1
|
Fitian AI, Shieh MC, Gimnich OA, Belousova T, Taylor AA, Ballantyne CM, Bismuth J, Shah DJ, Brunner G. Contrast-Enhanced Magnetic Resonance Imaging Based T1 Mapping and Extracellular Volume Fractions Are Associated with Peripheral Artery Disease. J Cardiovasc Dev Dis 2024; 11:181. [PMID: 38921681 PMCID: PMC11203653 DOI: 10.3390/jcdd11060181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/28/2024] [Accepted: 06/09/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Extracellular volume fraction (ECV), measured with contrast-enhanced magnetic resonance imaging (CE-MRI), has been utilized to study myocardial fibrosis, but its role in peripheral artery disease (PAD) remains unknown. We hypothesized that T1 mapping and ECV differ between PAD patients and matched controls. METHODS AND RESULTS A total of 37 individuals (18 PAD patients and 19 matched controls) underwent 3.0T CE-MRI. Skeletal calf muscle T1 mapping was performed before and after gadolinium contrast with a motion-corrected modified look-locker inversion recovery (MOLLI) pulse sequence. T1 values were calculated with a three-parameter Levenberg-Marquardt curve fitting algorithm. ECV and T1 maps were quantified in five calf muscle compartments (anterior [AM], lateral [LM], and deep posterior [DM] muscle groups; soleus [SM] and gastrocnemius [GM] muscles). Averaged peak blood pool T1 values were obtained from the posterior and anterior tibialis and peroneal arteries. T1 values and ECV are heterogeneous across calf muscle compartments. Native peak T1 values of the AM, LM, and DM were significantly higher in PAD patients compared to controls (all p < 0.028). ECVs of the AM and SM were significantly higher in PAD patients compared to controls (AM: 26.4% (21.2, 31.6) vs. 17.3% (10.2, 25.1), p = 0.046; SM: 22.7% (19.5, 27.8) vs. 13.8% (10.2, 19.1), p = 0.020). CONCLUSIONS Native peak T1 values across all five calf muscle compartments, and ECV fractions of the anterior muscle group and the soleus muscle were significantly elevated in PAD patients compared with matched controls. Non-invasive T1 mapping and ECV quantification may be of interest for the study of PAD.
Collapse
Affiliation(s)
- Asem I. Fitian
- Penn State Heart and Vascular Institute, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA
| | - Michael C. Shieh
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Olga A. Gimnich
- Penn State Heart and Vascular Institute, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA
| | - Tatiana Belousova
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Addison A. Taylor
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Michael E DeBakey VA Medical Center, Houston, TX 77030, USA
| | - Christie M. Ballantyne
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jean Bismuth
- Division of Vascular Surgery, University of South Florida Health Morsani School of Medicine, Tampa, FL 33620, USA
| | - Dipan J. Shah
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Gerd Brunner
- Penn State Heart and Vascular Institute, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| |
Collapse
|
2
|
Hananouchi T, Satake S, Sakao K, Katsuda H, Shimada N, Dorthe EW, D’Lima DD. Determining the Relationship between Mechanical Properties and Quantitative Magnetic Resonance Imaging of Joint Soft Tissues Using Patient-Specific Templates. Bioengineering (Basel) 2023; 10:1050. [PMID: 37760152 PMCID: PMC10525776 DOI: 10.3390/bioengineering10091050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/11/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
To determine whether the mechanical properties of joint soft tissues such as cartilage can be calculated from quantitative magnetic resonance imaging (MRI) data, we investigated whether the mechanical properties of articular cartilage and meniscus scheduled to be resected during arthroplasty are correlated with the T2 relaxation time on quantitative MRI at the same location. Six patients who had undergone knee arthroplasty and seven who had undergone hip arthroplasty were examined. For the knee joint, the articular cartilage and lateral meniscus of the distal lateral condyle of the femur and proximal lateral tibia were examined, while for the hip joint, the articular cartilage above the femoral head was studied. We investigated the relationship between T2 relaxation time by quantitative MRI and stiffness using a hand-made compression tester at 235 locations. The patient-individualized template technique was used to align the two measurement sites. The results showed a negative correlation (from -0.30 to -0.35) in the less severely damaged articular cartilage and meniscus. This indicates that tissue mechanical properties can be calculated from T2 relaxation time, suggesting that quantitative MRI is useful in determining when to start loading after interventional surgery on cartilage tissue and in managing the health of elderly patients.
Collapse
Affiliation(s)
- Takehito Hananouchi
- Biodesign Division, Department of Academia-Government-Industry Collaboration, Hiroshima University, Hiroshima, Hiroshima 734-8551, Japan
- Department of Mechanical Engineering, Faculty of Engineering, Osaka Sangyo University, Daito, Osaka 574-8530, Japan
- Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, Osaka 583-0875, Japan (K.S.)
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA 92037, USA
| | - Shinji Satake
- Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, Osaka 583-0875, Japan (K.S.)
| | - Kei Sakao
- Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, Osaka 583-0875, Japan (K.S.)
| | - Hiroshi Katsuda
- Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, Osaka 583-0875, Japan (K.S.)
| | - Nagakazu Shimada
- Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, Osaka 583-0875, Japan (K.S.)
| | - Erik W. Dorthe
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA 92037, USA
| | - Darryl D. D’Lima
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA 92037, USA
| |
Collapse
|
3
|
Ramasamy SK, Roudi R, Morakote W, Adams LC, Pisani LJ, Moseley M, Daldrup-Link HE. Measurement of Tumor T2* Relaxation Times after Iron Oxide Nanoparticle Administration. J Vis Exp 2023. [PMID: 37318243 PMCID: PMC10619562 DOI: 10.3791/64773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
T2* relaxometry is one of the established methods to measure the effect of superparamagnetic iron oxide nanoparticles on tumor tissues with magnetic resonance imaging (MRI). Iron oxide nanoparticles shorten the T1, T2, and T2* relaxation times of tumors. While the T1 effect is variable based on the size and composition of the nanoparticles, the T2 and T2* effects are usually predominant, and T2* measurements are the most time-efficient in a clinical context. Here, we present our approach to measuring tumor T2* relaxation times, using multi-echo gradient echo sequences, external software, and a standardized protocol for creating a T2* map with scanner-independent software. This facilitates the comparison of imaging data from different clinical scanners, different vendors, and co-clinical research work (i.e., tumor T2* data obtained in mouse models and patients). Once the software is installed, the T2 Fit Map plugin needs to be installed from the plugin manager. This protocol provides step-by-step procedural details, from importing the multi-echo gradient echo sequences into the software, to creating color-coded T2* maps and measuring tumor T2* relaxation times. The protocol can be applied to solid tumors in any body part and has been validated based on preclinical imaging data and clinical data in patients. This could facilitate tumor T2* measurements for multi-center clinical trials and improve the standardization and reproducibility of tumor T2* measurements in co-clinical and multi-center data analyses.
Collapse
Affiliation(s)
- Shakthi Kumaran Ramasamy
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, School of Medicine
| | - Raheleh Roudi
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, School of Medicine
| | - Wipawee Morakote
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, School of Medicine
| | - Lisa C Adams
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, School of Medicine
| | - Laura J Pisani
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, School of Medicine
| | - Michael Moseley
- Department of Radiology, Radiological Sciences Laboratory (RSL) at Stanford, Stanford University, School of Medicine
| | - Heike E Daldrup-Link
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, School of Medicine; Department of Pediatrics, Division of Hematology/Oncology, Stanford University, School of Medicine;
| |
Collapse
|
4
|
Huynh PT, Vu HD, Ryu J, Kim HS, Jung H, Youn SW. Gadolinium-Cyclic 1,4,7,10-Tetraazacyclododecane-1,4,7,10-Tetraacetic Acid-Click-Sulfonyl Fluoride for Probing Serine Protease Activity in Magnetic Resonance Imaging. Molecules 2023; 28:molecules28083538. [PMID: 37110769 PMCID: PMC10141219 DOI: 10.3390/molecules28083538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Serine protease is linked to a wide range of diseases, prompting the development of robust, selective, and sensitive protease assays and sensing methods. However, the clinical needs for serine protease activity imaging have not yet been met, and the efficient in vivo detection and imaging of serine protease remain challenging. Here, we report the development of the gadolinium-cyclic 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-click-Sulfonyl Fluoride (Gd-DOTA-click-SF) MRI contrast agent targeting serine protease. The HR-FAB mass spectrum confirmed the successful formation of our designed chelate. The molar longitudinal relaxivity (r1) of the Gd-DOTA-click-SF probe (r1 = 6.82 mM-1 s-1) was significantly higher than that of Dotarem (r1 = 4.63 mM-1 s-1), in the range of 0.01-0.64 mM at 9.4 T. The in vitro cellular study and the transmetallation kinetics study showed that the safety and stability of this probe are comparable to those of conventional Dotarem. Ex vivo abdominal aortic aneurysm (AAA) MRI revealed that this probe has a contrast-agent-to-noise ratio (CNR) that is approximately 51 ± 23 times greater than that of Dotarem. This study of superior visualization of AAA suggests that it has the potential to detect elastase in vivo and supports the feasibility of probing serine protease activity in T1-weighted MRI.
Collapse
Affiliation(s)
- Phuong Tu Huynh
- Department of Radiology, Daegu Catholic University School of Medicine, 3056-6, Daemyung-4-Dong, Nam-gu, Daegu 42472, Republic of Korea
| | - Huy Duc Vu
- Department of Radiology, Daegu Catholic University School of Medicine, 3056-6, Daemyung-4-Dong, Nam-gu, Daegu 42472, Republic of Korea
| | - Junghwa Ryu
- Department of Radiology, Daegu Catholic University School of Medicine, 3056-6, Daemyung-4-Dong, Nam-gu, Daegu 42472, Republic of Korea
| | - Hee Su Kim
- Korea Basic Science Institute (Daegu Center), Kyungpook University, 80, Daehak-ro, Buk-gu, Daegu 41566, Republic of Korea
| | - Hoesu Jung
- Preclinical Research Center, Daegu-Gyeongbuk Medical Innovation Foundation (KMEDIhub), 88, Dongnae-ro, Dong-gu, Daegu 41061, Republic of Korea
| | - Sung Won Youn
- Department of Radiology, Daegu Catholic University School of Medicine, 3056-6, Daemyung-4-Dong, Nam-gu, Daegu 42472, Republic of Korea
| |
Collapse
|
5
|
Al-Wakeel-Marquard N, Ferreira da Silva T, Berger F, Kuehne T, Messroghli DR. Myocardial extracellular volume is a non-invasive tissue marker of heart failure in patients with transposition of the great arteries and systemic right ventricle. Front Pediatr 2022; 10:949078. [PMID: 36419919 PMCID: PMC9676958 DOI: 10.3389/fped.2022.949078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/26/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Focal myocardial fibrosis in the systemic right ventricle (RV) is related to ventricular dysfunction and adverse outcome in patients with d-transposition of the great arteries (dTGA) post atrial redirection and those with congenitally corrected TGA (ccTGA). The role of diffuse fibrotic lesions in these conditions remains poorly understood. Our study aimed to investigate diffuse myocardial fibrosis by measuring extracellular volume (ECV) with cardiovascular magnetic resonance (CMR) and to explore correlations between ECV and clinical as well as functional markers of heart failure in patients with TGA and systemic RV. METHODS We prospectively included dTGA and ccTGA patients aged ≥14 years and compared them to healthy controls. Standardized CMR included modified Look-Locker Inversion recovery T1 mapping to quantify diffuse myocardial fibrosis in the systemic RV and the subpulmonary left ventricle (LV). The centerline of RV and LV myocardium was marked with a line of interest tool to determine native and post-contrast T1 for quantification of ECV. RESULTS In total, 13 patients (dTGA: n = 8, ccTGA: n = 5) with a median age of 30.3 years were enrolled. LV ECV was higher in patients than in controls [34% (30%-41%) vs. 26% (23%-27%), p < 0.001], with values increased above the upper limit of normal in 10/13 patients (77%). RV ECV tended to be higher in patients than in controls, albeit without statistical significance [29% (27%-32%) vs. 28% (26%-29%), p = 0.316]. Patients with elevated LV ECV had lower LV ejection fraction than those with normal ECV (52 ± 5% vs. 65 ± 4%, p = 0.007). Correlations with clinical parameters were not observed. LV ECV was significantly higher than RV ECV (p = 0.016) in the patient group. CONCLUSIONS In this study, LV ECV was significantly increased in TGA patients compared to controls, and was associated with LV dysfunction. Our data suggest that ECV may serve as a non-invasive tissue marker of heart failure in TGA with systemic RV. Further research is necessary to evaluate the prognostic implications and the potential role of ECV in monitoring disease progression and guiding therapy, aiming to maintain LV function or train the LV for subaortic location in TGA patients from infancy to adulthood.
Collapse
Affiliation(s)
- Nadya Al-Wakeel-Marquard
- Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany.,Institute of Computer-assisted Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Tiago Ferreira da Silva
- Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Felix Berger
- Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Department of Pediatrics, Division of Cardiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Titus Kuehne
- Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany.,Institute of Computer-assisted Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Daniel R Messroghli
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Department of Internal Medicine - Cardiology, German Heart Center Berlin, Berlin, Germany.,Department of Cardiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
6
|
Al-Wakeel-Marquard N, Seidel F, Herbst C, Kühnisch J, Kuehne T, Berger F, Klaassen S, Messroghli DR. Diffuse myocardial fibrosis by T1 mapping is associated with heart failure in pediatric primary dilated cardiomyopathy. Int J Cardiol 2021; 333:219-225. [PMID: 33737165 DOI: 10.1016/j.ijcard.2021.03.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 12/10/2020] [Accepted: 03/10/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND In adult cardiomyopathy (CM), diffuse myocardial fibrosis is associated with adverse clinical outcome. However, its relevance in pediatric patients remains relatively unknown. The study aimed to evaluate myocardial extracellular volume (ECV) reflecting diffuse myocardial fibrosis with cardiovascular magnetic resonance (CMR) T1 mapping, and to analyze correlations with clinical and functional data in children and adolescents with different CM phenotypes. METHODS Patients with primary dilated (DCM), hypertrophic (HCM) or left ventricular non-compaction CM (LVNC) were prospectively enrolled and compared with healthy controls. Study participants underwent standardized CMR with modified Look-Locker Inversion recovery (MOLLI) T1 mapping. RESULTS In total, 33 patients (median age 12.0 years; DCM: n = 10, HCM: n = 13; LVNC: n = 10) and 7 controls (14.5 years) were included. DCM: ECV was higher than in controls (38.1 ± 7.5% vs. 27.2 ± 3.6%; p = 0.014). Patients with elevated ECV were younger than those with normal values (p = 0.044). ECV correlated with N-terminal pro brain natriuretic peptide (r = 0.66, p = 0.038), left ventricular ejection fraction (r = -0.63, p = 0.053), and stroke volume of left (r = -0.75, p = 0.013) and right ventricle (r = -0.67, p = 0.033). During a median follow-up of 25.3 months, 3 patients underwent heart transplantation (HTx), and 2 were listed for HTx. All 5 patients had elevated ECV. HCM/LVNC ECV was within normal range in HCM (25.5 ± 4.5%) and LVNC (29.6 ± 4.2), and was not related with clinical and/or functional parameters. CONCLUSIONS Our results indicate an increased burden of diffuse myocardial fibrosis in relation with younger age in pediatric DCM. ECV was associated with clinical and biventricular functional markers of heart failure in DCM.
Collapse
Affiliation(s)
- Nadya Al-Wakeel-Marquard
- German Heart Center Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Augustenburger Platz 1, 13353 Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Augustenburger Platz 1, 13353 Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin.
| | - Franziska Seidel
- German Heart Center Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Augustenburger Platz 1, 13353 Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division Cardiology, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Christopher Herbst
- German Heart Center Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Augustenburger Platz 1, 13353 Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin; Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück-Center for Molecular Medicine, Lindenberger Weg 80, 13125 Berlin, Germany
| | - Jirko Kühnisch
- DZHK (German Centre for Cardiovascular Research), partner site Berlin; Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück-Center for Molecular Medicine, Lindenberger Weg 80, 13125 Berlin, Germany
| | - Titus Kuehne
- German Heart Center Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Augustenburger Platz 1, 13353 Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Augustenburger Platz 1, 13353 Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin
| | - Felix Berger
- German Heart Center Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Augustenburger Platz 1, 13353 Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division Cardiology, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Sabine Klaassen
- DZHK (German Centre for Cardiovascular Research), partner site Berlin; Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück-Center for Molecular Medicine, Lindenberger Weg 80, 13125 Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division Cardiology, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Daniel R Messroghli
- DZHK (German Centre for Cardiovascular Research), partner site Berlin; German Heart Center Berlin, Department of Internal Medicine and Cardiology, Augustenburger Platz 1, 13353 Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Cardiology, Augustenburger Platz 1, 13353 Berlin, Germany
| |
Collapse
|
7
|
Kim YC, Kim KR, Lee H, Choe YH. Fast calculation software for modified Look-Locker inversion recovery (MOLLI) T1 mapping. BMC Med Imaging 2021; 21:26. [PMID: 33579214 PMCID: PMC7881681 DOI: 10.1186/s12880-021-00558-8] [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: 07/14/2020] [Accepted: 02/02/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The purpose of this study was to develop a software tool and evaluate different T1 map calculation methods in terms of computation time in cardiac magnetic resonance imaging. METHODS The modified Look-Locker inversion recovery (MOLLI) sequence was used to acquire multiple inversion time (TI) images for pre- and post-contrast T1 mapping. The T1 map calculation involved pixel-wise curve fitting based on the T1 relaxation model. A variety of methods were evaluated using data from 30 subjects for computational efficiency: MRmap, python Levenberg-Marquardt (LM), python reduced-dimension (RD) non-linear least square, C++ single- and multi-core LM, and C++ single- and multi-core RD. RESULTS Median (interquartile range) computation time was 126 s (98-141) for the publicly available software MRmap, 261 s (249-282) for python LM, 77 s (74-80) for python RD, 3.4 s (3.1-3.6) for C++ multi-core LM, and 1.9 s (1.9-2.0) for C++ multi-core RD. The fastest C++ multi-core RD and the publicly available MRmap showed good agreement of myocardial T1 values, resulting in 95% Bland-Altman limits of agreement of (- 0.83 to 0.58 ms) and (- 6.57 to 7.36 ms) with mean differences of - 0.13 ms and 0.39 ms, for the pre- and post-contrast, respectively. CONCLUSION The C++ multi-core RD was the fastest method on a regular eight-core personal computer for pre- or post-contrast T1 map calculation. The presented software tool (fT1fit) facilitated rapid T1 map and extracellular volume fraction map calculations.
Collapse
Affiliation(s)
- Yoon-Chul Kim
- Clinical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Khu Rai Kim
- Department of Electronic Engineering, Sogang University, Seoul, South Korea
| | - Hyelee Lee
- Department of Mathematics, Sogang University, Seoul, South Korea
| | - Yeon Hyeon Choe
- Department of Radiology and HVSI Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| |
Collapse
|
8
|
Measuring myocardial extracellular volume of the right ventricle in patients with congenital heart disease. Sci Rep 2021; 11:2679. [PMID: 33514806 PMCID: PMC7846852 DOI: 10.1038/s41598-021-81440-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 01/04/2021] [Indexed: 01/29/2023] Open
Abstract
The right ventricle´s (RV) characteristics—thin walls and trabeculation—make it challenging to evaluate extracellular volume (ECV). We aimed to assess the feasibility of RV ECV measurements in congenital heart disease (CHD), and to introduce a novel ECV analysis tool. Patients (n = 39) and healthy controls (n = 17) underwent cardiovascular magnetic resonance T1 mapping in midventricular short axis (SAX) and transverse orientation (TRANS). Regions of interest (ROIs) were evaluated with regard to image quality and maximum RV wall thickness per ROI in pixels. ECV from plane ROIs was compared with values obtained with a custom-made tool that derives the mean T1 values from a “line of interest” (LOI) centered in the RV wall. In CHD, average image quality was good (no artifacts in the RV, good contrast between blood/myocardium), and RV wall thickness was 1–2 pixels. RV ECV was not quantifiable in 4/39 patients due to insufficient contrast or wall thickness < 1 pixel. RV myocardium tended to be more clearly delineated in SAX than TRANS. ECV from ROIs and corresponding LOIs correlated strongly in both directions (SAX/TRANS: r = 0.97/0.87, p < 0.001, respectively). In conclusion, RV ECV can be assessed if image quality allows sufficient distinction between myocardium and blood, and RV wall thickness per ROI is ≥ 1 pixel. T1 maps in SAX are recommended for RV ECV analysis. LOI application simplifies RV ECV measurements.
Collapse
|
9
|
Structural and Functional Correlates of Gradient-Area Patterns in Severe Aortic Stenosis and Normal Ejection Fraction. JACC Cardiovasc Imaging 2020; 14:525-536. [PMID: 33221240 DOI: 10.1016/j.jcmg.2020.09.031] [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: 04/29/2020] [Revised: 08/31/2020] [Accepted: 09/14/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The authors sought to characterize the functional and structural myocardial phenotypes of patients with moderate-to-severe aortic stenosis (AS) and to determine whether severe paradoxical low-gradient AS (LG-AS) is specifically associated with left ventricular (LV) remodeling and fibrosis. BACKGROUND Recently, it was suggested that severe paradoxical LG-AS is a more advanced form of AS, with greater reduction of longitudinal deformation, adverse LV remodeling, and more interstitial fibrosis. METHODS The study population includes 147 patients with moderate-to-severe AS and a normal LV ejection fraction, and 75 normal control subjects. They prospectively underwent 2-dimensional speckle-tracking echocardiography and cardiac magnetic resonance to evaluate myocardial deformation, LV remodeling, and age- and sex-adjusted extravascular volume fraction (ECV, %). Among AS patients, 18 had moderate AS, 74 had severe high-gradient AS (HG-AS), and 55 had severe paradoxical LG-AS. RESULTS Reduced longitudinal and circumferential deformation was observed in 21% and 6% of the AS patients, respectively. Multivariate analyses identified increased ECV (ß = 1.99; p = 0.001) and the absence of normal LV geometry (ß = -1.37; p = 0.007) and as independent predictors of reduced longitudinal deformation. Increased ECV was an independent predictor of reduced circumferential deformation (ß = 2.19; p = 0.001). Over a median follow-up of 29 months, reduced longitudinal deformation (hazard ratio: 0.82; p = 0.023) and higher transvalvular gradients (hazard ratio: 1.05; p < 0.001) increased the risk of death or need for aortic valve replacement. LV hypertrophy was more frequently observed among patients with severe HG-AS (65%) than among the other AS patients (14%; p < 0.001). On average, ECV was within normal limits and did not differ among gradient-area subgroups. When present, increased ECV was associated with reduced longitudinal deformation. CONCLUSIONS This study's data show that patients with severe paradoxical LG-AS less frequently display reduced longitudinal deformation, LV hypertrophy, or myocardial fibrosis than patients with HG-AS. Also, interstitial fibrosis only occurs when reduced longitudinal deformation and severe HG-AS are present together. Finally, this study suggests that reduced longitudinal deformation and higher transvalvular gradients adversely affect patients' outcomes.
Collapse
|
10
|
Shi B, Zhang B, Zhang Y, Gu Y, Zheng C, Yan J, Chen W, Yan F, Ye J, Zhang H. Multifunctional gap-enhanced Raman tags for preoperative and intraoperative cancer imaging. Acta Biomater 2020; 104:210-220. [PMID: 31927113 DOI: 10.1016/j.actbio.2020.01.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 12/12/2022]
Abstract
Multi-modality imaging agents are desirable for tumor diagnosis because they can provide more alternative and reliable information for accurate detection and therapy of diseases than single imaging technique. However, most reported conventional imaging agents have not been found to successfully overcome the disadvantages of traditional diagnoses such as sensitivity, spatial resolution, short half-decay time and complexity. Therefore, exploring a multifunctional nanocomposite with the combination of their individual modality characteristics has great impact on preoperative imaging and intraoperative diagnosis of cancer. In our study, mesoporous silica gadolinium-loaded gap-enhanced Raman tags (Gd-GERTs) specifically for preoperative and intraoperative imaging are designed and their imaging capability and biosafety are examined. They exhibit strong attenuation property for computed X-ray tomography (CT) imaging, high T1 relaxivity for magnetic resonance (MR) imaging capability and surface-enhanced Raman spectroscopy (SERS) signal with good dispersity and stability, which presents CT/MR/SERS multi-mode imaging performance of the tumor of mice within a given time. Furthermore, in vivo biodistribution and long-term toxicity studies reveal that the Gd-GERTs have good biocompatibility and bio-safety. Therefore, Gd-GERTs are of great potential as a multifunctional nanoplatform for accurate preoperative CT/MRI diagnosis and intraoperative Raman imaging-guide resection of cancers. STATEMENT OF SIGNIFICANCE: Recent advances in molecular imaging technology have provided a myriad of opportunities to prepare various nanomaterials for accurate diagnosis and response evaluation of cancer via different imaging modalities. However, single bioimaging modality is still challenging to overcome the issues such as sensitivity, spatial resolution, imaging speed and complexity for clinicians. In this work, we designed a kind of unique multifunctional nanoprobes with computed X-ray tomography/magnetic resonance/surface-enhanced Raman spectroscopy (CT/MR/SERS) triple-modal imaging capabilities. Multifunctional nanotags offer the capabilities of preoperative noninvasive CT/MR imaging for identification of tumors as well as intraoperative real-time SERS imaging for guidance of complete resection of tumors. These multifunctional nanoprobes show critical clinical significance on the improvement of tumor diagnosis and therapy.
Collapse
|
11
|
Deng R, Janssen AE, Vergeldt FJ, Van As H, de Graaf C, Mars M, Smeets PA. Exploring in vitro gastric digestion of whey protein by time-domain nuclear magnetic resonance and magnetic resonance imaging. Food Hydrocoll 2020. [DOI: 10.1016/j.foodhyd.2019.105348] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
12
|
Liu JF, Lan Z, Ferrari C, Stein JM, Higbee-Dempsey E, Yan L, Amirshaghaghi A, Cheng Z, Issadore D, Tsourkas A. Use of Oppositely Polarized External Magnets To Improve the Accumulation and Penetration of Magnetic Nanocarriers into Solid Tumors. ACS NANO 2020; 14:142-152. [PMID: 31854966 PMCID: PMC7002255 DOI: 10.1021/acsnano.9b05660] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Drug delivery to solid tumors is hindered by hydrostatic and physical barriers that limit the penetration of nanocarriers into tumor tissue. When exploiting the enhanced permeability and retention (EPR) effect for passive targeting of nanocarriers, the increased interstitial fluid pressure and dense extracellular matrix in tumors limits the distribution of the nanocarriers to perivascular regions. Previous strategies have shown that magnetophoresis enhances accumulation and penetration of nanoparticles into solid tumors. However, because magnetic fields fall off rapidly with distance from the magnet, these methods have been limited to use in superficial tumors. To overcome this problem, we have developed a system comprising two oppositely polarized magnets that enables the penetration of magnetic nanocarriers into more deeply seeded tumors. Using this method, we demonstrate a 5-fold increase in the penetration and a 3-fold increase in the accumulation of magnetic nanoparticles within solid tumors compared to EPR.
Collapse
Affiliation(s)
- Jessica F. Liu
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Ziyang Lan
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Carolina Ferrari
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Joel M. Stein
- Department of Radiology, Division of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Elizabeth Higbee-Dempsey
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Biochemistry and Molecular Biophysics Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Lesan Yan
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Ahmad Amirshaghaghi
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Zhiliang Cheng
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - David Issadore
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Corresponding Author: Andrew Tsourkas, Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 S. 33 St. Philadelphia, PA 19104, United States. , David Issadore, Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 S. 33 St. Philadelphia, PA 19104, United States.
| | - Andrew Tsourkas
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Corresponding Author: Andrew Tsourkas, Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 S. 33 St. Philadelphia, PA 19104, United States. , David Issadore, Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 S. 33 St. Philadelphia, PA 19104, United States.
| |
Collapse
|
13
|
Menacho K, Abdel-Gadir A, Moon JC, Fernandes JL. T2* Mapping Techniques: Iron Overload Assessment and Other Potential Clinical Applications. Magn Reson Imaging Clin N Am 2020; 27:439-451. [PMID: 31279448 DOI: 10.1016/j.mric.2019.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
T2* mapping techniques has evolved significantly since their introduction in the early 2000s and a significant amount of evidence has been gathered to support their clinical routine use for iron overload assessment. This article focuses on the most important aspects of how to perform T2* imaging, from acquisition, to postprocessing, to analyzing the data with clinical concentration. Newer techniques have made T2* mapping more robust and accurate, allowing a broader use of this technique for noncontrast ischemia imaging based on blood oxygen levels, in addition to evaluation of intramyocardial hemorrhage and microvascular obstruction.
Collapse
Affiliation(s)
- Katia Menacho
- Barts Heart Centre, The Cardiovascular Magnetic Resonance Imaging Unit, Institute of Cardiovascular Science, University College London, St Bartholomew's Hospital, 2nd Floor, King George V Block, West Smithfiled, London EC1A 7BE, UK
| | - Amna Abdel-Gadir
- Institute of Cardiovascular Science, University College London, Gower Street, London WC1E6BT, UK; Barts Heart Centre, St Bartholomew's Hospital, 2nd Floor, King George V Block, London EC1A 7BE, UK
| | - James C Moon
- The Cardiovascular Magnetic Resonance Imaging Unit, The Inherited Cardiovascular Diseases Unit, Barts Heart Centre, St Bartholomew's Hospital, 2nd Floor, King George V Block, West Smithfield, London EC1A 7BE, UK
| | - Juliano Lara Fernandes
- Jose Michel Kalaf Research Institute, Radiologia Clinica de Campinas, Av Jose de Souza Campos 840, Campinas, São Paulo 13092-100, Brazil.
| |
Collapse
|
14
|
Mass Spectrometry Imaging of atherosclerosis-affine Gadofluorine following Magnetic Resonance Imaging. Sci Rep 2020; 10:79. [PMID: 31919465 PMCID: PMC6952459 DOI: 10.1038/s41598-019-57075-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 12/22/2019] [Indexed: 12/16/2022] Open
Abstract
Molecular imaging of atherosclerosis by Magnetic Resonance Imaging (MRI) has been impaired by a lack of validation of the specific substrate responsible for the molecular imaging signal. We therefore aimed to investigate the additive value of mass spectrometry imaging (MSI) of atherosclerosis-affine Gadofluorine P for molecular MRI of atherosclerotic plaques. Atherosclerotic Ldlr−/− mice were investigated by high-field MRI (7 T) at different time points following injection of atherosclerosis-affine Gadofluorine P as well as at different stages of atherosclerosis formation (4, 8, 16 and 20 weeks of HFD). At each imaging time point mice were immediately sacrificed after imaging and aortas were excised for mass spectrometry imaging: Matrix Assisted Laser Desorption Ionization (MALDI) Imaging and Laser Ablation – Inductively Coupled Plasma – Mass Spectrometry (LA-ICP-MS) imaging. Mass spectrometry imaging allowed to visualize the localization and measure the concentration of the MR imaging probe Gadofluorine P in plaque tissue ex vivo with high spatial resolution and thus adds novel and more target specific information to molecular MR imaging of atherosclerosis.
Collapse
|
15
|
Henninger B, Alustiza J, Garbowski M, Gandon Y. Practical guide to quantification of hepatic iron with MRI. Eur Radiol 2019; 30:383-393. [PMID: 31392478 PMCID: PMC6890593 DOI: 10.1007/s00330-019-06380-9] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/03/2019] [Accepted: 07/19/2019] [Indexed: 01/19/2023]
Abstract
Abstract Our intention is to demystify the MR quantification of hepatic iron (i.e., the liver iron concentration) and give you a step-by-step approach by answering the most pertinent questions. The following article should be more of a manual or guide for every radiologist than a classic review article, which just summarizes the literature. Furthermore, we provide important background information for professional communication with clinicians. The information regarding the physical background is reduced to a minimum. After reading this article, you should be able to perform adequate MR measurements of the LIC with 1.5-T or 3.0-T scanners. Key Points • MRI is widely accepted as the primary approach to non-invasively determine liver iron concentration (LIC). • This article is a guide for every radiologist to perform adequate MR measurements of the LIC. • When using R2* relaxometry, some points have to be considered to obtain correct measurements—all explained in this article.
Collapse
Affiliation(s)
- Benjamin Henninger
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| | - Jose Alustiza
- Osatek, Donostia Universitary Hospital, P. Dr. Beguiristain 109, 20014, Donostia/San Sebastian, Spain
| | - Maciej Garbowski
- Department of Haematology, Cancer Institute, University College London, Paul O'Gorman Bld, 72 Huntley St, London, WC1E 6BT, UK
| | - Yves Gandon
- CHU Rennes, Inserm, LTSI - UMR_S 1099, University of Rennes, F-35000, Rennes, France
| |
Collapse
|
16
|
EVCMR: A tool for the quantitative evaluation and visualization of cardiac MRI data. Comput Biol Med 2019; 111:103334. [DOI: 10.1016/j.compbiomed.2019.103334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/24/2019] [Accepted: 06/17/2019] [Indexed: 01/18/2023]
|
17
|
Borrazzo C, Pacilio M, Galea N, Preziosi E, Carnì M, Francone M, Catalano C, Carbone I. T1 and extracellular volume fraction mapping in cardiac magnetic resonance: estimation of accuracy and precision of a novel algorithm. Phys Med Biol 2019; 64:04NT06. [PMID: 30625450 DOI: 10.1088/1361-6560/aafcca] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Magnetic resonance imaging is effective for non-invasive detection of myocardial diseases by extracellular volume fraction (ECV) estimation. A new methodology for T1 and ECV mapping is tested in this work, comparing results with other well-consolidated methods. The associated level of uncertainty for data was also estimated, to assess the reliability of the technique. A phantom with known T1 values was used for reference, and 60 subjects (40 controls, 20 diseased patients) were examined, using the modified look-locker inversion-recovery (MOLLI) method. Obtained T1 data were studied in terms of accuracy (difference with reference T1), paired comparisons with other methods, and Gamma-tool analysis with tolerances criteria of 4.21 mm for distance-to-agreement, and between 2%-5% for T1 difference. Accuracy and precision of the T1 mapping was analysed by phantom measurements, and the uncertainty of the ECV was estimated by T1 error propagation. Differences (in paired comparisons) of T1 datasets were not significant neither for statistical tests, nor for Bland-Altman analysis. T1 accuracy was between -12% and -1% across methods, slightly better for the tested method (mean accuracy in the T1 range of interest better than 2%). The Gamma analysis confirm slightly better results for the tested method than other methodologies. The new method improves the computational efficiency by a factor of 25 (at least), revealing to be also more suitable for Big Data-related applications.
Collapse
Affiliation(s)
- Cristian Borrazzo
- Department of Public Health and Infectious Disease, 'Sapienza' University of Rome, Viale del Policlinico 155, 00161 Rome, Italy. Department of Medical Physics, Azienda Ospedaliera Universitaria Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy. Author to whom any correspondence should be addressed
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Roy C, Slimani A, de Meester C, Amzulescu M, Pasquet A, Vancraeynest D, Beauloye C, Vanoverschelde JL, Gerber BL, Pouleur AC. Associations and prognostic significance of diffuse myocardial fibrosis by cardiovascular magnetic resonance in heart failure with preserved ejection fraction. J Cardiovasc Magn Reson 2018; 20:55. [PMID: 30086783 PMCID: PMC6081897 DOI: 10.1186/s12968-018-0477-4] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 07/19/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Increased myocardial fibrosis may play a key role in heart failure with preserved ejection fraction (HFpEF) pathophysiology. The study aim was to evaluate the presence, associations, and prognostic significance of diffuse fibrosis in HFpEF patients compared to age- and sex-matched controls. METHODS We prospectively included 118 consecutive HFpEF patients. Diffuse myocardial fibrosis was estimated by extracellular volume (ECV) quantified by cardiovascular magnetic resonance with the modified Look-Locker inversion recovery sequence. We determined an ECV age- and sex-adjusted cutoff value (33%) in 26 controls. RESULTS Mean ECV was significantly higher in HFpEF patients versus healthy controls (32.9 ± 4.8% vs 28.2 ± 2.4%, P < 0.001). Multivariate logistic regression showed that body mass index (BMI) (odds ratio (OR) =0.92 [0.86-0.98], P = 0.011), diabetes (OR = 2.62 [1.11-6.18], P = 0.028), and transmitral peak E wave velocity (OR = 1.02 [1.00-1.03], P = 0.022) were significantly associated with abnormal ECV value. During a median follow-up of 11 ± 6 months, the primary outcome (all-cause mortality or first heart failure hospitalization) occurred in 38 patients. In multivariate Cox regression analysis, diabetes (hazard ratio (HR) =1.98 [1.04; 3.76], P = 0.038) and hemoglobin level (HR = 0.81 [0.67; 0.98], P = 0.028) were significant predictors of composite outcome. The ECV ability to improve this model added significant prognostic information. We then developed a risk score including diabetes, hemoglobin and ECV > 33% demonstrating significant prediction of risk and validated this score in a validation cohort of 53 patients. Kaplan-Meier curves showed a significant difference according to tertiles of the probability score (P < 0.001). CONCLUSION Among HFpEF patients, high ECV, likely reflecting abnormal diffuse myocardial fibrosis, was associated with a higher rate of all-cause death and first HF hospitalization in short term follow up. TRIAL REGISTRATION Characterization of Heart Failure With Preserved Ejection Fraction. TRIAL REGISTRATION NUMBER NCT03197350 . Date of registration: 20/06/2017. This trial was retrospectively registered.
Collapse
Affiliation(s)
- Clotilde Roy
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwé St. Lambert, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Alisson Slimani
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwé St. Lambert, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Christophe de Meester
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwé St. Lambert, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Mihaela Amzulescu
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwé St. Lambert, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Agnes Pasquet
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwé St. Lambert, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - David Vancraeynest
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwé St. Lambert, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Christophe Beauloye
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwé St. Lambert, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Jean-Louis Vanoverschelde
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwé St. Lambert, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Bernhard L. Gerber
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwé St. Lambert, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Anne-Catherine Pouleur
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwé St. Lambert, Belgium
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| |
Collapse
|
19
|
Jiang M, Wang Z, Su X, Gong X, Pu J, Wu L, Liu C, Yao Q, Kong L, Xu J, He B. The Significance of Interstitial Fibrosis on Left Ventricular Function in Hypertensive versus Hypertrophic Cardiomyopathy. Sci Rep 2018; 8:9995. [PMID: 29968754 PMCID: PMC6030120 DOI: 10.1038/s41598-018-27049-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 05/29/2018] [Indexed: 01/19/2023] Open
Abstract
Extracellular volume (ECV) has been validated as a surrogate measure of interstitial fibrosis, that is increased in both hypertension-induced left ventricular hypertrophy (H-LVH) and hypertrophic cardiomyopathy (HCM). We aimed to explore the correlation between ECV and left ventricular cardiac function. Eighty-one patients with HCM, 44 with H-LVH and 35 controls were prospectively enrolled. Even among patients with normal diastolic function, patients in HCM group had increased- ECV. In terms of diastolic dysfunction (DD), a similar increase in ECV was associated with a larger percentage of patients with severe or moderate-to-severe DD in HCM group. In addition, there was a compensatory increase in the left ventricular ejection fraction (LVEF) in HCM, but no hyperdynamic LVEF was observed in H-LVH. ECV was negatively correlated with LVEF in the late gadolinium enhancement (+) (LGE+) subgroups in the H-LVH group, while no significant linear correlation was observed in HCM group. The increased ECV in HCM patients with normal diastolic function warrants further exploration of the prognostic value of ECV assessments in the early stages of HCM. The associations between ECV and left ventricular functional parameters differed and taking both LGE and ECV into account might be reasonable way to differentiate between the two disorders.
Collapse
Affiliation(s)
- Meng Jiang
- Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, 200127, China
| | - Zi Wang
- Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, 200127, China
| | - Xuan Su
- Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, 200127, China
| | - Xingrong Gong
- Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, 200127, China
| | - Jun Pu
- Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, 200127, China
| | - Lianming Wu
- Department of Radiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, 200127, China
| | - Chang Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, 610041, China
| | - Qiuying Yao
- Department of Radiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, 200127, China
| | - Lingcong Kong
- Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, 200127, China
| | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, 200127, China.
| | - Ben He
- Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, 200127, China.
| |
Collapse
|
20
|
Molecular imaging of myocardial infarction with Gadofluorine P - A combined magnetic resonance and mass spectrometry imaging approach. Heliyon 2018; 4:e00606. [PMID: 29862367 PMCID: PMC5968177 DOI: 10.1016/j.heliyon.2018.e00606] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 03/09/2018] [Accepted: 04/11/2018] [Indexed: 01/26/2023] Open
Abstract
Background Molecular MRI is becoming increasingly important for preclinical research. Validation of targeted gadolinium probes in tissue however has been cumbersome up to now. Novel methodology to assess gadolinium distribution in tissue after in vivo application is therefore needed. Purpose To establish combined Magnetic Resonance Imaging (MRI) and Mass Spectrometry Imaging (MSI) for improved detection and quantification of Gadofluorine P deposition in scar formation and myocardial remodeling. Materials and methods Animal studies were performed according to institutionally approved protocols. Myocardial infarction was induced by permanent ligation of the left ascending artery (LAD) in C57BL/6J mice. MRI was performed at 7T at 1 week and 6 weeks after myocardial infarction. Gadofluorine P was used for dynamic T1 mapping of extracellular matrix synthesis during myocardial healing and compared to Gd-DTPA. After in vivo imaging contrast agent concentration as well as distribution in tissue were validated and quantified by spatially resolved Matrix-Assisted Laser Desorption Ionization (MALDI) MSI and Laser Ablation – Inductively Coupled Plasma – Mass Spectrometry (LA-ICP-MS) imaging. Results Both Gadofluorine P enhancement as well as local tissue content in the myocardial scar were highest at 15 minutes post injection. R1 values increased from 1 to 6 weeks after MI (1.62 s−1 vs 2.68 s−1, p = 0.059) paralleled by an increase in Gadofluorine P concentration in the infarct from 0.019 mM at 1 week to 0.028 mM at 6 weeks (p = 0.048), whereas Gd-DTPA enhancement showed no differences (3.95 s−1 vs 3.47 s−1, p = 0.701). MALDI-MSI results were corroborated by elemental LA-ICP-MS of Gadolinium in healthy and infarcted myocardium. Histology confirmed increased extracellular matrix synthesis at 6 weeks compared to 1 week. Conclusion Adding quantitative MSI to MR imaging enables a quantitative validation of Gadofluorine P distribution in the heart after MI for molecular imaging.
Collapse
|
21
|
Nacif MS, Raman FS, Gai N, Jones J, van der Geest RJ, T Sibley C, Liu S, David AB. Myocardial T1 mapping and determination of partition coefficients at 3 tesla: comparison between gadobenate dimeglumine and gadofosveset trisodium. Radiol Bras 2018; 51:13-19. [PMID: 29559761 PMCID: PMC5846320 DOI: 10.1590/0100-3984.2016.0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective To compare an albumin-bound gadolinium chelate (gadofosveset trisodium) and
an extracellular contrast agent (gadobenate dimeglumine), in terms of their
effects on myocardial longitudinal (T1) relaxation time and partition
coefficient. Materials and Methods Study subjects underwent two imaging sessions for T1 mapping at 3 tesla with
a modified look-locker inversion recovery (MOLLI) pulse sequence to obtain
one pre-contrast T1 map and two post-contrast T1 maps (mean 15 and 21 min,
respectively). The partition coefficient was calculated as
ΔR1myocardium
/ΔR1blood , where
R1 is 1/T1. Results A total of 252 myocardial and blood pool T1 values were obtained in 21
healthy subjects. After gadolinium administration, the myocardial T1 was
longer for gadofosveset than for gadobenate, the mean difference between the
two contrast agents being −7.6 ± 60 ms (p = 0.41).
The inverse was true for the blood pool T1, which was longer for gadobenate
than for gadofosveset, the mean difference being 56.5 ± 67 ms
(p < 0.001). The partition coefficient (λ)
was higher for gadobenate than gadofosveset (0.41 vs. 0.33), indicating
slower blood pool washout for gadofosveset than for gadobenate. Conclusion Myocardial T1 times did not differ significantly between gadobenate and
gadofosveset. At typical clinical doses of the contrast agents, partition
coefficients were significantly lower for the intravascular contrast agent
than for the extravascular agent.
Collapse
Affiliation(s)
- Marcelo Souto Nacif
- MD, PhD, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Fabio S Raman
- Biomedical Engineer, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Neville Gai
- MD, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Jacquin Jones
- PhD, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | | | - Christopher T Sibley
- MD, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Songtao Liu
- MD, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - A Bluemke David
- MD, PhD, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| |
Collapse
|
22
|
|
23
|
Roy C, Slimani A, de Meester C, Amzulescu M, Pasquet A, Vancraeynest D, Vanoverschelde JL, Pouleur AC, Gerber BL. Age and sex corrected normal reference values of T1, T2 T2* and ECV in healthy subjects at 3T CMR. J Cardiovasc Magn Reson 2017; 19:72. [PMID: 28934962 PMCID: PMC5609021 DOI: 10.1186/s12968-017-0371-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/10/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Myocardial T1, T2 and T2* imaging techniques become increasingly used in clinical practice. While normal values for T1, T2 and T2* times are well established for 1.5 Tesla (T) cardiovascular magnetic resonance (CMR), data for 3T remain scarce. Therefore we sought to determine normal reference values relative to gender and age and day to day reproducibility for native T1, T2, T2* mapping and extracellular volume (ECV) at 3T in healthy subjects. METHODS After careful exclusion of cardiovascular abnormality, 75 healthy subjects aged 20 to 90 years old (mean 56 ± 19 years, 47% women) underwent left-ventricular T1 (3-(3)-3-(3)-5 MOLLI)), T2 (8 echo- spin echo-imaging) and T2 * (8 echo gradient echo imaging) mapping at 3T CMR (Philips Ingenia 3T and computation of extracellular volume after administration of 0.2 mmol/kg Gadovist). Inter- and intra-observer reproducibility was estimated by intraclass correlation coefficient (ICC). Day to day reproducibility was assessed in 10 other volunteers. RESULTS Mean myocardial T1 at 3T was 1122 ± 57 ms, T2 52 ± 6 ms, T2* 24 ± 5 ms and ECV 26.6 ± 3.2%. T1 (1139 ± 37 vs 1109 ± 73 ms, p < 0.05) and ECV (28 ± 3 vs 25 ± 2%, p < 0.001), but not T2 (53 ± 8 vs 51 ± 4, p = NS) were significantly greater in age matched women than in men. T1 (r = 0.40, p < 0.001) and ECV (r = 0.37, p = 0.001) increased, while T2 decreased significantly (r = -0.25, p < 0.05) with increasing age. T2* was not influenced by either gender or age. Intra and inter-observer reproducibility was high (ICC ranging between 0.81-0.99), and day to day coefficient of variation was low (6.2% for T1, 7% for T2, 11% for T2* and 11.5% for ECV). CONCLUSIONS We provide normal myocardial T2, T2*,T1 and ECV reference values for 3T CMR which are significantly different from those reported at 1.5 Tesla CMR. Myocardial T1 and ECV values are gender and age dependent. Measurement had high inter and intra-observer reproducibility and good day-to-day reproducibility.
Collapse
Affiliation(s)
- Clotilde Roy
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Alisson Slimani
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Christophe de Meester
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Mihaela Amzulescu
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Agnès Pasquet
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - David Vancraeynest
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Jean-Louis Vanoverschelde
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Anne-Catherine Pouleur
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Bernhard L. Gerber
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| |
Collapse
|
24
|
Al-Wakeel-Marquard N, Rastin S, Muench F, O H-Ici D, Yilmaz S, Berger F, Kuehne T, Messroghli DR. Cardiac T1 mapping in congenital heart disease: bolus vs. infusion protocols for measurements of myocardial extracellular volume fraction. Int J Cardiovasc Imaging 2017; 33:1961-1968. [PMID: 28620681 DOI: 10.1007/s10554-017-1191-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/09/2017] [Indexed: 11/28/2022]
Abstract
Myocardial extracellular volume fraction (ECV) reflecting diffuse myocardial fibrosis can be measured with T1 mapping cardiovascular magnetic resonance (CMR) before and after the application of a gadolinium-based extracellular contrast agent. The equilibrium between blood and myocardium contrast concentration required for ECV measurements can be obtained with a primed contrast infusion (equilibrium contrast-CMR). We hypothesized that equilibrium can also be achieved with a single contrast bolus to accurately measure diffuse myocardial fibrosis in patients with congenital heart disease (CHD). Healthy controls (n = 17; median age 24.0 years) and patients with CHD (n = 19; 25.0 years) were prospectively enrolled. Using modified Look-Locker inversion recovery T1 mapping before, 15 min after bolus injection, and during constant infusion of gadolinium-DOTA, T1 values were obtained for blood pool and myocardium of the left ventricle (LV), the interventricular septum (IVS), and the right ventricle (RV) in a single midventricular plane in short axis or in transverse orientation. ECV of LV, IVS and RV by bolus-only and bolus-infusion correlated significantly in CHD patients (r = 0.94, 0.95, and 0.74; p < 0.01, respectively) and healthy controls (r = 0.96, 0.89, and 0.64; p < 0.05, respectively). Bland-Altman plots revealed no significant bias between the techniques for any of the analyzed regions. ECV of LV and RV myocardium measured by bolus-only T1 mapping agrees well with bolus-infusion measurements in patients with CHD. The use of a bolus-only approach facilitates the integration of ECV measurements into existing CMR imaging protocols, allowing for assessment of diffuse myocardial fibrosis in CHD in clinical routine.
Collapse
Affiliation(s)
- Nadya Al-Wakeel-Marquard
- Department of Congenital Heart Disease - Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.
| | - Sanaz Rastin
- Department of Congenital Heart Disease - Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Frédéric Muench
- Department of Congenital Heart Disease - Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Internal Medicine - Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Darach O H-Ici
- Department of Congenital Heart Disease - Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Sevim Yilmaz
- Department of Congenital Heart Disease - Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Felix Berger
- Department of Congenital Heart Disease - Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
- Department of Pediatrics, Division of Cardiology, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - Titus Kuehne
- Department of Congenital Heart Disease - Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
- Department of Pediatrics, Division of Cardiology, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - Daniel R Messroghli
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
- Department of Internal Medicine - Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
- Department of Cardiology, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| |
Collapse
|
25
|
Towards accurate and precise T 1 and extracellular volume mapping in the myocardium: a guide to current pitfalls and their solutions. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:143-163. [PMID: 28608328 PMCID: PMC5813078 DOI: 10.1007/s10334-017-0631-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/05/2017] [Accepted: 05/24/2017] [Indexed: 01/27/2023]
Abstract
Mapping of the longitudinal relaxation time (T1) and extracellular volume (ECV) offers a means of identifying pathological changes in myocardial tissue, including diffuse changes that may be invisible to existing T1-weighted methods. This technique has recently shown strong clinical utility for pathologies such as Anderson-Fabry disease and amyloidosis and has generated clinical interest as a possible means of detecting small changes in diffuse fibrosis; however, scatter in T1 and ECV estimates offers challenges for detecting these changes, and bias limits comparisons between sites and vendors. There are several technical and physiological pitfalls that influence the accuracy (bias) and precision (repeatability) of T1 and ECV mapping methods. The goal of this review is to describe the most significant of these, and detail current solutions, in order to aid scientists and clinicians to maximise the utility of T1 mapping in their clinical or research setting. A detailed summary of technical and physiological factors, issues relating to contrast agents, and specific disease-related issues is provided, along with some considerations on the future directions of the field.
Collapse
|
26
|
Fernandes JL, Fioravante LAB, Verissimo MP, Loggetto SR. A free software for the calculation of T2* values for iron overload assessment. Acta Radiol 2017; 58:698-701. [PMID: 27614069 DOI: 10.1177/0284185116666416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background Iron overload assessment with magnetic resonance imaging (MRI) using T2* has become a key diagnostic method in the management of many diseases. Quantitative analysis of the MRI images with a cost-effective tool has been a limitation to increased use of the method. Purpose To provide a free software solution for this purpose comparing the results with a commercial solution. Material and Methods The free tool was developed as a standalone program to be directly downloaded and ran in a common personal computer platform without the need of a dedicated workstation. Liver and cardiac T2* values were calculated using both tools and the values obtained compared between them in a group of 56 patients with suspected iron overload using Bland-Altman plots and concordance correlation coefficients (CCC). Results In the heart, the mean T2* differences between the two methods was 0.46 ms (95% confidence interval [CI], -0.037 -0.965) and in the liver 0.49 ms (95% CI, 0.257-0.722). The CCC for both the heart and the liver were significantly high (0.98 [95% CI, 0.966-0.988] with a Pearson ρ of 0.9811 and 0.991 [95% CI, 0.986-0.994] with a Pearson ρ of 0.996, respectively. No significant differences were observed when analyzing only patients with abnormal concentrations of iron in both organs compared to the whole cohort. Conclusion The proposed free software tool is accurate for calculation of T2* values of the liver and heart and might be a solution for centers that cannot use paid commercial solutions.
Collapse
|
27
|
Bradham WS, Bell SP, Adkisson DW, Smith HM, Harrell FE, Lawson MA, Ooi H, Sawyer DB, Kronenberg MW. Myocardial T1 Measurement Predicts Beneficial LV Remodeling After Long-Term Heart Failure Therapy. J Card Fail 2017; 23:262-265. [PMID: 27940336 PMCID: PMC5350022 DOI: 10.1016/j.cardfail.2016.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 11/09/2016] [Accepted: 11/23/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND The myocardial longitudinal relaxation time (T1) on cardiac magnetic resonance imaging (CMR) can quantify myocardial fibrosis in the presence or absence of visually detectable late gadolinium (Gd) enhancement (LGE). Mineralocorticoid receptor antagonist (MRA) treatment produces beneficial remodeling in nonischemic dilated cardiomyopathy (NIDCM). We assessed the hypothesis that interstitial myocardial fibrosis measured with the use of CMR predicts left ventricular (LV) beneficial remodeling in NIDCM after heart failure (HF) treatment including MRAs. METHODS AND RESULTS Twelve patients with NIDCM, on stable beta-blocker and angiotensin-converting enzyme inhibitor/angiotensin receptor-blocking therapy, were studied before and after 6-29 months of treatment with MRAs, by means of CMR assessment of LV structure, function, and T1 from standard Look-Locker sequences (T1LL). All patients had depressed cardiac function, dilated left ventricles, and no visual LGE. After adding MRA to HF treatment, the LV ejection fraction increased and the LV end-systolic volume index (LV end-systolic volume/m2) decreased in all patients (P < .0001). This this was inversely proportional to the baseline myocardial T1LL (r = -0.65; P = .02). CONCLUSION Myocardial T1LL, in the absence of visually detectable LGE, was quantitatively related to the degree of beneficial LV remodeling achieved in response to adding MRA to a HF regimen.
Collapse
Affiliation(s)
- William S Bradham
- Division of Cardiovascular Medicine and Department of Biostatistics, Vanderbilt University School of Medicine and the Cardiology Section, Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Susan P Bell
- Division of Cardiovascular Medicine and Department of Biostatistics, Vanderbilt University School of Medicine and the Cardiology Section, Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Douglas W Adkisson
- Division of Cardiovascular Medicine and Department of Biostatistics, Vanderbilt University School of Medicine and the Cardiology Section, Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Holly M Smith
- Division of Cardiovascular Medicine and Department of Biostatistics, Vanderbilt University School of Medicine and the Cardiology Section, Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Frank E Harrell
- Division of Cardiovascular Medicine and Department of Biostatistics, Vanderbilt University School of Medicine and the Cardiology Section, Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Mark A Lawson
- Division of Cardiovascular Medicine and Department of Biostatistics, Vanderbilt University School of Medicine and the Cardiology Section, Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Henry Ooi
- Division of Cardiovascular Medicine and Department of Biostatistics, Vanderbilt University School of Medicine and the Cardiology Section, Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Douglas B Sawyer
- Division of Cardiovascular Medicine and Department of Biostatistics, Vanderbilt University School of Medicine and the Cardiology Section, Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Marvin W Kronenberg
- Division of Cardiovascular Medicine and Department of Biostatistics, Vanderbilt University School of Medicine and the Cardiology Section, Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee.
| |
Collapse
|
28
|
A feasible and automatic free tool for T1 and ECV mapping. Phys Med 2017; 33:47-55. [DOI: 10.1016/j.ejmp.2016.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 10/28/2016] [Accepted: 12/04/2016] [Indexed: 11/22/2022] Open
|
29
|
Hagberg GE, Bause J, Ethofer T, Ehses P, Dresler T, Herbert C, Pohmann R, Shajan G, Fallgatter A, Pavlova MA, Scheffler K. Whole brain MP2RAGE-based mapping of the longitudinal relaxation time at 9.4T. Neuroimage 2017; 144:203-216. [DOI: 10.1016/j.neuroimage.2016.09.047] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 09/16/2016] [Accepted: 09/20/2016] [Indexed: 11/16/2022] Open
|
30
|
Bidhult S, Kantasis G, Aletras AH, Arheden H, Heiberg E, Hedström E. Validation of T1 and T2 algorithms for quantitative MRI: performance by a vendor-independent software. BMC Med Imaging 2016; 16:46. [PMID: 27501697 PMCID: PMC4977731 DOI: 10.1186/s12880-016-0148-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 07/28/2016] [Indexed: 11/26/2022] Open
Abstract
Background Determination of the relaxation time constants T1 and T2 with quantitative magnetic resonance imaging is increasingly used for both research and clinical practice. Recently, groups have been formed within the Society of Cardiovascular Magnetic Resonance to address issues with relaxometry. However, so far they have avoided specific recommendations on methodology due to lack of consensus and current evolving research. Standardised widely available software may simplify this process. The purpose of the current study was to develop and validate vendor-independent T1 and T2 mapping modules and implement those in the versatile and widespread software Segment, freely available for research and FDA approved for clinical applications. Results The T1 and T2 mapping modules were developed and validated in phantoms at 1.5 T and 3 T with reference standard values calculated from reference pulse sequences using the Nelder-Mead Simplex optimisation method. The proposed modules support current commonly available MRI pulse sequences and both 2- and 3-parameter curve fitting. Images acquired in patients using three major vendors showed vendor-independence. Bias and variability showed high agreement with T1 and T2 reference standards for T1 (range 214–1752 ms) and T2 (range 45–338 ms), respectively. Conclusions The developed and validated T1 and T2 mapping and quantification modules generated relaxation maps from current commonly used MRI sequences and multiple signal models. Patient applications showed usability for three major vendors.
Collapse
Affiliation(s)
- Sebastian Bidhult
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden.,Department of Biomedical Engineering, Faculty of Engineering, Lund University, Lund, Sweden
| | - George Kantasis
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden.,Laboratory of Medical Informatics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anthony H Aletras
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden.,Laboratory of Medical Informatics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Håkan Arheden
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Einar Heiberg
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden.,Department of Biomedical Engineering, Faculty of Engineering, Lund University, Lund, Sweden
| | - Erik Hedström
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skane University Hospital, Lund, Sweden. .,Department of Clinical Sciences Lund, Diagnostic Radiology, Lund University, Skane University Hospital, Lund, Sweden.
| |
Collapse
|
31
|
Montgomery JA, Abdallah W, Yoneda ZT, Brittain E, Aznaurov SG, Parvez B, Adkins K, Whalen SP, Estrada J, Shen S, Crossley GH, Kanagasundram A, Saavedra P, Ellis CR, Lawson M, Darbar D, Shoemaker MB. Measurement of diffuse ventricular fibrosis with myocardial T1 in patients with atrial fibrillation. J Arrhythm 2016; 32:51-6. [PMID: 26949431 PMCID: PMC4759117 DOI: 10.1016/j.joa.2015.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 08/11/2015] [Accepted: 08/24/2015] [Indexed: 11/19/2022] Open
Abstract
Background Atrial fibrillation (AF) is associated with cardiac fibrosis, which can now be measured noninvasively using T1-mapping with cardiac magnetic resonance imaging (CMRI). This study aimed to assess the impact of AF on ventricular T1 at the time of CMRI. Methods Subjects with AF scheduled for AF ablation underwent CMRI with standard electrocardiography gating and breath-hold protocols on a 1.5 T scanner with post-contrast ventricular T1 recorded from 6 regions of interest at the mid-ventricle. Baseline demographic, clinical, and imaging characteristics were examined using univariate and multivariable linear regression modeling for an association with myocardial T1. Results One hundred fifty-seven patients were studied (32% women; median age, 61 years [interquartile range {IQR}, 55–67], 50% persistent AF [episodes>7 days or requiring electrical or pharmacologic cardioversion], 30% in AF at the time of the CMRI). The median global T1 was 404 ms (IQR, 381–428). AF at the time of CMRI was associated with a 4.4% shorter T1 (p=0.000) compared to sinus rhythm when adjusted for age, sex, persistent AF, body mass index, congestive heart failure, and renal dysfunction (estimated glomerular filtration rate<60). A post-hoc multivariate model adjusted for heart rate suggested that heart rate elevation (p=0.009) contributes to the reduction in T1 observed in patients with AF at the time of CMRI. No association between ventricular T1 and AF recurrence after ablation was demonstrated. Conclusion AF at the time of CMRI was associated with lower post-contrast ventricular T1 compared with sinus rhythm. This effect was at least partly due to elevated heart rate. T1 was not associated with the recurrence of AF after ablation.
Collapse
Affiliation(s)
- Jay A. Montgomery
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
- Correspondence to: Division of Cardiovascular Medicine, Vanderbilt University, 383 PRB, 2200 Pierce Avenue, Nashville, TN 37232-6300, USA. Tel.: +1 785 577 4575.
| | - Wissam Abdallah
- Spectrum Health Medical Group, 2900 Bradford St NE, Grand Rapids, MI 49525, USA
| | - Zachary T. Yoneda
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Evan Brittain
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Sam G. Aznaurov
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Babar Parvez
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Keith Adkins
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - S. Patrick Whalen
- Wake Forest Baptist Health Cardiology, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - J.C. Estrada
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Sharon Shen
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - George H. Crossley
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Arvindh Kanagasundram
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Pablo Saavedra
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Christopher R. Ellis
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Mark Lawson
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Dawood Darbar
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - M. Benjamin Shoemaker
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| |
Collapse
|
32
|
Schelbert EB, Messroghli DR. State of the Art: Clinical Applications of Cardiac T1 Mapping. Radiology 2016; 278:658-76. [DOI: 10.1148/radiol.2016141802] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
33
|
Kockova R, Kacer P, Pirk J, Maly J, Sukupova L, Sikula V, Kotrc M, Barciakova L, Honsova E, Maly M, Kautzner J, Sedmera D, Penicka M. Native T1 Relaxation Time and Extracellular Volume Fraction as Accurate Markers of Diffuse Myocardial Fibrosis in Heart Valve Disease – Comparison With Targeted Left Ventricular Myocardial Biopsy –. Circ J 2016; 80:1202-9. [DOI: 10.1253/circj.cj-15-1309] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Radka Kockova
- Department of Cardiology, Institute for Clinical and Experimental Medicine
- Institute of Physiology, Academy of Sciences of the Czech Republic
| | - Petr Kacer
- Department of Cardiothoracic Surgery, Institute for Clinical and Experimental Medicine
| | - Jan Pirk
- Department of Cardiothoracic Surgery, Institute for Clinical and Experimental Medicine
| | - Jiri Maly
- Department of Cardiothoracic Surgery, Institute for Clinical and Experimental Medicine
| | - Lucie Sukupova
- Department of Cardiology, Institute for Clinical and Experimental Medicine
| | - Viktor Sikula
- Department of Cardiology, Institute for Clinical and Experimental Medicine
| | - Martin Kotrc
- Department of Cardiology, Institute for Clinical and Experimental Medicine
| | - Lucia Barciakova
- Department of Cardiothoracic Surgery, Institute for Clinical and Experimental Medicine
| | - Eva Honsova
- Clinical and Transplant Pathology Department, Institute for Clinical and Experimental Medicine
| | | | - Josef Kautzner
- Department of Cardiology, Institute for Clinical and Experimental Medicine
| | - David Sedmera
- First Faculty of Medicine, Institute of Anatomy, Charles University in Prague
- Institute of Physiology, Academy of Sciences of the Czech Republic
| | | |
Collapse
|
34
|
Alam MH, Auger D, Smith GC, He T, Vassiliou V, Baksi AJ, Wage R, Drivas P, Feng Y, Firmin DN, Pennell DJ. T1 at 1.5T and 3T compared with conventional T2* at 1.5T for cardiac siderosis. J Cardiovasc Magn Reson 2015; 17:102. [PMID: 26602203 PMCID: PMC4659152 DOI: 10.1186/s12968-015-0207-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 11/16/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Myocardial black blood (BB) T2* relaxometry at 1.5T provides robust, reproducible and calibrated non-invasive assessment of cardiac iron burden. In vitro data has shown that like T2*, novel native Modified Look-Locker Inversion recovery (MOLLI) T1 shortens with increasing tissue iron. The relative merits of T1 and T2* are largely unexplored. We compared the established 1.5T BB T2* technique against native T1 values at 1.5T and 3T in iron overload patients and in normal volunteers. METHODS A total of 73 subjects (42 male) were recruited, comprising 20 healthy volunteers (controls) and 53 patients (thalassemia major 22, sickle cell disease 9, hereditary hemochromatosis 9, other iron overload conditions 13). Single mid-ventricular short axis slices were acquired for BB T2* at 1.5T and MOLLI T1 quantification at 1.5T and 3T. RESULTS In healthy volunteers, median T1 was 1014 ms (full range 939-1059 ms) at 1.5T and modestly increased to 1165ms (full range 1056-1224 ms) at 3T. All patients with significant cardiac iron overload (1.5T T2* values <20 ms) had T1 values <939 ms at 1.5T, and <1056 ms at 3T. Associations between T2* and T1 were found to be moderate with y =377 · x(0.282) at 1.5T (R(2) = 0.717), and y =406 · x(0.294) at 3T (R(2) = 0.715). Measures of reproducibility of T1 appeared superior to T2*. CONCLUSIONS T1 mapping at 1.5T and at 3T can identify individuals with significant iron loading as defined by the current gold standard T2* at 1.5T. However, there is significant scatter between results which may reflect measurement error, but it is also possible that T1 interacts with T2*, or is differentially sensitive to aspects of iron chemistry or other biology. Hurdles to clinical implementation of T1 include the lack of calibration against human myocardial iron concentration, no demonstrated relation to cardiac outcomes, and variation in absolute T1 values between scanners, which makes inter-centre comparisons difficult. The relative merits of T1 at 3T versus T2* at 3T require further consideration.
Collapse
Affiliation(s)
- Mohammed H Alam
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
- Imperial College London, London, UK.
| | - Dominique Auger
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
- Imperial College London, London, UK.
| | - Gillian C Smith
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
- Imperial College London, London, UK.
| | - Taigang He
- St George's, University of London, London, UK.
| | - Vassilis Vassiliou
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
- Imperial College London, London, UK.
| | - A John Baksi
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
- Imperial College London, London, UK.
| | - Rick Wage
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
| | - Peter Drivas
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China.
| | - David N Firmin
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
- Imperial College London, London, UK.
| | - Dudley J Pennell
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
- Imperial College London, London, UK.
| |
Collapse
|
35
|
Rudolph A, Messroghli D, von Knobelsdorff-Brenkenhoff F, Traber J, Schüler J, Wassmuth R, Schulz-Menger J. Prospective, randomized comparison of gadopentetate and gadobutrol to assess chronic myocardial infarction applying cardiovascular magnetic resonance. BMC Med Imaging 2015; 15:55. [PMID: 26576944 PMCID: PMC4650341 DOI: 10.1186/s12880-015-0099-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 11/09/2015] [Indexed: 01/20/2023] Open
Abstract
Background We hypothesized that the contrast medium gadobutrol is not inferior compared to Gd-DTPA in identifying and quantifying ischemic late gadolinium enhancement (LGE), even by using a lower dose. Methods We prospectively enrolled 30 patients with chronic myocardial infarction as visualized by LGE during clinical routine scan at 1.5 T with 0.20 mmol/kg Gd-DTPA. Participants were randomized to either 0.15 mmol/kg gadobutrol (group A) or 0.10 mmol/kg gadobutrol (group B). CMR protocol was identical in both exams. LGE was quantified using a semiautomatic approach. Signal intensities of scar, remote myocardium, blood and air were measured. Signal to noise (SNR) and contrast to noise ratios (CNR) were calculated. Results Signal intensities were not different between Gd-DTPA and gadobutrol in group A, whereas significant differences were detected in group B. SNR of injured myocardium (53.5+/−21.4 vs. 30.1+/−10.4, p = 0.0001) and CNR between injured and remote myocardium (50.3+/−20.3 vs. 27.3+/−9.3, p < 0.0001) were lower in gadobutrol. Infarct size was lower in both gadobutrol groups compared to Gd-DTPA (group A: 16.8+/−10.2 g vs. 12.8+/−6.8 g, p = 0.03; group B: 18.6+/−12.0 g vs. 14.0+/−9.9 g, p = 0.0016). Conclusions Taking application of 0.2 mmol/kg Gd-DTPA as the reference, the delineation of infarct scar was similar with 0.15 mmol/kg gadobutrol, whereas the use 0.10 mmol/kg gadobutrol led to reduced tissue contrast. Trial registration The study had been registered under EudraCT Number: 2010-020775-22. Registration date: 2010.08.10
Collapse
Affiliation(s)
- Andre Rudolph
- Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. .,Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
| | - Daniel Messroghli
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
| | - Florian von Knobelsdorff-Brenkenhoff
- Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. .,Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
| | - Julius Traber
- Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. .,Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
| | - Johannes Schüler
- Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. .,Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
| | - Ralf Wassmuth
- Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. .,Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
| | - Jeanette Schulz-Menger
- Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. .,Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
| |
Collapse
|
36
|
Varga-Szemes A, Muscogiuri G, Schoepf UJ, De Cecco CN, Wichmann JL, Mangold S, Caruso D, Fuller SR, Spottiswoode BS, van der Geest RJ, Suranyi P. Overview of Myocardial T1 Mapping Applications. CURRENT RADIOLOGY REPORTS 2015. [DOI: 10.1007/s40134-015-0114-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
37
|
Nucifora G, Muser D, Gianfagna P, Morocutti G, Proclemer A. Systolic and diastolic myocardial mechanics in hypertrophic cardiomyopathy and their link to the extent of hypertrophy, replacement fibrosis and interstitial fibrosis. Int J Cardiovasc Imaging 2015. [PMID: 26210792 DOI: 10.1007/s10554-015-0720-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Aim of the present study was to investigate the relations between myocardial mechanics and the extent of hypertrophy and fibrosis in hypertrophic cardiomyopathy (HCM). Forty-five consecutive patients with HCM and 15 subjects without structural heart disease were included. Cardiac magnetic resonance with late gadolinium enhancement (LGE) imaging was performed to evaluate biventricular function, LV mass index and presence/extent of LGE, expression of replacement fibrosis. Myocardial T1 relaxation, a surrogate of interstitial fibrosis, was measured from Look-Locker sequence. Feature-tracking analysis was applied to LV basal, mid and apical short-axis images to assess systolic and diastolic global LV circumferential strain (CS) and strain rate (CSr). Peak systolic CS and CSr were significantly higher among HCM patients as compared to control subjects (p = 0.015 and p = 0.007, respectively). The ratio of peak CSr during early filling to peak systolic CSr was significantly lower among HCM patients (p = 0.002). At multivariate linear regression analysis, LV mass index (p < 0.001) and %LV LGE (p = 0.011) were significantly and independently related to peak systolic CS; LV mass index (p < 0.001) and %LV LGE (p = 0.023) were significantly and independently related to peak systolic CSr; %LV LGE (p = 0.021) and T1 ratio (p = 0.006) were significantly and independently related to the ratio of peak CSr during early filling to peak systolic CSr. LV systolic mechanics are enhanced and LV diastolic mechanics are impaired in HCM. Extent of hypertrophy and replacement fibrosis influence the LV systolic mechanics while extent of replacement fibrosis and interstitial fibrosis influence the LV diastolic mechanics.
Collapse
Affiliation(s)
- Gaetano Nucifora
- Division of Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Udine, Italy.
| | - Daniele Muser
- Division of Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Udine, Italy
| | - Pasquale Gianfagna
- Division of Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Udine, Italy
| | - Giorgio Morocutti
- Division of Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Udine, Italy
| | - Alessandro Proclemer
- Division of Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Udine, Italy
| |
Collapse
|
38
|
Hamlin SA, Henry TS, Little BP, Lerakis S, Stillman AE. Mapping the future of cardiac MR imaging: case-based review of T1 and T2 mapping techniques. Radiographics 2015; 34:1594-611. [PMID: 25310419 DOI: 10.1148/rg.346140030] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Cardiac magnetic resonance (MR) imaging has grown over the past several decades into a validated, noninvasive diagnostic imaging tool with a pivotal role in cardiac morphologic and functional assessment and tissue characterization. With traditional cardiac MR imaging sequences, assessment of various pathologic conditions ranging from ischemic and nonischemic cardiomyopathy to cardiac involvement in systemic diseases (eg, amyloidosis and sarcoidosis) is possible; however, these sequences are most useful in focal myocardial disease, and image interpretation relies on subjective qualitative analysis of signal intensity. Newer T1 and T2 myocardial mapping techniques offer a quantitative assessment of the myocardium (by using T1 and T2 relaxation times), which can be helpful in focal disease, and demonstrate special utility in the evaluation of diffuse myocardial disease (eg, edema and fibrosis). Altered T1 and T2 relaxation times in disease states can be compared with published ranges of normal relaxation times in healthy patients. In conjunction with traditional cardiac MR imaging sequences, T1 and T2 mapping can limit the interpatient and interstudy variability that are common with qualitative analysis and may provide clinical markers for long-term follow-up.
Collapse
Affiliation(s)
- Scott A Hamlin
- From the Department of Radiology and Imaging Sciences, Division of Cardiothoracic Imaging (S.A.H., T.S.H., B.P.L., A.E.S.), and Department of Cardiology (S.L.), Emory University School of Medicine, 1364 Clifton Rd NE, Room D125A, Atlanta, GA 30322
| | | | | | | | | |
Collapse
|
39
|
de Meester de Ravenstein C, Bouzin C, Lazam S, Boulif J, Amzulescu M, Melchior J, Pasquet A, Vancraeynest D, Pouleur AC, Vanoverschelde JLJ, Gerber BL. Histological Validation of measurement of diffuse interstitial myocardial fibrosis by myocardial extravascular volume fraction from Modified Look-Locker imaging (MOLLI) T1 mapping at 3 T. J Cardiovasc Magn Reson 2015; 17:48. [PMID: 26062931 PMCID: PMC4464705 DOI: 10.1186/s12968-015-0150-0] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 05/18/2015] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Gadolinium (Gd) Extracellular volume fraction (ECV) by Cardiovascular Magnetic Resonance (CMR) has been proposed as a non-invasive method for assessment of diffuse myocardial fibrosis. Yet only few studies used 3 T CMR to measure ECV, and the accuracy of ECV measurements at 3 T has not been established. Therefore the aims of the present study were to validate measurement of ECV by MOLLI T1 mapping by 3 T CMR against fibrosis measured by histopathology. We also evaluated the recently proposed hypothesis that native-T1 mapping without contrast injection would be sufficient to detect fibrosis. METHODS 31 patients (age = 58 ± 17 years, 77% men) with either severe aortic stenosis (n = 12) severe aortic regurgitation (n = 9) or severe mitral regurgitation (n = 10), all free of coronary artery disease, underwent 3 T-CMR with late gadolinium enhancement (LGE) and pre- and post-contrast MOLLI T1 mapping and ECV computation, prior to valve surgery. LV biopsies were performed at the time of surgery, a median 13 [1-30] days later, and stained with picrosirius red. Pre-, and post-contrast T1 values, ECV, and amount of LGE were compared against magnitude of fibrosis by histopathology by Pearson correlation coefficients. RESULTS The average amount of interstitial fibrosis by picrosirius red staining in biopsy samples was 6.1 ± 4.3%. ECV computed from pre-post contrast MOLLI T1 time changes was 28.9 ± 5.5%, and correlated (r = 0.78, p < 0.001) strongly with the magnitude of histological fibrosis. By opposition, neither amount of LGE (r = 0.17, p = 0.36) nor native pre-contrast myocardial T1 time (r = -0.18, p = 0.32) correlated with fibrosis by histopathology. CONCLUSIONS ECV determined by 3 T CMR T1 MOLLI images closely correlates with histologically determined diffuse interstitial fibrosis, providing a non-invasive estimation for quantification of interstitial fibrosis in patients with valve diseases. By opposition, neither non-contrast T1 times nor the amount of LGE were indicative of the magnitude of diffuse interstitial fibrosis measured by histopathology.
Collapse
Affiliation(s)
- Christophe de Meester de Ravenstein
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - Caroline Bouzin
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - Siham Lazam
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - Jamila Boulif
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - Mihaela Amzulescu
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - Julie Melchior
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - Agnès Pasquet
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - David Vancraeynest
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - Anne-Catherine Pouleur
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - Jean-Louis J Vanoverschelde
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - Bernhard L Gerber
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10 / 2806, B-1200, Woluwe St. Lambert, Belgium.
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| |
Collapse
|
40
|
Wong AKO, Merali Z, Adachi JD. Development of a Skeletal Muscle Mimic Phantom Compatible with QCT and MR Imaging. J Med Imaging Radiat Sci 2015; 46:174-181. [PMID: 31052091 DOI: 10.1016/j.jmir.2014.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/30/2014] [Accepted: 10/01/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The purpose of this study was to develop a skeletal muscle mimic phantom compatible with quantitative computed tomography (QCT) and magnetic resonance imaging, yielding physiologically appropriate values. METHODS Agar-based phantoms contained varying concentrations of CuCl2 and EDTA to adjust T2 relaxation time and phantom density concurrently. T2 relaxation times were quantified using a 4-mm single-slice fast spin echo sequence repeated for six serial echo times at 937-μm resolution. T2 relaxation maps were generated using the Levenberg-Marquardt equation. A peripheral QCT scanner measured linear attenuation coefficients of phantoms, which were converted to density (mg/cm3) values. Five 2.3 ± 0.5 mm thick slices were acquired at 15 mm/s scan speed and 500-μm resolution. Logarithmic or linear regression models were fitted to EDTA or CuCl2 versus density and T2 relaxation data. RESULTS Density (D) was linearly dependent on CuCl2 (D = 0.27 [CuCl2] + 63.92, R2 = 0.84, P = 0.01) and invariant to EDTA. T2 relaxation time was related negatively to CuCl2 (T2 = -10.13 ln [CuCl2] + 66.70, R2 = 0.91, P < .01) and positively to EDTA (T2 = 5.72 ln [EDTA] + 54.47, R2 = 0.86, P < .01). Reproducibility within and between phantoms of the same compositions was acceptable (<5% error). Long-term stability was achieved for density but poorer for T2 relaxation time. CONCLUSIONS This phantom optimization method provides a means for altering a soft tissue phantom suited for calibrating magnetic resonance imaging and QCT signals within values representative of muscle. Phantoms can be used during scans for calibrating magnetic resonance signals between and within individuals over time and can cross-calibrate different scanners.
Collapse
Affiliation(s)
- Andy Kin On Wong
- Department of Medicine, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada; University Health Network, Osteoporosis Program, Toronto General Research Institute, Toronto, Ontario, Canada.
| | - Zamir Merali
- University Of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
| | - Jonathan D Adachi
- Department of Medicine, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
| |
Collapse
|
41
|
Positano V, Meloni A, Santarelli MF, Gerardi C, Bitti PP, Cirotto C, De Marchi D, Salvatori C, Landini L, Pepe A. Fast generation of T2⁎ maps in the entire range of clinical interest: Application to thalassemia major patients. Comput Biol Med 2015; 56:200-10. [DOI: 10.1016/j.compbiomed.2014.10.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 10/20/2014] [Accepted: 10/25/2014] [Indexed: 11/16/2022]
|
42
|
Soslow JH, Damon BM, Saville BR, Lu Z, Burnette WB, Lawson MA, Parra DA, Sawyer DB, Markham LW. Evaluation of post-contrast myocardial t1 in duchenne muscular dystrophy using cardiac magnetic resonance imaging. Pediatr Cardiol 2015; 36:49-56. [PMID: 25070387 PMCID: PMC4439095 DOI: 10.1007/s00246-014-0963-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 07/11/2014] [Indexed: 03/04/2023]
Abstract
The objective of the study was to perform a retrospective pilot study to evaluate the potential of myocardial T1 in assessment of Duchenne muscular dystrophy (DMD) cardiomyopathy. Early identification of DMD cardiac disease, particularly myocardial fibrosis, would allow earlier therapy, potentially improving outcomes. Shortened myocardial T1 measured by cardiac MRI (CMR) is a measure of cardiac fibrosis that may be detected before late gadolinium enhancement (LGE). We hypothesized that the post-contrast T1 obtained from the Look-Locker sequences (T1LL), an easily obtainable surrogate of myocardial T1, would be abnormally shortened in DMD compared with controls. T1LL measurement was performed on 21 DMD subjects and 11 controls; to account for individual variations in gadolinium distribution, myocardial T1LL was divided by blood pool T1LL, deriving T1LL ratios. DMD subjects had shorter mean T1LL ratio than controls (1.42 vs 1.72, p < 0.001). Subset analyses in DMD subjects with normal LVEF and without LGE also demonstrated significantly shorter T1LL ratio (-0.28, p < 0.001 and -0.25, p = 0.028). Post-contrast T1LL ratio is abnormally shortened in DMD compared with controls, even in DMD patients with otherwise normal CMRs. The application of more aggressive therapy for those with shorter T1LL may favorably alter morbidity and improve mortality associated with DMD cardiomyopathy. These data suggest that further prospective evaluation of myocardial T1 will be of benefit to patients with DMD.
Collapse
Affiliation(s)
- Jonathan H. Soslow
- Department of Pediatrics, Division of Pediatric Cardiology, Vanderbilt University Medical Center
| | - Bruce M. Damon
- Departments of Radiology and Radiological Sciences, Molecular Physiology and Biophysics, and Biomedical Engineering, Vanderbilt University Medical Center
| | | | - Zengqi Lu
- Department of Biostatistics, Vanderbilt University Medical Center
| | | | - Mark A. Lawson
- Department of Medicine, Division of Cardiology, Vanderbilt University Medical Center
| | - David A. Parra
- Department of Pediatrics, Division of Pediatric Cardiology, Vanderbilt University Medical Center
| | - Douglas B. Sawyer
- Department of Medicine, Division of Cardiology, Vanderbilt University Medical Center
| | - Larry W. Markham
- Departments of Medicine and Pediatrics, Divisions of Cardiology, Vanderbilt University Medical Center
| |
Collapse
|
43
|
Abstract
T(1) mapping of the heart has evolved into a valuable tool to evaluate myocardial tissue properties, with or without contrast injection, including assessment of myocardial edema and free water content, extracellular volume (expansion), and most recently cardiomyocyte hypertrophy. The magnetic resonance imaging pulse sequence techniques developed for these applications have had to address at least 2 important considerations for cardiac applications: measure magnetization-inversion recoveries during cardiac motion with sufficient temporal resolution for the shortest expected T(1) values, and, second, obtain these measurements within a time during which a patient can comfortably suspend breathing. So-called Look-Locker techniques, and variants thereof, which all sample multiple points of a magnetization recovery after each magnetization preparation, have therefore become a mainstay in this field. The rapid pace of advances and new findings based on cardiac T(1) mapping for assessment of diffuse fibrosis or myocardial edema show that these techniques enrich the capabilities of magnetic resonance imaging for myocardial tissue profiling, which is arguably unmatched by other cardiac imaging modalities.
Collapse
|
44
|
aus dem Siepen F, Buss SJ, Messroghli D, Andre F, Lossnitzer D, Seitz S, Keller M, Schnabel PA, Giannitsis E, Korosoglou G, Katus HA, Steen H. T1 mapping in dilated cardiomyopathy with cardiac magnetic resonance: quantification of diffuse myocardial fibrosis and comparison with endomyocardial biopsy. Eur Heart J Cardiovasc Imaging 2014; 16:210-6. [DOI: 10.1093/ehjci/jeu183] [Citation(s) in RCA: 182] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
|
45
|
Global T2 versus water T2 in NMR imaging of fatty infiltrated muscles: different methodology, different information, and different implications. Neuromuscul Disord 2014; 24:1120-1. [PMID: 25153266 DOI: 10.1016/j.nmd.2014.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 07/14/2014] [Indexed: 11/20/2022]
|
46
|
Thuny F, Lovric D, Schnell F, Bergerot C, Ernande L, Cottin V, Derumeaux G, Croisille P. Quantification of Myocardial Extracellular Volume Fraction with Cardiac MR Imaging for Early Detection of Left Ventricle Involvement in Systemic Sclerosis. Radiology 2014; 271:373-80. [DOI: 10.1148/radiol.13131280] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
47
|
Brouwer WP, Baars EN, Germans T, de Boer K, Beek AM, van der Velden J, van Rossum AC, Hofman MBM. In-vivo T1 cardiovascular magnetic resonance study of diffuse myocardial fibrosis in hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 2014; 16:28. [PMID: 24766828 PMCID: PMC4026831 DOI: 10.1186/1532-429x-16-28] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 03/17/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND In hypertrophic cardiomyopathy (HCM), autopsy studies revealed both increased focal and diffuse deposition of collagen fibers. Late gadolinium enhancement imaging (LGE) detects focal fibrosis, but is unable to depict interstitial fibrosis. We hypothesized that with T1 mapping, which is employed to determine the myocardial extracellular volume fraction (ECV), can detect diffuse interstitial fibrosis in HCM patients. METHODS T1 mapping with a modified Look-Locker Inversion Recovery (MOLLI) pulse sequence was used to calculate ECV in manifest HCM (n = 16) patients and in healthy controls (n = 14). ECV was determined in areas where focal fibrosis was excluded with LGE. RESULTS The total group of HCM patients showed no significant changes in mean ECV values with respect to controls (0.26 ± 0.03 vs 0.26 ± 0.02, p = 0.83). Besides, ECV in LGE positive HCM patients was comparable with LGE negative HCM patients (0.27 ± 0.03 vs 0.25 ± 0.03, p = 0.12). CONCLUSIONS This study showed that HCM patients have a similar ECV (e.g. interstitial fibrosis) in myocardium without LGE as healthy controls. Therefore, the additional clinical value of T1 mapping in HCM seems limited, but future larger studies are needed to establish the clinical and prognostic potential of this new technique within HCM.
Collapse
Affiliation(s)
- Wessel P Brouwer
- Department of Cardiology, ICaR-VU, VU University Medical Center, De Boelelaan 1117, Amsterdam 1081 HV, the Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands
| | - Emma N Baars
- Department of Cardiology, ICaR-VU, VU University Medical Center, De Boelelaan 1117, Amsterdam 1081 HV, the Netherlands
- Department of Physics and Medical Technology, ICaR-VU, VU University Medical Center, Amsterdam, the Netherlands
| | - Tjeerd Germans
- Department of Cardiology, ICaR-VU, VU University Medical Center, De Boelelaan 1117, Amsterdam 1081 HV, the Netherlands
| | - Karin de Boer
- Department of Cardiology, ICaR-VU, VU University Medical Center, De Boelelaan 1117, Amsterdam 1081 HV, the Netherlands
| | - Aernout M Beek
- Department of Cardiology, ICaR-VU, VU University Medical Center, De Boelelaan 1117, Amsterdam 1081 HV, the Netherlands
| | - Jolanda van der Velden
- Department of Physiology, ICaR-VU, VU University Medical Center, Amsterdam, the Netherlands
| | - Albert C van Rossum
- Department of Cardiology, ICaR-VU, VU University Medical Center, De Boelelaan 1117, Amsterdam 1081 HV, the Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands
| | - Mark BM Hofman
- Department of Physics and Medical Technology, ICaR-VU, VU University Medical Center, Amsterdam, the Netherlands
| |
Collapse
|
48
|
Stuckey DJ, McSweeney SJ, Thin MZ, Habib J, Price AN, Fiedler LR, Gsell W, Prasad SK, Schneider MD. T₁ mapping detects pharmacological retardation of diffuse cardiac fibrosis in mouse pressure-overload hypertrophy. Circ Cardiovasc Imaging 2014; 7:240-9. [PMID: 24425501 DOI: 10.1161/circimaging.113.000993] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Diffuse interstitial fibrosis is present in diverse cardiomyopathies and associated with poor prognosis. We investigated whether magnetic resonance imaging-based T1 mapping could quantify the induction and pharmacological suppression of diffuse cardiac fibrosis in murine pressure-overload hypertrophy. METHODS AND RESULTS Mice were subjected to transverse aortic constriction or sham surgery. The angiotensin receptor blocker losartan was given to half the animals. Cine-magnetic resonance imaging performed at 7 and 28 days showed hypertrophy and remodeling and systolic and diastolic dysfunction in transverse aortic constriction groups as expected. Late gadolinium-enhanced magnetic resonance imaging revealed focal signal enhancement at the inferior right ventricular insertion point of transverse aortic constriction mice concordant with the foci of fibrosis in histology. The extracellular volume fraction, calculated from pre- and postcontrast T1 measurements, was elevated by transverse aortic constriction and showed direct linear correlation with picrosirius red collagen volume fraction, thus confirming the suitability of extracellular volume fraction as an in vivo measure of diffuse fibrosis. Treatment with losartan reduced left ventricular dysfunction and prevented increased extracellular volume fraction, indicating that T1 mapping is sensitive to pharmacological prevention of fibrosis. CONCLUSIONS Magnetic resonance imaging can detect diffuse and focal cardiac fibrosis in a clinically relevant animal model of pressure overload and is sensitive to pharmacological reduction of fibrosis by angiotensin receptor blockade. Thus, T1 mapping can be used to assess antifibrotic therapeutic strategies.
Collapse
Affiliation(s)
- Daniel J Stuckey
- British Heart Foundation Centre of Research Excellence, National Heart and Lung Institute
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Lindgren E, Wirestam R, Markenroth Bloch K, Ahlgren A, van Osch MJP, van Westen D, Surova Y, Ståhlberg F, Knutsson L. Absolute quantification of perfusion by dynamic susceptibility contrast MRI using Bookend and VASO steady-state CBV calibration: a comparison with pseudo-continuous ASL. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2014; 27:487-99. [PMID: 24570336 DOI: 10.1007/s10334-014-0431-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 12/09/2013] [Accepted: 01/10/2014] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Dynamic susceptibility contrast MRI (DSC-MRI) tends to return elevated estimates of cerebral blood flow (CBF) and cerebral blood volume (CBV). In this study, subject-specific calibration factors (CFs), based on steady-state CBV measurements, were applied to rescale the absolute level of DSC-MRI CBF. MATERIALS AND METHODS Twenty healthy volunteers were scanned in a test-retest approach. Independent CBV measurements for calibration were accomplished using a T1-based contrast agent steady-state method (referred to as Bookend), as well as a blood-nulling vascular space occupancy (VASO) approach. Calibrated DSC-MRI was compared with pseudo-continuous arterial spin labeling (pCASL). RESULTS For segmented grey matter (GM) regions of interests (ROIs), pCASL-based CBF was 63 ± 11 ml/(min 100 g) (mean ± SD). Nominal CBF from non-calibrated DSC-MRI was 277 ± 61 ml/(min 100 g), while calibrations resulted in 56 ± 23 ml/(min 100 g) (Bookend) and 52 ± 16 ml/(min 100 g) (VASO). Calibration tended to eliminate the overestimation, although the repeatability was generally moderate and the correlation between calibrated DSC-MRI and pCASL was low (r < 0.25). However, using GM instead of WM ROIs for extraction of CFs resulted in improved repeatability. CONCLUSION Both calibration approaches provided reasonable absolute levels of GM CBF, although the calibration methods suffered from low signal-to-noise ratio, resulting in weak repeatability and difficulties in showing high degrees of correlation with pCASL measurements.
Collapse
Affiliation(s)
- Emelie Lindgren
- Department of Medical Radiation Physics, Lund University, Lund University Hospital, 22185, Lund, Sweden,
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Meloni A, Rienhoff HY, Jones A, Pepe A, Lombardi M, Wood JC. Cardiac R2* values are independent of the image analysis approach employed. Magn Reson Med 2013; 72:485-91. [PMID: 24123261 DOI: 10.1002/mrm.24942] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 07/29/2013] [Accepted: 08/15/2013] [Indexed: 01/19/2023]
Abstract
PURPOSE To determine whether systematic differences were present between myocardial R2* values obtained with two different decay models: truncation and exponential + constant (Exp-C). METHODS Single-center cohorts were used to compare black and bright blood sequences separately, and a multicenter cohort of mixed bright and black blood studies was used to assess the generalizability. Truncated exponential estimates were calculated with CMRtools, which uses a single region of interest (ROI) method. Exp-C estimates were calculated using a pixelwise approach. RESULTS No differences could be distinguished based upon whether a white or black blood sequence was examined. The two fitting algorithms yielded similar R2* values, with R-squared values exceeding 0.997 and a coefficient of variation of 3% to 4%. Results using the pixelwise method yielded a small systematic bias (∼3%) that became apparent in patients with severe iron deposition. This disparity disappeared when Exp-C fitting was used on a single ROI, suggesting that the use of pixelwise mapping was responsible for the bias. In the multicenter cohort, the strong agreement between the two fitting approaches was reconfirmed. CONCLUSION Cardiac R2* values are independent of the signal model used for its calculation over clinically relevant ranges. Clinicians can compare results among centers using these disparate approaches with confidence.
Collapse
Affiliation(s)
- Antonella Meloni
- CMR Unit, Fondazione G. Monasterio CNR-Regione Toscana and Institute of Clinical Physiology, Pisa, Italy; Division of Cardiology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
| | | | | | | | | | | |
Collapse
|