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Yang Y, Hair J, Yerly J, Piccini D, Di Sopra L, Bustin A, Prsa M, Si-Mohamed S, Stuber M, Oshinski JN. Quiescent frame, contrast-enhanced coronary magnetic resonance angiography reconstructed using limited number of physiologic frames from 5D free-running acquisitions. Magn Reson Imaging 2024; 113:110209. [PMID: 38972471 DOI: 10.1016/j.mri.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/12/2024] [Accepted: 07/03/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND 5D, free-running imaging resolves sets of 3D whole-heart images in both cardiac and respiratory dimensions. In an application such as coronary imaging when a single, static image is of interest, computationally expensive offline iterative reconstruction is still needed to compute the multiple 3D datasets. PURPOSE Evaluate how the number of physiologic bins included in the reconstruction affects the computational cost and resulting image quality of a single, static volume reconstruction. STUDY TYPE Retrospective. SUBJECTS 15 pediatric patients following Ferumoxytol infusion (4 mg/kg). FIELD STRENGTH/SEQUENCE 1.5 T/Ungated 5D free-running GRE sequence. ASSESSMENT The raw data of each subject were binned and reconstructed into a 5D (x-y-z-cardiac-respiratory) images. 1, 3, 5, 7, and 9 bins adjacent to both sides of the retrospectively determined cardiac resting phase and 1, 3 bins adjacent to the end-expiration phase are used for limited frame reconstructions. The static volume within each limited reconstruction was compared with the corresponding full 5D reconstruction using the structural similarity index measure (SSIM). A non-linear regression model was used to fit SSIM with the percentage of data used compared to full reconstruction (% data). A linear regression model was used to fit computation time with % raw data used. Coronary artery sharpness is measured on each limited reconstructed images to determine the minimal number of cardiac and respiratory bins needed to preserve image quality. STATISTICAL TESTS The coefficient of determination (R2) is computed for each regression model. RESULTS The % of data used in the reconstruction was linearly related to the computational time (R2 = 0.99). The SSIM of the static image from the limited reconstructions is non-linearly related with the % of data used (R2 = 0.80). Over the 15 patients, the model showed SSIM of 0.9 with 18% of data, and SSIM of 0.96 with 30% of data. The coronary artery sharpness of images reconstructed using no less than 5 cardiac and all respiratory phases is not significantly different from the full reconstructed images using all cardiac and respiratory bins. DATA CONCLUSION Reconstruction using only a limited number of acquired physiological states can linearly reduce the computational cost while preserving similarity to the full reconstruction image. It is suggested to use no less than 5 cardiac and all respiratory phases in the limited reconstruction to best preserve the original quality seen on the full reconstructed images.
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Affiliation(s)
- Yitong Yang
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Jackson Hair
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Center for Biomedical Imaging, Lausanne, Switzerland
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland
| | - Lorenzo Di Sopra
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Center for Biomedical Imaging, Lausanne, Switzerland
| | - Aurelien Bustin
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Center for Biomedical Imaging, Lausanne, Switzerland
| | - Milan Prsa
- Department of Interventional Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Salim Si-Mohamed
- Department of Radiology, University of Claude Bernard Lyon 1., Lyon, France
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Center for Biomedical Imaging, Lausanne, Switzerland
| | - John N Oshinski
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States; Department of Radiology, Emory University School of Medicine, Atlanta, GA, United States.
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Zhou Z, Wei D, Azhe S, Fu C, Zhou X, An J, Piccini D, Bastiaansen J, Guo Y, Wen L. Self-navigated coronary MR angiography for coronary aneurysm detection in Kawasaki disease at 3T: comparison with conventional diaphragm-navigated coronary MR angiography. Eur Radiol 2024; 34:3400-3410. [PMID: 37857903 DOI: 10.1007/s00330-023-10350-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/26/2023] [Accepted: 08/24/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVES To assess the scan time, image quality, and diagnostic performance of self-navigated coronary MR angiography (SN-CMRA) for coronary aneurysm (CAA) detection in Kawasaki disease (KD) patients and compare it with diaphragm-navigated CMRA (DN-CMRA). MATERIALS AND METHODS SN-CMRA and DN-CMRA were performed on 76 pediatric patients with KD (48 males, 6.75 ± 3.59 years). Thirty-three of whom underwent coronary CT angiography (CCTA)/invasive coronary angiography (ICA). The scan time and qualitative and quantitative image quality assessment were compared between the two sequences. The diagnostic performance for CAA detection by the two approaches using CCTA/ICA as the reference standard was compared on per-patient, per-vessel, and per-segment basis. RESULTS The scan time of SN-CMRA was significantly shorter than that of DN-CMRA (7.49 ± 2.31 min vs. 10.03 ± 4.47 min, p < 0.001). There was no difference in overall and segmental image quality to reach the clinical diagnostic criteria between the two sequences (all p > 0.05). No significant difference in vessel length of the three main coronary arteries was found between the two approaches (all p > 0.05). Moreover, SN-CMRA showed no difference from DN-CMRA in contrast ratio of blood-myocardium (1.25 (interquartile range [IQR], 1.06 to 1.51) vs. 1.18 (IQR, 0.95 to 1.64), p = 0.706). There was no difference in the diagnostic accuracy of SN-CMRA and DN-CMRA for CAA detection on per-patient, per-vessel, or per-segment basis (all p > 0.05). CONCLUSION SN-CMRA at 3T showed reliable diagnostic performance and application value for CAA detection in children with KD. Compared with DN-CMRA, SN-CMRA can simplify the scanning procedure and shorten the scan time, achieving comparable image quality and diagnostic accuracy. CLINICAL RELEVANCE STATEMENT Coronary aneurysm in children with Kawasaki disease (KD) can be detected by self-navigated coronary MR angiography (CMRA) non-invasively and without radiation, achieving comparable image quality and diagnostic performance as diaphragm-navigated CMRA while shortening scanning time. It can provide reference for risk stratification and treatment management of KD. KEY POINTS • Evaluating the size of coronary aneurysm is important for risk stratification and treatment of Kawasaki disease. • Self-navigated coronary MR angiography (SN-CMRA) shortens scan time and achieves comparable image quality and diagnostic performance compared with diaphragm-navigated coronary MR angiography. • SN-CMRA can evaluate coronary aneurysm non-invasively and without radiation, providing information for risk stratification and treatment.
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Affiliation(s)
- Zhongqin Zhou
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Dongmei Wei
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), West China Second Hospital, Sichuan University, Chengdu, China
| | - Shiganmo Azhe
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Chuan Fu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Xiaoyue Zhou
- Siemens Healthineers Digital Technology (Shanghai) Co., Ltd., Shanghai, 200131, China
| | - Jing An
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Jessica Bastiaansen
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
- Translation Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Yingkun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Lingyi Wen
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
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Ishida M, Yerly J, Ito H, Takafuji M, Nakamori S, Takase S, Ichiba Y, Komori Y, Dohi K, Piccini D, Bastiaansen JA, Stuber M, Sakuma H. Optimal Protocol for Contrast-enhanced Free-running 5D Whole-heart Coronary MR Angiography at 3T. Magn Reson Med Sci 2024; 23:225-237. [PMID: 36682776 PMCID: PMC11024717 DOI: 10.2463/mrms.tn.2022-0086] [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: 07/14/2022] [Accepted: 11/11/2022] [Indexed: 01/20/2023] Open
Abstract
Free-running 5D whole-heart coronary MR angiography (MRA) is gaining in popularity because it reduces scanning complexity by removing the need for specific slice orientations, respiratory gating, or cardiac triggering. At 3T, a gradient echo (GRE) sequence is preferred in combination with contrast injection. However, neither the injection scheme of the gadolinium (Gd) contrast medium, the choice of the RF excitation angle, nor the dedicated image reconstruction parameters have been established for 3T GRE free-running 5D whole-heart coronary MRA. In this study, a Gd injection scheme, RF excitation angles of lipid-insensitive binominal off-resonance RF excitation (LIBRE) pulse for valid fat suppression and continuous data acquisition, and compressed-sensing reconstruction regularization parameters were optimized for contrast-enhanced free-running 5D whole-heart coronary MRA using a GRE sequence at 3T. Using this optimized protocol, contrast-enhanced free-running 5D whole-heart coronary MRA using a GRE sequence is feasible with good image quality at 3T.
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Affiliation(s)
- Masaki Ishida
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Haruno Ito
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | | | - Shiro Nakamori
- Department of Cardiology, Mie University Hospital, Tsu, Mie, Japan
| | - Shinichi Takase
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | | | | | - Kaoru Dohi
- Department of Cardiology, Mie University Hospital, Tsu, Mie, Japan
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Jessica A.M. Bastiaansen
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Hajime Sakuma
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
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Wang J, Han B, Ma M, Zhao Y, Li B, Zhou J, Wu C, Zhang X, Pan J, Sun SK. Magnetic Resonance Angiography with Hour-Scale Duration after Single Low-Dose Administration of Biocompatible Gadolinium Oxide Nanoprobe. Adv Healthc Mater 2024; 13:e2303389. [PMID: 38164886 DOI: 10.1002/adhm.202303389] [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: 10/06/2023] [Revised: 12/17/2023] [Indexed: 01/03/2024]
Abstract
Long-term contrast-enhanced angiography offers significant advantages in theranostics for diverse vascular diseases, particularly in terms of real-time dynamic monitoring during acute vascular events; However, achieving vascular imaging with a duration of hours through a single administration of low-dose contrast agent remains challenging. Herein, a hyaluronic acid-templated gadolinium oxide (HA@Gd2O3) nanoprobe-enhanced magnetic resonance angiography (MRA) is proposed to address this bottleneck issue for the first time. The HA@Gd2O3 nanoprobe synthesized from a facile one-pot biomineralization method owns ultrasmall size, good biocompatibility, optimal circulation half-life (≈149 min), and a relatively high T1 relaxivity (r1) under both clinical 3 T (8.215 mM-1s-1) and preclinical 9.4 T (4.023 mM-1s-1) equipment. The HA@Gd2O3 nanoprobe-enhanced MRA highlights major vessels readily with significantly improved contrast, extended imaging duration for at least 2 h, and ultrahigh resolution of 0.15 mm under 9.4 T, while only requiring half clinical dosage of Gd. This technique can enable rapid diagnosis and real-time dynamic monitoring of vascular changes in a model of acute superior mesenteric vein thrombosis with only a single injection of nanoprobe. The HA@Gd2O3 nanoprobe-enhanced MRA provides a sophisticated approach for long-term (hour scale) vascular imaging with ultrahigh resolution and high contrast through single administration of low-dose contrast agent.
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Affiliation(s)
- Jiaojiao Wang
- Department of Radiology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Bing Han
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Min Ma
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Yujie Zhao
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Bingjie Li
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Junzi Zhou
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Chao Wu
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Xuening Zhang
- Department of Radiology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Jinbin Pan
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Shao-Kai Sun
- School of Medical Imaging, Tianjin Medical University, Tianjin, 300203, China
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5
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Tenisch E, Rutz T. The unmet needs for aortic diameter determination in patients with aortopathies. Int J Cardiol 2023; 393:131299. [PMID: 37657669 DOI: 10.1016/j.ijcard.2023.131299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 08/27/2023] [Indexed: 09/03/2023]
Affiliation(s)
- Estelle Tenisch
- Pediatric Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Tobias Rutz
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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6
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Alkassar M, Engelhardt S, Abu-Tair T, Ojeda E, Treffer PC, Weyand M, Rompel O. Comparative Study of 2D-Cine and 3D-wh Volumetry: Revealing Systemic Error of 2D-Cine Volumetry. Diagnostics (Basel) 2023; 13:3162. [PMID: 37891983 PMCID: PMC10605840 DOI: 10.3390/diagnostics13203162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/28/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
This study investigates the crucial factors influencing the end-systolic and end-diastolic volumes in MRI volumetry and their direct effects on the derived functional parameters. Through the simultaneous acquisition of 2D-cine and 3D whole-heart slices in end-diastole and end-systole, we present a novel direct comparison of the volumetric measurements from both methods. A prospective study was conducted with 18 healthy participants. Both 2D-cine and 3D whole-heart sequences were obtained. Despite the differences in the creation of 3D volumes and trigger points, the impact on the LV volume was minimal (134.9 mL ± 16.9 mL vs. 136.6 mL ± 16.6 mL, p < 0.01 for end-diastole; 50.6 mL ± 11.0 mL vs. 51.6 mL ± 11.2 mL, p = 0.03 for end-systole). In our healthy patient cohort, a systematic underestimation of the end-systolic volume resulted in a significant overestimation of the SV (5.6 mL ± 2.6 mL, p < 0.01). The functional calculations from the 3D whole-heart method proved to be highly accurate and correlated well with function measurements from the phase-contrast sequences. Our study is the first to demonstrate the superiority of 3D whole-heart volumetry over 2D-cine volumetry and sheds light on the systematic error inherent in 2D-cine measurements.
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Affiliation(s)
- Muhnnad Alkassar
- Department of Cardiac Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.E.); (M.W.)
- Department of Pediatrics, Paracelsus Medical School, General Hospital of Nuremberg, 90419 Nuremberg, Germany
| | - Sophia Engelhardt
- Department of Cardiac Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.E.); (M.W.)
| | - Tariq Abu-Tair
- Department of Congenital Heart Disease, Centre for Diseases in Childhood and Adolescence, University Medicine Mainz, 55131 Mainz, Germany;
| | - Efren Ojeda
- Siemens Healtineers, 91052 Erlangen, Germany; (E.O.); (P.C.T.)
| | | | - Michael Weyand
- Department of Cardiac Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.E.); (M.W.)
| | - Oliver Rompel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany;
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7
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Tian D, Sun Y, Guo JJ, Zhao SH, Lu HF, Chen YY, Ge MY, Zeng MS, Jin H. 3.0 T unenhanced Dixon water-fat separation whole-heart coronary magnetic resonance angiography: compressed-sensing sensitivity encoding imaging versus conventional 2D sensitivity encoding imaging. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:1775-1784. [PMID: 37428247 DOI: 10.1007/s10554-023-02878-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/16/2023] [Indexed: 07/11/2023]
Abstract
This study was aimed to investigate 3.0 T unenhanced Dixon water-fat whole-heart CMRA (coronary magnetic resonance angiography) using compressed-sensing sensitivity encoding (CS-SENSE) and conventional sensitivity encoding (SENSE) in vitro and in vivo. The key parameters of CS-SENSE and conventional 1D/2D SENSE were compared in vitro phantom study. In vivo study, fifty patients with suspected coronary artery disease (CAD) completed unenhanced Dixon water-fat whole-heart CMRA at 3.0 T using both CS-SENSE and conventional 2D SENSE methods. We compared mean acquisition time, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and the diagnostic accuracy between two techniques. In vitro study, CS-SENSE achieved better effectiveness between higher SNR/CNR and shorter scan times using the appropriate acceleration factor compared with conventional 2D SENSE. In vivo study, CS-SENSE CMRA had better performance than 2D SENSE in terms of the mean acquisition time, SNR and CNR (7.4 ± 3.2 min vs. 8.3 ± 3.4 min, P = 0.001; SNR: 115.5 ± 35.4 vs. 103.3 ± 32.2; CNR: 101.1 ± 33.2 vs. 90.6 ± 30.1, P < 0.001 for both). The diagnostic accuracy between CS-SENSE and 2D SENSE had no significant difference on a patient-based analysis (sensitivity: 97.3% vs. 91.9%; specificity: 76.9% vs. 61.5%; accuracy: 92.0% vs. 84.0%; P > 0.05 for each). Unenhanced CS-SENSE Dixon water-fat separation whole-heart CMRA at 3.0 T can improve the SNR and CNR, shorten the acquisition time while providing equally satisfactory image quality and diagnostic accuracy compared with 2D SENSE CMRA.
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Affiliation(s)
- Di Tian
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Yi Sun
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Jia-Jun Guo
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Shi-Hai Zhao
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Hong-Fei Lu
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Yin-Yin Chen
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Mei-Ying Ge
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China.
| | - Meng-Su Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China
| | - Hang Jin
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Rd, Shanghai, 200032, China.
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Kato S, Azuma M, Nakayama N, Fukui K, Ito M, Saito N, Horita N, Utsunomiya D. Diagnostic accuracy of whole heart coronary magnetic resonance angiography: a systematic review and meta-analysis. J Cardiovasc Magn Reson 2023; 25:36. [PMID: 37357310 PMCID: PMC10291762 DOI: 10.1186/s12968-023-00949-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND The purpose of this meta-analysis was to comprehensively investigate the diagnostic ability of 1.5 T and 3.0 T whole heart coronary angiography (WHCA) to detect significant coronary artery disease (CAD) on X-ray coronary angiography. METHODS A literature search of electronic databases, including PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE, was performed to retrieve and integrate articles showing significant CAD detectability of 1.5 and 3.0 T WHCA. RESULTS Data from 1899 patients from 34 studies were included in the meta-analysis. 1.5 T WHCA had a summary area under ROC of 0.88 in the patient-based analysis, 0.90 in the vessel-based analysis, and 0.92 in the segment-based analysis. These values for 3.0 T WHCA were 0.94, 0.95, 0.96, respectively. Contrast-enhanced 3.0 T WHCA had significantly higher specificity than non-contrast-enhanced 1.5 T WHCA on a patient-based analysis (0.87, 95% CI 0.80-0.92 vs. 0.74, 95% CI 0.64-0.82, P = 0.02). There were no differences in diagnostic performance on a patient-based analysis by use of vasodilators, beta-blockers or between Asian and Western countries. CONCLUSIONS The diagnostic performance of WHCA was deemed satisfactory, with contrast-enhanced 3.0 T WHCA exhibiting higher specificity compared to non-contrast-enhanced 1.5 T WHCA in a patient-based analysis. There were no significant differences in diagnostic performance on a patient-based analysis in terms of vasodilator or beta-blocker use, nor between Asian and Western countries. However, further large-scale multicentre studies are crucial for the widespread global adoption of WHCA.
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Affiliation(s)
- Shingo Kato
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Mai Azuma
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Naoki Nakayama
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Kazuki Fukui
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Masanori Ito
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Naka Saito
- Department of Clinical Laboratory, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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9
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Koundinyan SP, Baron CA, Malavé MO, Ong F, Addy NO, Cheng JY, Yang PC, Hu BS, Nishimura DG. High-resolution, respiratory-resolved coronary MRA using a Phyllotaxis-reordered variable-density 3D cones trajectory. Magn Reson Imaging 2023; 98:140-148. [PMID: 36646397 PMCID: PMC9991864 DOI: 10.1016/j.mri.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
PURPOSE To develop a respiratory-resolved motion-compensation method for free-breathing, high-resolution coronary magnetic resonance angiography (CMRA) using a 3D cones trajectory. METHODS To achieve respiratory-resolved 0.98 mm resolution images in a clinically relevant scan time, we undersample the imaging data with a variable-density 3D cones trajectory. For retrospective motion compensation, translational estimates from 3D image-based navigators (3D iNAVs) are used to bin the imaging data into four phases from end-expiration to end-inspiration. To ensure pseudo-random undersampling within each respiratory phase, we devise a phyllotaxis readout ordering scheme mindful of eddy current artifacts in steady state free precession imaging. Following binning, residual 3D translational motion within each phase is computed using the 3D iNAVs and corrected for in the imaging data. The noise-like aliasing characteristic of the combined phyllotaxis and cones sampling pattern is leveraged in a compressed sensing reconstruction with spatial and temporal regularization to reduce aliasing in each of the respiratory phases. RESULTS In initial studies of six subjects, respiratory motion compensation using the proposed method yields improved image quality compared to non-respiratory-resolved approaches with no motion correction and with 3D translational correction. Qualitative assessment by two cardiologists and quantitative evaluation with the image edge profile acutance metric indicate the superior sharpness of coronary segments reconstructed with the proposed method (P < 0.01). CONCLUSION We have demonstrated a new method for free-breathing, high-resolution CMRA based on a variable-density 3D cones trajectory with modified phyllotaxis ordering and respiratory-resolved motion compensation with 3D iNAVs.
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Affiliation(s)
| | - Corey A Baron
- Medical Biophysics, Western University, London, Ontario, Canada
| | - Mario O Malavé
- Electrical Engineering, Stanford University, Stanford, CA, United States
| | - Frank Ong
- Electrical Engineering, Stanford University, Stanford, CA, United States
| | - Nii Okai Addy
- Electrical Engineering, Stanford University, Stanford, CA, United States
| | - Joseph Y Cheng
- Electrical Engineering, Stanford University, Stanford, CA, United States; Radiology, Stanford University, Stanford, CA, United States
| | - Phillip C Yang
- Cardiovascular Medicine, Stanford University, Stanford, CA, United States
| | - Bob S Hu
- Electrical Engineering, Stanford University, Stanford, CA, United States; Cardiology, Palo Alto Medical Foundation, Palo Alto, CA, United States
| | - Dwight G Nishimura
- Electrical Engineering, Stanford University, Stanford, CA, United States.
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10
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Whittington B, Dweck MR, van Beek EJR, Newby D, Williams MC. PET-MRI of Coronary Artery Disease. J Magn Reson Imaging 2023; 57:1301-1311. [PMID: 36524452 DOI: 10.1002/jmri.28554] [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: 05/10/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Simultaneous positron emission tomography and magnetic resonance imaging (PET-MRI) combines the anatomical detail and tissue characterization of MRI with the functional information from PET. Within the coronary arteries, this hybrid technique can be used to identify biological activity combined with anatomically high-risk plaque features to better understand the processes underlying coronary atherosclerosis. Furthermore, the downstream effects of coronary artery disease on the myocardium can be characterized by providing information on myocardial perfusion, viability, and function. This review will describe the current capabilities of PET-MRI in coronary artery disease and discuss the limitations and future directions of this emerging technique. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Beth Whittington
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging Facility QMRI, University of Edinburgh, Edinburgh, UK
| | - Marc R Dweck
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging Facility QMRI, University of Edinburgh, Edinburgh, UK
| | | | - David Newby
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging Facility QMRI, University of Edinburgh, Edinburgh, UK
| | - Michelle C Williams
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging Facility QMRI, University of Edinburgh, Edinburgh, UK
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11
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Moscatelli S, Leo I, Lisignoli V, Boyle S, Bucciarelli-Ducci C, Secinaro A, Montanaro C. Cardiovascular Magnetic Resonance from Fetal to Adult Life-Indications and Challenges: A State-of-the-Art Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050763. [PMID: 37238311 DOI: 10.3390/children10050763] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023]
Abstract
Cardiovascular magnetic resonance (CMR) imaging offers a comprehensive, non-invasive, and radiation-free imaging modality, which provides a highly accurate and reproducible assessment of cardiac morphology and functions across a wide spectrum of cardiac conditions spanning from fetal to adult life. It minimises risks to the patient, particularly the risks associated with exposure to ionising radiation and the risk of complications from more invasive haemodynamic assessments. CMR utilises high spatial resolution and provides a detailed assessment of intracardiac and extracardiac anatomy, ventricular and valvular function, and flow haemodynamic and tissue characterisation, which aid in the diagnosis, and, hence, with the management of patients with cardiac disease. This article aims to discuss the role of CMR and the indications for its use throughout the different stages of life, from fetal to adult life.
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Affiliation(s)
- Sara Moscatelli
- Inherited Cardiovascular Diseases, Great Ormond Street, Children NHS Foundation Trust, London WC1N 3JH, UK
- Paediatric Cardiology Department, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 5NP, UK
| | - Isabella Leo
- Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy
- CMR Unit, Cardiology Department, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 5NP, UK
| | - Veronica Lisignoli
- Department of Cardiac Surgery, Cardiology, Heart and Lung Transplantation, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy
- Adult Congenital Heart Disease Department, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 5NP, UK
| | - Siobhan Boyle
- Adult Congenital Heart Disease Department, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 5NP, UK
- Cardiology Department, Logan Hospital, Loganlea Rd, Meadowbrook, QLD 4131, Australia
| | - Chiara Bucciarelli-Ducci
- CMR Unit, Cardiology Department, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 5NP, UK
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College University, London SW7 2BX, UK
| | - Aurelio Secinaro
- Radiology Department, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy
| | - Claudia Montanaro
- CMR Unit, Cardiology Department, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 5NP, UK
- Adult Congenital Heart Disease Department, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 5NP, UK
- National Heart and Lung Institute, Imperial Collage London, Dovehouse St, London SW3 6LY, UK
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12
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Li Z, Huang C, Tong A, Chandarana H, Feng L. Kz-accelerated variable-density stack-of-stars MRI. Magn Reson Imaging 2023; 97:56-67. [PMID: 36577458 PMCID: PMC10072203 DOI: 10.1016/j.mri.2022.12.017] [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: 09/20/2022] [Revised: 10/17/2022] [Accepted: 12/23/2022] [Indexed: 12/26/2022]
Abstract
This work aimed to develop a modified stack-of-stars golden-angle radial sampling scheme with variable-density acceleration along the slice (kz) dimension (referred to as VD-stack-of-stars) and to test this new sampling trajectory with multi-coil compressed sensing reconstruction for rapid motion-robust 3D liver MRI. VD-stack-of-stars sampling implements additional variable-density undersampling along the kz dimension, so that slice resolution (or volumetric coverage) can be increased without prolonging scan time. The new sampling trajectory (with increased slice resolution) was compared with standard stack-of-stars sampling with fully sampled kz (with standard slice resolution) in both non-contrast-enhanced free-breathing liver MRI and dynamic contrast-enhanced MRI (DCE-MRI) of the liver in volunteers. For both sampling trajectories, respiratory motion was extracted from the acquired radial data, and images were reconstructed using motion-compensated (respiratory-resolved or respiratory-weighted) dynamic radial compressed sensing reconstruction techniques. Qualitative image quality assessment (visual assessment by experienced radiologists) and quantitative analysis (as a metric of image sharpness) were performed to compare images acquired using the new and standard stack-of-stars sampling trajectories. Compared to standard stack-of-stars sampling, both non-contrast-enhanced and DCE liver MR images acquired with VD-stack-of-stars sampling presented improved overall image quality, sharper liver edges and increased hepatic vessel clarity in all image planes. The results have suggested that the proposed VD-stack-of-stars sampling scheme can achieve improved performance (increased slice resolution or volumetric coverage with better image quality) over standard stack-of-stars sampling in free-breathing DCE-MRI without increasing scan time. The reformatted coronal and sagittal images with better slice resolution may provide added clinical value.
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Affiliation(s)
- Zhitao Li
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Chenchan Huang
- Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Angela Tong
- Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Hersh Chandarana
- Department of Radiology, New York University School of Medicine, New York, NY, USA; Center for Advanced Imaging Innovation and Research (CAI(2)R), and Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, NY, USA
| | - Li Feng
- Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, USA.
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13
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Feng L. Golden-Angle Radial MRI: Basics, Advances, and Applications. J Magn Reson Imaging 2022; 56:45-62. [PMID: 35396897 PMCID: PMC9189059 DOI: 10.1002/jmri.28187] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 12/21/2022] Open
Abstract
In recent years, golden‐angle radial sampling has received substantial attention and interest in the magnetic resonance imaging (MRI) community, and it has become a popular sampling trajectory for both research and clinical use. However, although the number of relevant techniques and publications has grown rapidly, there is still a lack of a review paper that provides a comprehensive overview and summary of the basics of golden‐angle rotation, the advantages and challenges/limitations of golden‐angle radial sampling, and recommendations in using different types of golden‐angle radial trajectories for MRI applications. Such a review paper is expected to be helpful both for clinicians who are interested in learning the potential benefits of golden‐angle radial sampling and for MRI physicists who are interested in exploring this research direction. The main purpose of this review paper is thus to present an overview and summary about golden‐angle radial MRI sampling. The review consists of three sections. The first section aims to answer basic questions such as: what is a golden angle; how is the golden angle calculated; why is golden‐angle radial sampling useful, and what are its limitations. The second section aims to review more advanced trajectories of golden‐angle radial sampling, including tiny golden‐angle rotation, stack‐of‐stars golden‐angle radial sampling, and three‐dimensional (3D) kooshball golden‐angle radial sampling. Their respective advantages and limitations and potential solutions to address these limitations are also discussed. Finally, the third section reviews MRI applications that can benefit from golden‐angle radial sampling and provides recommendations to readers who are interested in implementing golden‐angle radial trajectories in their MRI studies.
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Affiliation(s)
- Li Feng
- BioMedical Engineering and Imaging Institute (BMEII) and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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14
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Assessment of Non-contrast-enhanced Dixon Water-fat Separation Compressed Sensing Whole-heart Coronary MR Angiography at 3.0 T: A Single-center Experience. Acad Radiol 2022; 29 Suppl 4:S82-S90. [PMID: 34127363 DOI: 10.1016/j.acra.2021.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/08/2021] [Accepted: 05/11/2021] [Indexed: 11/23/2022]
Abstract
RATIONALE AND OBJECTIVES The clinical utility of Dixon water-fat separation coronary MR angiography (CMRA) with compressed sensing (CS) reconstruction has not been determined in a patient population. This study was designed to evaluate the performance of 3.0 T non-contrast-enhanced Dixon water-fat separation CS whole-heart CMRA sequence in vitro and in vivo. MATERIALS AND METHODS In vitro phantom MRI, we compared key parameters of the SENSE and CS images. And in this prospective in vivo study, from November 2019 to October 2020, 94 participants were recruited for 3.0 T non-contrast-enhanced Dixon water-fat separation CS whole-heart CMRA. The accuracy of CMRA for detecting a ≥ 50% reduction in diameter was determined using X-ray coronary angiography (CA) as the reference method. RESULTS Compared with SENSE, CS with an appropriate acceleration factor offers both higher SNR/CNR (p < 0.05) and a shortened acquisition. Fifty-eight patients successfully completed the CMRA and CA. The sensitivity, specificity, positive predictive values, negative predictive values, and accuracy of 3.0 T non-contrast-enhanced Dixon water-fat separation CS whole-heart CMRA according to a patient-based analysis were 96.4%, 66.7%, 73.0%, 95.2% and 81.0%, respectively. The area under the receiver-operator characteristic (ROC) curve (AUC) of 3.0 T non-contrast-enhanced Dixon water-fat separation CS whole-heart CMRA for detecting significant coronary artery stenosis is 0.908, 0.895, and 0.904 in patient-, vessel-, and segment-based analyses respectively. CONCLUSION 3.0 T non-contrast-enhanced Dixon water-fat separation whole-heart CMRA using appropriate CS is a promising noninvasive and radiation-free technique to detect clinically significant coronary stenosis on patients with suspected CAD.
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15
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Unenhanced Whole-Heart Coronary MRA: Prospective Intraindividual Comparison of 1.5-T SSFP and 3-T Dixon Water-Fat Separation GRE Methods Using Coronary Angiography as Reference. AJR Am J Roentgenol 2022; 219:199-211. [PMID: 35293232 DOI: 10.2214/ajr.21.27292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Coronary MRA is commonly performed at 1.5 T using SSFP acquisitions. Coronary MRA at 3 T is limited using SSFP due to impaired fat suppression and has been investigated typically using contrast-enhanced techniques. A Dixon fat-water separation gradient-recalled echo (GRE) method may enable high-quality unenhanced 3-T coronary MRA. Objective: To compare 1.5-T SSFP and 3-T Dixon water-fat separation GRE methods for unenhanced whole-heart coronary MRA in patients with suspected coronary artery disease (CAD). Methods: This prospective study included 44 patients (27 men, 17 women; mean age 59±8 years) with intermediate-to-high risk of CAD who underwent both 1.5-T SSFP and 3-T Dixon GRE coronary MRA examinations before coronary angiography (CAG). Two radiologists independently assessed coronary arteries in terms of subjective image quality (1-5 scale; 5=highest image quality), number of visible segments, apparent contrast-to-noise ratio (CNR; vs myocardium)), and presence of significant stenoses. Methods were compared using readers' mean values for apparent CNR and consensus interpretations for other measures. CAG served as reference standard for presence of stenoses. Results: Interobserver agreement expressed as kappa was 0.85 for image quality, 0.85 for segment visibility, and 0.83 for stenosis, and expressed as intraclass correlation coefficient was 0.92 for apparent CNR. Mean overall image quality score was 4.0±1.1 for 3-T Dixon GRE versus 3.0±1.2 for 1.5-T SSFP. Percentage of visible segments for 3-T Dixon GRE versus 1.5-T SSFP was 96.7% versus 88.9% for all segments, 96.9% versus 90.1% for distal segments, and 93.1% versus 77.2% for branch segments. Mean overall apparent CNR was 93.2±29.2 for 3-T Dixon GRE versus 80.8±27.9 for 1.5-T SSFP. 3-T Dixon GRE, compared with 1.5-T SSFP, showed higher sensitivity and specificity in per-vessel analysis (87.9% vs 77.3%; 83.3% vs 60.6%), per-segment analysis (84.6% vs 74.8%, 90.9% vs 79.6%), and per-segment analysis of distal and branch segments (89.7% vs 75.9%, 89.7% vs 73.7%). Conclusion: For unenhanced coronary MRA, 3-T unenhanced Dixon GRE had better image quality and diagnostic performance than 1.5-T SSFP, particularly for distal and branch segments. Clinical Impact: The 3-T Dixon GRE technique may be preferred to the current clinical standard of 1.5-T SSFP for unenhanced coronary MRA.
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16
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Ismail TF, Strugnell W, Coletti C, Božić-Iven M, Weingärtner S, Hammernik K, Correia T, Küstner T. Cardiac MR: From Theory to Practice. Front Cardiovasc Med 2022; 9:826283. [PMID: 35310962 PMCID: PMC8927633 DOI: 10.3389/fcvm.2022.826283] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/17/2022] [Indexed: 01/10/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading single cause of morbidity and mortality, causing over 17. 9 million deaths worldwide per year with associated costs of over $800 billion. Improving prevention, diagnosis, and treatment of CVD is therefore a global priority. Cardiovascular magnetic resonance (CMR) has emerged as a clinically important technique for the assessment of cardiovascular anatomy, function, perfusion, and viability. However, diversity and complexity of imaging, reconstruction and analysis methods pose some limitations to the widespread use of CMR. Especially in view of recent developments in the field of machine learning that provide novel solutions to address existing problems, it is necessary to bridge the gap between the clinical and scientific communities. This review covers five essential aspects of CMR to provide a comprehensive overview ranging from CVDs to CMR pulse sequence design, acquisition protocols, motion handling, image reconstruction and quantitative analysis of the obtained data. (1) The basic MR physics of CMR is introduced. Basic pulse sequence building blocks that are commonly used in CMR imaging are presented. Sequences containing these building blocks are formed for parametric mapping and functional imaging techniques. Commonly perceived artifacts and potential countermeasures are discussed for these methods. (2) CMR methods for identifying CVDs are illustrated. Basic anatomy and functional processes are described to understand the cardiac pathologies and how they can be captured by CMR imaging. (3) The planning and conduct of a complete CMR exam which is targeted for the respective pathology is shown. Building blocks are illustrated to create an efficient and patient-centered workflow. Further strategies to cope with challenging patients are discussed. (4) Imaging acceleration and reconstruction techniques are presented that enable acquisition of spatial, temporal, and parametric dynamics of the cardiac cycle. The handling of respiratory and cardiac motion strategies as well as their integration into the reconstruction processes is showcased. (5) Recent advances on deep learning-based reconstructions for this purpose are summarized. Furthermore, an overview of novel deep learning image segmentation and analysis methods is provided with a focus on automatic, fast and reliable extraction of biomarkers and parameters of clinical relevance.
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Affiliation(s)
- Tevfik F. Ismail
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Cardiology Department, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Wendy Strugnell
- Queensland X-Ray, Mater Hospital Brisbane, Brisbane, QLD, Australia
| | - Chiara Coletti
- Magnetic Resonance Systems Lab, Delft University of Technology, Delft, Netherlands
| | - Maša Božić-Iven
- Magnetic Resonance Systems Lab, Delft University of Technology, Delft, Netherlands
- Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
| | | | - Kerstin Hammernik
- Lab for AI in Medicine, Technical University of Munich, Munich, Germany
- Department of Computing, Imperial College London, London, United Kingdom
| | - Teresa Correia
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Centre of Marine Sciences, Faro, Portugal
| | - Thomas Küstner
- Medical Image and Data Analysis (MIDAS.lab), Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany
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17
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Dorniak K, Di Sopra L, Sabisz A, Glinska A, Roy CW, Gorczewski K, Piccini D, Yerly J, Jankowska H, Fijałkowska J, Szurowska E, Stuber M, van Heeswijk RB. Respiratory Motion-Registered Isotropic Whole-Heart T 2 Mapping in Patients With Acute Non-ischemic Myocardial Injury. Front Cardiovasc Med 2021; 8:712383. [PMID: 34660714 PMCID: PMC8511642 DOI: 10.3389/fcvm.2021.712383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: T2 mapping is a magnetic resonance imaging technique that can be used to detect myocardial edema and inflammation. However, the focal nature of myocardial inflammation may render conventional 2D approaches suboptimal and make whole-heart isotropic 3D mapping desirable. While self-navigated 3D radial T2 mapping has been demonstrated to work well at a magnetic field strength of 3T, it results in too noisy maps at 1.5T. We therefore implemented a novel respiratory motion-resolved compressed-sensing reconstruction in order to improve the 3D T2 mapping precision and accuracy at 1.5T, and tested this in a heterogeneous patient cohort. Materials and Methods: Nine healthy volunteers and 25 consecutive patients with suspected acute non-ischemic myocardial injury (sarcoidosis, n = 19; systemic sclerosis, n = 2; acute graft rejection, n = 2, and myocarditis, n = 2) were included. The free-breathing T2 maps were acquired as three ECG-triggered T2-prepared 3D radial volumes. A respiratory motion-resolved reconstruction was followed by image registration of the respiratory states and pixel-wise T2 mapping. The resulting 3D maps were compared to routine 2D T2 maps. The T2 values of segments with and without late gadolinium enhancement (LGE) were compared in patients. Results: In the healthy volunteers, the myocardial T2 values obtained with the 2D and 3D techniques were similar (45.8 ± 1.8 vs. 46.8 ± 2.9 ms, respectively; P = 0.33). Conversely, in patients, T2 values did differ between 2D (46.7 ± 3.6 ms) and 3D techniques (50.1 ± 4.2 ms, P = 0.004). Moreover, with the 2D technique, T2 values of the LGE-positive segments were similar to those of the LGE-negative segments (T2LGE-= 46.2 ± 3.7 vs. T2LGE+ = 47.6 ± 4.1 ms; P = 0.49), whereas the 3D technique did show a significant difference (T2LGE- = 49.3 ± 6.7 vs. T2LGE+ = 52.6 ± 8.7 ms, P = 0.006). Conclusion: Respiratory motion-registered 3D radial imaging at 1.5T led to accurate isotropic 3D whole-heart T2 maps, both in the healthy volunteers and in a small patient cohort with suspected non-ischemic myocardial injury. Significantly higher T2 values were found in patients as compared to controls in 3D but not in 2D, suggestive of the technique's potential to increase the sensitivity of CMR at earlier stages of disease. Further study will be needed to demonstrate its accuracy.
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Affiliation(s)
- Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland
| | - Lorenzo Di Sopra
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Agnieszka Sabisz
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Anna Glinska
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Christopher W Roy
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | | | - Davide Piccini
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Hanna Jankowska
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland
| | - Jadwiga Fijałkowska
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Matthias Stuber
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Ruud B van Heeswijk
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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18
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Hajhosseiny R, Munoz C, Cruz G, Khamis R, Kim WY, Prieto C, Botnar RM. Coronary Magnetic Resonance Angiography in Chronic Coronary Syndromes. Front Cardiovasc Med 2021; 8:682924. [PMID: 34485397 PMCID: PMC8416045 DOI: 10.3389/fcvm.2021.682924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/23/2021] [Indexed: 01/14/2023] Open
Abstract
Cardiovascular disease is the leading cause of mortality worldwide, with atherosclerotic coronary artery disease (CAD) accounting for the majority of cases. X-ray coronary angiography and computed tomography coronary angiography (CCTA) are the imaging modalities of choice for the assessment of CAD. However, the use of ionising radiation and iodinated contrast agents remain drawbacks. There is therefore a clinical need for an alternative modality for the early identification and longitudinal monitoring of CAD without these associated drawbacks. Coronary magnetic resonance angiography (CMRA) could be a potential alternative for the detection and monitoring of coronary arterial stenosis, without exposing patients to ionising radiation or iodinated contrast agents. Further advantages include its versatility, excellent soft tissue characterisation and suitability for repeat imaging. Despite the early promise of CMRA, widespread clinical utilisation remains limited due to long and unpredictable scan times, onerous scan planning, lower spatial resolution, as well as motion related image quality degradation. The past decade has brought about a resurgence in CMRA technology, with significant leaps in image acceleration, respiratory and cardiac motion estimation and advanced motion corrected or motion-resolved image reconstruction. With the advent of artificial intelligence, great advances are also seen in deep learning-based motion estimation, undersampled and super-resolution reconstruction promising further improvements of CMRA. This has enabled high spatial resolution (1 mm isotropic), 3D whole heart CMRA in a clinically feasible and reliable acquisition time of under 10 min. Furthermore, latest super-resolution image reconstruction approaches which are currently under evaluation promise acquisitions as short as 1 min. In this review, we will explore the recent technological advances that are designed to bring CMRA closer to clinical reality.
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Affiliation(s)
- Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Camila Munoz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Ramzi Khamis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Won Yong Kim
- Department of Cardiology and Institute of Clinical Medicine, Aarhus University Hospital, Skejby, Denmark
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - René M. Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Instituto de Ingeniería Biologica y Medica, Pontificia Universidad Catolica de Chile, Santiago, Chile
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19
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Correa Londono M, Trussardi N, Obmann VC, Piccini D, Ith M, von Tengg-Kobligk H, Jung B. Radial self-navigated native magnetic resonance angiography in comparison to navigator-gated contrast-enhanced MRA of the entire thoracic aorta in an aortic patient collective. J Cardiovasc Magn Reson 2021; 23:94. [PMID: 34247640 PMCID: PMC8274024 DOI: 10.1186/s12968-021-00774-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/12/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The native balanced steady state with free precession (bSSFP) magnetic resonance angiography (MRA) technique has been shown to provide high diagnostic image quality for thoracic aortic disease. This study compares a 3D radial respiratory self-navigated native MRA (native-SN-MRA) based on a bSSFP sequence with conventional Cartesian, 3D, contrast-enhanced MRA (CE-MRA) with navigator-gated respiration control for image quality of the entire thoracic aorta. METHODS Thirty-one aortic native-SN-MRA were compared retrospectively (63.9 ± 10.3 years) to 61 CE-MRA (63.1 ± 11.7 years) serving as a reference standard. Image quality was evaluated at the aortic root/ascending aorta, aortic arch and descending aorta. Scan time was recorded. In 10 patients with both MRA sequences, aortic pathologies were evaluated and normal and pathologic aortic diameters were measured. The influence of artifacts on image quality was analyzed. RESULTS Compared to the overall image quality of CE-MRA, the overall image quality of native-SN-MRA was superior for all segments analyzed (aortic root/ascending, p < 0.001; arch, p < 0.001, and descending, p = 0.005). Regarding artifacts, the image quality of native-SN-MRA remained superior at the aortic root/ascending aorta and aortic arch before and after correction for confounders of surgical material (i.e., susceptibility-related artifacts) (p = 0.008 both) suggesting a benefit in terms of motion artifacts. Native-SN-MRA showed a trend towards superior intraindividual image quality, but without statistical significance. Intraindividually, the sensitivity and specificity for the detection of aortic disease were 100% for native-SN-MRA. Aortic diameters did not show a significant difference (p = 0.899). The scan time of the native-SN-MRA was significantly reduced, with a mean of 05:56 ± 01:32 min vs. 08:51 ± 02:57 min in the CE-MRA (p < 0.001). CONCLUSIONS Superior image quality of the entire thoracic aorta, also regarding artifacts, can be achieved with native-SN-MRA, especially in motion prone segments, in addition to a shorter acquisition time.
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Affiliation(s)
- Martina Correa Londono
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland.
| | - Nino Trussardi
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Verena C Obmann
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Davide Piccini
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Michael Ith
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Hendrik von Tengg-Kobligk
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
- Experimental Radiology, Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Bernd Jung
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
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20
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Nussbaumer C, Bouchardy J, Blanche C, Piccini D, Pavon AG, Monney P, Stuber M, Schwitter J, Rutz T. 2D cine vs. 3D self-navigated free-breathing high-resolution whole heart cardiovascular magnetic resonance for aortic root measurements in congenital heart disease. J Cardiovasc Magn Reson 2021; 23:65. [PMID: 34039356 PMCID: PMC8157643 DOI: 10.1186/s12968-021-00744-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/17/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) is considered the method of choice for evaluation of aortic root dilatation in congenital heart disease. Usually, a cross-sectional 2D cine stack is acquired perpendicular to the vessel's axis. However, this method requires a considerable patient collaboration and precise planning of image planes. The present study compares a recently introduced 3D self-navigated free-breathing high-resolution whole heart CMR sequence (3D self nav) allowing a multiplanar retrospective reconstruction of the aortic root as an alternative to the 2D cine technique for determination of aortic root diameters. METHODS A total of 6 cusp-commissure (CuCo) and cusp-cusp (CuCu) enddiastolic diameters were measured by two observers on 2D cine and 3D self nav cross-sectional planes of the aortic root acquired on a 1.5 T CMR scanner. Asymmetry of the aortic root was evaluated by the ratio of the minimal to the maximum 3D self nav CuCu diameter. CuCu diameters were compared to standard transthoracic echocardiographic (TTE) aortic root diameters. RESULTS Sixty-five exams in 58 patients (32 ± 15 years) were included. Typically, 2D cine and 3D self nav spatial resolution was 1.1-1.52 × 4.5-7 mm and 0.9-1.153 mm, respectively. 3D self nav yielded larger maximum diameters than 2D cine: CuCo 37.2 ± 6.4 vs. 36.2 ± 7.0 mm (p = 0.006), CuCu 39.7 ± 6.3 vs. 38.5 ± 6.5 mm (p < 0.001). CuCu diameters were significantly larger (2.3-3.9 mm, p < 0.001) than CuCo and TTE diameters on both 2D cine and 3D self nav. Intra- and interobserver variabilities were excellent for both techniques with bias of -0.5 to 1.0 mm. Intra-observer variability of the more experienced observer was better for 3D self nav (F-test p < 0.05). Aortic root asymmetry was more pronounced in patients with bicuspid aortic valve (BAV: 0.73 (interquartile (IQ) 0.69; 0.78) vs. 0.93 (IQ 0.9; 0.96), p < 0.001), which was associated to a larger difference of maximum CuCu to TTE diameters: 5.5 ± 3.3 vs. 3.3 ± 3.8 mm, p = 0.033. CONCLUSION Both, the 3D self nav and 2D cine CMR techniques allow reliable determination of aortic root diameters. However, we propose to privilege the 3D self nav technique and measurement of CuCu diameters to avoid underestimation of the maximum diameter, particularly in patients with asymmetric aortic roots and/or BAV.
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Affiliation(s)
- Clément Nussbaumer
- Service of Cardiology, Centre de Resonance Magnétique Cardiaque, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Judith Bouchardy
- Service of Cardiology, Adult Congenital Heart Disease Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Coralie Blanche
- Service of Cardiology, Centre de Resonance Magnétique Cardiaque, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Davide Piccini
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Anna-Giulia Pavon
- Service of Cardiology, Centre de Resonance Magnétique Cardiaque, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pierre Monney
- Service of Cardiology, Centre de Resonance Magnétique Cardiaque, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Matthias Stuber
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jürg Schwitter
- Service of Cardiology, Centre de Resonance Magnétique Cardiaque, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Tobias Rutz
- Service of Cardiology, Centre de Resonance Magnétique Cardiaque, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Service of Cardiology, Adult Congenital Heart Disease Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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21
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Hajhosseiny R, Rashid I, Bustin A, Munoz C, Cruz G, Nazir MS, Grigoryan K, Ismail TF, Preston R, Neji R, Kunze K, Razavi R, Chiribiri A, Masci PG, Rajani R, Prieto C, Botnar RM. Clinical comparison of sub-mm high-resolution non-contrast coronary CMR angiography against coronary CT angiography in patients with low-intermediate risk of coronary artery disease: a single center trial. J Cardiovasc Magn Reson 2021; 23:57. [PMID: 33993890 PMCID: PMC8127202 DOI: 10.1186/s12968-021-00758-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 04/06/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The widespread clinical application of coronary cardiovascular magnetic resonance (CMR) angiography (CMRA) for the assessment of coronary artery disease (CAD) remains limited due to low scan efficiency leading to prolonged and unpredictable acquisition times; low spatial-resolution; and residual respiratory motion artefacts resulting in limited image quality. To overcome these limitations, we have integrated highly undersampled acquisitions with image-based navigators and non-rigid motion correction to enable high resolution (sub-1 mm3) free-breathing, contrast-free 3D whole-heart coronary CMRA with 100% respiratory scan efficiency in a clinically feasible and predictable acquisition time. OBJECTIVES To evaluate the diagnostic performance of this coronary CMRA framework against coronary computed tomography angiography (CTA) in patients with suspected CAD. METHODS Consecutive patients (n = 50) with suspected CAD were examined on a 1.5T CMR scanner. We compared the diagnostic accuracy of coronary CMRA against coronary CTA for detecting a ≥ 50% reduction in luminal diameter. RESULTS The 50 recruited patients (55 ± 9 years, 33 male) completed coronary CMRA in 10.7 ± 1.4 min. Twelve (24%) had significant CAD on coronary CTA. Coronary CMRA obtained diagnostic image quality in 95% of all, 97% of proximal, 97% of middle and 90% of distal coronary segments. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were: per patient (100%, 74%, 55%, 100% and 80%), per vessel (81%, 88%, 46%, 97% and 88%) and per segment (76%, 95%, 44%, 99% and 94%) respectively. CONCLUSIONS The high diagnostic image quality and diagnostic performance of coronary CMRA compared against coronary CTA demonstrates the potential of coronary CMRA as a robust and safe non-invasive alternative for excluding significant disease in patients at low-intermediate risk of CAD.
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Affiliation(s)
- Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK.
| | - Imran Rashid
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Aurélien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Camila Munoz
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Muhummad Sohaib Nazir
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Karine Grigoryan
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Tevfik F Ismail
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Rebecca Preston
- Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
| | - Karl Kunze
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Amedeo Chiribiri
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Pier Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
| | - Ronak Rajani
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rdfloor Lambeth Wing, London, SE1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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22
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Roy CW, Heerfordt J, Piccini D, Rossi G, Pavon AG, Schwitter J, Stuber M. Motion compensated whole-heart coronary cardiovascular magnetic resonance angiography using focused navigation (fNAV). J Cardiovasc Magn Reson 2021; 23:33. [PMID: 33775246 PMCID: PMC8006382 DOI: 10.1186/s12968-021-00717-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 01/28/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Radial self-navigated (RSN) whole-heart coronary cardiovascular magnetic resonance angiography (CCMRA) is a free-breathing technique that estimates and corrects for respiratory motion. However, RSN has been limited to a 1D rigid correction which is often insufficient for patients with complex respiratory patterns. The goal of this work is therefore to improve the robustness and quality of 3D radial CCMRA by incorporating both 3D motion information and nonrigid intra-acquisition correction of the data into a framework called focused navigation (fNAV). METHODS We applied fNAV to 500 data sets from a numerical simulation, 22 healthy subjects, and 549 cardiac patients. In each of these cohorts we compared fNAV to RSN and respiratory resolved extradimensional golden-angle radial sparse parallel (XD-GRASP) reconstructions of the same data. Reconstruction times for each method were recorded. Motion estimate accuracy was measured as the correlation between fNAV and ground truth for simulations, and fNAV and image registration for in vivo data. Percent vessel sharpness was measured in all simulated data sets and healthy subjects, and a subset of patients. Finally, subjective image quality analysis was performed by a blinded expert reviewer who chose the best image for each in vivo data set and scored on a Likert scale 0-4 in a subset of patients by two reviewers in consensus. RESULTS The reconstruction time for fNAV images was significantly higher than RSN (6.1 ± 2.1 min vs 1.4 ± 0.3, min, p < 0.025) but significantly lower than XD-GRASP (25.6 ± 7.1, min, p < 0.025). Overall, there is high correlation between the fNAV and reference displacement estimates across all data sets (0.73 ± 0.29). For simulated data, healthy subjects, and patients, fNAV lead to significantly sharper coronary arteries than all other reconstruction methods (p < 0.01). Finally, in a blinded evaluation by an expert reviewer fNAV was chosen as the best image in 444 out of 571 data sets (78%; p < 0.001) and consensus grades of fNAV images (2.6 ± 0.6) were significantly higher (p < 0.05) than uncorrected (1.7 ± 0.7), RSN (1.9 ± 0.6), and XD-GRASP (1.8 ± 0.8). CONCLUSION fNAV is a promising technique for improving the quality of RSN free-breathing 3D whole-heart CCMRA. This novel approach to respiratory self-navigation can derive 3D nonrigid motion estimations from an acquired 1D signal yielding statistically significant improvement in image sharpness relative to 1D translational correction as well as XD-GRASP reconstructions. Further study of the diagnostic impact of this technique is therefore warranted to evaluate its full clinical utility.
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Affiliation(s)
- Christopher W Roy
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Rue de Bugnon 46, BH-7-84, 1011, Lausanne, Switzerland.
| | - John Heerfordt
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Rue de Bugnon 46, BH-7-84, 1011, Lausanne, Switzerland
- Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare AG, Lausanne, Switzerland
| | - Davide Piccini
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Rue de Bugnon 46, BH-7-84, 1011, Lausanne, Switzerland
- Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare AG, Lausanne, Switzerland
| | - Giulia Rossi
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Rue de Bugnon 46, BH-7-84, 1011, Lausanne, Switzerland
| | - Anna Giulia Pavon
- Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Juerg Schwitter
- Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Director CMR-Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Matthias Stuber
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Rue de Bugnon 46, BH-7-84, 1011, Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
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23
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Heerfordt J, Whitehead KK, Bastiaansen JAM, Di Sopra L, Roy CW, Yerly J, Milani B, Fogel MA, Stuber M, Piccini D. Similarity-driven multi-dimensional binning algorithm (SIMBA) for free-running motion-suppressed whole-heart MRA. Magn Reson Med 2021; 86:213-229. [PMID: 33624348 DOI: 10.1002/mrm.28713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/19/2020] [Accepted: 01/11/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE Whole-heart MRA techniques typically target predetermined motion states, address cardiac and respiratory dynamics independently, and require either complex planning or computationally demanding reconstructions. In contrast, we developed a fast data-driven reconstruction algorithm with minimal physiological assumptions and compatibility with ungated free-running sequences. THEORY AND METHODS We propose a similarity-driven multi-dimensional binning algorithm (SIMBA) that clusters continuously acquired k-space data to find a motion-consistent subset for whole-heart MRA reconstruction. Free-running 3D radial data sets from 12 non-contrast-enhanced scans of healthy volunteers and six ferumoxytol-enhanced scans of pediatric cardiac patients were reconstructed with non-motion-suppressed regridding of all the acquired data ("All Data"), with SIMBA, and with a previously published free-running framework (FRF) that uses cardiac and respiratory self-gating and compressed sensing. Images were compared for blood-myocardium sharpness and contrast ratio, visibility of coronary artery ostia, and right coronary artery sharpness. RESULTS Both the 20-second SIMBA reconstruction and FRF provided significantly higher blood-myocardium sharpness than All Data in both patients and volunteers (P < .05). The SIMBA reconstruction provided significantly sharper blood-myocardium interfaces than FRF in volunteers (P < .001) and higher blood-myocardium contrast ratio than All Data and FRF, both in volunteers and patients (P < .05). Significantly more ostia could be visualized with both SIMBA (31 of 36) and FRF (34 of 36) than with All Data (4 of 36) (P < .001). Inferior right coronary artery sharpness using SIMBA versus FRF was observed (volunteers: SIMBA 36.1 ± 8.1%, FRF 40.4 ± 8.9%; patients: SIMBA 35.9 ± 7.7%, FRF 40.3 ± 6.1%, P = not significant). CONCLUSION The SIMBA technique enabled a fast, data-driven reconstruction of free-running whole-heart MRA with image quality superior to All Data and similar to the more time-consuming FRF reconstruction.
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Affiliation(s)
- John Heerfordt
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Kevin K Whitehead
- Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jessica A M Bastiaansen
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Lorenzo Di Sopra
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Christopher W Roy
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Center for Biomedical Imaging, Lausanne, Switzerland
| | - Bastien Milani
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mark A Fogel
- Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Center for Biomedical Imaging, Lausanne, Switzerland
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
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24
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Yacoub B, Stroud RE, Piccini D, Schoepf UJ, Heerfordt J, Yerly J, Di Sopra L, Rollins JD, Turner DA, Emrich T, Xiong F, Suranyi P, Varga-Szemes A. Measurement accuracy of prototype non-contrast, compressed sensing-based, respiratory motion-resolved whole heart cardiovascular magnetic resonance angiography for the assessment of thoracic aortic dilatation: comparison with computed tomography angiography. J Cardiovasc Magn Reson 2021; 23:7. [PMID: 33557887 PMCID: PMC7871614 DOI: 10.1186/s12968-020-00697-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 12/09/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Patients with thoracic aortic dilatation who undergo annual computed tomography angiography (CTA) are subject to repeated radiation and contrast exposure. The purpose of this study was to evaluate the feasibility of a non-contrast, respiratory motion-resolved whole-heart cardiovascular magnetic resonance angiography (CMRA) technique against reference standard CTA, for the quantitative assessment of cardiovascular anatomy and monitoring of disease progression in patients with thoracic aortic dilatation. METHODS: Twenty-four patients (68.6 ± 9.8 years) with thoracic aortic dilatation prospectively underwent clinical CTA and research 1.5T CMRA between July 2017 and November 2018. Scans were repeated in 15 patients 1 year later. A prototype free-breathing 3D radial balanced steady-state free-precession whole-heart CMRA sequence was used in combination with compressed sensing-based reconstruction. Area, circumference, and diameter measurements were obtained at seven aortic levels by two experienced and two inexperienced readers. In addition, area and diameter measurements of the cardiac chambers, pulmonary arteries and pulmonary veins were also obtained. Agreement between the two modalities was assessed with intraclass correlation coefficient (ICC) analysis, Bland-Altman plots and scatter plots. RESULTS Area, circumference and diameter measurements on a per-level analysis showed good or excellent agreement between CTA and CMRA (ICCs > 0.84). Means of differences on Bland-Altman plots were: area 0.0 cm2 [- 1.7; 1.6]; circumference 1.0 mm [- 10.0; 12.0], and diameter 0.6 mm [- 2.6; 3.6]. Area and diameter measurements of the left cardiac chambers showed good agreement (ICCs > 0.80), while moderate to good agreement was observed for the right chambers (all ICCs > 0.56). Similar good to excellent inter-modality agreement was shown for the pulmonary arteries and veins (ICC range 0.79-0.93), with the exception of the left lower pulmonary vein (ICC < 0.51). Inter-reader assessment demonstrated mostly good or excellent agreement for both CTA and CMRA measurements on a per-level analysis (ICCs > 0.64). Difference in maximum aortic diameter measurements at baseline vs follow up showed excellent agreement between CMRA and CTA (ICC = 0.91). CONCLUSIONS The radial whole-heart CMRA technique combined with respiratory motion-resolved reconstruction provides comparable anatomical measurements of the thoracic aorta and cardiac structures as the reference standard CTA. It could potentially be used to diagnose and monitor patients with thoracic aortic dilatation without exposing them to radiation or contrast media.
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Affiliation(s)
- Basel Yacoub
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - Robert E Stroud
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - U Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - John Heerfordt
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Lorenzo Di Sopra
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jonathan D Rollins
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - D Alan Turner
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Tilman Emrich
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA
- Department of Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany
| | - Fei Xiong
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA
- Cardiovascular MR R&D, Siemens Medical Solutions USA Inc, Charleston, SC, USA
| | - Pal Suranyi
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA.
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Self-navigated versus navigator-gated 3D MRI sequence for non-enhanced aortic root measurement in transcatheter aortic valve implantation. Eur J Radiol 2021; 137:109573. [PMID: 33578090 DOI: 10.1016/j.ejrad.2021.109573] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/27/2020] [Accepted: 01/22/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To prospectively compare image-quality, reliability and graft sizing of a prototype self-navigated and a navigator-gated non-contrast three dimensional (3D) whole-heart magnetic-resonance-angiography (MRA) sequence with computed-tomography-angiography (CTA) for planning transcatheter-aortic-valve-implantation (TAVI). METHODS Self- and navigator-gated 1.5 T MRA were performed in 27 patients (aged 83 ± 5 years, 41 % male) for aortic root sizing and coronary ostia height measurements; 15 (56 %) patients underwent additional CTA. Subjective-image quality was graded on a 4-point Likert scale, objective MRA image-quality was assessed by signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Continuous MRA and CTA measurements were analyzed with regression and Bland-Altman analysis, valve sizing by kappa statistics. RESULTS Median image-quality as rated by two observers was 1.5 [interquartile range (IQR) 1-3] for self-navigated MRA and 1 [IQR 1-2] for navigator-gated MRA (p = 0.059). SNR and CNR were comparable between MRA sequences (p = 0.471 and 0.445, respectively). Acquisition time was shorter for self-navigated MRA compared to navigator-gated MRA (5.5 ± 1 min vs, 6.5 ± 2 min, p = 0.029). Inter-observer correlation of aortic root measurements was high to very high for both self- and navigator-gated MRA (r = 0.75 to 0.94 and r = 0.85 to 0.96, respectively, all p < 0.0001). Theoretical prosthetic valve sizing of self-navigated MRA and CTA was equivalent (κ = 1). However, in four patients (15 %) one coronary ostium each (right coronary artery 3, left main artery 1) was not clearly definable on self-navigated MRA. CONCLUSION Self-navigated MRA enables aortic annulus TAVI measurements without significant difference to navigator-gated MRA at shortened acquisition time. Prosthesis sizing by self-navigated MRA measurements is equivalent to navigator-gated MRA and CTA-based choice.
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Self-navigated 3D whole-heart MRA for non-enhanced surveillance of thoracic aortic dilation: A comparison to CTA. Magn Reson Imaging 2020; 76:123-130. [PMID: 33309920 DOI: 10.1016/j.mri.2020.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/02/2020] [Accepted: 12/06/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To prospectively compare image quality and reliability of a non-contrast, self-navigated 3D whole-heart magnetic resonance angiography (MRA) sequence with contrast-enhanced computed tomography angiography (CTA) for sizing of thoracic aortic aneurysm (TAA). METHODS Self-navigated 3D whole-heart 1.5 T MRA was performed in 20 patients (aged 67 ± 9 years, 75% male) for sizing of TAA; a subgroup of 18 (90%) patients underwent additional contrast-enhanced CTA on the same day. Subjective image quality was scored according to a 4-point Likert scale and ratings between observers were compared by Cohen's Kappa statistics. For MRA, subjective motion blurring and signal inhomogeneity was rated according to a 3-point scale, respectively. Objective signal inhomogeneity of MRA was quantified as standard deviation of the voxel intensities in a circular region of interest (ROI) placed in the ascending aorta divided by their mean value. Continuous MRA and CTA measurements were analyzed with regression and Bland-Altman analysis. RESULTS Overall subjective image quality as rated by two observers was 1 [interquartile range (IQR) 1-2] for self-navigated MRA and 1.5 [IQR 1-2] for CTA (p = 0.717). For MRA, perfect inter-observer agreement was found regarding presence of artefacts and subjective image sharpness (κ = 1). Subjective signal inhomogeneity agreed moderately between the observers (κ = 0.58, p = 0.007), however, it correlated strongly with objectively quantified inhomogeneity of the blood pool signal (r = 0.78, p < 0.0001). Maximum diameters of TAA as measured by self-navigated MRA and CTA showed very strong correlation (r = 0.99, p < 0.0001) without significant inter-method bias (bias -0.03 mm, lower and upper limit of agreement -0.74 and 0.68 mm, p = 0.749). Inter-observer correlation of aortic aneurysm as measured by MRA was very strong (r = 0.96) without significant bias (p = 0.695). CONCLUSION Self-navigated 3D whole-heart MRA enables reliable contrast- and radiation free aortic dilation surveillance without significant difference to standardized CTA while providing predictable acquisition time and offering excellent image quality.
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Hajhosseiny R, Bustin A, Munoz C, Rashid I, Cruz G, Manning WJ, Prieto C, Botnar RM. Coronary Magnetic Resonance Angiography: Technical Innovations Leading Us to the Promised Land? JACC Cardiovasc Imaging 2020; 13:2653-2672. [PMID: 32199836 DOI: 10.1016/j.jcmg.2020.01.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 01/03/2020] [Accepted: 01/08/2020] [Indexed: 02/07/2023]
Abstract
Coronary artery disease remains the leading cause of cardiovascular morbidity and mortality. Invasive X-ray angiography and coronary computed tomography angiography are established gold standards for coronary luminography. However, they expose patients to invasive complications, ionizing radiation, and iodinated contrast agents. Among a number of imaging modalities, coronary cardiovascular magnetic resonance (CMR) angiography may be used in some cases as an alternative for the detection and monitoring of coronary arterial stenosis, with advantages including its versatility, excellent soft tissue characterization, and avoidance of ionizing radiation and iodinated contrast agents. In this review, we explore the recent advances in motion correction, image acceleration, and reconstruction technologies that are bringing coronary CMR angiography closer to widespread clinical implementation.
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Affiliation(s)
- Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; National Heart and Lung Institute, Imperial College London, London, United Kingdom.
| | - Aurelien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Camila Munoz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Imran Rashid
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Warren J Manning
- Department of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
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Ludwig J, Speier P, Seifert F, Schaeffter T, Kolbitsch C. Pilot tone-based motion correction for prospective respiratory compensated cardiac cine MRI. Magn Reson Med 2020; 85:2403-2416. [PMID: 33226699 DOI: 10.1002/mrm.28580] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/24/2020] [Accepted: 10/12/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate prospective motion correction using the pilot tone (PT) as a quantitative respiratory motion signal with high temporal resolution for cardiac cine images during free breathing. METHODS Before cine data acquisition, a short prescan was performed, calibrating the PT to the respiratory-induced heart motion using respiratory-resolved real-time images. The calibrated PT was then applied for nearly real-time prospective motion correction of cine MRI through slice tracking (ie, updating the slice position before every readout). Additionally, in-plane motion correction was performed retrospectively also based on the calibrated PT data. The proposed method was evaluated in a moving phantom and 10 healthy volunteers. RESULTS The PT showed very good correlation to the phantom motion. In volunteer studies using a long-term scan over 7.96 ± 1.40 min, the mean absolute error between registered and predicted motion from the PT was 1.44 ± 0.46 mm in head-feet and 0.46 ± 0.07 mm in anterior-posterior direction. Irregular breathing could also be corrected well with the PT. The PT motion correction leads to a significant improvement of contrast-to-noise ratio by 68% (P ≤ .01) between blood pool and myocardium and sharpness of endocardium by 24% (P = .04) in comparison to uncorrected data. The image score, which refers to the cine image quality, has improved with the utilization of the proposed PT motion correction. CONCLUSION The proposed approach provides respiratory motion-corrected cine images of the heart with improved image quality and a high scan efficiency using the PT. The PT is independent of the MR acquisition, making this a very flexible motion-correction approach.
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Affiliation(s)
- Juliane Ludwig
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | | | - Frank Seifert
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Tobias Schaeffter
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany.,Technische Universität Berlin, Biomedical Engineering, Berlin, Germany
| | - Christoph Kolbitsch
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
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Leiner T, Bogaert J, Friedrich MG, Mohiaddin R, Muthurangu V, Myerson S, Powell AJ, Raman SV, Pennell DJ. SCMR Position Paper (2020) on clinical indications for cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2020; 22:76. [PMID: 33161900 PMCID: PMC7649060 DOI: 10.1186/s12968-020-00682-4] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/18/2020] [Indexed: 12/22/2022] Open
Abstract
The Society for Cardiovascular Magnetic Resonance (SCMR) last published its comprehensive expert panel report of clinical indications for CMR in 2004. This new Consensus Panel report brings those indications up to date for 2020 and includes the very substantial increase in scanning techniques, clinical applicability and adoption of CMR worldwide. We have used a nearly identical grading system for indications as in 2004 to ensure comparability with the previous report but have added the presence of randomized controlled trials as evidence for level 1 indications. In addition to the text, tables of the consensus indication levels are included for rapid assimilation and illustrative figures of some key techniques are provided.
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Affiliation(s)
- Tim Leiner
- Department of Radiology, E.01.132, Utrecht University Medical Center, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands.
| | - Jan Bogaert
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Catholic University Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Matthias G Friedrich
- Departments of Medicine and Diagnostic Radiology, McGill University, 1001 Decarie Blvd., Montreal, QC, H4A 3J1, Canada
| | - Raad Mohiaddin
- Department of Radiology, Royal Brompton Hospital, Sydney Street, Chelsea, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, South Kensington Campus, London, SW7 2AZ, UK
| | - Vivek Muthurangu
- Centre for Cardiovascular Imaging, Science & Great Ormond Street Hospital for Children, UCL Institute of Cardiovascular, Great Ormond Street, London, WC1N 3JH, UK
| | - Saul Myerson
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Farley, 2nd Floor, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, 300 Longwood Avenue, Farley, 2nd Floor, Boston, MA, 02115, USA
| | - Subha V Raman
- Krannert Institute of Cardiology, Indiana University School of Medicine, 340 West 10th Street, Fairbanks Hall, Suite 6200, Indianapolis, IN, 46202-3082, USA
| | - Dudley J Pennell
- Royal Brompton Hospital, Sydney Street, Chelsea, London, SW3 6NP, UK
- Imperial College, South Kensington Campus, London, SW7 2AZ, UK
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Quantitative evaluation of coronary artery visibility on CT angiography in Kawasaki disease: young vs. old children. Int J Cardiovasc Imaging 2020; 37:1085-1092. [PMID: 33044718 DOI: 10.1007/s10554-020-02054-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/29/2020] [Indexed: 12/19/2022]
Abstract
Coronary artery visibility on coronary CT angiography has rarely been investigated in young children with Kawasaki disease. This retrospective study was performed to quantitatively evaluate and compare coronary artery visibility with sufficient quality to measure it on coronary CT angiography among younger and older children with Kawasaki disease. Seventy-eight consecutive children with Kawasaki disease who underwent coronary CT angiography were divided into two groups: group 1 (age ≤ 6 years; n = 37) and group 2 (age > 6 years and < 18 years; n = 41). The visibility of the right coronary artery, left anterior descending artery, and left circumflex artery was quantitatively evaluated by dividing the length of the assessable coronary artery by the length of the corresponding groove, and compared between the two groups. The coronary artery visibility in group 1 was significantly lower than that in group 2 for the right coronary artery (77.8 ± 26.3% vs. 94.2 ± 13.6%, p < 0.002) and left anterior descending artery (54.8 ± 19.5% vs. 69.6 ± 21.3%, p < 0.003, but the difference was not significant for the left circumflex artery (43.7 ± 23.1% vs. 43.9 ± 26.7%, p > 0.9). In both groups, the visibility of the right coronary artery was the highest, followed by those of the left anterior descending artery and left circumflex artery. Compared with older children with Kawasaki disease, younger children with Kawasaki disease demonstrate significantly lower visibility of the right coronary artery and left anterior descending artery on coronary CT angiography. In contrast, the visibility of the left circumflex artery showed no significant difference between younger and older children with Kawasaki disease.
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Piccini D, Demesmaeker R, Heerfordt J, Yerly J, Di Sopra L, Masci PG, Schwitter J, Van De Ville D, Richiardi J, Kober T, Stuber M. Deep Learning to Automate Reference-Free Image Quality Assessment of Whole-Heart MR Images. Radiol Artif Intell 2020; 2:e190123. [PMID: 33937825 DOI: 10.1148/ryai.2020190123] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 03/03/2020] [Accepted: 03/11/2020] [Indexed: 11/11/2022]
Abstract
Purpose To develop and characterize an algorithm that mimics human expert visual assessment to quantitatively determine the quality of three-dimensional (3D) whole-heart MR images. Materials and Methods In this study, 3D whole-heart cardiac MRI scans from 424 participants (average age, 57 years ± 18 [standard deviation]; 66.5% men) were used to generate an image quality assessment algorithm. A deep convolutional neural network for image quality assessment (IQ-DCNN) was designed, trained, optimized, and cross-validated on a clinical database of 324 (training set) scans. On a separate test set (100 scans), two hypotheses were tested: (a) that the algorithm can assess image quality in concordance with human expert assessment as assessed by human-machine correlation and intra- and interobserver agreement and (b) that the IQ-DCNN algorithm may be used to monitor a compressed sensing reconstruction process where image quality progressively improves. Weighted κ values, agreement and disagreement counts, and Krippendorff α reliability coefficients were reported. Results Regression performance of the IQ-DCNN was within the range of human intra- and interobserver agreement and in very good agreement with the human expert (R 2 = 0.78, κ = 0.67). The image quality assessment during compressed sensing reconstruction correlated with the cost function at each iteration and was successfully applied to rank the results in very good agreement with the human expert. Conclusion The proposed IQ-DCNN was trained to mimic expert visual image quality assessment of 3D whole-heart MR images. The results from the IQ-DCNN were in good agreement with human expert reading, and the network was capable of automatically comparing different reconstructed volumes.Supplemental material is available for this article.© RSNA, 2020.
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Affiliation(s)
- Davide Piccini
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Robin Demesmaeker
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - John Heerfordt
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Jérôme Yerly
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Lorenzo Di Sopra
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Pier Giorgio Masci
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Juerg Schwitter
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Dimitri Van De Ville
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Jonas Richiardi
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Tobias Kober
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
| | - Matthias Stuber
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland (D.P., R.D., J.H., J.R., T.K.); Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 8.80, 1011 Lausanne, Switzerland (D.P., J.H., J.Y., L.D.S., J.R., T.K., M.S.); LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (D.P., J.R., T.K.); Institute of Electrical Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D.); Institute of Bioengineering/Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland (R.D., D.V.D.V.); Center for Biomedical Imaging (CIBM), Lausanne, Switzerland (J.Y., M.S.); Division of Cardiology and Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (P.G.M., J.S.); and Department of Radiology and Medical Informatics, University Hospital of Geneva (HUG), Geneva, Switzerland (D.V.D.V.)
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Bustin A, Rashid I, Cruz G, Hajhosseiny R, Correia T, Neji R, Rajani R, Ismail TF, Botnar RM, Prieto C. 3D whole-heart isotropic sub-millimeter resolution coronary magnetic resonance angiography with non-rigid motion-compensated PROST. J Cardiovasc Magn Reson 2020; 22:24. [PMID: 32299445 PMCID: PMC7161114 DOI: 10.1186/s12968-020-00611-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 02/19/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To enable free-breathing whole-heart sub-millimeter resolution coronary magnetic resonance angiography (CMRA) in a clinically feasible scan time by combining low-rank patch-based undersampled reconstruction (3D-PROST) with a highly accelerated non-rigid motion correction framework. METHODS Non-rigid motion corrected CMRA combined with 2D image-based navigators has been previously proposed to enable 100% respiratory scan efficiency in modestly undersampled acquisitions. Achieving sub-millimeter isotropic resolution with such techniques still requires prohibitively long acquisition times. We propose to combine 3D-PROST reconstruction with a highly accelerated non-rigid motion correction framework to achieve sub-millimeter resolution CMRA in less than 10 min. Ten healthy subjects and eight patients with suspected coronary artery disease underwent 4-5-fold accelerated free-breathing whole-heart CMRA with 0.9 mm3 isotropic resolution. Vessel sharpness, vessel length and image quality obtained with the proposed non-rigid (NR) PROST approach were compared against translational correction only (TC-PROST) and a previously proposed NR motion-compensated technique (non-rigid SENSE) in healthy subjects. For the patient study, image quality scoring and visual comparison with coronary computed tomography angiography (CCTA) were performed. RESULTS Average scan times [min:s] were 6:01 ± 0:59 (healthy subjects) and 8:29 ± 1:41 (patients). In healthy subjects, vessel sharpness of the left anterior descending (LAD) and right (RCA) coronary arteries were improved with the proposed non-rigid PROST (LAD: 51.2 ± 8.8%, RCA: 61.2 ± 9.1%) in comparison to TC-PROST (LAD: 43.8 ± 5.1%, P = 0.051, RCA: 54.3 ± 8.3%, P = 0.218) and non-rigid SENSE (LAD: 46.1 ± 5.8%, P = 0.223, RCA: 56.7 ± 9.6%, P = 0.50), although differences were not statistically significant. The average visual image quality score was significantly higher for NR-PROST (LAD: 3.2 ± 0.6, RCA: 3.3 ± 0.7) compared with TC-PROST (LAD: 2.1 ± 0.6, P = 0.018, RCA: 2.0 ± 0.7, P = 0.014) and non-rigid SENSE (LAD: 2.3 ± 0.5, P = 0.008, RCA: 2.5 ± 0.7, P = 0.016). In patients, the proposed approach showed good delineation of the coronaries, in agreement with CCTA, with image quality scores and vessel sharpness similar to that of healthy subjects. CONCLUSIONS We demonstrate the feasibility of combining high undersampling factors with non-rigid motion-compensated reconstruction to obtain high-quality sub-millimeter isotropic CMRA images in ~ 8 min. Validation in a larger cohort of patients with coronary artery disease is now warranted.
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Affiliation(s)
- Aurélien Bustin
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 3rd Floor, Lambeth Wing, London, SE1 7EH, UK
| | - Imran Rashid
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 3rd Floor, Lambeth Wing, London, SE1 7EH, UK
| | - Gastao Cruz
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 3rd Floor, Lambeth Wing, London, SE1 7EH, UK
| | - Reza Hajhosseiny
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 3rd Floor, Lambeth Wing, London, SE1 7EH, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Teresa Correia
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 3rd Floor, Lambeth Wing, London, SE1 7EH, UK
| | - Radhouene Neji
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 3rd Floor, Lambeth Wing, London, SE1 7EH, UK
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
| | - Ronak Rajani
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 3rd Floor, Lambeth Wing, London, SE1 7EH, UK
- Department of Cardiology, Guy's & St Thomas' Hospitals, London, UK
| | - Tevfik F Ismail
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 3rd Floor, Lambeth Wing, London, SE1 7EH, UK
| | - René M Botnar
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 3rd Floor, Lambeth Wing, London, SE1 7EH, UK.
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - Claudia Prieto
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, 3rd Floor, Lambeth Wing, London, SE1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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Masala N, Bastiaansen JAM, Di Sopra L, Roy CW, Piccini D, Yerly J, Colotti R, Stuber M. Free‐running 5D coronary MR angiography at 1.5T using LIBRE water excitation pulses. Magn Reson Med 2020; 84:1470-1485. [DOI: 10.1002/mrm.28221] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 12/31/2019] [Accepted: 01/30/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Nemanja Masala
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne Switzerland
| | - Jessica A. M. Bastiaansen
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne Switzerland
| | - Lorenzo Di Sopra
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne Switzerland
| | - Christopher W. Roy
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne Switzerland
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne Switzerland
- Advanced Clinical Imaging Technology Siemens Healthcare AG Lausanne Switzerland
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne Switzerland
- Center for Biomedical Imaging (CIBM) Lausanne Switzerland
| | - Roberto Colotti
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne Switzerland
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne Switzerland
- Center for Biomedical Imaging (CIBM) Lausanne Switzerland
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Hirai K, Kido T, Kido T, Ogawa R, Tanabe Y, Nakamura M, Kawaguchi N, Kurata A, Watanabe K, Yamaguchi O, Schmidt M, Forman C, Mochizuki T. Feasibility of contrast-enhanced coronary artery magnetic resonance angiography using compressed sensing. J Cardiovasc Magn Reson 2020; 22:15. [PMID: 32050982 PMCID: PMC7017458 DOI: 10.1186/s12968-020-0601-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 01/09/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Coronary magnetic resonance angiography (CMRA) is a promising technique for assessing the coronary arteries. However, a disadvantage of CMRA is the comparatively long acquisition time. Compressed sensing (CS) can considerably reduce the scan time. The aim of this study was to verify the feasibility of CS CMRA scanning during the waiting time between contrast injection and late gadolinium enhancement (LGE) scan in a clinical protocol. METHODS Fifty clinical patients underwent contrast-enhanced CS CMRA and conventional CMRA on a 3 T CMR scanner. After contrast injection, CS CMRA was scanned during the waiting time for LGE CMR. A conventional CMRA scan was performed after LGE CMR. We assessed acquisition times and coronary artery image quality for each segment on a 4-point scale. Visible vessel length, sharpness and diameter of right (RCA), left anterior descending (LAD), and left circumflex (LCX) coronary arteries were also quantitatively compared among the scans. RESULTS All CS CMRA scans were successfully performed within the LGE waiting time. The median total scan time was 207 s (163, 259 s) for CS and 785 s (698, 975 s) for conventional CMRA (p < 0.001). No significant differences were observed in image quality scores, vessel length measurements, sharpness, and diameter between CS and conventional CMRA. CONCLUSIONS We could achieve all CS CMRA scans within the LGE waiting time. Contrast-enhanced CS CMRA could considerably shorten the scan time while maintaining image quality compared with conventional CMRA.
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Affiliation(s)
- Kuniaki Hirai
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Tomoyuki Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Ryo Ogawa
- Department of Radiology, Saiseikai Matsuyama Hospital, 880-2, Yamanishi, Matsuyama, Ehime 791-8026 Japan
| | - Yuki Tanabe
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Masashi Nakamura
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Naoto Kawaguchi
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Akira Kurata
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Kouki Watanabe
- Department of Cardiology, Saiseikai Matsuyama Hospital, 880-2, Yamanishi, Matsuyama, Ehime 791-8026 Japan
| | - Osamu Yamaguchi
- Department of Cardiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Michaela Schmidt
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052 Erlangen, Germany
| | - Christoph Forman
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052 Erlangen, Germany
| | - Teruhito Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
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Yu S, Cui C, Lu M, Zhao S. Diagnostic Accuracy of Three-Dimensional Whole-Heart Magnetic Resonance Angiography to Detect Coronary Artery Disease with Invasive Coronary Angiography as a Reference: A Meta-Analysis. CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 2020. [DOI: 10.15212/cvia.2019.0561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: We aimed to evaluate the diagnostic performance of three-dimensional whole-heart magnetic resonance coronary angiography (MRCA) in detecting coronary artery disease (CAD) with invasive coronary angiography as the reference standard.Methods: We searched PubMed
and Embase for studies evaluating the diagnostic performance of three-dimensional whole-heart MRCA for the diagnosis of CAD with invasive coronary angiography as the reference standard. The bivariate mixed-effects regression model was applied to synthesize available data. The clinical utility
of whole-heart MRCA was calculated by the posttest probability based on Bayes’s theorem.Results: Eighteen studies were included, of which 16 provided data at the artery level. Patient-based analysis revealed a pooled sensitivity of 0.90 (95% confidence interval [CI] 0.87‐0.93)
and specificity of 0.79 (95% CI 0.73‐0.84), while the pooled estimates were 0.86 (95% CI 0.82‐0.89) and 0.89 (95% CI 0.84‐0.92), respectively, at the artery level. The areas under the summary receiver operating characteristic curve were 0.93 (95% CI 0.90‐0.95) and
0.92 (95% CI 0.90‐0.94) at the patient and artery levels, respectively. With a pretest probability of 50%, the patients’ posttest probabilities of CAD were 81% for positive results and 11% for negative results.Conclusions: Whole-heart MRCA can be an alternative noninvasive
method for diagnosis and assessment of CAD.
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Affiliation(s)
- Shiqin Yu
- Department of Cardiac MR, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, 100037 Beijing, People’s Republic of China
| | - Chen Cui
- Department of Cardiac MR, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, 100037 Beijing, People’s Republic of China
| | - Minjie Lu
- Department of Cardiac MR, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, 100037 Beijing, People’s Republic of China
| | - Shihua Zhao
- Department of Cardiac MR, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, 100037 Beijing, People’s Republic of China
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Heerfordt J, Stuber M, Maillot A, Bianchi V, Piccini D. A quantitative comparison between a navigated Cartesian and a self-navigated radial protocol from clinical studies for free-breathing 3D whole-heart bSSFP coronary MRA. Magn Reson Med 2019; 84:157-169. [PMID: 31815322 DOI: 10.1002/mrm.28101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 11/07/2019] [Accepted: 11/09/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE Navigator-gated 3D bSSFP whole-heart coronary MRA has been evaluated in several large studies including a multi-center trial. Patient studies have also been performed with more recent self-navigated techniques. In this study, these two approaches are compared side-by-side using a Cartesian navigator-gated and corrected (CNG) and a 3D radial self-navigated (RSN) protocol from published patient studies. METHODS Sixteen healthy subjects were examined with both sequences on a 1.5T scanner. Assessment of the visibility of coronary ostia and quantitative comparisons of acquisition times, blood pool homogeneity, and visible length and sharpness of the right coronary artery (RCA) and the combined left main (LM)+left anterior descending (LAD) coronary arteries were performed. Paired sample t-tests with P < .05 considered statistically significant were used for all comparisons. RESULTS The acquisition time was 5:40 ± 0:28 min (mean ± SD) for RSN, being significantly shorter than the 16:59 ± 5:05 min of CNG (P < .001). RSN images showed higher blood pool homogeneity (P < .001). All coronary ostia were visible with both techniques. CNG provided significantly higher vessel sharpness in the RCA (CNG: 50.0 ± 8.6%, RSN: 34.2 ± 6.9%, P < .001) and the LM+LAD (CNG: 48.7 ± 6.7%, RSN: 32.3 ± 7.1%, P < .001). The visible vessel length was significantly longer in the LM+LAD using CNG (CNG: 9.8 ± 2.7 cm, RSN: 8.5 ± 2.6 cm, P < .05) but not in the RCA (CNG: 9.7 ± 2.3 cm, RSN: 9.3 ± 2.9 cm, P = .29). CONCLUSION CNG provided superior vessel sharpness and might hence be the better option for examining coronary lumina. However, its blood pool inhomogeneity and prolonged and unpredictable acquisition times compared to RSN may make clinical adoption more challenging.
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Affiliation(s)
- John Heerfordt
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Aurélien Maillot
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Veronica Bianchi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
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Zitzelsberger T, Krumm P, Hornung A, Kramer U, Nikolaou K, Schäfer JF, Schick F, Sieverding L, Martirosian P. Multi-phase coronary magnetic resonance angiography improves delineation of coronary arteries. Acta Radiol 2019; 60:1422-1429. [PMID: 30799635 DOI: 10.1177/0284185119830289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Tanja Zitzelsberger
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Germany
| | - Patrick Krumm
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Germany
| | - Andreas Hornung
- Department of Pediatric Cardiology, University of Tuebingen, Germany
| | - Ulrich Kramer
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Germany
| | - Jürgen F Schäfer
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Germany
| | - Fritz Schick
- Department of Diagnostic and Interventional Radiology, Section on Experimental Radiology, University of Tuebingen, Germany
| | - Ludger Sieverding
- Department of Pediatric Cardiology, University of Tuebingen, Germany
| | - Petros Martirosian
- Department of Diagnostic and Interventional Radiology, Section on Experimental Radiology, University of Tuebingen, Germany
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Albrecht MH, Varga-Szemes A, Schoepf UJ, Nance JW, De Cecco CN, De Santis D, Tesche C, Eid MH, Penmetsa M, Lesslie VW, Piccini D, Goeller M, Wichmann JL, Vogl TJ, Chowdhury SM, Nutting A, Hlavacek AM. Diagnostic Accuracy of Noncontrast Self-navigated Free-breathing MR Angiography versus CT Angiography: A Prospective Study in Pediatric Patients with Suspected Anomalous Coronary Arteries. Acad Radiol 2019; 26:1309-1317. [PMID: 30655052 DOI: 10.1016/j.acra.2018.12.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/09/2018] [Accepted: 12/10/2018] [Indexed: 01/15/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate the diagnostic accuracy of a prototype noncontrast, free-breathing, self-navigated 3D (SN3D) MR angiography (MRA) technique for the assessment of coronary artery anatomy in children with known or suspected coronary anomalies, using CT angiography (CTA) as the reference standard. MATERIALS AND METHODS Twenty-one children (15 male, 12.3 ± 2.6 years) were prospectively enrolled between July 2014 and August 2016 in this IRB-approved, HIPAA-compliant study. Patients underwent same-day unenhanced SN3D-MRA and contrast-enhanced CTA. Two observers rated the visualization of coronary artery segments and diagnostic confidence on a 3-point scale and assessed coronary arteries for anomalous origin, as well as interarterial and intramural course. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of SN3D-MRA for the detection of coronary artery abnormalities were calculated. Interobserver agreement was assessed using Intraclass Correlation Coefficients (ICC). RESULTS Fourteen children showed coronary artery abnormalities on CTA. The visualization of coronary segments was rated significantly higher for CTA compared to MRA (p <0.015), except for the left main coronary artery (p = 0.301), with good to excellent interobserver agreement (ICC = 0.62-0.94). Diagnostic confidence was higher for CTA (p = 0.046). Sensitivity, specificity, PPV, and NPV of MRA were 92%, 92%, 96%, and 87% for the detection of coronary artery anomalies, 85%, 85%, 74%, and 92% for high origin, 71%, 92%, 82%, and 87% for interarterial, and 41%, 96%, 87%, and 80% for intramural course. CONCLUSIONS Noncontrast SN3D-MRA is highly accurate for the detection of coronary artery anomalies in pediatric patients while diagnostic confidence and coronary artery visualization remain superior with CTA.
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Stroud RE, Piccini D, Schoepf UJ, Heerfordt J, Yerly J, Di Sopra L, Rollins JD, Fischer AM, Suranyi P, Varga-Szemes A. Correcting versus resolving respiratory motion in free-breathing whole-heart MRA: a comparison in patients with thoracic aortic disease. Eur Radiol Exp 2019; 3:29. [PMID: 31363865 PMCID: PMC6667582 DOI: 10.1186/s41747-019-0107-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/02/2019] [Indexed: 11/28/2022] Open
Abstract
Background Whole-heart magnetic resonance angiography (MRA) requires sophisticated methods accounting for respiratory motion. Our purpose was to evaluate the image quality of compressed sensing-based respiratory motion-resolved three-dimensional (3D) whole-heart MRA compared with self-navigated motion-corrected whole-heart MRA in patients with known thoracic aorta dilation. Methods Twenty-five patients were prospectively enrolled in this ethically approved study. Whole-heart 1.5-T MRA was acquired using a prototype 3D radial steady-state free-precession free-breathing sequence. The same data were reconstructed with a one-dimensional motion-correction algorithm (1D-MCA) and an extradimensional golden-angle radial sparse parallel reconstruction (XD-GRASP). Subjective image quality was scored and objective image quality was quantified (signal intensity ratio, SIR; vessel sharpness). Wilcoxon, McNemar, and paired t tests were used. Results Subjective image quality was significantly higher using XD-GRASP compared to 1D-MCA (median 4.5, interquartile range 4.5–5.0 versus 4.0 [2.25–4.75]; p < 0.001), as well as signal homogeneity (3.0 [3.0–3.0] versus 2.0 [2.0–3.0]; p = 0.003), and image sharpness (3.0 [2.0–3.0] vs 2.0 [1.25–3.0]; p < 0.001). SIR with the 1D-MCA and XD-GRASP was 6.1 ± 3.9 versus 7.4 ± 2.5, respectively (p < 0.001); while signal homogeneity was 274.2 ± 265.0 versus 199.8 ± 67.2 (p = 0.129). XD-GRASP provided a higher vessel sharpness (45.3 ± 10.7 versus 40.6 ± 101, p = 0.025). Conclusions XD-GRASP-based motion-resolved reconstruction of free-breathing 3D whole-heart MRA datasets provides improved image contrast, sharpness, and signal homogeneity and seems to be a promising technique that overcomes some of the limitations of motion correction or respiratory navigator gating.
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Affiliation(s)
- Robert E Stroud
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 7.84, 1010, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, EPFL QI-E, 1015, Lausanne, Switzerland
| | - U Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - John Heerfordt
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 7.84, 1010, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, EPFL QI-E, 1015, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 7.84, 1010, Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Rue de Bugnon 46, BH 7.84, 1010, Lausanne, Switzerland
| | - Lorenzo Di Sopra
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue de Bugnon 46, BH 7.84, 1010, Lausanne, Switzerland
| | - Jonathan D Rollins
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - Andreas M Fischer
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC, 29425, USA.,Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Pal Suranyi
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC, 29425, USA.
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Di Sopra L, Piccini D, Coppo S, Stuber M, Yerly J. An automated approach to fully self‐gated free‐running cardiac and respiratory motion‐resolved 5D whole‐heart MRI. Magn Reson Med 2019; 82:2118-2132. [DOI: 10.1002/mrm.27898] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/13/2019] [Accepted: 06/14/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Lorenzo Di Sopra
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital Lausanne Switzerland
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital Lausanne Switzerland
- Advanced Clinical Imaging Technology Siemens Healthcare Lausanne Switzerland
| | - Simone Coppo
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital Lausanne Switzerland
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital Lausanne Switzerland
- Center for Biomedical Imaging Lausanne Switzerland
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology Lausanne University Hospital Lausanne Switzerland
- Center for Biomedical Imaging Lausanne Switzerland
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Bastiaansen JAM, van Heeswijk RB, Stuber M, Piccini D. Noncontrast free-breathing respiratory self-navigated coronary artery cardiovascular magnetic resonance angiography at 3 T using lipid insensitive binomial off-resonant excitation (LIBRE). J Cardiovasc Magn Reson 2019; 21:38. [PMID: 31291957 PMCID: PMC6621993 DOI: 10.1186/s12968-019-0543-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/20/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Robust and homogeneous lipid suppression is mandatory for coronary artery cardiovascular magnetic resonance (CMR) imaging since the coronary arteries are commonly embedded in epicardial fat. However, effective large volume lipid suppression becomes more challenging when performing radial whole-heart coronary artery CMR for respiratory self-navigation and the problem may even be exacerbated at increasing magnetic field strengths. Incomplete fat suppression not only hinders a correct visualization of the coronary vessels and generates image artifacts, but may also affect advanced motion correction methods. The aim of this study was to evaluate a recently reported lipid insensitive CMR method when applied to a noncontrast self-navigated coronary artery CMR acquisitions at 3 T, and to compare it to more conventional fat suppression techniques. METHODS Lipid insensitive binomial off resonant excitation (LIBRE) radiofrequency excitation pulses were included into a self-navigated 3D radial GRE coronary artery CMR sequence at 3 T. LIBRE was compared against a conventional CHESS fat saturation (FS) and a binomial 1-180°-1 water excitation (WE) pulse. First, fat suppression of all techniques was numerically characterized using Matlab and experimentally validated in phantoms and in legs of human volunteers. Subsequently, free-breathing self-navigated coronary artery CMR was performed using the LIBRE pulse as well as FS and WE in ten healthy subjects. Myocardial, arterial and chest fat signal-to-noise ratios (SNR), as well as coronary vessel conspicuity were quantitatively compared among those scans. RESULTS The results obtained in the simulations were confirmed by the experimental validations as LIBRE enabled near complete fat suppression for 3D radial imaging in vitro and in vivo. For self-navigated whole-heart coronary artery CMR at 3 T, fat SNR was significantly attenuated using LIBRE compared with conventional FS. LIBRE increased the right coronary artery (RCA) vessel sharpness significantly (37 ± 9% (LIBRE) vs. 29 ± 8% (FS) and 30 ± 8% (WE), both p < 0.05) and led to a significant increase in the measured RCA vessel length to (83 ± 31 mm (LIBRE) vs. 56 ± 12 mm (FS) and 59 ± 27 (WE) p < 0.05). CONCLUSIONS Applied to a respiratory self-navigated noncontrast 3D radial whole-heart sequence, LIBRE enables robust large volume fat suppression and significantly improves coronary artery image quality at 3 T compared to the use of conventional FS and WE.
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Affiliation(s)
- Jessica A. M. Bastiaansen
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ruud B. van Heeswijk
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Center for Biomedical Imaging, Lausanne, Switzerland
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Advanced clinical imaging technology, Siemens Healthcare AG, Lausanne, Switzerland
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Velasco Forte MN, Valverde I, Prabhu N, Correia T, Narayan SA, Bell A, Mathur S, Razavi R, Hussain T, Pushparajah K, Henningsson M. Visualization of coronary arteries in paediatric patients using whole-heart coronary magnetic resonance angiography: comparison of image-navigation and the standard approach for respiratory motion compensation. J Cardiovasc Magn Reson 2019; 21:13. [PMID: 30798789 PMCID: PMC6388473 DOI: 10.1186/s12968-019-0525-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 02/05/2019] [Indexed: 11/10/2022] Open
Abstract
AIMS To investigate the use of respiratory motion compensation using image-based navigation (iNAV) with constant respiratory efficiency using single end-expiratory thresholding (CRUISE) for coronary magnetic resonance angiography (CMRA), and compare it to the conventional diaphragmatic navigator (dNAV) in paediatric patients with congenital or suspected heart disease. METHODS iNAV allowed direct tracking of the respiratory heart motion and was generated using balanced steady state free precession startup echoes. Respiratory gating was achieved using CRUISE with a fixed 50% efficiency. Whole-heart CMRA was acquired with 1.3 mm isotropic resolution. For comparison, CMRA with identical imaging parameters were acquired using dNAV. Scan time, visualization of coronary artery origins and mid-course, imaging quality and sharpness was compared between the two sequences. RESULTS Forty patients (13 females; median weight: 44 kg; median age: 12.6, range: 3 months-17 years) were enrolled. 25 scans were performed in awake patients. A contrast agent was used in 22 patients. The scan time was significantly reduced using iNAV for awake patients (iNAV 7:48 ± 1:26 vs dNAV 9:48 ± 3:11, P = 0.01) but not for patients under general anaesthesia (iNAV = 6:55 ± 1:50 versus dNAV = 6:32 ± 2:16; P = 0.32). In 98% of the cases, iNAV image quality had an equal or higher score than dNAV. The visual score analysis showed a clear difference, favouring iNAV (P = 0.002). The right coronary artery and the left anterior descending vessel sharpness was significantly improved (iNAV: 56.8% ± 10.1% vs dNAV: 53.7% ± 9.9%, P < 0.002 and iNAV: 55.8% ± 8.6% vs dNAV: 53% ± 9.2%, P = 0.001, respectively). CONCLUSION iNAV allows for a higher success-rate and clearer depiction of the mid-course of coronary arteries in paediatric patients. Its acquisition time is shorter in awake patients and image quality score is equal or superior to the conventional method in most cases.
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Affiliation(s)
- Mari Nieves Velasco Forte
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London, UK
- Cardiovascular Pathology Unit, Institute of Biomedicine of Seville, IBIS, Virgen del Rocio University Hospital/CSIC/University of Seville, Seville, Spain
| | - Israel Valverde
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London, UK
- Cardiovascular Pathology Unit, Institute of Biomedicine of Seville, IBIS, Virgen del Rocio University Hospital/CSIC/University of Seville, Seville, Spain
| | - Nanda Prabhu
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London, UK
| | - Teresa Correia
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Srinivas Ananth Narayan
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London, UK
| | - Aaron Bell
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London, UK
| | - Sujeev Mathur
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London, UK
| | - Reza Razavi
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London, UK
| | - Tarique Hussain
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Department of Pediatrics, University of Texas Southwestern Medical Center, 1935 Medical District Drive, Dallas, USA
| | - Kuberan Pushparajah
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London, UK
| | - Markus Henningsson
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Ma J, März M, Funk S, Schulz-Menger J, Kutyniok G, Schaeffter T, Kolbitsch C. Shearlet-based compressed sensing for fast 3D cardiac MR imaging using iterative reweighting. Phys Med Biol 2018; 63:235004. [PMID: 30465546 DOI: 10.1088/1361-6560/aaea04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
High-resolution three-dimensional (3D) cardiovascular magnetic resonance (CMR) is a valuable medical imaging technique, but its widespread application in clinical practice is hampered by long acquisition times. Here we present a novel compressed sensing (CS) reconstruction approach using shearlets as a sparsifying transform allowing for fast 3D CMR (3DShearCS) using 3D radial phase encoding (RPE). An iterative reweighting scheme was applied during image reconstruction to ensure fast convergence and high image quality. Shearlets are mathematically optimal for a simplified model of natural images and have been proven to be more efficient than classical systems such as wavelets. 3DShearCS was compared to three other commonly used reconstruction approaches. Image quality was assessed quantitatively using general image quality metrics and using clinical diagnostic scores from expert reviewers. The proposed technique had lower relative errors, higher structural similarity and higher diagnostic scores compared to the other reconstruction techniques especially for high undersampling factors, i.e. short scan times. 3DShearCS provided ensured accurate depiction of cardiac anatomy for fast imaging and could help to promote 3D high-resolution CMR in clinical practice.
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Affiliation(s)
- Jackie Ma
- Image and Video Coding Group, Fraunhofer Institute for Telecommunications-Heinrich Hertz Institute, Berlin, Germany. Author to whom any correspondence should be addressed
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Technical Feasibility of a Combined Noncontrast Magnetic Resonance Protocol for Preoperative Transcatheter Aortic Valve Replacement Evaluation. J Thorac Imaging 2018; 33:60-67. [PMID: 28549023 DOI: 10.1097/rti.0000000000000278] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE The aim of this study was to prospectively evaluate the technical feasibility of a noncontrast magnetic resonance angiography (MRA) protocol using investigational prototype self-navigated 3D (SN3D) radial whole-heart and quiescent-interval single-shot (QISS) pulse sequences regarding their potential in planning transcatheter aortic valve replacement (TAVR). MATERIALS AND METHODS Five patients (76±7 y) with severe aortic valve stenosis and prior computed tomographic angiography (CTA) for TAVR planning and 10 healthy volunteers (28±6 y) underwent noncontrast MRA on a 1.5 T system. A SN3D whole-heart acquisition was used to assess the aortic root anatomy. Evaluation of the aortoiliac access route was performed with both SN3D and QISS. Measurements were compared among SN3D, QISS, and CTA using a paired t test or 1-way analysis of variance. Image quality ratings and contrast-to-noise ratios (CNR) were analyzed using Mann-Whitney U tests. Interobserver agreement was evaluated using Cohen's κ. RESULTS The combined SN3D and QISS protocol provided a 10.1±1.6-minute acquisition time. TAVR-relevant evaluation was technically feasible in healthy volunteers. All measurements showed good agreement with CTA in patients (all P>0.098). SN3D and QISS produced similar image quality both in volunteers and in patients (all P>0.122). There was no difference in qualitative ratings between MRA and CTA (all P>0.119). Interobserver agreement was good for MRA (κ=0.71 to 0.76) and excellent for CTA (κ=0.82 to 0.84). Thoracic SN3D provided a similar CNR compared with CTA (P=0.117). CTA yielded higher CNR in the abdominopelvic region compared with QISS (P=0.006). CONCLUSIONS A noncontrast MRA protocol combining SN3D and QISS acquisitions for the assessment of cardiac and vascular access route anatomy has technical feasibility for TAVR planning.
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Nakamura M, Kido T, Kido T, Watanabe K, Schmidt M, Forman C, Mochizuki T. Non-contrast compressed sensing whole-heart coronary magnetic resonance angiography at 3T: A comparison with conventional imaging. Eur J Radiol 2018; 104:43-48. [PMID: 29857865 DOI: 10.1016/j.ejrad.2018.04.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 04/17/2018] [Accepted: 04/24/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Whole-heart coronary magnetic resonance angiography (MRA) is a promising non-contrast, radiation-free technique for assessing the coronary artery. Yet, a disadvantage of coronary MRA is the relatively long acquisition time. The purpose of this study was to evaluate the scan time and image quality of compressed sensing (CS) coronary MRA compared with conventional coronary MRA. MATERIALS AND METHODS Twenty healthy volunteers underwent navigator-gated coronary MRA with a CS prototype sequence and conventional navigator-gated coronary MRA on a clinical 3T MRI scanner without contrast medium. The spatial resolutions were 1.33 × 1.33 × 1.20 mm3 for CS and 1.33 × 1.33 × 1.48 mm3 interpolated to 0.70 × 0.70 × 1.20 mm3 for conventional, respectively. We compared acquisition times, rated image quality on a 4-point scale (RCA; proximal, middle, and distal, LAD; main, proximal, middle, and distal, LCX; proximal and distal), and measured the visualized vessel lengths of three vessels. RESULTS The mean acceptance rates were 44.9% for CS coronary MRA and 48.7% for conventional coronary MRA (p = .39). The mean effective scan time was 3 min 45 s for CS coronary MRA and 15 min 6 s for conventional coronary MRA (p < 0.001). Image quality scores were significantly lower for CS coronary MRA than for conventional coronary MRA (3.4 ± 0.7 for CS vs. 3.8 ± 0.4 for conventional; p < 0.0001). Conventional coronary MRA images were scored >3.4 in all segments on average, while CS coronary MRA images were scored >3.2 (good quality for diagnosis) in almost all segments, with only the distal RCA segment graded 2.9 on average. The average visible vessel lengths for CS and conventional coronary MRA were as follows: 11.5 ± 4.4 cm and 12.5 ± 4.8 cm for the RCA, respectively (p < 0.05, 95% limits of agreement [LOA]; -3.6 to 1.6 cm); 10.6 ± 3.0 cm and 11.1 ± 2.9 cm for the LAD, respectively (p = .15, 95% LOA -4.0 to 2.8 cm); and 7.1 ± 2.2 cm and 8.2 ± 2.5 cm for the LCX, respectively (p < 0.05, 95% LOA -4.0 to 1.7 cm). CONCLUSIONS Non-contrast coronary MRA using CS could largely shorten acquisition time, compared with conventional navigator-gated coronary MRA, while maintaining acceptable visualization at 3T.
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Affiliation(s)
- Masashi Nakamura
- Department of Radiology, Ehime University Graduate School of Medicine, Matsuyama, Ehime, Japan.
| | - Tomoyuki Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Matsuyama, Ehime, Japan
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Matsuyama, Ehime, Japan
| | - Kouki Watanabe
- Department of Cardiology, Saiseikai Matsuyama Hospital, Matsuyama, Ehime, Japan
| | | | | | - Teruhito Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Matsuyama, Ehime, Japan
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Coristine AJ, Chaptinel J, Ginami G, Bonanno G, Coppo S, van Heeswijk RB, Piccini D, Stuber M. Improved respiratory self-navigation for 3D radial acquisitions through the use of a pencil-beam 2D-T 2 -prep for free-breathing, whole-heart coronary MRA. Magn Reson Med 2018; 79:1293-1303. [PMID: 28568961 PMCID: PMC5931377 DOI: 10.1002/mrm.26764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 05/01/2017] [Accepted: 05/03/2017] [Indexed: 12/26/2022]
Abstract
PURPOSE In respiratory self-navigation (SN), signal from static structures, such as the chest wall, may complicate motion detection or introduce post-correction artefacts. Suppressing signal from superfluous tissues may therefore improve image quality. We thus test the hypothesis that SN whole-heart coronary magnetic resonance angiography (MRA) will benefit from an outer-volume suppressing 2D-T2 -Prep and present both phantom and in vivo results. METHODS A 2D-T2 -Prep and a conventional T2 -Prep were used prior to a free-breathing 3D-radial SN sequence. Both techniques were compared by imaging a home-built moving cardiac phantom and by performing coronary MRA in nine healthy volunteers. Reconstructions were performed using both a reference-based and a reference-independent approach to motion tracking, along with several coil combinations. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were compared, along with vessel sharpness (VS). RESULTS In phantoms, using the 2D-T2 -Prep increased SNR by 16% to 53% and mean VS by 8%; improved motion tracking precision was also achieved. In volunteers, SNR increased by an average of 29% to 33% in the blood pool and by 15% to 25% in the myocardium, depending on the choice of reconstruction coils and algorithm, and VS increased by 34%. CONCLUSION A 2D-T2 -Prep significantly improves image quality in both phantoms and volunteers when performing SN coronary MRA. Magn Reson Med 79:1293-1303, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- A. J. Coristine
- Department of BioMedical Engineering, Case Western Reserve University (CWRU), Cleveland, Ohio, USA
- Department of Radiology, University Hospital (CHUV) / University of Lausanne (UNIL), Lausanne, VD, Switzerland
| | - J. Chaptinel
- Department of Radiology, University Hospital (CHUV) / University of Lausanne (UNIL), Lausanne, VD, Switzerland
| | - G. Ginami
- Department of Radiology, University Hospital (CHUV) / University of Lausanne (UNIL), Lausanne, VD, Switzerland
| | - G. Bonanno
- Department of Radiology, University Hospital (CHUV) / University of Lausanne (UNIL), Lausanne, VD, Switzerland
| | - S. Coppo
- Department of Radiology, University Hospital (CHUV) / University of Lausanne (UNIL), Lausanne, VD, Switzerland
| | - R. B. van Heeswijk
- Department of Radiology, University Hospital (CHUV) / University of Lausanne (UNIL), Lausanne, VD, Switzerland
| | - D. Piccini
- Department of Radiology, University Hospital (CHUV) / University of Lausanne (UNIL), Lausanne, VD, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland
| | - M. Stuber
- Department of Radiology, University Hospital (CHUV) / University of Lausanne (UNIL), Lausanne, VD, Switzerland
- CardioVascular Magnetic Resonance (CVMR) research centre, Centre for BioMedical Imaging (CIBM), Lausanne, VD, Switzerland
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Silva Vieira M, Henningsson M, Dedieu N, Vassiliou VS, Bell A, Mathur S, Pushparajah K, Figueroa CA, Hussain T, Botnar R, Greil GF. Improved coronary magnetic resonance angiography using gadobenate dimeglumine in pediatric congenital heart disease. Magn Reson Imaging 2018; 49:47-54. [PMID: 29339139 DOI: 10.1016/j.mri.2017.12.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 12/25/2017] [Accepted: 12/29/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND CMRA in pediatrics remains challenging due to the smaller vessel size, high heart rates (HR), potential image degradation caused by limited patient cooperation and long acquisition times. High-relaxivity contrast agents have been shown to improve coronary imaging in adults, but limited data is available in children. We sought to investigate whether gadobenate dimeglumine (Gd-BOPTA) together with self-navigated inversion-prepared coronary magnetic resonance angiography (CMRA) sequence design improves coronary image quality in pediatric patients. METHODS Forty consecutive patients (mean age 6±2.8years; 73% males) were prospectively recruited for a 1.5-T MRI study under general anesthesia. Two electrocardiographic-triggered free breathing steady-state free precession (SSFP) angiography sequences (A and B) with isotropic spatial resolution (1.3mm3) were acquired using a recently developed image-based self-navigation technique. Sequence A was acquired prior to contrast administration using T2 magnetization preparation (T2prep). Sequence B was acquired 5-8min after a bolus of Gd-BOPTA with the T2prep replaced by an inversion recovery (IR) pulse to null the signal from the myocardium. Scan time, signal-to noise and contrast-to-noise ratios (SNR and CNR), vessel wall sharpness (VWS) and qualitative visual score for each sequence were compared. RESULTS Scan time was similar for both sequences (5.3±1.8 vs 5.2±1.5min, p=.532) and average heart rate (78±14.7 vs 78±14.5bpm, p=.443) remained constant throughout both acquisitions. Sequence B resulted in higher SNR (12.6±4.4 vs 31.1±7.4, p<.001) and CNR (9.0±1.8 vs 13.5±3.7, p<.001) and provided improved coronary visualization in all coronary territories (VWS A=0.53±0.07 vs B=0.56±0.07, p=.001; and visual scoring A=3.8±0.59 vs B=4.1±0.53, p<.001). The number of non-diagnostic coronary segments was lower for sequence B [A=42 (13.1%) segments vs B=33 (10.3%) segments; p=.002], and contrary to the pre-contrast sequence, never involved a proximal segment. These results were independent of the patients' age, body surface area and HR. CONCLUSIONS The use of Gd-BOPTA with a 3D IR SSFP CMRA sequence results in improved coronary visualization in small infants and young children with high HR within a clinically acceptable scan time.
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Affiliation(s)
- Miguel Silva Vieira
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK.
| | - Markus Henningsson
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK.
| | - Nathalie Dedieu
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
| | | | - Aaron Bell
- Evelina Children's Hospital London, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Sujeev Mathur
- Evelina Children's Hospital London, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Kuberan Pushparajah
- Evelina Children's Hospital London, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Carlos Alberto Figueroa
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK; Departments of Surgery and Biomedical Engineering, University of Michigan, MI, USA.
| | - Tarique Hussain
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, USA.
| | - René Botnar
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK; Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile.
| | - Gerald F Greil
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, USA.
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Crowe LA, Manasseh G, Chmielewski A, Hachulla AL, Speicher D, Greiser A, Muller H, de Perrot T, Vallee JP, Salomir R. Spatially Resolved MR-Compatible Doppler Ultrasound: Proof of Concept for Triggering of Diagnostic Quality Cardiovascular MRI for Function and Flow Quantification at 3T. IEEE Trans Biomed Eng 2017; 65:294-306. [PMID: 29053451 DOI: 10.1109/tbme.2017.2764111] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE We demonstrate the use of a magnetic-resonance (MR)-compatible ultrasound (US) imaging probe using spatially resolved Doppler for diagnostic quality cardiovascular MR imaging (MRI) as an initial step toward hybrid US/MR fetal imaging. METHODS A newly developed technology for a dedicated MR-compatible phased array ultrasound-imaging probe acquired pulsed color Doppler carotid images, which were converted in near-real time to a trigger signal for cardiac cine and flow quantification MRI. Ultrasound and MR data acquired simultaneously were interference free. Conventional electrocardiogram (ECG) and the proposed spatially resolved Doppler triggering were compared in 10 healthy volunteers. A synthetic "false-triggered" image was retrospectively processed using metric optimized gating (MOG). Images were scored by expert readers, and sharpness, cardiac function and aortic flow were quantified. Four-dimensional (4-D) flow (two volunteers) showed feasibility of Doppler triggering over a long acquisition time. RESULTS Imaging modalities were compatible. US probe positioning was stable and comfortable. Image quality scores and quantified sharpness were statistically equal for Doppler- and ECG-triggering (p ). ECG-, Doppler-triggered, and MOG ejection fractions were equivalent (p ), with false-triggered values significantly lower (p < 0.0005). Aortic flow showed no difference between ECG- and Doppler-triggered and MOG (p > 0.05). 4-D flow quantification gave consistent results between ECG and Doppler triggering. CONCLUSION We report interference-free pulsed color Doppler ultrasound during MR data acquisition. Cardiovascular MRI of diagnostic quality was successfully obtained with pulsed color Doppler triggering. SIGNIFICANCE The hardware platform could further enable advanced free-breathing cardiac imaging. Doppler ultrasound triggering is applicable where ECG is compromised due to pathology or interference at higher magnetic fields, and where direct ECG is impossible, i.e., fetal imaging.
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Campbell-Washburn AE, Tavallaei MA, Pop M, Grant EK, Chubb H, Rhode K, Wright GA. Real-time MRI guidance of cardiac interventions. J Magn Reson Imaging 2017; 46:935-950. [PMID: 28493526 PMCID: PMC5675556 DOI: 10.1002/jmri.25749] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 03/29/2017] [Indexed: 11/09/2022] Open
Abstract
Cardiac magnetic resonance imaging (MRI) is appealing to guide complex cardiac procedures because it is ionizing radiation-free and offers flexible soft-tissue contrast. Interventional cardiac MR promises to improve existing procedures and enable new ones for complex arrhythmias, as well as congenital and structural heart disease. Guiding invasive procedures demands faster image acquisition, reconstruction and analysis, as well as intuitive intraprocedural display of imaging data. Standard cardiac MR techniques such as 3D anatomical imaging, cardiac function and flow, parameter mapping, and late-gadolinium enhancement can be used to gather valuable clinical data at various procedural stages. Rapid intraprocedural image analysis can extract and highlight critical information about interventional targets and outcomes. In some cases, real-time interactive imaging is used to provide a continuous stream of images displayed to interventionalists for dynamic device navigation. Alternatively, devices are navigated relative to a roadmap of major cardiac structures generated through fast segmentation and registration. Interventional devices can be visualized and tracked throughout a procedure with specialized imaging methods. In a clinical setting, advanced imaging must be integrated with other clinical tools and patient data. In order to perform these complex procedures, interventional cardiac MR relies on customized equipment, such as interactive imaging environments, in-room image display, audio communication, hemodynamic monitoring and recording systems, and electroanatomical mapping and ablation systems. Operating in this sophisticated environment requires coordination and planning. This review provides an overview of the imaging technology used in MRI-guided cardiac interventions. Specifically, this review outlines clinical targets, standard image acquisition and analysis tools, and the integration of these tools into clinical workflow. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2017;46:935-950.
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Affiliation(s)
- Adrienne E Campbell-Washburn
- Laboratory of Imaging Technology, Biochemistry and Biophysics Center, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Mohammad A Tavallaei
- Physical Sciences Platform and Schulich Heart Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Mihaela Pop
- Physical Sciences Platform and Schulich Heart Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Elena K Grant
- Laboratory of Imaging Technology, Biochemistry and Biophysics Center, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Department of Cardiology, Children's National Medical Center, Washington, DC, USA
| | - Henry Chubb
- Division of Imaging Sciences and Biomedical Engineering, King's College London, UK
| | - Kawal Rhode
- Division of Imaging Sciences and Biomedical Engineering, King's College London, UK
| | - Graham A Wright
- Physical Sciences Platform and Schulich Heart Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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Henningsson M, Shome J, Bratis K, Vieira MS, Nagel E, Botnar RM. Diagnostic performance of image navigated coronary CMR angiography in patients with coronary artery disease. J Cardiovasc Magn Reson 2017; 19:68. [PMID: 28893296 PMCID: PMC5594598 DOI: 10.1186/s12968-017-0381-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/17/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The use of coronary MR angiography (CMRA) in patients with coronary artery disease (CAD) remains limited due to the long scan times, unpredictable and often non-diagnostic image quality secondary to respiratory motion artifacts. The purpose of this study was to evaluate CMRA with image-based respiratory navigation (iNAV CMRA) and compare it to gold standard invasive x-ray coronary angiography in patients with CAD. METHODS Consecutive patients referred for CMR assessment were included to undergo iNAV CMRA on a 1.5 T scanner. Coronary vessel sharpness and a visual score were assigned to the coronary arteries. A diagnostic reading was performed on the iNAV CMRA data, where a lumen narrowing >50% was considered diseased. This was compared to invasive x-ray findings. RESULTS Image-navigated CMRA was performed in 31 patients (77% male, 56 ± 14 years). The iNAV CMRA scan time was 7 min:21 s ± 0 min:28 s. Out of a possible 279 coronary segments, 26 segments were excluded from analysis due to stents or diameter less than 1.5 mm, resulting in a total of 253 coronary segments. Diagnostic image quality was obtained for 98% of proximal coronary segments, 94% of middle segments, and 91% of distal coronary segments. The sensitivity and specificity was 86% and 83% per patient, 80% and 92% per vessel and 73% and 95% per segment. CONCLUSION In this study, iNAV CMRA offered a very good diagnostic performance when compared against invasive x-ray angiography. Due to the short and predictable scan time it can add clinical value as a part of a comprehensive CAD assessment protocol.
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Affiliation(s)
- Markus Henningsson
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Joy Shome
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Konstantinos Bratis
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Miguel Silva Vieira
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Eike Nagel
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Institute for Experimental and Translational Cardiovascular Imaging, Goethe University, Frankfurt/Main, Germany
- DZHK (German Centre for Cardiovascular Research, Standort RheinMain), Berlin, Germany
| | - Rene M. Botnar
- Division of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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