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Daudé P, Troalen T, Mackowiak ALC, Royer E, Piccini D, Yerly J, Pfeuffer J, Kober F, Gouny SC, Bernard M, Stuber M, Bastiaansen JAM, Rapacchi S. Trajectory correction enables free-running chemical shift encoded imaging for accurate cardiac proton-density fat fraction quantification at 3T. J Cardiovasc Magn Reson 2024; 26:101048. [PMID: 38878970 PMCID: PMC11269917 DOI: 10.1016/j.jocmr.2024.101048] [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: 11/10/2023] [Revised: 05/04/2024] [Accepted: 05/31/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Metabolic diseases can negatively alter epicardial fat accumulation and composition, which can be probed using quantitative cardiac chemical shift encoded (CSE) cardiovascular magnetic resonance (CMR) by mapping proton-density fat fraction (PDFF). To obtain motion-resolved high-resolution PDFF maps, we proposed a free-running cardiac CSE-CMR framework at 3T. To employ faster bipolar readout gradients, a correction for gradient imperfections was added using the gradient impulse response function (GIRF) and evaluated on intermediate images and PDFF quantification. METHODS Ten minutes free-running cardiac 3D radial CSE-CMR acquisitions were compared in vitro and in vivo at 3T. Monopolar and bipolar readout gradient schemes provided 8 echoes (TE1/ΔTE = 1.16/1.96 ms) and 13 echoes (TE1/ΔTE = 1.12/1.07 ms), respectively. Bipolar-gradient free-running cardiac fat and water images and PDFF maps were reconstructed with or without GIRF correction. PDFF values were evaluated in silico, in vitro on a fat/water phantom, and in vivo in 10 healthy volunteers and 3 diabetic patients. RESULTS In monopolar mode, fat-water swaps were demonstrated in silico and confirmed in vitro. Using bipolar readout gradients, PDFF quantification was reliable and accurate with GIRF correction with a mean bias of 0.03% in silico and 0.36% in vitro while it suffered from artifacts without correction, leading to a PDFF bias of 4.9% in vitro and swaps in vivo. Using bipolar readout gradients, in vivo PDFF of epicardial adipose tissue was significantly lower compared to subcutaneous fat (80.4 ± 7.1% vs 92.5 ± 4.3%, P < 0.0001). CONCLUSIONS Aiming for an accurate PDFF quantification, high-resolution free-running cardiac CSE-MRI imaging proved to benefit from bipolar echoes with k-space trajectory correction at 3T. This free-breathing acquisition framework enables to investigate epicardial adipose tissue PDFF in metabolic diseases.
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Affiliation(s)
- Pierre Daudé
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
| | | | - Adèle L C Mackowiak
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Translation Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland.
| | - Emilien Royer
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland.
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Center for Biomedical Imaging, Lausanne, Switzerland.
| | - Josef Pfeuffer
- Siemens Healthcare, MR Application Development, Erlangen, Germany.
| | - Frank Kober
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
| | - Sylviane Confort Gouny
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
| | - Monique Bernard
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; Center for Biomedical Imaging, Lausanne, Switzerland.
| | - Jessica A M Bastiaansen
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Translation Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Stanislas Rapacchi
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
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Campbell-Washburn AE, Varghese J, Nayak KS, Ramasawmy R, Simonetti OP. Cardiac MRI at Low Field Strengths. J Magn Reson Imaging 2024; 59:412-430. [PMID: 37530545 PMCID: PMC10834858 DOI: 10.1002/jmri.28890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/16/2023] [Accepted: 06/16/2023] [Indexed: 08/03/2023] Open
Abstract
Cardiac MR imaging is well established for assessment of cardiovascular structure and function, myocardial scar, quantitative flow, parametric mapping, and myocardial perfusion. Despite the clear evidence supporting the use of cardiac MRI for a wide range of indications, it is underutilized clinically. Recent developments in low-field MRI technology, including modern data acquisition and image reconstruction methods, are enabling high-quality low-field imaging that may improve the cost-benefit ratio for cardiac MRI. Studies to-date confirm that low-field MRI offers high measurement concordance and consistent interpretation with clinical imaging for several routine sequences. Moreover, low-field MRI may enable specific new clinical opportunities for cardiac imaging such as imaging near metal implants, MRI-guided interventions, combined cardiopulmonary assessment, and imaging of patients with severe obesity. In this review, we discuss the recent progress in low-field cardiac MRI with a focus on technical developments and early clinical validation studies. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Adrienne E Campbell-Washburn
- Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD USA
| | - Juliet Varghese
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
- Alfred Mann Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
| | - Rajiv Ramasawmy
- Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD USA
| | - Orlando P Simonetti
- Division of Cardiovascular Medicine, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Department of Radiology, The Ohio State University, Columbus, Ohio, USA
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Chartsias A, Papanastasiou G, Wang C, Semple S, Newby DE, Dharmakumar R, Tsaftaris SA. Disentangle, Align and Fuse for Multimodal and Semi-Supervised Image Segmentation. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:781-792. [PMID: 33156786 PMCID: PMC8011298 DOI: 10.1109/tmi.2020.3036584] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Magnetic resonance (MR) protocols rely on several sequences to assess pathology and organ status properly. Despite advances in image analysis, we tend to treat each sequence, here termed modality, in isolation. Taking advantage of the common information shared between modalities (an organ's anatomy) is beneficial for multi-modality processing and learning. However, we must overcome inherent anatomical misregistrations and disparities in signal intensity across the modalities to obtain this benefit. We present a method that offers improved segmentation accuracy of the modality of interest (over a single input model), by learning to leverage information present in other modalities, even if few (semi-supervised) or no (unsupervised) annotations are available for this specific modality. Core to our method is learning a disentangled decomposition into anatomical and imaging factors. Shared anatomical factors from the different inputs are jointly processed and fused to extract more accurate segmentation masks. Image misregistrations are corrected with a Spatial Transformer Network, which non-linearly aligns the anatomical factors. The imaging factor captures signal intensity characteristics across different modality data and is used for image reconstruction, enabling semi-supervised learning. Temporal and slice pairing between inputs are learned dynamically. We demonstrate applications in Late Gadolinium Enhanced (LGE) and Blood Oxygenation Level Dependent (BOLD) cardiac segmentation, as well as in T2 abdominal segmentation. Code is available at https://github.com/vios-s/multimodal_segmentation.
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Friedrich MG. Tracking Myocardial Oxygenation over a Breath Hold with Blood Oxygen Level−Dependent MRI: A Radically Different Approach to Study Ischemia. Radiology 2020; 294:546-547. [DOI: 10.1148/radiol.2020192674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Matthias G. Friedrich
- From the Departments of Medicine and Diagnostic Radiology, McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC, Canada H4A 3J1
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van den Boomen M, Manhard MK, Snel GJH, Han S, Emblem KE, Slart RHJA, Sosnovik DE, Catana C, Rosen BR, Prakken NHJ, Nguyen CT, Borra RJH, Setsompop K. Blood Oxygen Level-Dependent MRI of the Myocardium with Multiecho Gradient-Echo Spin-Echo Imaging. Radiology 2020; 294:538-545. [PMID: 31961241 PMCID: PMC7053244 DOI: 10.1148/radiol.2020191845] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/28/2019] [Accepted: 11/12/2019] [Indexed: 12/17/2022]
Abstract
Background Myocardial oxygenation imaging could help determine the presence of microvascular dysfunction associated with increased cardiovascular risk. However, it is challenging to depict the potentially small oxygenation alterations with current noninvasive cardiac MRI blood oxygen level-dependent (BOLD) techniques. Purpose To demonstrate the cardiac application of a gradient-echo spin-echo (GESE) echo-planar imaging sequence for dynamic and quantitative heartbeat-to-heartbeat BOLD MRI and evaluate the sequence in populations both healthy and with hypertension in combination with a breath hold-induced CO2 intervention. Materials and Methods GESE echo-planar imaging sequence was performed in 18 healthy participants and in eight prospectively recruited participants with hypertension on a 3.0-T MRI system. T2 and T2* maps were calculated per heartbeat with a four-parameter fitting technique. Septal regions of interests were used to determine T2 and T2* values per heartbeat and examined over the course of a breath hold to determine BOLD changes. T2 and T2* changes of healthy participants and participants with hypertension were compared by using a nonparametric Mann-Whitney test. Results GESE echo-planar imaging approach gave spatially stable T2 and T2* maps per heartbeat for healthy participants and participants with hypertension, with mean T2 values of 43 msec ± 5 (standard deviation) and 46 msec ± 9, respectively, and mean T2* values of 28 msec ± 5 and 22 msec ± 5, respectively. The healthy participants exhibited increasing T2 and T2* values over the course of a breath hold with a mean positive slope of 0.2 msec per heartbeat ± 0.1 for T2 and 0.2 msec per heartbeat ± 0.1 for T2*, whereas for participants with hypertension these dynamic T2 and T2* values had a mean negative slope of -0.2 msec per heartbeat ± 0.2 for T2 and -0.1 msec per heartbeat ± 0.2 for T2*. The difference in these mean slopes between healthy participants and participants with hypertension was significant for both T2 (P < .001) and T2* (P < .001). Conclusion Gradient-echo spin-echo echo-planar imaging sequence provided quantitative T2 and T2* maps per heartbeat and enabled dynamic heartbeat-to-heartbeat blood oxygen level-dependent (BOLD)-response imaging by analyzing changes in T2 and T2* over the time of a breath-hold intervention. This approach could identify differences in the BOLD response between healthy participants and participants with hypertension. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Friedrich in this issue.
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Affiliation(s)
- Maaike van den Boomen
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - Mary Kate Manhard
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - Gert Jan H. Snel
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - SoHyun Han
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - Kyrre E. Emblem
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - Riemer H. J. A. Slart
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - David E. Sosnovik
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - Ciprian Catana
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - Bruce R. Rosen
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - Niek H. J. Prakken
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - Christopher T. Nguyen
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - Ronald J. H. Borra
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
| | - Kawin Setsompop
- From the Departments of Radiology (M.v.d.B., G.J.H.S., N.H.J.P.,
R.J.H.B.) and Nuclear Medicine and Molecular Imaging (R.H.J.A.S.), University
Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ
Groningen, the Netherlands; Department of Radiology, Athinoula A. Martinos
Center for Biomedical Imaging (M.v.d.B., M.K.M., S.H.H., D.E.S., C.C., B.R.R.,
C.T.N., K.S.), and Cardiovascular Research Center (D.E.S., C.T.N.),
Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass;
Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
(K.E.E.); Department of Biomedical Photonic Imaging, University of Twente,
Enschede, the Netherlands (R.H.J.A.S., R.J.H.B.); and Division of Health
Sciences and Technology, Harvard-MIT, Cambridge, Mass (D.E.S., K.S.)
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Li X, Min X. The role of M-mode echocardiography in patients with heart failure and preserved ejection fraction: A prospective cohort study. Exp Ther Med 2020; 19:1969-1976. [PMID: 32104256 DOI: 10.3892/etm.2020.8428] [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: 10/13/2018] [Accepted: 11/14/2019] [Indexed: 11/05/2022] Open
Abstract
Epicardial movement during diastole is inversely proportional to myocardial stiffness but systolic regional thickening cannot precisely identify ischemic territories. The aim of the present study was to test the hypothesis that a correlation may be present between M-mode echocardiography parameters and poor outcomes in patients with heart failure and preserved ejection fraction. Patients with known cardiovascular disease were included in the test group (n=1,244) and patients without known cardiovascular disease were included in the control group (n=1,952). Patient records of routine measurements, M-mode echocardiography and mortality were collected. The control population and test population had the same left ventricular end-diastolic dimension (P=0.062) and left ventricular end-diastolic volume (P=0.053). A lower mitral flow velocity (P<0.05), higher Tei index (P<0.0001) and reduced distribution of diastolic wall strain (P<0.0001) were reported in the test populations compared with the control population. Patients of the test population with lower diastolic wall strain (<0.28) demonstrated a higher mortality rate than those with higher diastolic wall strain (≥0.28; P<0.0001) at the 3-year follow-up. M-mode echocardiographic parameters may be of use for predicting poor outcomes in patients with heart failure and preserved ejection fraction.
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Affiliation(s)
- Xin Li
- Department of Cardiovascular Medicine, Cardiovascular Research Institute, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei 442008, P.R. China
| | - Xinwen Min
- Department of Cardiovascular Medicine, Cardiovascular Research Institute, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei 442008, P.R. China
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Chartsias A, Joyce T, Papanastasiou G, Semple S, Williams M, Newby DE, Dharmakumar R, Tsaftaris SA. Disentangled representation learning in cardiac image analysis. Med Image Anal 2019; 58:101535. [PMID: 31351230 PMCID: PMC6815716 DOI: 10.1016/j.media.2019.101535] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 07/11/2019] [Accepted: 07/17/2019] [Indexed: 01/08/2023]
Abstract
Typically, a medical image offers spatial information on the anatomy (and pathology) modulated by imaging specific characteristics. Many imaging modalities including Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) can be interpreted in this way. We can venture further and consider that a medical image naturally factors into some spatial factors depicting anatomy and factors that denote the imaging characteristics. Here, we explicitly learn this decomposed (disentangled) representation of imaging data, focusing in particular on cardiac images. We propose Spatial Decomposition Network (SDNet), which factorises 2D medical images into spatial anatomical factors and non-spatial modality factors. We demonstrate that this high-level representation is ideally suited for several medical image analysis tasks, such as semi-supervised segmentation, multi-task segmentation and regression, and image-to-image synthesis. Specifically, we show that our model can match the performance of fully supervised segmentation models, using only a fraction of the labelled images. Critically, we show that our factorised representation also benefits from supervision obtained either when we use auxiliary tasks to train the model in a multi-task setting (e.g. regressing to known cardiac indices), or when aggregating multimodal data from different sources (e.g. pooling together MRI and CT data). To explore the properties of the learned factorisation, we perform latent-space arithmetic and show that we can synthesise CT from MR and vice versa, by swapping the modality factors. We also demonstrate that the factor holding image specific information can be used to predict the input modality with high accuracy. Code will be made available at https://github.com/agis85/anatomy_modality_decomposition.
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Affiliation(s)
- Agisilaos Chartsias
- Institute for Digital Communications, School of Engineering, University of Edinburgh, West Mains Rd, Edinburgh EH9 3FB, UK.
| | - Thomas Joyce
- Institute for Digital Communications, School of Engineering, University of Edinburgh, West Mains Rd, Edinburgh EH9 3FB, UK
| | - Giorgos Papanastasiou
- Edinburgh Imaging Facility QMRI, Edinburgh, EH16 4TJ, UK; Centre for Cardiovascular Science, Edinburgh, EH16 4TJ, UK
| | - Scott Semple
- Edinburgh Imaging Facility QMRI, Edinburgh, EH16 4TJ, UK; Centre for Cardiovascular Science, Edinburgh, EH16 4TJ, UK
| | - Michelle Williams
- Edinburgh Imaging Facility QMRI, Edinburgh, EH16 4TJ, UK; Centre for Cardiovascular Science, Edinburgh, EH16 4TJ, UK
| | - David E Newby
- Edinburgh Imaging Facility QMRI, Edinburgh, EH16 4TJ, UK; Centre for Cardiovascular Science, Edinburgh, EH16 4TJ, UK
| | | | - Sotirios A Tsaftaris
- Institute for Digital Communications, School of Engineering, University of Edinburgh, West Mains Rd, Edinburgh EH9 3FB, UK; The Alan Turing Institute, London, UK
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Oksuz I, Mukhopadhyay A, Dharmakumar R, Tsaftaris SA. Unsupervised Myocardial Segmentation for Cardiac BOLD. IEEE TRANSACTIONS ON MEDICAL IMAGING 2017; 36:2228-2238. [PMID: 28708550 PMCID: PMC5726889 DOI: 10.1109/tmi.2017.2726112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A fully automated 2-D+time myocardial segmentation framework is proposed for cardiac magnetic resonance (CMR) blood-oxygen-level-dependent (BOLD) data sets. Ischemia detection with CINE BOLD CMR relies on spatio-temporal patterns in myocardial intensity, but these patterns also trouble supervised segmentation methods, the de facto standard for myocardial segmentation in cine MRI. Segmentation errors severely undermine the accurate extraction of these patterns. In this paper, we build a joint motion and appearance method that relies on dictionary learning to find a suitable subspace. Our method is based on variational pre-processing and spatial regularization using Markov random fields, to further improve performance. The superiority of the proposed segmentation technique is demonstrated on a data set containing cardiac phase-resolved BOLD MR and standard CINE MR image sequences acquired in baseline and ischemic condition across ten canine subjects. Our unsupervised approach outperforms even supervised state-of-the-art segmentation techniques by at least 10% when using Dice to measure accuracy on BOLD data and performs at par for standard CINE MR. Furthermore, a novel segmental analysis method attuned for BOLD time series is utilized to demonstrate the effectiveness of the proposed method in preserving key BOLD patterns.
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Affiliation(s)
- Ilkay Oksuz
- IMT School for Advanced Studies Lucca, Italy () and also with Diagnostic Radiology Department of Yale University, CT, USA
| | - Anirban Mukhopadhyay
- Interactive Graphics Systems Group, Technische Universitat Darmstadt, Darmstadt, Germany, ()
| | - Rohan Dharmakumar
- Cedars-Sinai Medical Center and University of California Los Angeles, CA, USA ()
| | - Sotirios A. Tsaftaris
- Institute for Digital Communications, School of Engineering, University of Edinburgh, West Mains Rd, Edinburgh EH9 3FB, UK. ()
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Panagia M, Chen YCI, Chen HH, Ernande L, Chen C, Chao W, Kwong K, Scherrer-Crosbie M, Sosnovik DE. Functional and anatomical characterization of brown adipose tissue in heart failure with blood oxygen level dependent magnetic resonance. NMR IN BIOMEDICINE 2016; 29:978-984. [PMID: 27226402 PMCID: PMC4912044 DOI: 10.1002/nbm.3557] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 04/15/2016] [Accepted: 04/19/2016] [Indexed: 06/05/2023]
Abstract
Recent studies have suggested that brown adipose tissue (BAT) plays an important role in obesity, insulin resistance and heart failure. The characterization of BAT in vivo, however, has been challenging. No technique to comprehensively image BAT anatomy and function has been described. Moreover, the impact on BAT of the neuroendocrine activation seen in heart failure has only recently begun to be evaluated in vivo. The aim of this study was to use MRI to characterize the impact of heart failure on the morphology and function of BAT. Mice subjected to permanent ligation of the left coronary artery were imaged with MRI 6 weeks later. T2 weighted MRI of BAT volume and blood oxygen level dependent MRI of BAT function were performed. T2 * maps of BAT were obtained at multiple time points before and after administration of the β3 adrenergic agonist CL 316 243 (CL). Blood flow to BAT was studied after CL injection using the flow alternating inversion recovery (FAIR) approach. Excised BAT tissue was analyzed for lipid droplet content and for uncoupling protein 1 (UCP1) mRNA expression. BAT volume was significantly lower in heart failure (51 ± 1 mm(3) versus 65 ± 3 mm(3) ; p < 0.05), and characterized by a reduction in lipid globules and a fourfold increase in UCP1 mRNA (p < 0.05). CL injection increased BAT T2 * in healthy animals but not in mice with heart failure (24 ± 4% versus 6 ± 2%; p < 0.01), consistent with an increase in flow in control BAT. This was confirmed by a significant difference in the FAIR response in BAT in control and heart failure mice. Heart failure results in the chronic activation of BAT, decreased BAT lipid stores and decreased BAT volume, and it is associated with a marked decrease in ability to respond to acute physiological stimuli. This may have important implications for substrate utilization and overall metabolic homeostasis in heart failure. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Marcello Panagia
- Cardiology Section, Boston Medical Center, Boston, MA
- Cardiology Division, Massachusetts General Hospital, Boston, MA
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston MA
| | - Yin-Ching Iris Chen
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston MA
| | - Howard H Chen
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston MA
| | - Laura Ernande
- Cardiology Division, Massachusetts General Hospital, Boston, MA
- DHU Ageing-Thorax-Vessel-Blood, Hôpital Henri Mondor, AP-HP, Créteil, France
| | - Chan Chen
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School
| | - Wei Chao
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School
| | - Kenneth Kwong
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston MA
| | | | - David E. Sosnovik
- Cardiology Division, Massachusetts General Hospital, Boston, MA
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston MA
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Huelnhagen T, Hezel F, Serradas Duarte T, Pohlmann A, Oezerdem C, Flemming B, Seeliger E, Prothmann M, Schulz-Menger J, Niendorf T. Myocardial effective transverse relaxation time T2* Correlates with left ventricular wall thickness: A 7.0 T MRI study. Magn Reson Med 2016; 77:2381-2389. [PMID: 27342430 DOI: 10.1002/mrm.26312] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/23/2016] [Accepted: 05/25/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE Myocardial effective relaxation time T2* is commonly regarded as a surrogate for myocardial tissue oxygenation. However, it is legitimate to assume that there are multiple factors that influence T2*. To this end, this study investigates the relationship between T2* and cardiac macromorphology given by left ventricular (LV) wall thickness and left ventricular radius, and provides interpretation of the results in the physiological context. METHODS High spatio-temporally resolved myocardial CINE T2* mapping was performed in 10 healthy volunteers using a 7.0 Tesla (T) full-body MRI system. Ventricular septal wall thickness, left ventricular inner radius, and T2* were analyzed. Macroscopic magnetic field changes were elucidated using cardiac phase-resolved magnetic field maps. RESULTS Ventricular septal T2* changes periodically over the cardiac cycle, increasing in systole and decreasing in diastole. Ventricular septal wall thickness and T2* showed a significant positive correlation, whereas the inner LV radius and T2* were negatively correlated. The effect of macroscopic magnetic field gradients on T2* can be considered minor in the ventricular septum. CONCLUSION Our findings suggest that myocardial T2* is related to tissue blood volume fraction. Temporally resolved T2* mapping could be beneficial for myocardial tissue characterization and for understanding cardiac (patho)physiology in vivo. Magn Reson Med 77:2381-2389, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Till Huelnhagen
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Fabian Hezel
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Teresa Serradas Duarte
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Celal Oezerdem
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Bert Flemming
- Institute of Physiology, Charité University Medicine, Berlin, Germany
| | - Erdmann Seeliger
- Institute of Physiology, Charité University Medicine, Berlin, Germany
| | - Marcel Prothmann
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
| | - Jeanette Schulz-Menger
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
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11
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Bevilacqua M, Dharmakumar R, Tsaftaris SA. Dictionary-Driven Ischemia Detection From Cardiac Phase-Resolved Myocardial BOLD MRI at Rest. IEEE TRANSACTIONS ON MEDICAL IMAGING 2016; 35:282-93. [PMID: 26292338 PMCID: PMC4883113 DOI: 10.1109/tmi.2015.2470075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Cardiac Phase-resolved Blood-Oxygen-Level Dependent (CP-BOLD) MRI provides a unique opportunity to image an ongoing ischemia at rest. However, it requires post-processing to evaluate the extent of ischemia. To address this, here we propose an unsupervised ischemia detection (UID) method which relies on the inherent spatio-temporal correlation between oxygenation and wall motion to formalize a joint learning and detection problem based on dictionary decomposition. Considering input data of a single subject, it treats ischemia as an anomaly and iteratively learns dictionaries to represent only normal observations (corresponding to myocardial territories remote to ischemia). Anomaly detection is based on a modified version of One-class Support Vector Machines (OCSVM) to regulate directly the margins by incorporating the dictionary-based representation errors. A measure of ischemic extent (IE) is estimated, reflecting the relative portion of the myocardium affected by ischemia. For visualization purposes an ischemia likelihood map is created by estimating posterior probabilities from the OCSVM outputs, thus obtaining how likely the classification is correct. UID is evaluated on synthetic data and in a 2D CP-BOLD data set from a canine experimental model emulating acute coronary syndromes. Comparing early ischemic territories identified with UID against infarct territories (after several hours of ischemia), we find that IE, as measured by UID, is highly correlated (Pearson's r=0.84) with respect to infarct size. When advances in automated registration and segmentation of CP-BOLD images and full coverage 3D acquisitions become available, we hope that this method can enable pixel-level assessment of ischemia with this truly non-invasive imaging technique.
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Affiliation(s)
| | - Rohan Dharmakumar
- Biomedical Imaging Research Institute, Cedars-Sinai Medical, CA, USA
| | - Sotirios A. Tsaftaris
- IMT Institute for Advanced Studies Lucca, Italy and the Department of Electrical Engineering and Computer Science, Northwestern University, IL, USA
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Santos A, Fernández-Friera L, Villalba M, López-Melgar B, España S, Mateo J, Mota RA, Jiménez-Borreguero J, Ruiz-Cabello J. Cardiovascular imaging: what have we learned from animal models? Front Pharmacol 2015; 6:227. [PMID: 26539113 PMCID: PMC4612690 DOI: 10.3389/fphar.2015.00227] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/22/2015] [Indexed: 12/17/2022] Open
Abstract
Cardiovascular imaging has become an indispensable tool for patient diagnosis and follow up. Probably the wide clinical applications of imaging are due to the possibility of a detailed and high quality description and quantification of cardiovascular system structure and function. Also phenomena that involve complex physiological mechanisms and biochemical pathways, such as inflammation and ischemia, can be visualized in a non-destructive way. The widespread use and evolution of imaging would not have been possible without animal studies. Animal models have allowed for instance, (i) the technical development of different imaging tools, (ii) to test hypothesis generated from human studies and finally, (iii) to evaluate the translational relevance assessment of in vitro and ex-vivo results. In this review, we will critically describe the contribution of animal models to the use of biomedical imaging in cardiovascular medicine. We will discuss the characteristics of the most frequent models used in/for imaging studies. We will cover the major findings of animal studies focused in the cardiovascular use of the repeatedly used imaging techniques in clinical practice and experimental studies. We will also describe the physiological findings and/or learning processes for imaging applications coming from models of the most common cardiovascular diseases. In these diseases, imaging research using animals has allowed the study of aspects such as: ventricular size, shape, global function, and wall thickening, local myocardial function, myocardial perfusion, metabolism and energetic assessment, infarct quantification, vascular lesion characterization, myocardial fiber structure, and myocardial calcium uptake. Finally we will discuss the limitations and future of imaging research with animal models.
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Affiliation(s)
- Arnoldo Santos
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain ; Madrid-MIT M+Visión Consortium Madrid, Spain ; Department of Anesthesia, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
| | - Leticia Fernández-Friera
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; Hospital Universitario HM Monteprincipe Madrid, Spain
| | - María Villalba
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain
| | - Beatriz López-Melgar
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; Hospital Universitario HM Monteprincipe Madrid, Spain
| | - Samuel España
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain ; Madrid-MIT M+Visión Consortium Madrid, Spain
| | - Jesús Mateo
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain
| | - Ruben A Mota
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; Charles River Barcelona, Spain
| | - Jesús Jiménez-Borreguero
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; Cardiac Imaging Department, Hospital de La Princesa Madrid, Spain
| | - Jesús Ruiz-Cabello
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain ; CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain ; Universidad Complutense de Madrid Madrid, Spain
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Yuan F, Guo ZZ, Ji WJ, Ma YQ, Zhang Z, Zhou X, Li YM. BOLD-MRI evaluation of subcutaneous and visceral adipose tissue oxygenation status: effect of dietary salt intake. Am J Transl Res 2015; 7:598-606. [PMID: 26045898 PMCID: PMC4448198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 02/24/2015] [Indexed: 06/04/2023]
Abstract
To investigate the feasibility of blood oxygen level dependent magnetic resonance imaging (BOLD-MRI) in evaluating human subcutaneous and visceral adipose tissue (AT) oxygenation status, as well as their responses to dietary salt loading/depletion, we enrolled 16 healthy subjects [mean body mass index (BMI): 24.8 ± 2.7 kg/m(2)] to conduct a dietary intervention study, beginning with a 3-day run-in period for usual diet, followed by a 7-day high-salt diet (≥ 15 g NaCl/day) and a 7-day low-salt diet (≤ 5 g NaCl/day). Abdominal BOLD-MRI scan was performed to evaluate oxygenation in waist subcutaneous and perirenal (visceral) AT. Two subjects with lower BMI were excluded because of the difficulty to identify subcutaneous AT. High salt diet led to a consistent increase in R2* signal (a parameter for increased hypoxia) both in subcutaneous and visceral AT (all P < 0.0001), which was completely regressed to baseline levels by low salt diet. In addition, subcutaneous AT R2* values at any time points, were all higher than that of visceral AT (all P < 0.0001). Pearson correlation analysis revealed that the visceral AT R2* levels were negatively associated obesity indicators (waist circumference, waist-to-hip ratio and BMI). On the contrary, although a trend towards negative associations between the subcutaneous AT R2* and obesity indicators was observed, none of the associations reached statistical significances. Thus, our data demonstrate the possibility of simultaneous detection of human subcutaneous and visceral AT oxygenation status using BOLD-MRI. In addition, there is a more close relationship visceral AT oxygenation status and the development of obesity.
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Affiliation(s)
- Fei Yuan
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Institute of Cardiovascular Disease and Heart Center, Pingjin Hospital, Logistics University of The Chinese People’s Armed Police ForcesTianjin, China
- MRI Department, Pingjin Hospital, Logistics University of The Chinese People’s Armed Police ForcesTianjin, China
| | - Zhao-Zeng Guo
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Institute of Cardiovascular Disease and Heart Center, Pingjin Hospital, Logistics University of The Chinese People’s Armed Police ForcesTianjin, China
| | - Wen-Jie Ji
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Institute of Cardiovascular Disease and Heart Center, Pingjin Hospital, Logistics University of The Chinese People’s Armed Police ForcesTianjin, China
| | - Yong-Qiang Ma
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Institute of Cardiovascular Disease and Heart Center, Pingjin Hospital, Logistics University of The Chinese People’s Armed Police ForcesTianjin, China
| | - Zhuoli Zhang
- Department of Radiology, Northwestern UniversityChicago, Illinois, USA
| | - Xin Zhou
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Institute of Cardiovascular Disease and Heart Center, Pingjin Hospital, Logistics University of The Chinese People’s Armed Police ForcesTianjin, China
| | - Yu-Ming Li
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Institute of Cardiovascular Disease and Heart Center, Pingjin Hospital, Logistics University of The Chinese People’s Armed Police ForcesTianjin, China
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Functional relevance of coronary artery disease by cardiac magnetic resonance and cardiac computed tomography: myocardial perfusion and fractional flow reserve. BIOMED RESEARCH INTERNATIONAL 2015; 2015:297696. [PMID: 25692133 PMCID: PMC4323071 DOI: 10.1155/2015/297696] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/31/2014] [Indexed: 01/17/2023]
Abstract
Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality and it is responsible for an increasing resource burden. The identification of patients at high risk for adverse events is crucial to select those who will receive the greatest benefit from revascularization. To this aim, several non-invasive functional imaging modalities are usually used as gatekeeper to invasive coronary angiography, but the diagnostic yield of elective invasive coronary angiography remains unfortunately low. Stress myocardial perfusion imaging by cardiac magnetic resonance (stress-CMR) has emerged as an accurate technique for diagnosis and prognostic stratification of the patients with known or suspected CAD thanks to high spatial and temporal resolution, absence of ionizing radiation, and the multiparametric value including the assessment of cardiac anatomy, function, and viability. On the other side, cardiac computed tomography (CCT) has emerged as unique technique providing coronary arteries anatomy and more recently, due to the introduction of stress-CCT and noninvasive fractional flow reserve (FFR-CT), functional relevance of CAD in a single shot scan. The current review evaluates the technical aspects and clinical experience of stress-CMR and CCT in the evaluation of functional relevance of CAD discussing the strength and weakness of each approach.
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Abstract
Cardiac Phase-resolved Blood-Oxygen-Level-Dependent (CP-BOLD) MRI examines changes in myocardial oxygenation in response to ischemia without contrast and stress agents. Since signal intensity changes are subtle, quantitative approaches are necessary to examine variations in myocardial BOLD signals and identify ischemic myocardial territories. Here, using data from animal studies, we extract myocardial time series (BOLD signal as a function of cardiac phase) and explore such variations using a structured dictionary-learning framework, considering shift-invariant learning and spatial priors. We use it: to learn a model of baseline (absence of disease) myocardial time series; and in datasets where disease is assumed, to obtain a spatial map of ischemia presence, identifying myocardial time series from ischemic territories in an unsupervised fashion, by exploiting structural properties, or the lack thereof, in the data. By providing new visualization and quantification approaches, we hope to accelerate the clinical translation of cardiac BOLD MRI for noninvasive ischemia assessment.
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Mukhopadhyay A, Oksuz I, Bevilacqua M, Dharmakumar R, Tsaftaris SA. Unsupervised Myocardial Segmentation for Cardiac MRI. LECTURE NOTES IN COMPUTER SCIENCE 2015. [DOI: 10.1007/978-3-319-24574-4_2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Rusu C, Morisi R, Boschetto D, Dharmakumar R, Tsaftaris SA. Synthetic generation of myocardial blood-oxygen-level-dependent MRI time series via structural sparse decomposition modeling. IEEE TRANSACTIONS ON MEDICAL IMAGING 2014; 33:1422-1433. [PMID: 24691119 PMCID: PMC4079741 DOI: 10.1109/tmi.2014.2313000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This paper aims to identify approaches that generate appropriate synthetic data (computer generated) for cardiac phase-resolved blood-oxygen-level-dependent (CP-BOLD) MRI. CP-BOLD MRI is a new contrast agent- and stress-free approach for examining changes in myocardial oxygenation in response to coronary artery disease. However, since signal intensity changes are subtle, rapid visualization is not possible with the naked eye. Quantifying and visualizing the extent of disease relies on myocardial segmentation and registration to isolate the myocardium and establish temporal correspondences and ischemia detection algorithms to identify temporal differences in BOLD signal intensity patterns. If transmurality of the defect is of interest pixel-level analysis is necessary and thus a higher precision in registration is required. Such precision is currently not available affecting the design and performance of the ischemia detection algorithms. In this work, to enable algorithmic developments of ischemia detection irrespective to registration accuracy, we propose an approach that generates synthetic pixel-level myocardial time series. We do this by 1) modeling the temporal changes in BOLD signal intensity based on sparse multi-component dictionary learning, whereby segmentally derived myocardial time series are extracted from canine experimental data to learn the model; and 2) demonstrating the resemblance between real and synthetic time series for validation purposes. We envision that the proposed approach has the capacity to accelerate development of tools for ischemia detection while markedly reducing experimental costs so that cardiac BOLD MRI can be rapidly translated into the clinical arena for the noninvasive assessment of ischemic heart disease.
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Affiliation(s)
| | - Rita Morisi
- IMT Institute for Advanced Studies Lucca, Italy
| | | | - Rohan Dharmakumar
- Biomedical Imaging Research Institute, Cedars-Sinai Medical, CA, USA
| | - Sotirios A. Tsaftaris
- IMT Institute for Advanced Studies Lucca, Italy. Departments of Radiology, Electrical Engineering and Computer Science, Northwestern University, IL, USA
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Zhou X, Yuan F, Ji WJ, Guo ZZ, Zhang L, Lu RY, Liu X, Liu HM, Zhang WC, Jiang TM, Zhang Z, Li YM. High-salt intake induced visceral adipose tissue hypoxia and its association with circulating monocyte subsets in humans. Obesity (Silver Spring) 2014; 22:1470-6. [PMID: 24493236 DOI: 10.1002/oby.20716] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 01/29/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate the feasibility of blood oxygen level dependent magnetic resonance imaging (BOLD-MRI) in evaluating human visceral adipose tissue (AT) oxygenation induced by salt loading/depletion and its association with changes in circulating monocyte subsets. METHODS A dietary intervention study was performed in 23 healthy volunteers beginning with a 3-day usual diet followed by a 7-day high-salt diet (≥15 g NaCl/day) and a 7-day low-salt diet (≤5 g NaCl/day). BOLD-MRI was used to evaluate oxygenation in perirenal AT. RESULTS Salt loading led to a consistent AT hypoxia (increase in the R2* signal, 25.2 ± 0.90 s(-1) vs. baseline 21.5 ± 0.71 s(-1) , P < 0.001) and suppression of circulating renin-angiotensin-aldosterone system (RAAS), as well as an expansion of the CD14++CD16+ monocytes and monocyte pro-inflammatory activation. In salt depletion phase, the hypoxic state of AT and the expanded CD14++CD16+ monocyte pool were regressed to baseline levels, accompanied by a rebound activation of RAAS. Moreover, AT oxygenation level was positively correlated with the CD14++CD16+ monocytes (r = 0.419, P < 0.001). CONCLUSIONS This work provides proof-of-principle evidence supporting the feasibility of BOLD-MRI in monitoring visceral AT oxygenation in humans induced by dietary salt loading/depletion. In addition, the CD14++CD16+ monocytes may participate in the pathogenesis of high-salt intake induced AT hypoxia.
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Affiliation(s)
- Xin Zhou
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury Institute of Cardiovascular Disease and Heart Center Pingjin Hospital, Logistics University of the Chinese People's Armed Police Forces, Tianjin, China
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Stalder AF, Schmidt M, Greiser A, Speier P, Guehring J, Friedrich MG, Mueller E. Robust cardiac BOLD MRI using an fMRI-like approach with repeated stress paradigms. Magn Reson Med 2014; 73:577-85. [DOI: 10.1002/mrm.25164] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/20/2013] [Accepted: 01/13/2014] [Indexed: 01/07/2023]
Affiliation(s)
| | | | | | | | | | - Matthias G. Friedrich
- Montreal Heart Institute; Departments of Cardiology and Radiology; Université de Montréal; Montreal Canada
- Departments of Cardiac Sciences and Radiology; University of Calgary; Calgary Canada
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Fernández-Jiménez R, Fernández-Friera L, Sánchez-González J, Ibáñez B. Animal Models of Tissue Characterization of Area at Risk, Edema and Fibrosis. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9259-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Friedrich MG, Karamitsos TD. Oxygenation-sensitive cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2013; 15:43. [PMID: 23706167 PMCID: PMC3681671 DOI: 10.1186/1532-429x-15-43] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 04/29/2013] [Indexed: 12/30/2022] Open
Abstract
Oxygenation-sensitive cardiovascular magnetic resonance (CMR) is a non-contrast technique that allows the non-invasive assessment of myocardial oxygenation. It capitalizes on the fact that deoxygenated hemoglobin in blood can act as an intrinsic contrast agent, changing proton signals in a fashion that can be imaged to reflect the level of blood oxygenation. Increases in O(2) saturation increase the BOLD imaging signal (T2 or T2*), whereas decreases diminish it. This review presents the basic concepts and limitations of the BOLD technique, and summarizes the preclinical and clinical studies in the assessment of myocardial oxygenation with a focus on recent advances. Finally, it provides future directions and a brief look at emerging techniques of this evolving CMR field.
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Affiliation(s)
- Matthias G Friedrich
- Montreal Heart Institute, Departments of Cardiology and Radiology, Université de Montréal, Montreal, QC, Canada
- Departments of Cardiac Sciences and Radiology, University of Calgary, Calgary, Canada
| | - Theodoros D Karamitsos
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
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Zheng J. Assessment of myocardial oxygenation with MRI. Quant Imaging Med Surg 2013; 3:67-72. [PMID: 23630653 DOI: 10.3978/j.issn.2223-4292.2013.03.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 03/07/2013] [Indexed: 11/14/2022]
Affiliation(s)
- Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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