into a widely accepted clinical tool. It offers important diagnostic and prognostic information for a variety of clinical indications, which include ischaemic heart disease, cardiomyopathies, valvular dysfunction and congenital heart disorders. It is a safe non-invasive technique that employs a variety of imaging sequences optimized for temporal or spatial resolution, tissue-specific contrast, flow quantification or angiography. Cardiac MRI offers specific advantages over conventional imaging techniques for a significant number of patients. The demand for cardiac MRI studies from cardiothoracic surgeons, cardiologists and other referrers is likely to continue to rise with pressure for more widespread local service provision. Setting up a cardiac MRI service requires careful consideration regarding funding issues and how it will be integrated with existing service provision. The purchase of cardiac phased array coils, monitoring equipment and software upgrades must also be considered, as well as the training needs of those involved. The choice of appropriate imaging protocols will be guided by operator experience, clinical indication and equipment capability, and is likely to evolve as the service develops. Post-processing and offline analysis form a significant part of the time taken to report studies and an efficient method of providing quantitative reports is an important requirement. Collaboration between radiologists and cardiologists is needed to develop a successful service and multi-disciplinary meetings are key component of this. This review will explore these issues from our perspective of a new clinical cardiac MRI service operating over its first year in a teaching hospital imaging department.
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Affiliation(s)
- D P O'Regan
- Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital Campus, Imperial College, London, UK.
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