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Reiter C, Puseljic M, Fuchsjäger M, Schmid J. Estimating synthetic hematocrit and extracellular volume from native blood pool T1 times at 3 Tesla CMR: Derivation of a conversion equation, accuracy and comparison with published formulas. Eur J Radiol 2024; 178:111659. [PMID: 39096824 DOI: 10.1016/j.ejrad.2024.111659] [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: 03/04/2024] [Revised: 07/27/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
PURPOSE Calculation of extracellular volume fraction (ECV), a marker of myocardial fibrosis in cardiac magnetic resonance imaging (CMR), requires hematocrit (Hct). We aimed to correlate Hct levels with native blood T1 times, to derive a formula for estimating synthetic Hct (Hctsyn) and synthetic ECV (ECVsyn), to assess accuracy of ECVsyn and to compare our model with published formulas. METHOD In this retrospective study, a cohort of 250 CMR scans with T1 mapping (3T, MOLLI 5(3)3, endsystolic aquisition), was divided into a derivation and validation cohort. Native T1 times of the left ventricular blood pool (T1native,midLV) were correlated with Hct levels from blood sampling within 24 h (Hct24h) and a formula for calculation of Hctsyn was derived by linear regression. RESULTS In the derivation cohort (n = 167), Hct24h showed a good association with T1native,midLV (r = -0.711, p < 0.001). The resulting regression equation was Hctsyn = 1/T1native,midLV * 1355.52-0.310. In the validation cohort (n = 83), Hctsyn and Hct24h showed good correlation (r = 0.726, p < 0.001), while ECVsyn, and ECV24h demonstrated excellent correlation (r = 0.940, p < 0.001). ECVsyn had a minimal bias of 0.28 % and the misclassification rate (8.8 %) was comparable to the variability introduced by repeated Hct measurements (misclassification in 7.5 %). Applying published formulas in our cohort resulted in incorrect classification in up to 60 %. CONCLUSION We provide a formula for estimating Hctsyn from native blood T1 on a 3T scanner. The measurement error of ECVsyn is low and comparable to the error due to retest variability of conventional Hct. Scanner- and sequence-specific formulas should be used.
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Affiliation(s)
- Clemens Reiter
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036 Graz, Austria.
| | - Marijan Puseljic
- Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036 Graz, Austria.
| | - Michael Fuchsjäger
- Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036 Graz, Austria.
| | - Johannes Schmid
- Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036 Graz, Austria.
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Ueda J, Kurata H, Ota M, Yabata I, Itagaki K, Sawaya R, Murata C, Banura N, Nishida H, Saito S. Conditions for late gadolinium enhancement MRI in myocardial infarction model rats that better reflect microscopic tissue staining. Sci Rep 2024; 14:18308. [PMID: 39112681 PMCID: PMC11306602 DOI: 10.1038/s41598-024-69540-y] [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: 05/14/2024] [Accepted: 08/06/2024] [Indexed: 08/10/2024] Open
Abstract
Late gadolinium enhancement (LGE) is a widely used magnetic resonance imaging method for assessing cardiac disease. However, the relationship between different LGE signal thresholds and microscopic tissue staining images is unclear. In this study, we performed cardiovascular MRI on myocardial infarction (MI) model rats and evaluated the relationship between LGE with different signal thresholding methods and tissue staining images. We prepared 16 rats that underwent MRI 14-18 days following a surgery to create an MI model. We captured cine and LGE images of the cardiac short-axis and longitudinal two- and four-chamber views. The mean ± 2SD, ± 3SD, and ± 5SD of the pixel values in the non-infarcted area were defined as the LGE area. We compared areas of Sirius red staining, determined by the color tone, with their respective LGE areas at end-diastole and end-systole. We observed that the LGE area calculated as the mean ± 2SD of the non-infarcted area at end-diastole demonstrated a significant positive correlation with the area of Sirius red staining (Pearson's correlation coefficient in both: 0.81 [p < 0.01]). Therefore, the LGE area calculated as the mean ± 2SD of the non-infarcted area at end-diastole best reflected the MI area in tissue staining.
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Affiliation(s)
- Junpei Ueda
- Division of Health Sciences, Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, 560-0871, Japan
- Department of Radiological Sciences, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, 559-8611, Japan
| | - Hayato Kurata
- ROHTO Pharmaceutical Co., Ltd, Kizugawa, Kyoto, 619-0216, Japan
| | - Miwa Ota
- ROHTO Pharmaceutical Co., Ltd, Kizugawa, Kyoto, 619-0216, Japan
| | - Isamu Yabata
- Division of Health Sciences, Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, 560-0871, Japan
- Division of Radiology, Department of Medical Technology, Osaka University Hospital, Osaka, 564-8565, Japan
| | - Koji Itagaki
- Division of Health Sciences, Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, 560-0871, Japan
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, 606-8507, Japan
| | - Reika Sawaya
- Division of Health Sciences, Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, 560-0871, Japan
- Division of Radiology, Department of Medical Technology, Osaka University Hospital, Osaka, 564-8565, Japan
| | - Chiharu Murata
- ROHTO Pharmaceutical Co., Ltd, Kizugawa, Kyoto, 619-0216, Japan
| | - Natsuo Banura
- Division of Health Sciences, Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, 560-0871, Japan
- Department of Advanced Medical Technologies, National Cardiovascular and Cerebral Research Center, Suita, Osaka, 564-8565, Japan
| | | | - Shigeyoshi Saito
- Division of Health Sciences, Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, 560-0871, Japan.
- Department of Advanced Medical Technologies, National Cardiovascular and Cerebral Research Center, Suita, Osaka, 564-8565, Japan.
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Erley J, Jahnke CM, Schüttler S, Molwitz I, Chen H, Meyer M, Muellerleile K, Cavus E, Lund GK, Blankenberg S, Adam G, Tahir E. Sex-specific ventricular morphology, function, and tissue characteristics in arterial hypertension: a magnetic resonance study of the Hamburg city health cohort. Eur Radiol 2024:10.1007/s00330-024-10797-2. [PMID: 38819515 DOI: 10.1007/s00330-024-10797-2] [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: 12/19/2023] [Revised: 03/08/2024] [Accepted: 04/10/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE To determine the influence of arterial hypertension (AHT), sex, and the interaction between both left- and right ventricular (LV, RV) morphology, function, and tissue characteristics. METHODS The Hamburg City Health Study (HCHS) is a population-based, prospective, monocentric study. 1972 individuals without a history of cardiac diseases/ interventions underwent 3 T cardiac MR imaging (CMR). Generalized linear models were conducted, including AHT, sex (and the interaction if significant), age, body mass index, place of birth, diabetes mellitus, smoking, hyperlipoproteinemia, atrial fibrillation, and medication. RESULTS Of 1972 subjects, 68% suffered from AHT. 42% with AHT and 49% controls were female. Females overall showed a higher ejection fraction (EF) (LV: regression coefficient +2.4% [95% confidence interval: 1.7; 3.1]), lower volumes and LV mass (-19.8% [-21.3; -18.5]), and prolonged native septal T1 (+22.1 ms [18.3; 25.9])/T2 relaxation times (+1.1 ms [0.9; 1.3]) (all p < 0.001) compared to males. Subjects with AHT showed a higher EF (LV: +1.2% [0.3; 2.0], p = 0.009) and LV mass (+6.6% [4.3; 9.0], p < 0.001) than controls. The interaction between sex and AHT influenced mapping. After excluding segments with LGE, males (-0.7 ms [-1.0; -0.3 | ) and females with AHT (-1.1 ms [-1.6; -0.6]) showed shorter T2 relaxation times than the sex-respective controls (p < 0.001), but the effect was stronger in females. CONCLUSION In the HCHS, female and male subjects with AHT likewise showed a higher EF and LV mass than controls, independent of sex. However, differences in tissue characteristics between subjects with AHT and controls appeared to be sex-specific. CLINICAL RELEVANCE STATEMENT The interaction between sex and cardiac risk factors is an underestimated factor that should be considered when comparing tissue characteristics between hypertensive subjects and controls, and when establishing cut-off values for normal and pathological relaxation times. KEY POINTS There are sex-dependent differences in arterial hypertension, but it is unclear if cardiac MR parameters are sex-specific. Differences in cardiac MR parameters between hypertensive subjects and healthy controls appeared to be sex-specific for tissue characteristics. Sex needs to be considered when comparing tissue characteristics in patients with arterial hypertension to healthy controls.
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Affiliation(s)
- Jennifer Erley
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Charlotte M Jahnke
- Department of Cardiology, University Heart and Vascular Center Hamburg Eppendorf, Hamburg, Germany
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK, German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Germany, Hamburg, Germany
| | - Samuel Schüttler
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Isabel Molwitz
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hang Chen
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mathias Meyer
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kai Muellerleile
- Department of Cardiology, University Heart and Vascular Center Hamburg Eppendorf, Hamburg, Germany
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK, German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Germany, Hamburg, Germany
| | - Ersin Cavus
- Department of Cardiology, University Heart and Vascular Center Hamburg Eppendorf, Hamburg, Germany
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK, German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Germany, Hamburg, Germany
| | - Gunnar K Lund
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Center Hamburg Eppendorf, Hamburg, Germany
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK, German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Germany, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Enver Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hamilton JI, Lima da Cruz G, Rashid I, Walker J, Rajagopalan S, Seiberlich N. Deep image prior cine MR fingerprinting with B 1 + spin history correction. Magn Reson Med 2024; 91:2010-2027. [PMID: 38098428 PMCID: PMC10950517 DOI: 10.1002/mrm.29979] [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] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 03/07/2024]
Abstract
PURPOSE To develop a deep image prior (DIP) reconstruction for B1 + -corrected 2D cine MR fingerprinting (MRF). METHODS The proposed method combines low-rank (LR) modeling with a DIP to generate cardiac phase-resolved parameter maps without motion correction, employing self-supervised training to enforce consistency with undersampled spiral k-space data. Two implementations were tested: one approach (DIP) for cine T1 , T2 , and M0 mapping, and a second approach (DIP with effective B1 + estimation [DIP-B1]) that also generated an effective B1 + map to correct for errors due to RF transmit inhomogeneities, through-plane motion, and blood flow. Cine MRF data were acquired in 14 healthy subjects and four reconstructions were compared: LR, low-rank motion-corrected (LRMC), DIP, and DIP-B1. Results were compared to diastolic ECG-triggered MRF, MOLLI, and T2 -prep bSSFP. Additionally, bright-blood and dark-blood images calculated from cine MRF maps were used to quantify ventricular function and compared to reference cine measurements. RESULTS DIP and DIP-B1 outperformed other cine MRF reconstructions with improved noise suppression and delineation of high-resolution details. Within-segment variability in the myocardium (reported as the coefficient of variation for T1 /T2 ) was lowest for DIP-B1 (2.3/8.3%) followed by DIP (2.7/8.7%), LRMC (3.5/10.5%), and LR (15.3/39.6%). Spatial homogeneity improved with DIP-B1 having the lowest intersegment variability (2.6/4.1%). The mean bias in ejection fraction was -1.1% compared to reference cine scans. CONCLUSION A DIP reconstruction for 2D cine MRF enabled cardiac phase-resolved mapping of T1 , T2 , M0 , and the effective B1 + with improved noise suppression and precision compared to LR and LRMC.
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Affiliation(s)
- Jesse I. Hamilton
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | | | - Imran Rashid
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Harrington Heart and Vascular Institute, Cleveland, OH, USA
| | - Jonathan Walker
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Harrington Heart and Vascular Institute, Cleveland, OH, USA
| | - Sanjay Rajagopalan
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Harrington Heart and Vascular Institute, Cleveland, OH, USA
| | - Nicole Seiberlich
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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Roehl M, Conway M, Ghonim S, Ferreira PF, Nielles-Vallespin S, Babu-Narayan SV, Pennell DJ, Gatehouse PD, Scott AD. STEAM-SASHA: a novel approach for blood- and fat-suppressed native T1 measurement in the right ventricular myocardium. MAGMA (NEW YORK, N.Y.) 2024; 37:295-305. [PMID: 38216813 PMCID: PMC10995026 DOI: 10.1007/s10334-023-01141-8] [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: 06/15/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE The excellent blood and fat suppression of stimulated echo acquisition mode (STEAM) can be combined with saturation recovery single-shot acquisition (SASHA) in a novel STEAM-SASHA sequence for right ventricular (RV) native T1 mapping. MATERIALS AND METHODS STEAM-SASHA splits magnetization preparation over two cardiac cycles, nulling blood signal and allowing fat signal to decay. Breath-hold T1 mapping was performed in a T1 phantom and twice in 10 volunteers using STEAM-SASHA and a modified Look-Locker sequence at peak systole at 3T. T1 was measured in 3 RV regions, the septum and left ventricle (LV). RESULTS In phantoms, MOLLI under-estimated while STEAM-SASHA over-estimated T1, on average by 3.0% and 7.0% respectively, although at typical 3T myocardial T1 (T1 > 1200 ms) STEAM-SASHA was more accurate. In volunteers, T1 was higher using STEAM-SASHA than MOLLI in the LV and septum (p = 0.03, p = 0.006, respectively), but lower in RV regions (p > 0.05). Inter-study, inter-observer and intra-observer coefficients of variation in all regions were < 15%. Blood suppression was excellent with STEAM-SASHA and noise floor effects were minimal. DISCUSSION STEAM-SASHA provides accurate and reproducible T1 in the RV with excellent blood and fat suppression. STEAM-SASHA has potential to provide new insights into pathological changes in the RV in future studies.
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Affiliation(s)
- Malte Roehl
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Miriam Conway
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sarah Ghonim
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Pedro F Ferreira
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sonia Nielles-Vallespin
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sonya V Babu-Narayan
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Dudley J Pennell
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter D Gatehouse
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andrew D Scott
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK.
- National Heart and Lung Institute, Imperial College London, London, UK.
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Thomas KE, Lukaschuk E, Shanmuganathan M, Kitt JA, Popescu IA, Neubauer S, Piechnik SK, Ferreira VM. Misclassification of females and males in cardiovascular magnetic resonance parametric mapping: the importance of sex-specific normal ranges for diagnosis of health vs. disease. Eur Heart J Cardiovasc Imaging 2024; 25:339-346. [PMID: 37788638 PMCID: PMC10883727 DOI: 10.1093/ehjci/jead247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/31/2023] [Accepted: 09/24/2023] [Indexed: 10/05/2023] Open
Abstract
AIMS Cardiovascular magnetic resonance parametric mapping enables non-invasive quantitative myocardial tissue characterization. Human myocardium has normal ranges of T1 and T2 values, deviation from which may indicate disease or change in physiology. Normal myocardial T1 and T2 values are affected by biological sex. Consequently, normal ranges created with insufficient numbers of each sex may result in sampling biases, misclassification of healthy values vs. disease, and even misdiagnoses. In this study, we investigated the impact of using male normal ranges for classifying female cases as normal or abnormal (and vice versa). METHODS AND RESULTS One hundred and forty-two healthy volunteers (male and female) were scanned on two Siemens 3T MR systems, providing averaged global myocardial T1 and T2 values on a per-subject basis. The Monte Carlo method was used to generate simulated normal ranges from these values to estimate the statistical accuracy of classifying healthy female or male cases correctly as 'normal' when using sex-specific vs. mixed-sex normal ranges. The normal male and female T1- and T2-mapping values were significantly different by sex, after adjusting for age and heart rate. CONCLUSION Using 15 healthy volunteers who are not sex specific to establish a normal range resulted in a typical misclassification of up to 36% of healthy females and 37% of healthy males as having abnormal T1 values and up to 16% of healthy females and 12% of healthy males as having abnormal T2 values. This paper highlights the potential adverse impact on diagnostic accuracy that can occur when local normal ranges contain insufficient numbers of both sexes. Sex-specific reference ranges should thus be routinely adopted in clinical practice.
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Affiliation(s)
- Katharine E Thomas
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, Level 0, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
| | - Elena Lukaschuk
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, Level 0, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
| | - Mayooran Shanmuganathan
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, Level 0, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
| | - Jamie A Kitt
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, Level 0, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
| | - Iulia A Popescu
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, Level 0, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, Level 0, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
| | - Stefan K Piechnik
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, Level 0, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
| | - Vanessa M Ferreira
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, Level 0, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
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7
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Nickander J, Cole B, Nordin S, Vijapurapu R, Steeds RP, Moon JC, Kellman P, Ugander M, Kozor R. Increased cardiac involvement in Fabry disease using blood-corrected native T1 mapping. Sci Rep 2023; 13:4420. [PMID: 36932097 PMCID: PMC10023696 DOI: 10.1038/s41598-023-31211-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 03/08/2023] [Indexed: 03/19/2023] Open
Abstract
Fabry disease (FD) is a rare lysosomal storage disorder resulting in myocardial sphingolipid accumulation which is detectable by cardiovascular magnetic resonance as low native T1. However, myocardial T1 contains signal from intramyocardial blood which affects variability and consequently measurement precision and accuracy. Correction of myocardial T1 by blood T1 increases precision. We therefore deployed a multicenter study of FD patients (n = 218) and healthy controls (n = 117) to investigate if blood-correction of myocardial native T1 increases the number of FD patients with low T1, and thus reclassifies FD patients as having cardiac involvement. Cardiac involvement was defined as a native T1 value 2 standard deviations below site-specific means in healthy controls for both corrected and uncorrected measures. Overall low T1 was 135/218 (62%) uncorrected vs. 145/218 (67%) corrected (p = 0.02). With blood-correction, 13/83 previously normal patients were reclassified to low T1. This reclassification appears clinically relevant as 6/13 (46%) of reclassified had focal late gadolinium enhancement or left ventricular hypertrophy as signs of cardiac involvement. Blood-correction of myocardial native T1 increases the proportion of FD subjects with low myocardial T1, with blood-corrected results tracking other markers of cardiac involvement. Blood-correction may potentially offer earlier detection and therapy initiation, but merits further prospective studies.
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Affiliation(s)
- Jannike Nickander
- Department of Clinical Physiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden.
| | - Ben Cole
- Kolling Institute, Royal North Shore Hospital, and University of Sydney, Sydney, Australia
| | - Sabrina Nordin
- Institute of Cardiovascular Science, University College London, London, UK
| | - Ravi Vijapurapu
- Institute of Cardiovascular Science, University of Birmingham, Birmingham, UK
| | - Richard P Steeds
- Institute of Cardiovascular Science, University of Birmingham, Birmingham, UK
| | - James C Moon
- Institute of Cardiovascular Science, University College London, London, UK
| | - Peter Kellman
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Martin Ugander
- Department of Clinical Physiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden
- Kolling Institute, Royal North Shore Hospital, and University of Sydney, Sydney, Australia
- Charles Perkins Center, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Rebecca Kozor
- Kolling Institute, Royal North Shore Hospital, and University of Sydney, Sydney, Australia
- Royal North Shore Hospital, North Shore Private Hospital, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
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8
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Shaw M, Ojha V, Ganga KP, Malhi AS, Chandrashekhara SH, Kumar S, Khan MA, Jagia P, Sharma S. Reference values of myocardial native T1 and T2 mapping values in normal Indian population at 1.5 Tesla scanner. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:2403-2411. [PMID: 36434341 DOI: 10.1007/s10554-022-02648-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
T1 and T2 mapping techniques on cardiovascular magnetic resonance (CMR) provide insights into the myocardial tissue characterisation. We sought to establish the normal reference values of native T1 and T2 mapping in Indian population which can be used subsequently in clinical practice for addressing various cardiac pathologies. This prospective study included consecutive healthy volunteers (18-60 years) who underwent CMR on a 1.5 Tesla scanner using standard protocol. T1 mapping sequence was performed using MOLLI sequence with two different flip angles (FA) (35° and 50°). T2 mapping was performed using a hybrid gradient and spin-echo sequence sequence with two different FA (70° and 12°). Images were analysed with ROIs drawn in all the 16 AHA myocardial segments. 50 volunteers (average age-34 years, males-72%) were included. All the scans were normal. The mean T1 value at 35-degree FA was 946.86 + 14.16 ms and at 50-degree FA was 941.60 + 11.89 ms. The mean T2 mapping value at 70-degree FA was 45.67 + 1.39 ms and at 12-degree FA was 45.61 + 1.47 ms. The mapping values were not statistically different between males and females (all p > 0.2). The T1 and T2 mapping values did not show any significant correlation with LVEF, age, BMI or heart rate (all r < 0.33). The T1 mapping values significantly differ at 35- and 50-degree FAs (p = 0.002). The results establish the normal reference T1 and T2 mapping value for Indian population in institutes using the same protocol and parameters at 1.5 Tesla and may guide future research.
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Affiliation(s)
- Manish Shaw
- Department of Cardiovascular Radiology and Endovascular Interventions, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, Room 10A, New Delhi, 110029, India
| | - Vineeta Ojha
- Department of Cardiovascular Radiology and Endovascular Interventions, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, Room 10A, New Delhi, 110029, India
| | - Kartik P Ganga
- Department of Cardiovascular Radiology and Endovascular Interventions, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, Room 10A, New Delhi, 110029, India
| | - Amarindar Singh Malhi
- Department of Cardiovascular Radiology and Endovascular Interventions, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, Room 10A, New Delhi, 110029, India
| | - S H Chandrashekhara
- Department of Cardiovascular Radiology and Endovascular Interventions, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, Room 10A, New Delhi, 110029, India
| | - Sanjeev Kumar
- Department of Cardiovascular Radiology and Endovascular Interventions, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, Room 10A, New Delhi, 110029, India
| | - Maroof Ahmad Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Priya Jagia
- Department of Cardiovascular Radiology and Endovascular Interventions, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, Room 10A, New Delhi, 110029, India.
| | - Sanjiv Sharma
- Department of Cardiovascular Radiology and Endovascular Interventions, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, Room 10A, New Delhi, 110029, India
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9
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Weingärtner S, Demirel ÖB, Gama F, Pierce I, Treibel TA, Schulz-Menger J, Akçakaya M. Cardiac phase-resolved late gadolinium enhancement imaging. Front Cardiovasc Med 2022; 9:917180. [PMID: 36247474 PMCID: PMC9557076 DOI: 10.3389/fcvm.2022.917180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022] Open
Abstract
Late gadolinium enhancement (LGE) with cardiac magnetic resonance (CMR) imaging is the clinical reference for assessment of myocardial scar and focal fibrosis. However, current LGE techniques are confined to imaging of a single cardiac phase, which hampers assessment of scar motility and does not allow cross-comparison between multiple phases. In this work, we investigate a three step approach to obtain cardiac phase-resolved LGE images: (1) Acquisition of cardiac phase-resolved imaging data with varying T1 weighting. (2) Generation of semi-quantitative T1* maps for each cardiac phase. (3) Synthetization of LGE contrast to obtain functional LGE images. The proposed method is evaluated in phantom imaging, six healthy subjects at 3T and 20 patients at 1.5T. Phantom imaging at 3T demonstrates consistent contrast throughout the cardiac cycle with a coefficient of variation of 2.55 ± 0.42%. In-vivo results show reliable LGE contrast with thorough suppression of the myocardial tissue is healthy subjects. The contrast between blood and myocardium showed moderate variation throughout the cardiac cycle in healthy subjects (coefficient of variation 18.2 ± 3.51%). Images were acquired at 40–60 ms and 80 ms temporal resolution, at 3T and 1.5, respectively. Functional LGE images acquired in patients with myocardial scar visualized scar tissue throughout the cardiac cycle, albeit at noticeably lower imaging resolution and noise resilience than the reference technique. The proposed technique bears the promise of integrating the advantages of phase-resolved CMR with LGE imaging, but further improvements in the acquisition quality are warranted for clinical use.
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Affiliation(s)
- Sebastian Weingärtner
- Department of Imaging Physics, Delft University of Technology, Delft, Netherlands
- *Correspondence: Sebastian Weingärtner
| | - Ömer B. Demirel
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, United States
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Francisco Gama
- Bart's Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Iain Pierce
- Bart's Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Thomas A. Treibel
- Bart's Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Jeanette Schulz-Menger
- Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Joint Cooperation of the Max-Delbrück-Centrum and Charite-Medical University Berlin, Berlin, Germany
- Department of Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch and DZHK, Berlin, Germany
| | - Mehmet Akçakaya
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, United States
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
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10
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Alfarih M, Augusto JB, Knott KD, Fatih N, Kumar MP, Boubertakh R, Hughes AD, Moon JC, Weingärtner S, Captur G. Saturation-pulse prepared heart-rate independent inversion-recovery (SAPPHIRE) biventricular T1 mapping: inter-field strength, head-to-head comparison of diastolic, systolic and dark-blood measurements. BMC Med Imaging 2022; 22:122. [PMID: 35799139 PMCID: PMC9264718 DOI: 10.1186/s12880-022-00843-0] [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: 10/03/2021] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background To assess the feasibility of biventricular SAPPHIRE T1 mapping in vivo across field strengths using diastolic, systolic and dark-blood (DB) approaches. Methods 10 healthy volunteers underwent same-day non-contrast cardiovascular magnetic resonance at 1.5 Tesla (T) and 3 T. Left and right ventricular (LV, RV) T1 mapping was performed in the basal, mid and apical short axis using 4-variants of SAPPHIRE: diastolic, systolic, 0th and 2nd order motion-sensitized DB and conventional modified Look-Locker inversion recovery (MOLLI). Results LV global myocardial T1 times (1.5 T then 3 T results) were significantly longer by diastolic SAPPHIRE (1283 ± 11|1600 ± 17 ms) than any of the other SAPPHIRE variants: systolic (1239 ± 9|1595 ± 13 ms), 0th order DB (1241 ± 10|1596 ± 12) and 2nd order DB (1251 ± 11|1560 ± 20 ms, all p < 0.05). In the mid septum MOLLI and diastolic SAPPHIRE exhibited significant T1 signal contamination (longer T1) at the blood-myocardial interface not seen with the other 3 SAPPHIRE variants (all p < 0.025). Additionally, systolic, 0th order and 2nd order DB SAPPHIRE showed narrower dispersion of myocardial T1 times across the mid septum when compared to diastolic SAPPHIRE (interquartile ranges respectively: 25 ms, 71 ms, 73 ms vs 143 ms, all p < 0.05). RV T1 mapping was achievable using systolic, 0th and 2nd order DB SAPPHIRE but not with MOLLI or diastolic SAPPHIRE. All 4 SAPPHIRE variants showed excellent re-read reproducibility (intraclass correlation coefficients 0.953 to 0.996). Conclusion These small-scale preliminary healthy volunteer data suggest that DB SAPPHIRE has the potential to reduce partial volume effects at the blood-myocardial interface, and that systolic SAPPHIRE could be a feasible solution for right ventricular T1 mapping. Further work is needed to understand the robustness of these sequences and their potential clinical utility. Supplementary Information The online version contains supplementary material available at 10.1186/s12880-022-00843-0.
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Affiliation(s)
- Mashael Alfarih
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK.,Department of Cardiac Technology, College of Applied Medial Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - João B Augusto
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Kristopher D Knott
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Nasri Fatih
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - M Praveen Kumar
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Redha Boubertakh
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK.,UCL MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, UK
| | - James C Moon
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Sebastian Weingärtner
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, USA.,Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Gabriella Captur
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. .,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK. .,UCL MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, UK. .,Cardiology Department, Royal Free Hospital NHS Trust, Pond St, Hampstead, London, NW3 2QG, UK.
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11
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Phantom-based correction for standardization of myocardial native T1 and extracellular volume fraction in healthy subjects at 3-Tesla cardiac magnetic resonance imaging. Eur Radiol 2022; 32:8122-8130. [PMID: 35771246 DOI: 10.1007/s00330-022-08936-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 04/21/2022] [Accepted: 05/30/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To investigate the effect of the phantom-based correction method for standardizing myocardial native T1 and extracellular volume fraction (ECV) in healthy subjects. METHODS Seventy-one healthy asymptomatic adult (≥ 20 years) volunteers of five different age groups (34 men and 37 women, 45.5 ± 15.5 years) were prospectively enrolled in three academic hospitals. Cardiac MRI including Modified Look - Locker Inversion recovery T1 mapping sequence was performed using a 3-Tesla system with a different type of scanner for each hospital. Native T1 and ECV were measured in the short-axis T1 map and analyzed for mean values of the 16 entire segments. The myocardial T1 value of each subject was corrected based on the site-specific equation derived from the T1 Mapping and ECV Standardization phantom. The global native T1 and ECV were compared between institutions before and after phantom-based correction, and the variation in native T1 and ECV among institutions was assessed using a coefficient of variation (CoV). RESULTS The global native T1 value significantly differed between the institutions (1198.7 ± 32.1 ms, institution A; 1217.7 ± 39.9 ms, institution B; 1232.7 ± 31.1 ms, institution C; p = 0.002), but the mean ECV did not (26.6-27.5%, p = 0.355). After phantom-based correction, the global native T1 and ECV were 1289.7 ± 32.4 ms and 25.0 ± 2.7%, respectively, and CoV for native T1 between the three institutions decreased from 3.0 to 2.5%. The corrected native T1 value did not significantly differ between institutions (1284.5 ± 31.5 ms, institution A; 1296.5 ± 39.1 ms, institution B; 1291.3 ± 29.3 ms, institution C; p = 0.440), and neither did the ECV (24.4-25.9%, p = 0.078). CONCLUSIONS The phantom-based correction method can provide standardized reference T1 values in healthy subjects. KEY POINTS • After phantom-based correction, the global native T1 of 16 entire myocardial segments on 3-T cardiac MRI is 1289.4 ± 32.4 ms, and the extracellular volume fraction was 25.0 ± 2.7% for healthy subjects. • After phantom - based correction was applied, the differences in the global native T1 among institutions became insignificant, and the CoV also decreased from 3.0 to 2.5%.
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12
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Peereboom SM, Kozerke S. Metabolite-cycled echo-planar spectroscopic imaging of the human heart. Magn Reson Med 2022; 88:1516-1527. [PMID: 35666820 PMCID: PMC9544353 DOI: 10.1002/mrm.29333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/30/2022] [Accepted: 05/13/2022] [Indexed: 11/12/2022]
Abstract
Purpose Spectroscopic imaging could provide insights into regional cardiac triglyceride variations, but is hampered by relatively long scan times. It is proposed to synergistically combine echo‐planar spectroscopic imaging (EPSI) with motion‐adapted gating, weighted acquisition and metabolite cycling to reduce scan times to less than 10 min while preserving spatial‐spectral quality. The method is compared to single‐voxel measurements and to metabolite‐cycled EPSI with conventional acquisition for assessing triglyceride‐to‐water (TG/W) ratios in the human heart. Methods Measurements were performed on 10 healthy volunteers using a clinical 1.5T system. EPSI data was acquired both without and with motion‐adapted gating in combination with weighted acquisition to assess TG/W ratios and relative Cramér‐Rao lower bounds (CRLB) of TG. For comparison, single‐voxel (PRESS) spectra were acquired in the interventricular septum. Results Bland–Altman analyses did not show a significant bias in TG/W when comparing both metabolite‐cycled EPSI methods to PRESS for any of the cardiac segments. Scan time was 8.05 ± 2.06 min and 17.91 ± 3.93 min for metabolite‐cycled EPSI with and without motion‐adapted gating and weighted acquisition, respectively, while relative CRLB of TG did not differ significantly between the two methods for any of the cardiac segments. Conclusions Metabolite‐cycled EPSI with motion‐adapted gating and weighted acquisition allows detecting TG/W ratios in different regions of the in vivo human heart. Scan time is reduced by more than 2‐fold to less than 10 min as compared to conventional acquisition, while keeping the quality of TG fitting constant. Click here for author‐reader discussions
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Affiliation(s)
- Sophie M Peereboom
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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13
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Triadyaksa P, Overbosch J, Oudkerk M, Sijens PE. T2* assessment of the three coronary artery territories of the left ventricular wall by different monoexponential truncation methods. MAGNETIC RESONANCE MATERIALS IN PHYSICS, BIOLOGY AND MEDICINE 2022; 35:749-763. [PMID: 35437686 PMCID: PMC9463254 DOI: 10.1007/s10334-022-01008-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/04/2022] [Accepted: 03/18/2022] [Indexed: 11/28/2022]
Abstract
Abstract
Objectives
This study aimed at evaluating left ventricular myocardial pixel-wise T2* using two truncation methods for different iron deposition T2* ranges and comparison of segmental T2* in different coronary artery territories.
Material and methods
Bright blood multi-gradient echo data of 30 patients were quantified by pixel-wise monoexponential T2* fitting with its R2 and SNR truncation. T2* was analyzed at different iron classifications. At low iron classification, T2* values were also analyzed by coronary artery territories.
Results
The right coronary artery has a significantly higher T2* value than the other coronary artery territories. No significant difference was found in classifying severe iron by the two truncation methods in any myocardial region, whereas in moderate iron, it is only apparent at septal segments. The R2 truncation produces a significantly higher T2* value than the SNR method when low iron is indicated.
Conclusion
Clear T2* differentiation between the three coronary territories by the two truncation methods is demonstrated. The two truncation methods can be used interchangeably in classifying severe and moderate iron deposition at the recommended septal region. However, in patients with low iron indication, different results by the two truncation methods can mislead the investigation of early iron level progression.
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Affiliation(s)
- Pandji Triadyaksa
- University of Groningen, 9700 RB, Groningen, The Netherlands.
- Departemen Fisika, Universitas Diponegoro, Fakultas Sains Dan Matematika, Prof. Sudharto street, Semarang, 50275, Indonesia.
| | - Jelle Overbosch
- Department of Radiology, University of Groningen, University Medical Center Groningen, EB45, PO Box 30001, 9700 RB, Groningen, The Netherlands
| | - Matthijs Oudkerk
- University of Groningen, 9700 RB, Groningen, The Netherlands
- Institute for Diagnostic Accuracy, Groningen, The Netherlands
| | - Paul Eduard Sijens
- University of Groningen, 9700 RB, Groningen, The Netherlands
- Department of Radiology, University of Groningen, University Medical Center Groningen, EB45, PO Box 30001, 9700 RB, Groningen, The Netherlands
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14
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Meloni A, Martini N, Positano V, D'Angelo G, Barison A, Todiere G, Grigoratos C, Barra V, Pistoia L, Gargani L, Ripoli A, Pepe A. Myocardial T1 Values at 1.5 T: Normal Values for General Electric Scanners and Sex-Related Differences. J Magn Reson Imaging 2021; 54:1486-1500. [PMID: 33848021 DOI: 10.1002/jmri.27639] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/27/2021] [Accepted: 03/30/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND No data are available about normal ranges for native T1 in human myocardium using General Electric (GE) scanners. PURPOSE To establish normal ranges for myocardial T1 values and evaluate regional variability and the influence of physiological factors. STUDY TYPE Prospective. SUBJECTS One hundred healthy volunteers with normal electrocardiogram, no cardiovascular/systemic diseases, or risk factors (age range: 20-70 years; 50 females). FIELD STRENGTH/SEQUENCE 1.5 T/Steady-state free precession cine and a modified Look-Locker inversion recovery sequence in diastole (also in systole for 61 volunteers). ASSESSMENT Image analysis was performed by operators with >10 years experience in cardiac MR using commercially available software. T1 values were calculated for 16 myocardial segments, and the global value was the mean. Segments were grouped according to circumferential region (anterior, septal, inferior, and lateral) and to level (basal, medial, apical). Twenty images were analyzed twice by the same operator and by a different operator to assess reproducibility. STATISTICAL TESTS Independent-samples t-test or Mann-Whitney test; paired sample t-test or Wilcoxon signed-rank test; one-way repeated measures ANOVA or Friedman tests; Pearson's or Spearman's correlation. Reproducibility evaluated using coefficient of variability (CoV). RESULTS Due to artifacts and/or partial-volume effects, 45/1600 (2.8%) segments were excluded. A good intra- and inter-operator reproducibility was detected (CoV < 5%). There were significant differences in segmental T1 values (P < 0.05). A significant circumferential variability was present (P < 0.05): the mean native T1 value over the lateral region was significantly lower than in the other three regions. An increasing gradient from basal to apical slices was detected (P < 0.05). Segmental and global T1 values were not associated with age (range P = 0.052-0.911) but were significantly lower in males than in females (global: 993 ± 32 vs. 1037 ± 27 ms; P < 0.05) and significantly correlated with heart rate (range R for segmental values = 0.247-0.920; P < 0.05). Almost all segmental T1 values were inversely correlated with wall thickness (R from -0.233 to -0.514; P < 0.05). Systolic T1 values were significantly lower than diastolic values in basal anteroseptal segment, in all medial segments except the inferior one, and in all apical segments (P < 0.05). DATA CONCLUSION Myocardial T1 values differ among myocardial regions, are influenced by sex, heart rate, and wall thickness and vary according to the cardiac cycle in healthy adults. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Antonella Meloni
- Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.,Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Nicola Martini
- Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.,Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Vincenzo Positano
- Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.,Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Gennaro D'Angelo
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Andrea Barison
- Division of Cardiology and Cardiovascular Medicine, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Giancarlo Todiere
- Division of Cardiology and Cardiovascular Medicine, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Chrysanthos Grigoratos
- Division of Cardiology and Cardiovascular Medicine, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Valerio Barra
- Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Laura Pistoia
- Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Luna Gargani
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Andrea Ripoli
- Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Alessia Pepe
- Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
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15
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Kräuter C, Reiter U, Reiter C, Nizhnikava V, Schmidt A, Stollberger R, Fuchsjäger M, Reiter G. Impact of the Choice of Native T 1 in Pixelwise Myocardial Blood Flow Quantification. J Magn Reson Imaging 2021; 53:755-765. [PMID: 33034120 PMCID: PMC7891429 DOI: 10.1002/jmri.27375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Quantification of myocardial blood flow (MBF) from dynamic contrast-enhanced (DCE) MRI can be performed using a signal intensity model that incorporates T1 values of blood and myocardium. PURPOSE To assess the impact of T1 values on pixelwise MBF quantification, specifically to evaluate the influence of 1) study population-averaged vs. subject-specific, 2) diastolic vs. systolic, and 3) regional vs. global myocardial T1 values. STUDY TYPE Prospective. SUBJECTS Fifteen patients with chronic coronary heart disease. FIELD STRENGTH/SEQUENCE 3T; modified Look-Locker inversion recovery for T1 mapping and saturation recovery gradient echo for DCE imaging, both acquired in a mid-ventricular short-axis slice in systole and diastole. ASSESSMENT MBF was estimated using Fermi modeling and signal intensity nonlinearity correction with different T1 values: study population-averaged blood and myocardial, subject-specific systolic and diastolic, and segmental T1 values. Myocardial segments with perfusion deficits were identified visually from DCE series. STATISTICAL TESTS The relationships between MBF parameters derived by different methods were analyzed by Bland-Altman analysis; corresponding mean values were compared by t-test. RESULTS Using subject-specific diastolic T1 values, global diastolic MBF was 0.61 ± 0.13 mL/(min·g). It did not differ from global MBF derived from the study population-averaged T1 (P = 0.88), but the standard deviation of differences was large (0.07 mL/(min·g), 11% of mean MBF). Global diastolic and systolic MBF did not differ (P = 0.12), whereas global diastolic MBF using systolic (0.62 ± 0.13 mL/(min·g)) and diastolic T1 values differed (P < 0.05). If regional instead of global T1 values were used, segmental MBF was lower in segments with perfusion deficits (bias = -0.03 mL/(min·g), -7% of mean MBF, P < 0.05) but higher in segments without perfusion deficits (bias = 0.01 mL/(min·g), 1% of mean MBF, P < 0.05). DATA CONCLUSION Whereas cardiac phase-specific T1 values have a minor impact on MBF estimates, subject-specific and myocardial segment-specific T1 values substantially affect MBF quantification. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Corina Kräuter
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
- Institute of Medical EngineeringGraz University of TechnologyGrazAustria
| | - Ursula Reiter
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
| | - Clemens Reiter
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
| | - Volha Nizhnikava
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
| | - Albrecht Schmidt
- Division of Cardiology, Department of Internal MedicineMedical University of GrazGrazAustria
| | - Rudolf Stollberger
- Institute of Medical EngineeringGraz University of TechnologyGrazAustria
| | - Michael Fuchsjäger
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
| | - Gert Reiter
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
- Research and DevelopmentSiemens Healthcare Diagnostics GmbHGrazAustria
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16
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Kawel-Boehm N, Hetzel SJ, Ambale-Venkatesh B, Captur G, Francois CJ, Jerosch-Herold M, Salerno M, Teague SD, Valsangiacomo-Buechel E, van der Geest RJ, Bluemke DA. Reference ranges ("normal values") for cardiovascular magnetic resonance (CMR) in adults and children: 2020 update. J Cardiovasc Magn Reson 2020; 22:87. [PMID: 33308262 PMCID: PMC7734766 DOI: 10.1186/s12968-020-00683-3] [Citation(s) in RCA: 262] [Impact Index Per Article: 65.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 10/26/2020] [Indexed: 01/06/2023] Open
Abstract
Cardiovascular magnetic resonance (CMR) enables assessment and quantification of morphological and functional parameters of the heart, including chamber size and function, diameters of the aorta and pulmonary arteries, flow and myocardial relaxation times. Knowledge of reference ranges ("normal values") for quantitative CMR is crucial to interpretation of results and to distinguish normal from disease. Compared to the previous version of this review published in 2015, we present updated and expanded reference values for morphological and functional CMR parameters of the cardiovascular system based on the peer-reviewed literature and current CMR techniques. Further, databases and references for deep learning methods are included.
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Affiliation(s)
- Nadine Kawel-Boehm
- Department of Radiology, Kantonsspital Graubuenden, Loestrasse 170, 7000, Chur, Switzerland
- Institute for Diagnostic, Interventional and Pediatric Radiology (DIPR), Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, InselspitalBern, Switzerland
| | - Scott J Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin, 610 Walnut St, Madison, WI, 53726, USA
| | - Bharath Ambale-Venkatesh
- Department of Radiology, Johns Hopkins University, 600 N Wolfe Street, Baltimore, MD, 21287, USA
| | - Gabriella Captur
- MRC Unit of Lifelong Health and Ageing At UCL, 5-19 Torrington Place, Fitzrovia, London, WC1E 7HB, UK
- Inherited Heart Muscle Conditions Clinic, Royal Free Hospital NHS Foundation Trust, Hampstead, London, NW3 2QG, UK
| | - Christopher J Francois
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Michael Jerosch-Herold
- Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Michael Salerno
- Cardiovascular Division, University of Virginia Health System, 1215 Lee Street, Charlottesville, VA, 22908, USA
| | - Shawn D Teague
- Department of Radiology, National Jewish Health, 1400 Jackson St, Denver, CO, 80206, USA
| | - Emanuela Valsangiacomo-Buechel
- Division of Paediatric Cardiology, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Rob J van der Geest
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands
| | - David A Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA.
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17
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Shinbo H, Tomioka S, Ino T, Koyama K. Systolic modified Look-Locker inversion recovery myocardial T1 mapping improves the accuracy of T1 and extracellular volume fraction measurements of patients with high heart rate or atrial fibrillation. Radiol Phys Technol 2020; 13:405-413. [PMID: 33155177 DOI: 10.1007/s12194-020-00594-z] [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: 05/21/2020] [Revised: 10/22/2020] [Accepted: 10/25/2020] [Indexed: 10/23/2022]
Abstract
Image data for T1 mapping are generally acquired during mid-diastole period. However, T1 mapping tends to fail for patients with high heart rate or atrial fibrillation because of short or irregular R-R interval. Focusing on the evidence that the timing of systole is more stable than that of diastole from the R wave, we compared systolic T1 mapping with conventional diastolic T1 mapping for all participants (n = 58) by visual scoring of T1 calculation error. The systolic scores were significantly better than the diastolic scores (p < 0.05). This advantage of the systolic scores was confirmed selectively for patients with atrial fibrillation (p < 0.05, n = 19). The successful number of nonrigid image registration alignment for extracellular volume fraction (ECV) analysis also increased significantly for systolic images compared with diastolic images (p < 0.05). Thus, systolic T1 mapping improves the accuracy of T1 values and ECV analysis.
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Affiliation(s)
- Hirohiko Shinbo
- Gunma Prefectural Cardiovascular Center, 3-12 Kamiizumimachi, Maebashi-shi, Gunma, Japan.
| | - Satoshi Tomioka
- Gunma Prefectural Cardiovascular Center, 3-12 Kamiizumimachi, Maebashi-shi, Gunma, Japan
| | - Toshihiko Ino
- Gunma Prefectural Cardiovascular Center, 3-12 Kamiizumimachi, Maebashi-shi, Gunma, Japan
| | - Keiko Koyama
- Gunma Prefectural Cardiovascular Center, 3-12 Kamiizumimachi, Maebashi-shi, Gunma, Japan
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Puyol-Antón E, Ruijsink B, Baumgartner CF, Masci PG, Sinclair M, Konukoglu E, Razavi R, King AP. Automated quantification of myocardial tissue characteristics from native T 1 mapping using neural networks with uncertainty-based quality-control. J Cardiovasc Magn Reson 2020; 22:60. [PMID: 32814579 PMCID: PMC7439533 DOI: 10.1186/s12968-020-00650-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Tissue characterisation with cardiovascular magnetic resonance (CMR) parametric mapping has the potential to detect and quantify both focal and diffuse alterations in myocardial structure not assessable by late gadolinium enhancement. Native T1 mapping in particular has shown promise as a useful biomarker to support diagnostic, therapeutic and prognostic decision-making in ischaemic and non-ischaemic cardiomyopathies. METHODS Convolutional neural networks (CNNs) with Bayesian inference are a category of artificial neural networks which model the uncertainty of the network output. This study presents an automated framework for tissue characterisation from native shortened modified Look-Locker inversion recovery ShMOLLI T1 mapping at 1.5 T using a Probabilistic Hierarchical Segmentation (PHiSeg) network (PHCUMIS 119-127, 2019). In addition, we use the uncertainty information provided by the PHiSeg network in a novel automated quality control (QC) step to identify uncertain T1 values. The PHiSeg network and QC were validated against manual analysis on a cohort of the UK Biobank containing healthy subjects and chronic cardiomyopathy patients (N=100 for the PHiSeg network and N=700 for the QC). We used the proposed method to obtain reference T1 ranges for the left ventricular (LV) myocardium in healthy subjects as well as common clinical cardiac conditions. RESULTS T1 values computed from automatic and manual segmentations were highly correlated (r=0.97). Bland-Altman analysis showed good agreement between the automated and manual measurements. The average Dice metric was 0.84 for the LV myocardium. The sensitivity of detection of erroneous outputs was 91%. Finally, T1 values were automatically derived from 11,882 CMR exams from the UK Biobank. For the healthy cohort, the mean (SD) corrected T1 values were 926.61 (45.26), 934.39 (43.25) and 927.56 (50.36) for global, interventricular septum and free-wall respectively. CONCLUSIONS The proposed pipeline allows for automatic analysis of myocardial native T1 mapping and includes a QC process to detect potentially erroneous results. T1 reference values were presented for healthy subjects and common clinical cardiac conditions from the largest cohort to date using T1-mapping images.
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Affiliation(s)
- Esther Puyol-Antón
- School of Biomedical Engineering & Imaging Sciences, King’s College London, Rayne Institute, 4th Floor Lambeth Wing St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH UK
| | - Bram Ruijsink
- School of Biomedical Engineering & Imaging Sciences, King’s College London, Rayne Institute, 4th Floor Lambeth Wing St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH UK
- Department of Adult and Paediatric Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | | | - Pier-Giorgio Masci
- School of Biomedical Engineering & Imaging Sciences, King’s College London, Rayne Institute, 4th Floor Lambeth Wing St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH UK
- Department of Adult and Paediatric Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Matthew Sinclair
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, 3rd floor Huxley Building, 180 Queen’s Gate, London, SW7 2AZ UK
| | - Ender Konukoglu
- Computer Vision Lab, ETH Zürich, Sternwartstrasse 7, Zürich, Switzerland
| | - Reza Razavi
- School of Biomedical Engineering & Imaging Sciences, King’s College London, Rayne Institute, 4th Floor Lambeth Wing St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH UK
- Department of Adult and Paediatric Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Andrew P. King
- School of Biomedical Engineering & Imaging Sciences, King’s College London, Rayne Institute, 4th Floor Lambeth Wing St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH UK
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Saunders LC, Eaden JA, Bianchi SM, Swift AJ, Wild JM. Free breathing lung T 1 mapping using image registration in patients with idiopathic pulmonary fibrosis. Magn Reson Med 2020; 84:3088-3102. [PMID: 32557890 DOI: 10.1002/mrm.28342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/04/2020] [Accepted: 05/13/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE To assess the use of image registration for correcting respiratory motion in free breathing lung T1 mapping acquisition in patients with idiopathic pulmonary fibrosis (IPF). THEORY AND METHODS The method presented used image registration to synthetic images during postprocessing to remove respiratory motion. Synthetic images were generated from a model of the inversion recovery signal of the acquired images that incorporated a periodic lung motion model. Ten healthy volunteers and 19 patients with IPF underwent 2D Look-Locker T1 mapping acquisition at 1.5T during inspiratory breath-hold and free breathing. Eight healthy volunteers and seven patients with IPF underwent T1 mapping acquisition during expiratory breath-hold. Fourteen patients had follow-up scanning at 6 months. Dice similarity coefficient (DSC) was used to evaluate registration efficacy. RESULTS Image registration increased image DSC (P < .001) in the free breathing inversion recovery images. Lung T1 measured during a free breathing acquisition was lower in patients with IPF when compared with healthy controls (inspiration: P = .238; expiration: P = .261; free breathing: P = .021). Measured lung T1 was higher in expiration breath-hold than inspiration breath-hold in healthy volunteers (P < .001) but not in patients with IPF (P = .645). There were no other significant differences between lung T1 values within subject groups. CONCLUSIONS The registration technique significantly reduced motion in the Look-Locker images acquired during free breathing and may improve the robustness of lung T1 mapping in patients who struggle to hold their breath. Lung T1 measured during a free breathing acquisition was significantly lower in patients with IPF when compared with healthy controls.
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Affiliation(s)
- Laura C Saunders
- POLARIS, Imaging Sciences, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - James A Eaden
- POLARIS, Imaging Sciences, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Stephen M Bianchi
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Andrew J Swift
- POLARIS, Imaging Sciences, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Jim M Wild
- POLARIS, Imaging Sciences, Department of IICD, University of Sheffield, Sheffield, United Kingdom
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Altaha MA, Nolan M, Marwick TH, Somerset E, Houbois C, Amir E, Yip P, Connelly KA, Michalowska M, Sussman MS, Wintersperger BJ, Thavendiranathan P. Can Quantitative CMR Tissue Characterization Adequately Identify Cardiotoxicity During Chemotherapy? JACC Cardiovasc Imaging 2020; 13:951-962. [DOI: 10.1016/j.jcmg.2019.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/08/2019] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
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21
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Vo HQ, Marwick TH, Negishi K. Pooled summary of native T1 value and extracellular volume with MOLLI variant sequences in normal subjects and patients with cardiovascular disease. Int J Cardiovasc Imaging 2019; 36:325-336. [DOI: 10.1007/s10554-019-01717-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/16/2019] [Indexed: 01/02/2023]
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22
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Peereboom SM, Gastl M, Fuetterer M, Kozerke S. Navigator-free metabolite-cycled proton spectroscopy of the heart. Magn Reson Med 2019; 83:795-805. [PMID: 31448841 DOI: 10.1002/mrm.27961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/04/2019] [Accepted: 07/31/2019] [Indexed: 11/07/2022]
Abstract
PURPOSE Respiratory gating in cardiac water-suppressed (WS) proton spectroscopy leads to long and unpredictable scan times. Metabolite cycling allows to perform frequency and phase correction on the water signal and, hence, offers an approach to navigator-free cardiac spectroscopy with fixed scan time. The objective of the present study was to develop and implement navigator-free metabolite-cycled cardiac proton spectroscopy (MC nonav) and compare it with standard navigator-gated WS (WS nav) and navigator-free WS (WS nonav) measurements for the assessment of triglyceride-to-water ratios (TG/W) and creatine-to-water ratios (CR/W) in the intraventricular septum of the in vivo heart. METHODS Navigator-free metabolite-cycled spectroscopy was implemented on a clinical 1.5T system. In vivo measurements were performed on 10 young and 5 older healthy volunteers to assess signal-to-noise ratio efficiency as well as TG/W and CR/W and the relative Cramér-Rao lower bounds for CR. The performance of the metabolite-cycled sequence was verified using simulations. RESULTS On average, scan times of MC nonav were 3.4 times shorter compared with WS nav, while no significant bias for TG/W was observed (coefficient of variation = 14.0%). signal-to-noise ratio efficiency of both TG and CR increased for MC nonav compared with WS nav. Relative Cramér-Rao lower bounds of CR decreased for MC nonav. Overall spectral quality was found comparable between MC nonav and WS nav, while it was inferior for WS nonav. CONCLUSION Navigator-free metabolite-cycled cardiac proton spectroscopy offers 3.4-fold accelerated assessment of TG/W and CR/W in the heart with preserved spectral quality when compared with navigator-gated WS scans.
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Affiliation(s)
- Sophie M Peereboom
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Mareike Gastl
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Maximilian Fuetterer
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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Triadyaksa P, Kuijpers D, Akinci D'Antonoli T, Overbosch J, Rook M, van Swieten JM, Oudkerk M, Sijens PE. Early detection of heart function abnormality by native T1: a comparison of two T1 quantification methods. Eur Radiol 2019; 30:652-662. [PMID: 31410603 PMCID: PMC6890701 DOI: 10.1007/s00330-019-06364-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/25/2019] [Accepted: 07/10/2019] [Indexed: 02/02/2023]
Abstract
Objective To compare the robustness of native T1 mapping using mean and median pixel-wise quantification methods. Methods Fifty-seven consecutive patients without overt signs of heart failure were examined in clinical routine for suspicion of cardiomyopathy. MRI included the acquisition of native T1 maps by a motion-corrected modified Look-Locker inversion recovery sequence at 1.5 T. Heart function status according to four established volumetric left ventricular (LV) cardio MRI parameter thresholds was used for retrospective separation into subgroups of normal (n = 26) or abnormal heart function (n = 31). Statistical normality of pixel-wise T1 was tested on each myocardial segment and mean and median segmental T1 values were assessed. Results Segments with normally distributed pixel-wise T1 (57/58%) showed no difference between mean and median quantification in either patient group, while differences were highly significant (p < 0.001) for the respective 43/42% non-normally distributed segments. Heart function differentiation between two patient groups was significant in 14 myocardial segments (p < 0.001–0.040) by median quantification compared with six (p < 0.001–0.042) by using the mean. The differences by median quantification were observed between the native T1 values of the three coronary artery territories of normal heart function patients (p = 0.023) and insignificantly in the abnormal patients (p = 0.053). Conclusion Median quantification increases the robustness of myocardial native T1 definition, regardless of statistical normality of the data. Compared with the currently prevailing method of mean quantification, differentiation between LV segments and coronary artery territories is better and allows for earlier detection of heart function impairment. Key Points • Median pixel-wise quantification of native T1 maps is robust and can be applied regardless of the statistical distribution of data points. • Median quantification is more sensitive to early heart function abnormality compared with mean quantification. • The new method yields significant native T1 value differentiation between the three coronary artery territories. Electronic supplementary material The online version of this article (10.1007/s00330-019-06364-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pandji Triadyaksa
- University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
- Department of Physics, Diponegoro University, Prof. Sudharto street, Semarang, 50275, Indonesia
| | - Dirkjan Kuijpers
- Department of Radiology, HMC-Bronovo, Bronovolaan 5, The Hague, 2597 AX, The Netherlands
| | - Tugba Akinci D'Antonoli
- University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
- University Hospital Basel, Clinic of Radiology & Nuclear Medicine, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Jelle Overbosch
- Department of Radiology, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - Mieneke Rook
- University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - J Martijn van Swieten
- Department of Radiology, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - Matthijs Oudkerk
- University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
- Institute for Diagnostic Accuracy, Groningen, The Netherlands
| | - Paul E Sijens
- University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands.
- Department of Radiology, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands.
- Department of Radiology, EB45, University Medical Center Groningen, P.O. Box 30001, 9700 RB, Groningen, The Netherlands.
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Weingartner S, Demirel OB, Shenoy C, Schad LR, Schulz-Menger J, Akcakaya M. Functional LGE Imaging: Cardiac Phase-Resolved Assessment of Focal Fibrosis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:3999-4003. [PMID: 31946748 PMCID: PMC6986779 DOI: 10.1109/embc.2019.8857759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cardiac Magnetic Resonance Imaging (CMR) is a central tool for diagnosis of various ischemic and non-ischemic cardiomyopathies. CMR protocols commonly comprise assessment of functional properties using cardiac phase-resolved CINE MRI and characterization of myocardial viability using late gadolinium enhancement (LGE) imaging. Conventional LGE imaging requires inversion recovery preparation with a specific inversion time to null the healthy myocardium, which restricts the acquisition to a single cardiac phase. In turn, this necessitates separate scans for cardiac function and viability. In this work, we develop a new method for functional LGE imaging in a single breath-hold using a three-step approach: 1) ECG-triggered multi-contrast data is acquired for each cardiac phase, 2) semi-quantitative relaxation maps are generated, 3) LGE imaging contrast is synthesized based on the semi-quantitative maps. The proposed functional LGE method is evaluated in four healthy subject and 20 patients at 1.5T and 3T. Thorough suppression of the healthy myocardium, as well as 40-80ms temporal resolution are achieved, with no visually apparent temporal blurring at tissue interfaces. Functional LGE in patients with focal scar demonstrates robust hyperenhancement in the scar area throughout all cardiac phases, allowing for visual assessment of scar motility. The proposed technique bears the potential to simplify and speedup common cardiac imaging protocols, while enabling improved data fusion of functional and viability information for improved evaluation of CMR.
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25
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Gastl M, Peereboom SM, Fuetterer M, Boenner F, Kelm M, Manka R, Kozerke S. Retrospective phase-based gating for cardiac proton spectroscopy with fixed scan time. J Magn Reson Imaging 2019; 50:1973-1981. [PMID: 31125172 DOI: 10.1002/jmri.26802] [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: 03/14/2019] [Accepted: 05/13/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Respiratory motion is a major limiting factor for spectral quality and duration of in vivo proton MR spectroscopy of the heart. Prospective navigator gating is frequently applied to minimize the effects of respiratory motion, but scan durations are subject-dependent and hence difficult to predict. PURPOSE To implement cardiac proton MRS with fixed scan time by employing retrospective phase-based gating and to compare the proposed method to conventional navigator-gated MRS. STUDY TYPE Prospective. SUBJECTS Eighteen healthy volunteers (29.7 ± 7.8 years). FIELD STRENGTH/SEQUENCE 1.5, navigator-gated (16 averages without, 96 with water suppression [WS]) data acquisition as reference and navigator-free data acquisition with a fixed scan time (48 without WS, 304 with WS), cardiac-triggered point-resolved spectroscopy (PRESS). ASSESSMENT Navigator-free data acquisition with retrospective phase-based gating was compared with prospective navigator-gating. Navigator-free acquisition was repeated in 10 subjects to assess reproducibility. Scan time was assessed for prospective and retrospective gating. Retrospective phase-based gating was performed using a threshold based on the standard deviation (SD) of individual water (W) and triglyceride (TG) phases. STATISTICAL TESTS T-tests and Bland-Altman analysis. RESULTS The duration of the prospective navigator-gated scans ranged from 6:09 minutes to 21:50 minutes (mean 10:05 ± 3:46 min, gating efficiency 40.4 ± 10.5%), while data acquisition for retrospective phase-based gating had a fixed scan time of 11:44 minutes. Retrospective phase-based gating using a threshold of 1 × SD yielded a gating efficiency of 72.7 ± 4.3% and a coefficient of variation (CoV) of triglyceride-to-water ratios of 9.8% compared with the navigated reference. The intrasubject reproducibility of retrospective gating revealed a CoV of 9.5%. DATA CONCLUSION Cardiac proton MRS employing retrospective phase-based gating is feasible and provides reproducible assessment of TG/W in a fixed scan time. Since scan time is independent of respiratory motion, retrospective phase-based gating offers an approach to motion compensation with predictable exam time for proton MRS of the heart. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1973-1981.
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Affiliation(s)
- Mareike Gastl
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.,Department of Cardiology, Pneumology and Angiology, Heinrich Heine University, Düsseldorf, Germany
| | - Sophie M Peereboom
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Maximilian Fuetterer
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Florian Boenner
- Department of Cardiology, Pneumology and Angiology, Heinrich Heine University, Düsseldorf, Germany
| | - Malte Kelm
- Department of Cardiology, Pneumology and Angiology, Heinrich Heine University, Düsseldorf, Germany
| | - Robert Manka
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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Marty B, Carlier PG. Physiological and pathological skeletal muscle T1 changes quantified using a fast inversion-recovery radial NMR imaging sequence. Sci Rep 2019; 9:6852. [PMID: 31048765 PMCID: PMC6497638 DOI: 10.1038/s41598-019-43398-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 04/24/2019] [Indexed: 12/18/2022] Open
Abstract
We investigated the response of skeletal muscle global T1 under different physiological and pathological conditions using an inversion-recovery radial T1 mapping sequence. Thirty five healthy volunteers, seven patients with Becker muscular dystrophy (BMD) and seven patients with sporadic inclusion body myositis (IBM) were investigated in order to evaluate the effects of gender, age, muscle group, exercise and pathological processes on global T1 values. In addition, the intramuscular fat content was measured using 3-point Dixon and the global T2 and water T2 (T2H2O) were determined with a multi-spin-echo sequence. In the muscles of healthy volunteers, there was no impact of age on global T1. However, we measured a significant effect of sex and muscle group. After exercise, a significant 7.7% increase of global T1 was measured in the recruited muscles, and global T1 variations were highly correlated to T2H2O variations (R = 0.91). In pathologies, global T1 values were reduced in fat infiltrated muscles. When fat fraction was taken into account, global T1 values were higher in IBM patients compared to BMD. Global T1 variations are a sensitive indicator of tissue changes in skeletal muscle related to several physiological and pathological events.
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Affiliation(s)
- Benjamin Marty
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France. .,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France.
| | - Pierre G Carlier
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
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27
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Matsumoto S, Okuda S, Yamada Y, Suzuki T, Tanimoto A, Nozaki A, Jinzaki M. Myocardial T1 values in healthy volunteers measured with saturation method using adaptive recovery times for T1 mapping (SMART1Map) at 1.5 T and 3 T. Heart Vessels 2019; 34:1889-1894. [DOI: 10.1007/s00380-019-01401-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/05/2019] [Indexed: 10/27/2022]
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Beitzke D, Wielandner A, Wollenweber T, Vraka C, Pichler V, Uyanik-Uenal K, Zuckermann A, Greiser A, Hacker M, Loewe C. Assessment of sympathetic reinnervation after cardiac transplantation using hybrid cardiac PET/MRI: A pilot study. J Magn Reson Imaging 2019; 50:1326-1335. [PMID: 30892777 PMCID: PMC6766915 DOI: 10.1002/jmri.26722] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/01/2019] [Accepted: 03/02/2019] [Indexed: 12/12/2022] Open
Abstract
Background Sympathetic reinnervation after heart transplantation (HTX) is a known phenomenon, which has an impact on patient heart rate variability and exercise capacity. The impact of reinnervation on myocardial structure has not been evaluated yet. Propose To evaluate the feasibility of simultaneous imaging of cardiac reinnervation and cardiac structure using a hybrid PET/MRI system. Study type Prospective / pilot study. Subjects Ten patients, 4–21 years after cardiac transplantation. Field Strength/Sequence 3 T hybrid PET/MRI system. Cine SSFP, T1 mapping (modified Look–Locker inversion recovery sequence) pre/postcontrast as well as dynamic [11C]meta‐hydroxyephedrine ([11C]mHED) PET. Assessment All MRI and PET parameters were evaluated by experienced readers using dedicated postprocessing software packages for cardiac MRI and PET. For all parameters a 16‐segment model for the left ventricle was applied. Statistical Tests Mann–Whitney U‐test; Spearman correlations. Results Thirty‐six of 160 myocardial segments showed evidence of reinnervation by PET. On a segment‐based analysis, mean native T1 relaxation times were nonsignificantly altered in segments with evidence of reinnervation (1305 ± 151 msec vs. 1270 ± 112 msec; P = 0.1), whereas mean extracellular volume (ECV) was significantly higher in segments with evidence of reinnervation (35.8 ± 11% vs. 30.9 ± 7%; P = 0.019). There were no significant differences in wall motion (WM) and wall thickening (WT) between segments with or without reinnervation (mean WM: 7.6 ± 4 mm vs. group B: 9.3 ± 7 mm [P = 0.13]; WT: 79 ± 63% vs. 94 ± 74% [P = 0.27]) under resting conditions. Data Conclusion The assessment of cardiac reinnervation using a hybrid PET/MRI system is feasible. Segments with evidence of reinnervation by PET showed nonsignificantly higher T1 relaxation times and a significantly higher ECV, suggesting a higher percentage of diffuse fibrosis in these segments, without impairment of rest WM and WT. Level of Evidence: 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:1326–1335.
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Affiliation(s)
- Dietrich Beitzke
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria
| | - Alice Wielandner
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria
| | - Tim Wollenweber
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Chrysoula Vraka
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Verena Pichler
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Keziban Uyanik-Uenal
- Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Andreas Zuckermann
- Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Marcus Hacker
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Christian Loewe
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria
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Higgins DM, Keeble C, Juli C, Dawson DK, Waterton JC. Reference range determination for imaging biomarkers: Myocardial T 1. J Magn Reson Imaging 2019; 50:771-778. [PMID: 30756434 DOI: 10.1002/jmri.26683] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Imaging biomarkers, such as the T1 relaxation time of the myocardium using MRI, can be valuable in cardiac medicine if they are properly validated. Consensus statements recommend that for myocardial T1 , each investigator should establish a reference range. PURPOSE To describe a statistically valid method for determining and reporting the reference range in each center, which simultaneously minimizes the twin risks of undersampling, leading to a uselessly uncertain range, and oversampling, which exposes volunteers to unnecessary scanning and wastes resources. STUDY TYPE Cohort. POPULATION In all, 278 normal human subjects without cardiac disease from two cardiac MR centers. FIELD STRENGTH/SEQUENCE 1.5 T and 3 T; Modified Look-Locker Inversion recovery sequence. ASSESSMENT The T1 relaxation time was estimated from multiple samples of tissue magnetization after inversion. A valid method for calculating a reference range was used. STATISTICAL TESTS Shapiro-Wilk test for normality; Tukey robust approach for identification of outliers; reference range calculation with confidence intervals. RESULTS Reference ranges for measurement of myocardial T1 were calculated, with confidence intervals, enabling comparison with clinically important differences. At 3 T: 1129 to 1301 msec at site 1 (n = 21) and 1160 to 1309 msec at site 2 (n = 59), and at 1.5 T at site 2: 933 to 1020 msec (male, n = 130) and 965 to 1054 msec (female, n = 68). The 3 T reference range from site 1 was successfully benchmarked against the 3 T reference range at site 2. DATA CONCLUSION Myocardial T1 reference ranges can be properly characterized, enabling clinical comparison to a valid reference range with known confidence intervals, using methodology similar to that described in this report. LEVEL OF EVIDENCE 3 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2019;50:771-778.
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Affiliation(s)
| | - Claire Keeble
- Leeds Institute for Data Analytics, University of Leeds, UK
| | | | - Dana K Dawson
- Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK
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Gensler D, Salinger T, Düring M, Lorenz K, Jahns R, Wech T, Frantz S, Ertl G, Jakob PM, Nordbeck P. Real-time Triggered RAdial Single-Shot Inversion recovery for arrhythmia-insensitive myocardial T1 mapping: motion phantom validation and in vivo comparison. Magn Reson Med 2018; 81:1714-1725. [PMID: 30417940 DOI: 10.1002/mrm.27526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/24/2018] [Accepted: 08/20/2018] [Indexed: 11/11/2022]
Abstract
PURPOSE Cardiac T1 mapping has become an increasingly important imaging technique, contributing novel diagnostic options. However, currently utilized methods are often associated with accuracy problems because of heart rate variations and cardiac arrhythmia, limiting their value in clinical routine. This study aimed to introduce an improved arrhythmia-related robust T1 mapping sequence called RT-TRASSI (real-time Triggered RAdial Single-Shot Inversion recovery). METHODS All measurements were performed on a 3.0T whole-body imaging system. A real-time feedback algorithm for arrhythmia detection was implemented into the previously described pulse sequence. A programmable motion phantom was constructed and measurements with different simulated arrhythmias arranged. T1 mapping accuracy and susceptibility to artifacts were analyzed. In addition, in vivo measurements and comparisons with 3 prevailing T1 mapping sequences (MOLLI, ShMOLLI, and SASHA) were carried out to investigate the occurrence of artifacts. RESULTS In the motion phantom measurements, RT-TRASSI showed excellent agreement with predetermined reference T1 values. Percentage scattering of the T1 values ranged from -0.6% to +1.9% in sinus rhythm and -1.0% to +3.1% for high-grade arrhythmias. In vivo, RT-TRASSI showed diagnostic image quality with only 6% of the acquired T1 maps including image artifacts. In contrast, more than 40% of the T1 maps acquired with MOLLI, ShMOLLI, or SASHA included motion artifacts. CONCLUSION Accuracy issues because of heart rate variability and arrhythmia are a prevailing problem in current cardiac T1 mapping techniques. With RT-TRASSI, artifacts can be minimized because of the short acquisition time and effective real-time feedback, avoiding potential data acquisition during systolic heart phase.
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Affiliation(s)
- Daniel Gensler
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany.,Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Tim Salinger
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany.,Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Markus Düring
- Experimental Physics 5, University of Würzburg, Würzburg, Germany
| | - Kristina Lorenz
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany.,Department of Biomedical Research, Leibniz Institute for Analytical Sciences (ISAS) e.V, Dortmund, Germany
| | - Roland Jahns
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany.,Interdisciplinary Bank of Biomaterials and Data (IBDW), University Hospital Würzburg, Würzburg, Germany
| | - Tobias Wech
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany.,Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Stefan Frantz
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany.,Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Georg Ertl
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany.,Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Peter M Jakob
- Experimental Physics 5, University of Würzburg, Würzburg, Germany
| | - Peter Nordbeck
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany.,Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
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Gastl M, Peereboom SM, Fuetterer M, Boenner F, Kelm M, Manka R, Kozerke S. Cardiac- versus diaphragm-based respiratory navigation for proton spectroscopy of the heart. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2018; 32:259-268. [PMID: 30377860 DOI: 10.1007/s10334-018-0711-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/16/2018] [Accepted: 10/22/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To study inter-individual differences of the relation between diaphragm and heart motion, the objective of the present study was to implement respiratory navigation on the heart and compare it against the established method of navigator gating on the diaphragm for single-voxel cardiac 1H-MRS. MATERIALS AND METHODS 1H-MRS was performed on a 1.5T system in 19 healthy volunteers of mixed age (range 24-75 years). Spectra were recorded in a 6-8 ml voxel in the ventricular septum using a PRESS (point-resolved spectroscopy) sequence and ECG gating. Water-unsuppressed data acquired with pencil beam navigation on the heart were compared to data with navigation on the diaphragm. Water-suppressed data were obtained to assess triglyceride-to-water ratios. RESULTS Water phase and amplitude fluctuations for cardiac versus diaphragm navigation did not reveal significant differences. Both navigator positions provided comparable triglyceride-to-water ratios and gating efficiencies (coefficient of variation (CoV) 7.0%). The cardiac navigator showed a good reproducibility (CoV 5.2%). DISCUSSION Respiratory navigation on the heart does not convey an advantage over diaphragm-based navigator gating for cardiac 1H-MRS, but also no disadvantage. Consequently, cardiac and diaphragm respiratory navigation may be used interchangeably.
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Affiliation(s)
- Mareike Gastl
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland. .,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland. .,Department of Cardiology, Pneumology and Angiology, Heinrich Heine University, Düsseldorf, Germany.
| | - Sophie M Peereboom
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland
| | - Maximilian Fuetterer
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland
| | - Florian Boenner
- Department of Cardiology, Pneumology and Angiology, Heinrich Heine University, Düsseldorf, Germany
| | - Malte Kelm
- Department of Cardiology, Pneumology and Angiology, Heinrich Heine University, Düsseldorf, Germany
| | - Robert Manka
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland.,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092, Zurich, Switzerland
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Cardiac magnetic resonance T1 mapping. Part 1: Aspects of acquisition and evaluation. Eur J Radiol 2018; 109:223-234. [PMID: 30539758 DOI: 10.1016/j.ejrad.2018.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 09/29/2018] [Accepted: 10/05/2018] [Indexed: 12/13/2022]
Abstract
While an enormous number of studies have documented pathological alterations of the myocardial native longitudinal relaxation time (T1) and the fraction of the extracellular myocardial volume (ECV), it has also become clear that continuously evolving T1 mapping sequence, acquisition and evaluation techniques have a substantial impact on quantitative results, making the translation of reported findings into routine clinical use particularly challenging. To provide a basis for the discussion of pathological myocardial T1 and ECV alterations, the present review aims to summarize the methodological aspects of myocardial T1 mapping along with technical and physiological factors influencing results and normal ranges of myocardial native T1 and ECV reported across studies.
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Accurate and robust systolic myocardial T 1 mapping using saturation recovery with individualized delay time: comparison with diastolic T 1 mapping. Radiol Phys Technol 2018; 11:415-422. [PMID: 30251197 DOI: 10.1007/s12194-018-0478-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/16/2018] [Accepted: 09/18/2018] [Indexed: 01/01/2023]
Abstract
T1 mapping data are generally acquired in patients' diastolic phase, wherein their myocardium is the thinnest in the cardiac cycle. However, the analysis of the thin myocardium may cause errors in image registrations and settings related to the region of interest. In this study, we validated systolic T1 mapping using the saturation recovery with individualized delay time (SR-IDT) method and compared it with conventional diastolic T1 mapping. Both diastolic and systolic T1 mappings were performed in the mid-ventricular plane in 10 healthy volunteers (35 ± 9 years, 9 males) and 29 consecutive patients with cardiac diseases (68 ± 14 years, 19 males). Comparison of the myocardial T1 value at diastole and systole was performed with both the Pearson correlation coefficient (r) and the Bland-Altman analysis. Additionally, the systolic myocardial T1 value was compared between the volunteers and patients by using Tukey's test. Pearson correlation analysis demonstrated a strong positive correlation between diastolic and systolic T1 values (r = 0.88, P < 0.001). The Bland-Altman plot suggested that left ventricular T1 values in the diastole and systole showed high agreement (mean difference and 95% limits of agreement = 17 ± 104 ms). Further, systolic T1 values with SR-IDT in patients in the late gadolinium enhancement (LGE) group were significantly higher than those in the control group (1585 ± 118 ms vs 1469 ± 69 ms; P = 0.024). Therefore, the proposed systolic T1 mapping with the SR-IDT, which was validated with respect to the conventional diastolic method, is a useful clinical tool for the quantitative characterization of the myocardium.
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Georgiou L, Wilson DJ, Sharma N, Perren TJ, Buckley DL. A functional form for a representative individual arterial input function measured from a population using high temporal resolution DCE MRI. Magn Reson Med 2018; 81:1955-1963. [PMID: 30257053 DOI: 10.1002/mrm.27524] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE To measure the arterial input function (AIF), an essential component of tracer kinetic analysis, in a population of patients using an optimized dynamic contrast-enhanced (DCE) imaging sequence and to estimate inter- and intrapatient variability. From these data, a representative AIF that may be used for realistic simulation studies can be extracted. METHODS Thirty-nine female patients were imaged on multiple visits before and during a course of neoadjuvant chemotherapy for breast cancer. A total of 97 T1 -weighted DCE studies were analyzed including bookend estimates of T1 and model-fitting to each individual AIF. Area under the curve and cardiac output were estimated from each first pass peak, and these data were used to assess inter- and intrapatient variability of the AIF. RESULTS Interpatient variability exceeded intrapatient variability of the AIF. There was no change in cardiac output as a function of MR visit (mean value 5.6 ± 1.1 L/min) but baseline blood T1 increased significantly following the start of chemotherapy (which was accompanied by a decrease in hematocrit). CONCLUSION The AIF in an individual patient can be measured reproducibly but the variability of AIFs between patients suggests that use of a population AIF will decrease the precision of tracer kinetic analysis performed in cross-patient comparison studies. A representative AIF is presented that is typical of the population but retains the characteristics of an individually measured AIF.
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Affiliation(s)
- Leonidas Georgiou
- Biomedical Imaging, University of Leeds, Leeds, United Kingdom.,Department of Medical Physics, German Oncology Center, Limassol, Cyprus
| | - Daniel J Wilson
- Department of Medical Physics and Engineering, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom
| | - Nisha Sharma
- Department of Radiology, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom
| | - Timothy J Perren
- Leeds Institute of Cancer and Pathology, St. James's University Hospital, Leeds, United Kingdom
| | - David L Buckley
- Biomedical Imaging, University of Leeds, Leeds, United Kingdom
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Becker KM, Schulz‐Menger J, Schaeffter T, Kolbitsch C. Simultaneous high‐resolution cardiac T
1
mapping and cine imaging using model‐based iterative image reconstruction. Magn Reson Med 2018; 81:1080-1091. [DOI: 10.1002/mrm.27474] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 06/08/2018] [Accepted: 07/09/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Kirsten M. Becker
- Physikalisch‐Technische Bundesanstalt (PTB) Braunschweig and Berlin Germany
| | - Jeanette Schulz‐Menger
- Charité‐Universitätsmedizin Berlin Freie Universität Berlin, Humboldt‐Universität zu Berlin Berlin Institute of Health, DZHK Berlin Germany
- Working Group Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center Charité Medical Faculty Max‐Delbrueck Center for Molecular Medicine HELIOS Klinikum Berlin Buch Department of Cardiology and Nephrology Berlin Germany
| | - Tobias Schaeffter
- Physikalisch‐Technische Bundesanstalt (PTB) Braunschweig and Berlin Germany
- Division of Imaging Sciences and Biomedical Engineering King's College London London United Kingdom
| | - Christoph Kolbitsch
- Physikalisch‐Technische Bundesanstalt (PTB) Braunschweig and Berlin Germany
- Division of Imaging Sciences and Biomedical Engineering King's College London London United Kingdom
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T1 and T2 mapping in the identification of acute myocardial injury in patients with NSTEMI. Radiol Med 2018; 123:926-934. [PMID: 30132183 DOI: 10.1007/s11547-018-0931-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 08/07/2018] [Indexed: 12/18/2022]
Abstract
AIMS To test T1 and T2 mapping in the assessment of acute myocardial injury in patients with non-ST-segment elevation myocardial infarction (NSTEMI), evaluated before revascularization. METHODS Forty-seven patients with acute NSTEMI underwent cardiac magnetic resonance (CMR) at 1.5 T, including T1 and T2 mapping. RESULTS Coronary angiography (CA) evidenced an obstructive coronary artery disease (CAD) in 36 patients (80%) and a non-obstructive CAD in 11 patients (20%). Edema was detected in 51.1/65.9% of patients in T1/T2 maps, respectively. This difference was due to artifacts in T1 maps. T1/T2 values were significantly higher in the infarcted myocardium (IM) compared with the remote myocardium (RM) (in T1: 1151.6 ± 53.5 ms vs. 958.2 ± 38.6 ms, respectively; in T2: 69 ± 6 ms vs. 51.9 ± 2.9 ms, respectively; p < 0.0001 for both). We found both an obstructive CAD at CA and myocardial edema at CMR in 53.2% of patients, while 8.5% of patients had a non-obstructive CAD and no edema. However, 25.5% of patients had an obstructive CAD without edema, while 12.8% of patients showed edema despite a non-obstructive CAD. Furthermore, in 6 of the edema-positive patients with multi-vessels obstructive CAD, CMR identified myocardial edema in a vascular territory different from that of the lesion supposed to be the culprit at CA. CONCLUSIONS In a non-negligible percentage of NSTEMI patients, T1 and T2 mapping detect myocardial edema without significant stenosis at CA and vice versa. Therefore, CA and CMR edema imaging might provide complementary information in the evaluation of NSTEMI.
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Shaw JL, Nelson MD, Wei J, Motwani M, Landes S, Mehta PK, Thomson LEJ, Berman DS, Li D, Bairey Merz CN, Sharif B. Inverse association of MRI-derived native myocardial T1 and perfusion reserve index in women with evidence of ischemia and no obstructive CAD: A pilot study. Int J Cardiol 2018; 270:48-53. [PMID: 30041981 DOI: 10.1016/j.ijcard.2018.06.086] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 06/13/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND It has recently been shown that magnetic resonance (MR) "native T1" mapping is capable of characterizing abnormal microcirculation in patients with obstructive coronary artery disease (CAD). In studies involving women with signs and symptoms of ischemia and no obstructive CAD (INOCA), however, the potential role of native T1 as an imaging marker and its association with indices of diastolic function or vasodilator-induced myocardial ischemia have not been explored. We investigated whether native T1 in INOCA is associated with reduced myocardial perfusion reserve index (MPRI) or with diastolic dysfunction. METHODS Twenty-two female patients with INOCA and twelve female reference controls with matching age and body-mass index were studied. The patients had evidence of vasodilator-induced ischemia without obstructive CAD or any prior infarction. All 34 subjects underwent stress/rest MR including native T1 mapping (MOLLI 5(3)3) at 1.5-Tesla. RESULTS Compared with controls, patients had similar morphology/function. As expected, MPRI was significantly reduced in patients compared to controls (1.78 ± 0.39 vs. 2.49 ± 0.41, p < 0.0001). Native T1 was significantly elevated in patients (1040.1 ± 29.3 ms vs. 1003.8 ± 18.5 ms, p < 0.001) and the increased T1 showed a significant inverse correlation with MPRI (r = -0.481, p = 0.004), but was not correlated with reduced diastolic strain rate. CONCLUSIONS Symptomatic women with INOCA have elevated native T1 compared to matched reference controls and there is a significant association between elevated native T1 and impaired MPRI, considered a surrogate measure of ischemia severity in this cohort. Future studies in a larger cohort are needed to elucidate the mechanism underlying this inverse relationship.
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Affiliation(s)
- Jaime L Shaw
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States; Department of Bioengineering, University of California Los Angeles, CA, United States
| | - Michael D Nelson
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States; Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, United States
| | - Janet Wei
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States; Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, United States
| | - Manish Motwani
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Sofy Landes
- Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, United States
| | - Puja K Mehta
- Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, United States
| | - Louise E J Thomson
- Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, United States; Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Daniel S Berman
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States; Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, United States; David Geffen School of Medicine, University of California Los Angeles, CA, United States
| | - Debiao Li
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States; Department of Bioengineering, University of California Los Angeles, CA, United States; David Geffen School of Medicine, University of California Los Angeles, CA, United States
| | - C Noel Bairey Merz
- Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, United States; David Geffen School of Medicine, University of California Los Angeles, CA, United States
| | - Behzad Sharif
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States; Department of Bioengineering, University of California Los Angeles, CA, United States; David Geffen School of Medicine, University of California Los Angeles, CA, United States.
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Evaluation of Modified Look-Locker Inversion Recovery and Arrhythmia-Insensitive Rapid Cardiac T1 Mapping Pulse Sequences in Cardiomyopathy Patients. J Comput Assist Tomogr 2018; 42:732-738. [PMID: 29613994 DOI: 10.1097/rct.0000000000000746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of this study was to compare the performance of arrhythmia-insensitive rapid (AIR) and modified Look-Locker inversion recovery (MOLLI) T1 mapping in patients with cardiomyopathies. METHODS In 58 patients referred for clinical cardiac magnetic resonance imaging at 1.5 T, we compared MOLLI and AIR native and postcontrast T1 measurements. Two readers independently analyzed myocardial and blood T1 values. Agreement between techniques, interreader agreement per technique, and intrascan agreement per technique were evaluated. RESULTS The MOLLI and AIR T1 values were strongly correlated (r = 0.98); however, statistically significantly different T1 values were derived (bias 80 milliseconds, pooled data, P < 0.01). Both techniques demonstrated high repeatability (MOLLI, r = 1.00 and coefficient of repeatability [CR] = 72 milliseconds; AIR, r = 0.99 and CR = 184.2 milliseconds) and produced high interreader agreement (MOLLI, r = 1.00 and CR = 51.7 milliseconds; AIR, r = 0.99 and CR = 183.5 milliseconds). CONCLUSIONS Arrhythmia-insensitive rapid and MOLLI sequences produced significantly different T1 values in a diverse patient cohort.
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Zhou Y, Giffard-Roisin S, De Craene M, Camarasu-Pop S, D'Hooge J, Alessandrini M, Friboulet D, Sermesant M, Bernard O. A Framework for the Generation of Realistic Synthetic Cardiac Ultrasound and Magnetic Resonance Imaging Sequences From the Same Virtual Patients. IEEE TRANSACTIONS ON MEDICAL IMAGING 2018; 37:741-754. [PMID: 28574344 DOI: 10.1109/tmi.2017.2708159] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The use of synthetic sequences is one of the most promising tools for advanced in silico evaluation of the quantification of cardiac deformation and strain through 3-D ultrasound (US) and magnetic resonance (MR) imaging. In this paper, we propose the first simulation framework which allows the generation of realistic 3-D synthetic cardiac US and MR (both cine and tagging) image sequences from the same virtual patient. A state-of-the-art electromechanical (E/M) model was exploited for simulating groundtruth cardiac motion fields ranging from healthy to various pathological cases, including both ventricular dyssynchrony and myocardial ischemia. The E/M groundtruth along with template MR/US images and physical simulators were combined in a unified framework for generating synthetic data. We efficiently merged several warping strategies to keep the full control of myocardial deformations while preserving realistic image texture. In total, we generated 18 virtual patients, each with synthetic 3-D US, cine MR, and tagged MR sequences. The simulated images were evaluated both qualitatively by showing realistic textures and quantitatively by observing myocardial intensity distributions similar to real data. In particular, the US simulation showed a smoother myocardium/background interface than the state-of-the-art. We also assessed the mechanical properties. The pathological subjects were discriminated from the healthy ones by both global indexes (ejection fraction and the global circumferential strain) and regional strain curves. The synthetic database is comprehensive in terms of both pathology and modality, and has a level of realism sufficient for validation purposes. All the 90 sequences are made publicly available to the research community via an open-access database.
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Weingärtner S, Shenoy C, Rieger B, Schad LR, Schulz-Menger J, Akçakaya M. Temporally resolved parametric assessment of Z-magnetization recovery (TOPAZ): Dynamic myocardial T 1 mapping using a cine steady-state look-locker approach. Magn Reson Med 2017; 79:2087-2100. [PMID: 28856778 DOI: 10.1002/mrm.26887] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 08/02/2017] [Accepted: 08/02/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE To develop and evaluate a cardiac phase-resolved myocardial T1 mapping sequence. METHODS The proposed method for temporally resolved parametric assessment of Z-magnetization recovery (TOPAZ) is based on contiguous fast low-angle shot imaging readout after magnetization inversion from the pulsed steady state. Thereby, segmented k-space data are acquired over multiple heartbeats, before reaching steady state. This results in sampling of the inversion-recovery curve for each heart phase at multiple points separated by an R-R interval. Joint T1 and B1+ estimation is performed for reconstruction of cardiac phase-resolved T1 and B1+ maps. Sequence parameters are optimized using numerical simulations. Phantom and in vivo imaging are performed to compare the proposed sequence to a spin-echo reference and saturation pulse prepared heart rate-independent inversion-recovery (SAPPHIRE) T1 mapping sequence in terms of accuracy and precision. RESULTS In phantom, TOPAZ T1 values with integrated B1+ correction are in good agreement with spin-echo T1 values (normalized root mean square error = 4.2%) and consistent across the cardiac cycle (coefficient of variation = 1.4 ± 0.78%) and different heart rates (coefficient of variation = 1.2 ± 1.9%). In vivo imaging shows no significant difference in TOPAZ T1 times between the cardiac phases (analysis of variance: P = 0.14, coefficient of variation = 3.2 ± 0.8%), but underestimation compared with SAPPHIRE (T1 time ± precision: 1431 ± 56 ms versus 1569 ± 65 ms). In vivo precision is comparable to SAPPHIRE T1 mapping until middiastole (P > 0.07), but deteriorates in the later phases. CONCLUSIONS The proposed sequence allows cardiac phase-resolved T1 mapping with integrated B1+ assessment at a temporal resolution of 40 ms. Magn Reson Med 79:2087-2100, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Sebastian Weingärtner
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota, USA.,Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Computer Assisted Clinical Medicine, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Chetan Shenoy
- Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Benedikt Rieger
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Jeanette Schulz-Menger
- Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Joint Cooperation of the Max-Delbrück-Centrum and Charité-Medical University Berlin, Berlin, Germany.,Department of Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - Mehmet Akçakaya
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota, USA.,Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
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Walter TC, Knobloch G, Canaan-Kuehl S, Greiser A, Sandek A, Blaschke D, Denecke T, Hamm B, Makowski MR. Segment-by-segment assessment of left ventricular myocardial affection in Anderson-Fabry disease by non-enhanced T1-mapping. Acta Radiol 2017; 58:914-921. [PMID: 27799574 DOI: 10.1177/0284185116675657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background Anderson-Fabry disease (AFD) is an X-linked lysosomal enzyme disorder associated with an intracellular accumulation of sphingolipids, which shorten myocardial T1 relaxation times. Myocardial affection, however, varies between different segments. Purpose To evaluate the specific segmental distribution and degree of segmental affection in AFD patients. Material and Methods Twenty-five patients with AFD, 14 patients with hypertrophic cardiomyopathy (HCM), and 21 controls were included. A Modified Look-Locker Inversion Recovery sequence (MOLLI) was used for non-enhanced T1 mapping at 1.5 T in addition to standard cardiac imaging in 10-12 short axis views. T1 values were evaluated with a mixed model ANOVA and regression analysis to determine the best diagnostic cutoff values for T1 for each myocardial segment. Results Regression analysis showed the best diagnostic cutoff compared to controls in cardiac segments 1-4, 8-9, and 14. Mean differences between T1 for AFD versus HCM were greatest in segment 3, 4, and 9 (99 ms, 103 ms, 86 ms, respectively). Overall T1 times were 888 ± 70 ms and 903 ± 14 ms (AFD with and without LVH); 1014 ± 17 ms and 1001 ± 22 ms (HCM and controls, P < 0.05). Conclusion Myocardial segments are affected by a varying degree of T1 shortening in AFD patients. Segment-specific cutoff values allow the most specific detection and quantification of the extent of myocardial affection.
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Affiliation(s)
| | | | | | | | - Anja Sandek
- Department of Cardiology, University of Goettingen Medical School, Germany
| | | | | | - Bernd Hamm
- Department of Radiology, Charité, Germany
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Bulluck H, Hammond-Haley M, Fontana M, Knight DS, Sirker A, Herrey AS, Manisty C, Kellman P, Moon JC, Hausenloy DJ. Quantification of both the area-at-risk and acute myocardial infarct size in ST-segment elevation myocardial infarction using T1-mapping. J Cardiovasc Magn Reson 2017; 19:57. [PMID: 28764773 PMCID: PMC5539889 DOI: 10.1186/s12968-017-0370-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 07/04/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND A comprehensive cardiovascular magnetic resonance (CMR) in reperfused ST-segment myocardial infarction (STEMI) patients can be challenging to perform and can be time-consuming. We aimed to investigate whether native T1-mapping can accurately delineate the edema-based area-at-risk (AAR) and post-contrast T1-mapping and synthetic late gadolinium (LGE) images can quantify MI size at 1.5 T. Conventional LGE imaging and T2-mapping could then be omitted, thereby shortening the scan duration. METHODS Twenty-eight STEMI patients underwent a CMR scan at 1.5 T, 3 ± 1 days following primary percutaneous coronary intervention. The AAR was quantified using both native T1 and T2-mapping. MI size was quantified using conventional LGE, post-contrast T1-mapping and synthetic magnitude-reconstructed inversion recovery (MagIR) LGE and synthetic phase-sensitive inversion recovery (PSIR) LGE, derived from the post-contrast T1 maps. RESULTS Native T1-mapping performed as well as T2-mapping in delineating the AAR (41.6 ± 11.9% of the left ventricle [% LV] versus 41.7 ± 12.2% LV, P = 0.72; R2 0.97; ICC 0.986 (0.969-0.993); bias -0.1 ± 4.2% LV). There were excellent correlation and inter-method agreement with no bias, between MI size by conventional LGE, synthetic MagIR LGE (bias 0.2 ± 2.2%LV, P = 0.35), synthetic PSIR LGE (bias 0.4 ± 2.2% LV, P = 0.060) and post-contrast T1-mapping (bias 0.3 ± 1.8% LV, P = 0.10). The mean scan duration was 58 ± 4 min. Not performing T2 mapping (6 ± 1 min) and conventional LGE (10 ± 1 min) would shorten the CMR study by 15-20 min. CONCLUSIONS T1-mapping can accurately quantify both the edema-based AAR (using native T1 maps) and acute MI size (using post-contrast T1 maps) in STEMI patients without major cardiovascular risk factors. This approach would shorten the duration of a comprehensive CMR study without significantly compromising on data acquisition and would obviate the need to perform T2 maps and LGE imaging.
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Affiliation(s)
- Heerajnarain Bulluck
- The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, London, UK
| | - Matthew Hammond-Haley
- The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, London, UK
| | - Marianna Fontana
- National Amyloidosis Centre, University College London, Royal Free Hospital, London, UK
| | - Daniel S. Knight
- National Amyloidosis Centre, University College London, Royal Free Hospital, London, UK
| | - Alex Sirker
- The National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, UK
- Barts Heart Centre, St Bartholomew’s Hospital, London, UK
| | - Anna S. Herrey
- Barts Heart Centre, St Bartholomew’s Hospital, London, UK
| | | | - Peter Kellman
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, USA
| | - James C. Moon
- The National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, UK
- Barts Heart Centre, St Bartholomew’s Hospital, London, UK
| | - Derek J. Hausenloy
- The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, London, UK
- The National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, UK
- Barts Heart Centre, St Bartholomew’s Hospital, London, UK
- Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, Singapore, Singapore
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
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Nickander J, Lundin M, Abdula G, Sörensson P, Rosmini S, Moon JC, Kellman P, Sigfridsson A, Ugander M. Blood correction reduces variability and gender differences in native myocardial T1 values at 1.5 T cardiovascular magnetic resonance - a derivation/validation approach. J Cardiovasc Magn Reson 2017; 19:41. [PMID: 28376820 PMCID: PMC5381013 DOI: 10.1186/s12968-017-0353-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/14/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Myocardial native T1 measurements are likely influenced by intramyocardial blood. Since blood T1 is both variable and longer compared to myocardial T1, this will degrade the precision of myocardial T1 measurements. Precision could be improved by correction, but the amount of correction and the optimal blood T1 variables to correct with are unknown. We hypothesized that an appropriate correction would reduce the standard deviation (SD) of native myocardial T1. METHODS Consecutive patients (n = 400) referred for CMR with known or suspected heart disease were split into a derivation cohort for model construction (n = 200, age 51 ± 18 years, 50% male) and a validation cohort for assessing model performance (n = 200, age 48 ± 17 years, 50% male). Exclusion criteria included focal septal abnormalities. A Modified Look-Locker inversion recovery sequence (MOLLI, 1.5 T Siemens Aera) was used to acquire T1 and T1* maps. T1 and T1* maps were used to measure native myocardial T1, and blood T1 and T1*. A multivariate linear regression correction model was implemented using blood measurement of R1 (1/T1), R1* (1/T1*) or hematocrit. The correction model from the derivation cohort was applied to the validation cohort, and assessed for reduction in variability with the F-test. RESULTS Blood [LV + RV] mean R1, mean R1* and hematocrit correlated with myocardial T1 (Pearson's r, range 0.37 to 0.45, p < 0.05 for all) in both the derivation and validation cohorts respectively, suggesting that myocardial T1 measurements are influenced by intramyocardial blood. Mean myocardial native T1 did not differ between the derivation and validation cohorts (1030 ± 42.6 ms and 1023 ± 45.2 ms respectively, p = 0.07). In the derivation cohort, correction using blood mean R1 and mean R1* yielded a decrease in myocardial T1 SD (45.2 ms to 36.6 ms, p = 0.03). When the model from the derivation cohort was applied to the validation cohort, the SD reduction was maintained (39.3 ms, p = 0.049). This 13% reduction in measurement variability leads to a 23% reduction in sample size to detect a 50 ms difference in native myocardial T1. CONCLUSIONS Correcting native myocardial T1 for R1 and R1* of blood improves the precision of myocardial T1 measurement by ~13%, and could consequently improve disease detection and reduce sample size needs for clinical research.
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Affiliation(s)
- Jannike Nickander
- Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Lundin
- Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Goran Abdula
- Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Peder Sörensson
- Department of Medicine, Unit of Cardiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Stefania Rosmini
- Institute of Cardiovascular Science, University College London, London, UK
| | - James C. Moon
- Institute of Cardiovascular Science, University College London, London, UK
| | - Peter Kellman
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD USA
| | - Andreas Sigfridsson
- Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Martin Ugander
- Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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Kim PK, Hong YJ, Im DJ, Suh YJ, Park CH, Kim JY, Chang S, Lee HJ, Hur J, Kim YJ, Choi BW. Myocardial T1 and T2 Mapping: Techniques and Clinical Applications. Korean J Radiol 2017; 18:113-131. [PMID: 28096723 PMCID: PMC5240500 DOI: 10.3348/kjr.2017.18.1.113] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 07/29/2016] [Indexed: 01/02/2023] Open
Abstract
Cardiac magnetic resonance (CMR) imaging is widely used in various medical fields related to cardiovascular diseases. Rapid technological innovations in magnetic resonance imaging in recent times have resulted in the development of new techniques for CMR imaging. T1 and T2 image mapping sequences enable the direct quantification of T1, T2, and extracellular volume fraction (ECV) values of the myocardium, leading to the progressive integration of these sequences into routine CMR settings. Currently, T1, T2, and ECV values are being recognized as not only robust biomarkers for diagnosis of cardiomyopathies, but also predictive factors for treatment monitoring and prognosis. In this study, we have reviewed various T1 and T2 mapping sequence techniques and their clinical applications.
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Affiliation(s)
- Pan Ki Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Yoo Jin Hong
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Dong Jin Im
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Young Joo Suh
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Chul Hwan Park
- Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Jin Young Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Suyon Chang
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Hye-Jeong Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Jin Hur
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Young Jin Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Byoung Wook Choi
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
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Weingärtner S, Meßner NM, Budjan J, Loßnitzer D, Mattler U, Papavassiliu T, Zöllner FG, Schad LR. Myocardial T 1-mapping at 3T using saturation-recovery: reference values, precision and comparison with MOLLI. J Cardiovasc Magn Reson 2016; 18:84. [PMID: 27855705 PMCID: PMC5114738 DOI: 10.1186/s12968-016-0302-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 11/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myocardial T1-mapping recently emerged as a promising quantitative method for non-invasive tissue characterization in numerous cardiomyopathies. Commonly performed with an inversion-recovery (IR) magnetization preparation at 1.5T, the application at 3T has gained due to increased quantification precision. Alternatively, saturation-recovery (SR) T1-mapping has recently been introduced at 1.5T for improved accuracy. Thus, the purpose of this study is to investigate the robustness and precision of SR T1-mapping at 3T and to establish accurate reference values for native T1-times and extracellular volume fraction (ECV) of healthy myocardium. METHODS Balanced Steady-State Free-Precession (bSSFP) Saturation-Pulse Prepared Heart-rate independent Inversion-REcovery (SAPPHIRE) and Saturation-recovery Single-SHot Acquisition (SASHA) T1-mapping were compared with the Modified Look-Locker inversion recovery (MOLLI) sequence at 3T. Accuracy and precision were studied in phantom. Native and post-contrast T1-times and regional ECV were determined in 20 healthy subjects (10 men, 27 ± 5 years). Subjective image quality, susceptibility artifact rating, in-vivo precision and reproducibility were analyzed. RESULTS SR T1-mapping showed <4 % deviation from the spin-echo reference in phantom in the range of T1 = 100-2300 ms. The average quality and artifact scores of the T1-mapping methods were: MOLLI:3.4/3.6, SAPPHIRE:3.1/3.4, SASHA:2.9/3.2; (1: poor - 4: excellent/1: strong - 4: none). SAPPHIRE and SASHA yielded significantly higher T1-times (SAPPHIRE: 1578 ± 42 ms, SASHA: 1523 ± 46 ms), in-vivo T1-time variation (SAPPHIRE: 60.1 ± 8.7 ms, SASHA: 70.0 ± 9.3 ms) and lower ECV-values (SAPPHIRE: 0.20 ± 0.02, SASHA: 0.21 ± 0.03) compared with MOLLI (T1: 1181 ± 47 ms, ECV: 0.26 ± 0.03, Precision: 53.7 ± 8.1 ms). No significant difference was found in the inter-subject variability of T1-times or ECV-values (T1: p = 0.90, ECV: p = 0.78), the observer agreement (inter: p > 0.19; intra: p > 0.09) or consistency (inter: p > 0.07; intra: p > 0.17) between the three methods. CONCLUSIONS Saturation-recovery T1-mapping at 3T yields higher accuracy, comparable inter-subject, inter- and intra-observer variability and less than 30 % precision-loss compared to MOLLI.
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Affiliation(s)
- Sebastian Weingärtner
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN USA
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN USA
| | - Nadja M. Meßner
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
- DZHK (German Centre for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Johannes Budjan
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dirk Loßnitzer
- 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Uwe Mattler
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Theano Papavassiliu
- DZHK (German Centre for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany
- 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Frank G. Zöllner
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Lothar R. Schad
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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Lin K, Meng L, Collins JD, Chowdhary V, Markl M, Carr JC. Heart deformation analysis: the distribution of regional myocardial motion patterns at left ventricle. Int J Cardiovasc Imaging 2016; 33:351-359. [PMID: 27783187 DOI: 10.1007/s10554-016-1005-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 10/20/2016] [Indexed: 12/14/2022]
Abstract
The aim of the present study was to test the hypothesis that heart deformation analysis (HDA) is able to discriminate regional myocardial motion patterns on the left ventricle (LV). Totally 21 healthy volunteers (15 men and 6 women) without documented cardiovascular diseases were recruited. Cine MRI was performed on those subjects at four-chamber, two-chamber, and short-axis views. The variations of segmental myocardial motion indices of the LV, which were measured with the HDA tool, were investigated. Regional displacement, velocity, strain and strain rate were compared between lateral wall and septal wall using t tests. There are significant variations (CoV = 18.0-72.4%) of myocardial motion indices (average over 21 subjects) among 16 myocardial segments. There are significant differences (p < 0.05) between displacement, velocity, strain and strain rate measured at lateral and septal areas of the LV. In conclusion, HDA is able to present different regional LV motion patterns from multiple aspects in healthy volunteers.
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Affiliation(s)
- Kai Lin
- Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL, 60611, USA.
| | - Leng Meng
- Department of Radiology, Anzhen Hospital, Capital Medical University, Anzhen Li, Chaoyang District, Beijing, 100029, China
| | - Jeremy D Collins
- Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL, 60611, USA
| | - Varun Chowdhary
- Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL, 60611, USA
| | - Michael Markl
- Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL, 60611, USA
| | - James C Carr
- Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL, 60611, USA
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Mapeo miocárdico con resonancia magnética cardiaca: valor diagnóstico de las nuevas secuencias. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.04.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Sanz J, LaRocca G, Mirelis JG. Myocardial Mapping With Cardiac Magnetic Resonance: The Diagnostic Value of Novel Sequences. ACTA ACUST UNITED AC 2016; 69:849-61. [PMID: 27450946 DOI: 10.1016/j.rec.2016.04.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 04/18/2016] [Indexed: 01/05/2023]
Abstract
Cardiac magnetic resonance has evolved into a crucial modality for the evaluation of cardiomyopathy due to its ability to characterize myocardial structure and function. In the last few years, interest has increased in the potential of "mapping" techniques that provide direct and objective quantification of myocardial properties such as T1, T2, and T2* times. These approaches enable the detection of abnormalities that affect the myocardium in a diffuse fashion and/or may be too subtle for visual recognition. This article reviews the current state of myocardial T1 and T2-mapping in both health and disease.
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Affiliation(s)
- Javier Sanz
- The Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai School of Medicine, New York, United States; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
| | - Gina LaRocca
- The Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai School of Medicine, New York, United States
| | - Jesús G Mirelis
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
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Native myocardial T1 mapping in pulmonary hypertension: correlations with cardiac function and hemodynamics. Eur Radiol 2016; 27:157-166. [PMID: 27121929 PMCID: PMC5127865 DOI: 10.1007/s00330-016-4360-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 03/04/2016] [Accepted: 04/08/2016] [Indexed: 11/25/2022]
Abstract
Objectives To analyze alterations in left ventricular (LV) myocardial T1 times in patients with pulmonary hypertension (PH) and to investigate their associations with ventricular function, mass, geometry and hemodynamics. Methods Fifty-eight patients with suspected PH underwent right heart catheterization (RHC) and 3T cardiac magnetic resonance imaging. Ventricular function, geometry and mass were derived from cine real-time short-axis images. Myocardial T1 maps were acquired by a prototype modified Look-Locker inversion-recovery sequence in short-axis orientations. LV global, segmental and ventricular insertion point (VIP) T1 times were evaluated manually and corrected for blood T1. Results Septal, lateral, global and VIP T1 times were significantly higher in PH than in non-PH subjects (septal, 1249 ± 58 ms vs. 1186 ± 33 ms, p < 0.0001; lateral, 1190 ± 45 ms vs. 1150 ± 33 ms, p = 0.0003; global, 1220 ± 52 ms vs. 1171 ± 29 ms, p < 0.0001; VIP, 1298 ± 78 ms vs. 1193 ± 31 ms, p < 0.0001). In PH, LV eccentricity index was the strongest linear predictor of VIP T1 (r = 0.72). Septal, lateral and global T1 showed strong correlations with VIP T1 (r = 0.81, r = 0.59 and r = 0.75, respectively). Conclusions In patients with PH, T1 times in VIPs and in the entire LV myocardium are elevated. LV eccentricity strongly correlates with VIP T1 time, which in turn is strongly associated with T1 time changes in the entire LV myocardium. Key Points • Native T1 mapping detects left ventricular myocardial alterations in pulmonary hypertension • In pulmonary hypertension, native T1 times at ventricular insertion points are increased • These T1 times correlate strongly with left ventricular eccentricity • In pulmonary hypertension, global and segmental myocardial T1 times are increased • Global, segmental and ventricular insertion point T1 times are strongly correlated
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Zhao L, Li S, Ma X, Greiser A, Zhang T, An J, Bai R, Dong J, Fan Z. Systolic MOLLI T1 mapping with heart-rate-dependent pulse sequence sampling scheme is feasible in patients with atrial fibrillation. J Cardiovasc Magn Reson 2016; 18:13. [PMID: 26980571 PMCID: PMC4793619 DOI: 10.1186/s12968-016-0232-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/04/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND T1 mapping enables assessment of myocardial characteristics. As the most common type of arrhythmia, atrial fibrillation (AF) is often accompanied by a variety of cardiac pathologies, whereby the irregular and usually rapid ventricle rate of AF may cause inaccurate T1 estimation due to mis-triggering and inadequate magnetization recovery. We hypothesized that systolic T1 mapping with a heart-rate-dependent (HRD) pulse sequence scheme may overcome this issue. METHODS 30 patients with AF and 13 healthy volunteers were enrolled and underwent cardiovascular magnetic resonance (CMR) at 3 T. CMR was repeated for 3 patients after electric cardioversion and for 2 volunteers after lowering heart rate (HR). A Modified Look-Locker Inversion Recovery (MOLLI) sequence was acquired before and 15 min after administration of 0.1 mmol/kg gadopentetate dimeglumine. For AF patients, both the fixed 5(3)3/4(1)3(1)2 and the HRD sampling scheme were performed at diastole and systole, respectively. The HRD pulse sequence sampling scheme was 5(n)3/4(n)3(n)2, where n was determined by the heart rate to ensure adequate magnetization recovery. Image quality of T1 maps was assessed. T1 times were measured in myocardium and blood. Extracellular volume fraction (ECV) was calculated. RESULTS In volunteers with repeated T1 mapping, the myocardial native T1 and ECV generated from the 1st fixed sampling scheme were smaller than from the 1st HRD and 2nd fixed sampling scheme. In healthy volunteers, the overall native T1 times and ECV of the left ventricle (LV) in diastolic T1 maps were greater than in systolic T1 maps (P < 0.01, P < 0.05). In the 3 AF patients that had received electrical cardioversion therapy, the myocardial native T1 times and ECV generated from the fixed sampling scheme were smaller than in the 1st and 2nd HRD sampling scheme (all P < 0.05). In patients with AF (HR: 88 ± 20 bpm, HR fluctuation: 12 ± 9 bpm), more T1 maps with artifact were found in diastole than in systole (P < 0.01). The overall native T1 times and ECV of the left ventricle (LV) in diastolic T1 maps were greater than systolic T1 maps, either with fixed or HRD sampling scheme (all P < 0.05). CONCLUSION Systolic MOLLI T1 mapping with heart-rate-dependent pulse sequence scheme can improve image quality and avoid T1 underestimation. It is feasible and with further validation may extend clinical applicability of T1 mapping to patients with atrial fibrillation.
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Affiliation(s)
- Lei Zhao
- />Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
| | - Songnan Li
- />Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaohai Ma
- />Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
| | | | - Tianjing Zhang
- />MR Collaborations NE Asia, Siemens Healthcare, Beijing, China
| | - Jing An
- />MR Collaborations NE Asia, Siemens Healthcare, Beijing, China
| | - Rong Bai
- />Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jianzeng Dong
- />Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhanming Fan
- />Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
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