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Wang K, Zhang Y, Zhang W, Jin H, An J, Cheng J, Zheng J. Role of endogenous T1ρ and its dispersion imaging in differential diagnosis of cardiac amyloidosis. J Cardiovasc Magn Reson 2024; 26:101080. [PMID: 39127261 PMCID: PMC11422604 DOI: 10.1016/j.jocmr.2024.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 07/08/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) has demonstrated excellent performance in the diagnosis of cardiac amyloidosis (CA). However, misdiagnosis occasionally occurs because the morphological and functional features of CA are non-specific. This study was performed to determine the value of non-contrast CMR T1ρ in the diagnosis of CA. METHODS This prospective study included 45 patients with CA, 30 patients with hypertrophic cardiomyopathy (HCM), and 10 healthy controls (HCs). All participants underwent cine (whole heart), T1ρ mapping, pre- and post-contrast T1 mapping imaging (three slices), and late gadolinium enhancement using a 3T whole-body magnetic resonance imaging system. All participants underwent T1ρ at two spin-locking frequencies: 0 and 298 Hz. Extracellular volume (ECV) maps were obtained using pre- and post-contrast T1 maps. The myocardial T1ρ dispersion map, termed myocardial dispersion index (MDI), was also calculated. All parameters were measured in the left ventricular myocardial wall. Participants in the HC group were scanned twice on different days to assess the reproducibility of T1ρ measurements. RESULTS Excellent reproducibility was observed upon evaluation of the coefficient of variation between two scans (T1ρ [298 Hz]: 3.1%; T1ρ [0 Hz], 2.5%). The ECV (HC: 27.4 ± 2.8% vs HCM: 32.6 ± 5.8% vs CA: 46 ± 8.9%; p < 0.0001), T1ρ [0 Hz] (HC: 35.8 ± 1.7 ms vs HCM: 40.0 ± 4.5 ms vs CA: 51.4 ± 4.4 ms; p < 0.0001) and T1ρ [298 Hz] (HC: 41.9 ± 1.6 ms vs HCM: 48.8 ± 6.2 ms vs CA: 54.4 ± 5.2 ms; p < 0.0001) progressively increased from the HC group to the HCM group, and then the CA group. The MDI progressively decreased from the HCM group to the HC group, and then the CA group (HCM: 8.8 ± 2.8 ms vs HC: 6.1 ± 0.9 ms vs CA: 3.4 ± 2.1 ms; p < 0.0001). For differential diagnosis, the combination of MDI and T1ρ [298 Hz] showed the greatest sensitivity (98.3%) and specificity (95.5%) between CA and HCM, compared with the native T1 and ECV. CONCLUSION The T1ρ and MDI approaches can be used as non-contrast CMR imaging biomarkers to improve the differential diagnosis of patients with CA.
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Affiliation(s)
- Keyan Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenbo Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongrui Jin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing An
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Jingliang Cheng
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri, USA.
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2
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Youssef K, Zhang X, Yoosefian G, Chen Y, Chan SF, Yang HJ, Vora K, Howarth A, Kumar A, Sharif B, Dharmakumar R. Enabling Reliable Visual Detection of Chronic Myocardial Infarction with Native T1 Cardiac MRI Using Data-Driven Native Contrast Mapping. Radiol Cardiothorac Imaging 2024; 6:e230338. [PMID: 39023374 PMCID: PMC11369652 DOI: 10.1148/ryct.230338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 05/05/2024] [Accepted: 05/30/2024] [Indexed: 07/20/2024]
Abstract
Purpose To investigate whether infarct-to-remote myocardial contrast can be optimized by replacing generic fitting algorithms used to obtain native T1 maps with a data-driven machine learning pixel-wise approach in chronic reperfused infarct in a canine model. Materials and Methods A controlled large animal model (24 canines, equal male and female animals) of chronic myocardial infarction with histologic evidence of heterogeneous infarct tissue composition was studied. Unsupervised clustering techniques using self-organizing maps and t-distributed stochastic neighbor embedding were used to analyze and visualize native T1-weighted pixel-intensity patterns. Deep neural network models were trained to map pixel-intensity patterns from native T1-weighted image series to corresponding pixels on late gadolinium enhancement (LGE) images, yielding visually enhanced noncontrast maps, a process referred to as data-driven native mapping (DNM). Pearson correlation coefficients and Bland-Altman analyses were used to compare findings from the DNM approach against standard T1 maps. Results Native T1-weighted images exhibited distinct pixel-intensity patterns between infarcted and remote territories. Granular pattern visualization revealed higher infarct-to-remote cluster separability with LGE labeling as compared with native T1 maps. Apparent contrast-to-noise ratio from DNM (mean, 15.01 ± 2.88 [SD]) was significantly different from native T1 maps (5.64 ± 1.58; P < .001) but similar to LGE contrast-to-noise ratio (15.51 ± 2.43; P = .40). Infarcted areas based on LGE were more strongly correlated with DNM compared with native T1 maps (R2 = 0.71 for native T1 maps vs LGE; R2 = 0.85 for DNM vs LGE; P < .001). Conclusion Native T1-weighted pixels carry information that can be extracted with the proposed DNM approach to maximize image contrast between infarct and remote territories for enhanced visualization of chronic infarct territories. Keywords: Chronic Myocardial Infarction, Cardiac MRI, Data-Driven Native Contrast Mapping Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Khalid Youssef
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
| | - Xinheng Zhang
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
| | - Ghazal Yoosefian
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
| | - Yinyin Chen
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
| | - Shing Fai Chan
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
| | - Hsin-Jung Yang
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
| | - Keyur Vora
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
| | - Andrew Howarth
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
| | - Andreas Kumar
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
| | - Behzad Sharif
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
| | - Rohan Dharmakumar
- From the Krannert Cardiovascular Research Center, Indiana University
School of Medicine, IU Health Cardiovascular Institute, 1700 N Capitol Ave,
E316, Indianapolis, IN 46202-1228 (K.Y., X.Z., G.Y., S.F.C., K.V., B.S., R.D.);
University of California Los Angeles, Los Angeles, Calif (X.Z.); Zhongshan
Hospital, Fudan University, Shanghai, China (Y.C.); Cedars-Sinai Medical Center,
Los Angeles, Calif (H.J.Y.); Libin Cardiovascular Institute of Alberta,
University of Calgary, Alberta, Canada (A.H.); and Northern Ontario School of
Medicine University, Sudbury, Canada (A.K.)
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3
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de Villedon de Naide V, Narceau K, Ozenne V, Villegas-Martinez M, Nogues V, Brillet N, Huiyue Zhang J, Benlala I, Stuber M, Cochet H, Bustin A. Advanced Myocardial MRI Tissue Characterization Combining Contrast Agent-Free T1-Rho Mapping With Fully Automated Analysis. J Magn Reson Imaging 2024. [PMID: 38949101 DOI: 10.1002/jmri.29502] [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: 04/11/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Myocardial T1-rho (T1ρ) mapping is a promising method for identifying and quantifying myocardial injuries without contrast agents, but its clinical use is hindered by the lack of dedicated analysis tools. PURPOSE To explore the feasibility of clinically integrated artificial intelligence-driven analysis for efficient and automated myocardial T1ρ mapping. STUDY TYPE Retrospective. POPULATION Five hundred seventy-three patients divided into a training (N = 500) and a test set (N = 73) including ischemic and nonischemic cases. FIELD STRENGTH/SEQUENCE Single-shot bSSFP T1ρ mapping sequence at 1.5 T. ASSESSMENT The automated process included: left ventricular (LV) wall segmentation, right ventricular insertion point detection and creation of a 16-segment model for segmental T1ρ value analysis. Two radiologists (20 and 7 years of MRI experience) provided ground truth annotations. Interobserver variability and segmentation quality were assessed using the Dice coefficient with manual segmentation as reference standard. Global and segmental T1ρ values were compared. Processing times were measured. STATISTICAL TESTS Intraclass correlation coefficients (ICCs) and Bland-Altman analysis (bias ±2SD); Paired Student's t-tests and one-way ANOVA. A P value <0.05 was considered significant. RESULTS The automated approach significantly reduced processing time (3 seconds vs. 1 minute 51 seconds ± 22 seconds). In the test set, automated LV wall segmentation closely matched manual results (Dice 81.9% ± 9.0) and closely aligned with interobserver segmentation (Dice 82.2% ± 6.5). Excellent ICCs were achieved on a patient basis (0.94 [95% CI: 0.91 to 0.96]) with bias of -0.93 cm2 ± 6.60. There was no significant difference in global T1ρ values between manual (54.9 msec ± 4.6; 95% CI: 53.8 to 56.0 msec, range: 46.6-70.9 msec) and automated processing (55.4 msec ± 5.1; 95% CI: 54.2 to 56.6 msec; range: 46.4-75.1 msec; P = 0.099). The pipeline demonstrated a high level of agreement with manual-derived T1ρ values at the patient level (ICC = 0.85; bias +0.52 msec ± 5.18). No significant differences in myocardial T1ρ values were found between methods across the 16 segments (P = 0.75). DATA CONCLUSION Automated myocardial T1ρ mapping shows promise for the rapid and noninvasive assessment of heart disease. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Victor de Villedon de Naide
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
- Department of Cardiothoracic Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Kalvin Narceau
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
| | - Valery Ozenne
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
| | - Manuel Villegas-Martinez
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
- Department of Cardiothoracic Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Victor Nogues
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
| | - Nina Brillet
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
| | - Jana Huiyue Zhang
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ilyes Benlala
- Department of Cardiothoracic Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Matthias Stuber
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Hubert Cochet
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
- Department of Cardiothoracic Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Aurélien Bustin
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Pessac, France
- Department of Cardiothoracic Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Pessac, France
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Bustin A, Pineau X, Sridi S, van Heeswijk RB, Jaïs P, Stuber M, Cochet H. Assessment of myocardial injuries in ischaemic and non-ischaemic cardiomyopathies using magnetic resonance T1-rho mapping. Eur Heart J Cardiovasc Imaging 2024; 25:548-557. [PMID: 37987558 DOI: 10.1093/ehjci/jead319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/30/2023] [Accepted: 11/16/2023] [Indexed: 11/22/2023] Open
Abstract
AIMS To identify clinical correlates of myocardial T1ρ and to examine how myocardial T1ρ values change under various clinical scenarios. METHODS AND RESULTS A total of 66 patients (26% female, median age 57 years [Q1-Q3, 44-65 years]) with known structural heart disease and 44 controls (50% female, median age 47 years [28-57 years]) underwent cardiac magnetic resonance imaging at 1.5 T, including T1ρ mapping, T2 mapping, native T1 mapping, late gadolinium enhancement, and extracellular volume (ECV) imaging. In controls, T1ρ positively related with T2 (P = 0.038) and increased from basal to apical levels (P < 0.001). As compared with controls and remote myocardium, T1ρ significantly increased in all patients' sub-groups and all types of myocardial injuries: acute and chronic injuries, focal and diffuse tissue abnormalities, as well as ischaemic and non-ischaemic aetiologies (P < 0.05). T1ρ was independently associated with T2 in patients with acute injuries (P = 0.004) and with native T1 and ECV in patients with chronic injuries (P < 0.05). Myocardial T1ρ mapping demonstrated good intra- and inter-observer reproducibility (intraclass correlation coefficient = 0.86 and 0.83, respectively). CONCLUSION Myocardial T1ρ mapping appears to be reproducible and equally sensitive to acute and chronic myocardial injuries, whether of ischaemic or non-ischaemic origins. It may thus be a contrast-agent-free biomarker for gaining new and quantitative insight into myocardial structural disorders. These findings highlight the need for further studies through prospective and randomized trials.
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Affiliation(s)
- Aurélien Bustin
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, Avenue du Haut Lévêque, 33604 Pessac, France
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604 Pessac, France
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Xavier Pineau
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604 Pessac, France
| | - Soumaya Sridi
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604 Pessac, France
| | - Ruud B van Heeswijk
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Pierre Jaïs
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, Avenue du Haut Lévêque, 33604 Pessac, France
- Department of Cardiac Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604 Pessac, France
| | - Matthias Stuber
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, Avenue du Haut Lévêque, 33604 Pessac, France
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Hubert Cochet
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, Avenue du Haut Lévêque, 33604 Pessac, France
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604 Pessac, France
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Rashid I, Lima da Cruz G, Seiberlich N, Hamilton JI. Cardiac MR Fingerprinting: Overview, Technical Developments, and Applications. J Magn Reson Imaging 2023:10.1002/jmri.29206. [PMID: 38153855 PMCID: PMC11211246 DOI: 10.1002/jmri.29206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/30/2023] Open
Abstract
Cardiovascular magnetic resonance (CMR) is an established imaging modality with proven utility in assessing cardiovascular diseases. The ability of CMR to characterize myocardial tissue using T1 - and T2 -weighted imaging, parametric mapping, and late gadolinium enhancement has allowed for the non-invasive identification of specific pathologies not previously possible with modalities like echocardiography. However, CMR examinations are lengthy and technically complex, requiring multiple pulse sequences and different anatomical planes to comprehensively assess myocardial structure, function, and tissue composition. To increase the overall impact of this modality, there is a need to simplify and shorten CMR exams to improve access and efficiency, while also providing reproducible quantitative measurements. Multiparametric MRI techniques that measure multiple tissue properties offer one potential solution to this problem. This review provides an in-depth look at one such multiparametric approach, cardiac magnetic resonance fingerprinting (MRF). The article is structured as follows. First, a brief review of single-parametric and (non-Fingerprinting) multiparametric CMR mapping techniques is presented. Second, a general overview of cardiac MRF is provided covering pulse sequence implementation, dictionary generation, fast k-space sampling methods, and pattern recognition. Third, recent technical advances in cardiac MRF are covered spanning a variety of topics, including simultaneous multislice and 3D sampling, motion correction algorithms, cine MRF, synthetic multicontrast imaging, extensions to measure additional clinically important tissue properties (proton density fat fraction, T2 *, and T1ρ ), and deep learning methods for image reconstruction and parameter estimation. The last section will discuss potential clinical applications, concluding with a perspective on how multiparametric techniques like MRF may enable streamlined CMR protocols. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Imran Rashid
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Gastao Lima da Cruz
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA
| | - Nicole Seiberlich
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA
| | - Jesse I. Hamilton
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA
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Lyu Z, Hua S, Xu J, Shen Y, Guo R, Hu P, Qi H. Free-breathing simultaneous native myocardial T1, T2 and T1ρ mapping with Cartesian acquisition and dictionary matching. J Cardiovasc Magn Reson 2023; 25:63. [PMID: 37946191 PMCID: PMC10636995 DOI: 10.1186/s12968-023-00973-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND T1, T2 and T1ρ are well-recognized parameters for quantitative cardiac MRI. Simultaneous estimation of these parameters allows for comprehensive myocardial tissue characterization, such as myocardial fibrosis and edema. However, conventional techniques either quantify the parameters individually with separate breath-hold acquisitions, which may result in unregistered parameter maps, or estimate multiple parameters in a prolonged breath-hold acquisition, which may be intolerable to patients. We propose a free-breathing multi-parametric mapping (FB-MultiMap) technique that provides co-registered myocardial T1, T2 and T1ρ maps in a single efficient acquisition. METHODS The proposed FB-MultiMap performs electrocardiogram-triggered single-shot Cartesian acquisition over 16 consecutive cardiac cycles, where inversion, T2 and T1ρ preparations are introduced for varying contrasts. A diaphragmatic navigator was used for prospective through-plane motion correction and the in-plane motion was corrected retrospectively with a group-wise image registration method. Quantitative mapping was conducted through dictionary matching of the motion corrected images, where the subject-specific dictionary was created using Bloch simulations for a range of T1, T2 and T1ρ values, as well as B1 factors to account for B1 inhomogeneities. The FB-MultiMap was optimized and validated in numerical simulations, phantom experiments, and in vivo imaging of 15 healthy subjects and six patients with suspected cardiac diseases. RESULTS The phantom T1, T2 and T1ρ values estimated with FB-MultiMap agreed well with reference measurements with no dependency on heart rate. In healthy subjects, FB-MultiMap T1 was higher than MOLLI T1 mapping (1218 ± 50 ms vs. 1166 ± 38 ms, p < 0.001). The myocardial T2 and T1ρ estimated with FB-MultiMap were lower compared to the mapping with T2- or T1ρ-prepared 2D balanced steady-state free precession (T2: 41.2 ± 2.8 ms vs. 42.5 ± 3.1 ms, p = 0.06; T1ρ: 45.3 ± 4.4 ms vs. 50.2 ± 4.0, p < 0.001). The pathological changes in myocardial parameters measured with FB-MultiMap were consistent with conventional techniques in all patients. CONCLUSION The proposed free-breathing multi-parametric mapping technique provides co-registered myocardial T1, T2 and T1ρ maps in 16 heartbeats, achieving similar mapping quality to conventional breath-hold mapping methods.
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Affiliation(s)
- Zhenfeng Lyu
- School of Biomedical Engineering, ShanghaiTech University, 4th Floor, BME Building, 393 Middle Huaxia Road, Pudong District, Shanghai, 201210, China
- Shanghai Clinical Research and Trial Center, Shanghai, China
| | - Sha Hua
- Department of Cardiovascular Medicine, Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Xu
- UIH America, Inc., Houston, TX, USA
| | - Yiwen Shen
- Department of Cardiovascular Medicine, Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rui Guo
- School of Medical Technology, Beijing Institute of Technology, Beijing, China
| | - Peng Hu
- School of Biomedical Engineering, ShanghaiTech University, 4th Floor, BME Building, 393 Middle Huaxia Road, Pudong District, Shanghai, 201210, China.
- Shanghai Clinical Research and Trial Center, Shanghai, China.
| | - Haikun Qi
- School of Biomedical Engineering, ShanghaiTech University, 4th Floor, BME Building, 393 Middle Huaxia Road, Pudong District, Shanghai, 201210, China.
- Shanghai Clinical Research and Trial Center, Shanghai, China.
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7
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Coletti C, Fotaki A, Tourais J, Zhao Y, van de Steeg-Henzen C, Akçakaya M, Tao Q, Prieto C, Weingärtner S. Robust cardiac T 1 ρ $$ {\mathrm{T}}_{1_{\boldsymbol{\rho}}} $$ mapping at 3T using adiabatic spin-lock preparations. Magn Reson Med 2023; 90:1363-1379. [PMID: 37246420 PMCID: PMC10984724 DOI: 10.1002/mrm.29713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 04/26/2023] [Accepted: 05/04/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE The aim of this study is to develop and optimize an adiabaticT 1 ρ $$ {\mathrm{T}}_{1\uprho} $$ (T 1 ρ , adiab $$ {\mathrm{T}}_{1\uprho, \mathrm{adiab}} $$ ) mapping method for robust quantification of spin-lock (SL) relaxation in the myocardium at 3T. METHODS Adiabatic SL (aSL) preparations were optimized for resilience againstB 0 $$ {\mathrm{B}}_0 $$ andB 1 + $$ {\mathrm{B}}_1^{+} $$ inhomogeneities using Bloch simulations. OptimizedB 0 $$ {\mathrm{B}}_0 $$ -aSL, Bal-aSL andB 1 $$ {\mathrm{B}}_1 $$ -aSL modules, each compensating for different inhomogeneities, were first validated in phantom and human calf. MyocardialT 1 ρ $$ {\mathrm{T}}_{1\uprho} $$ mapping was performed using a single breath-hold cardiac-triggered bSSFP-based sequence. Then, optimizedT 1 ρ , adiab $$ {\mathrm{T}}_{1\uprho, \mathrm{adiab}} $$ preparations were compared to each other and to conventional SL-preparedT 1 ρ $$ {\mathrm{T}}_{1\uprho} $$ maps (RefSL) in phantoms to assess repeatability, and in 13 healthy subjects to investigate image quality, precision, reproducibility and intersubject variability. Finally, aSL and RefSL sequences were tested on six patients with known or suspected cardiovascular disease and compared with LGE,T 1 $$ {\mathrm{T}}_1 $$ , and ECV mapping. RESULTS The highestT 1 ρ , adiab $$ {\mathrm{T}}_{1\uprho, \mathrm{adiab}} $$ preparation efficiency was obtained in simulations for modules comprising 2 HS pulses of 30 ms each. In vivoT 1 ρ , adiab $$ {\mathrm{T}}_{1\uprho, \mathrm{adiab}} $$ maps yielded significantly higher quality than RefSL maps. Average myocardialT 1 ρ , adiab $$ {\mathrm{T}}_{1\uprho, \mathrm{adiab}} $$ values were 183.28± $$ \pm $$ 25.53 ms, compared with 38.21± $$ \pm $$ 14.37 ms RefSL-preparedT 1 ρ $$ {\mathrm{T}}_{1\uprho} $$ .T 1 ρ , adiab $$ {\mathrm{T}}_{1\uprho, \mathrm{adiab}} $$ maps showed a significant improvement in precision (avg. 14.47± $$ \pm $$ 3.71% aSL, 37.61± $$ \pm $$ 19.42% RefSL, p < 0.01) and reproducibility (avg. 4.64± $$ \pm $$ 2.18% aSL, 47.39± $$ \pm $$ 12.06% RefSL, p < 0.0001), with decreased inter-subject variability (avg. 8.76± $$ \pm $$ 3.65% aSL, 51.90± $$ \pm $$ 15.27% RefSL, p < 0.0001). Among aSL preparations,B 0 $$ {\mathrm{B}}_0 $$ -aSL achieved the better inter-subject variability. In patients,B 1 $$ {\mathrm{B}}_1 $$ -aSL preparations showed the best artifact resilience among the adiabatic preparations.T 1 ρ , adiab $$ {\mathrm{T}}_{1\uprho, \mathrm{adiab}} $$ times show focal alteration colocalized with areas of hyper-enhancement in the LGE images. CONCLUSION Adiabatic preparations enable robust in vivo quantification of myocardial SL relaxation times at 3T.
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Affiliation(s)
- Chiara Coletti
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Anastasia Fotaki
- Department of Biomedical Engineering, King’s College London, London, United Kingdom
| | - Joao Tourais
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Yidong Zhao
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | | | - Mehmet Akçakaya
- Department of Electrical and Computer Engineering and Center for Magnetic Resonance Research, University of Minnesota, Minnesota, USA
| | - Qian Tao
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Claudia Prieto
- Department of Biomedical Engineering, King’s College London, London, United Kingdom
- School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
- Milleniun Institute for Intelligent Healthcare Engineering, Santiago, Chile
| | - Sebastian Weingärtner
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
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8
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Gaur S, Panda A, Fajardo JE, Hamilton J, Jiang Y, Gulani V. Magnetic Resonance Fingerprinting: A Review of Clinical Applications. Invest Radiol 2023; 58:561-577. [PMID: 37026802 PMCID: PMC10330487 DOI: 10.1097/rli.0000000000000975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
ABSTRACT Magnetic resonance fingerprinting (MRF) is an approach to quantitative magnetic resonance imaging that allows for efficient simultaneous measurements of multiple tissue properties, which are then used to create accurate and reproducible quantitative maps of these properties. As the technique has gained popularity, the extent of preclinical and clinical applications has vastly increased. The goal of this review is to provide an overview of currently investigated preclinical and clinical applications of MRF, as well as future directions. Topics covered include MRF in neuroimaging, neurovascular, prostate, liver, kidney, breast, abdominal quantitative imaging, cardiac, and musculoskeletal applications.
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Affiliation(s)
- Sonia Gaur
- Department of Radiology, Michigan Medicine, Ann Arbor, MI
| | - Ananya Panda
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | | | - Jesse Hamilton
- Department of Radiology, Michigan Medicine, Ann Arbor, MI
| | - Yun Jiang
- Department of Radiology, Michigan Medicine, Ann Arbor, MI
| | - Vikas Gulani
- Department of Radiology, Michigan Medicine, Ann Arbor, MI
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9
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Fotaki A, Velasco C, Prieto C, Botnar RM. Quantitative MRI in cardiometabolic disease: From conventional cardiac and liver tissue mapping techniques to multi-parametric approaches. Front Cardiovasc Med 2023; 9:991383. [PMID: 36756640 PMCID: PMC9899858 DOI: 10.3389/fcvm.2022.991383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023] Open
Abstract
Cardiometabolic disease refers to the spectrum of chronic conditions that include diabetes, hypertension, atheromatosis, non-alcoholic fatty liver disease, and their long-term impact on cardiovascular health. Histological studies have confirmed several modifications at the tissue level in cardiometabolic disease. Recently, quantitative MR methods have enabled non-invasive myocardial and liver tissue characterization. MR relaxation mapping techniques such as T1, T1ρ, T2 and T2* provide a pixel-by-pixel representation of the corresponding tissue specific relaxation times, which have been shown to correlate with fibrosis, altered tissue perfusion, oedema and iron levels. Proton density fat fraction mapping approaches allow measurement of lipid tissue in the organ of interest. Several studies have demonstrated their utility as early diagnostic biomarkers and their potential to bear prognostic implications. Conventionally, the quantification of these parameters by MRI relies on the acquisition of sequential scans, encoding and mapping only one parameter per scan. However, this methodology is time inefficient and suffers from the confounding effects of the relaxation parameters in each single map, limiting wider clinical and research applications. To address these limitations, several novel approaches have been proposed that encode multiple tissue parameters simultaneously, providing co-registered multiparametric information of the tissues of interest. This review aims to describe the multi-faceted myocardial and hepatic tissue alterations in cardiometabolic disease and to motivate the application of relaxometry and proton-density cardiac and liver tissue mapping techniques. Current approaches in myocardial and liver tissue characterization as well as latest technical developments in multiparametric quantitative MRI are included. Limitations and challenges of these novel approaches, and recommendations to facilitate clinical validation are also discussed.
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Affiliation(s)
- Anastasia Fotaki
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom,*Correspondence: Anastasia Fotaki,
| | - Carlos Velasco
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom,School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile,Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile,Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile
| | - René M. Botnar
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom,School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile,Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile,Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile
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10
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Qi H, Lv Z, Hu J, Xu J, Botnar R, Prieto C, Hu P. Accelerated 3D free-breathing high-resolution myocardial T 1ρ mapping at 3 Tesla. Magn Reson Med 2022; 88:2520-2531. [PMID: 36054715 DOI: 10.1002/mrm.29417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/18/2022] [Accepted: 07/27/2022] [Indexed: 11/08/2022]
Abstract
PURPOSE To develop a fast free-breathing whole-heart high-resolution myocardial T1ρ mapping technique with robust spin-lock preparation that can be performed at 3 Tesla. METHODS An adiabatically excited continuous-wave spin-lock module, insensitive to field inhomogeneities, was implemented with an electrocardiogram-triggered low-flip angle spoiled gradient echo sequence with variable-density 3D Cartesian undersampling at a 3 Tesla whole-body scanner. A saturation pulse was performed at the beginning of each cardiac cycle to null the magnetization before T1ρ preparation. Multiple T1ρ -weighted images were acquired with T1ρ preparations with different spin-lock times in an interleaved fashion. Respiratory self-gating approach was adopted along with localized autofocus to enable 3D translational motion correction of the data acquired in each heartbeat. After motion correction, multi-contrast locally low-rank reconstruction was performed to reduce undersampling artifacts. The accuracy and feasibility of the 3D T1ρ mapping technique was investigated in phantoms and in vivo in 10 healthy subjects compared with the 2D T1ρ mapping. RESULTS The 3D T1ρ mapping technique provided similar phantom T1ρ measurements in the range of 25-120 ms to the 2D T1ρ mapping reference over a wide range of simulated heart rates. With the robust adiabatically excited continuous-wave spin-lock preparation, good quality 2D and 3D in vivo T1ρ -weighted images and T1ρ maps were obtained. Myocardial T1ρ values with the 3D T1ρ mapping were slightly longer than 2D breath-hold measurements (septal T1ρ : 52.7 ± 1.4 ms vs. 50.2 ± 1.8 ms, P < 0.01). CONCLUSION A fast 3D free-breathing whole-heart T1ρ mapping technique was proposed for T1ρ quantification at 3 T with isotropic spatial resolution (2 mm3 ) and short scan time of ∼4.5 min.
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Affiliation(s)
- Haikun Qi
- School of Biomedical Engineering, ShanghaiTech University, Shanghai, People's Republic of China
| | - Zhenfeng Lv
- School of Biomedical Engineering, ShanghaiTech University, Shanghai, People's Republic of China
| | - Junpu Hu
- United Imaging Healthcare, Shanghai, People's Republic of China
| | - Jian Xu
- UIH America, Inc., Houston, Texas
| | - René Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile
| | - Peng Hu
- School of Biomedical Engineering, ShanghaiTech University, Shanghai, People's Republic of China
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Tourais J, Demirel OB, Tao Q, Pierce I, Thornton GD, Treibel TA, Akcakaya M, Weingartner S. Myocardial Approximate Spin-lock Dispersion Mapping using a Simultaneous T 2 and T RAFF2 Mapping at 3T MRI. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:1694-1697. [PMID: 36086364 PMCID: PMC10978103 DOI: 10.1109/embc48229.2022.9871465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Ischemic heart disease (IHD) is one of the leading causes of death worldwide. Myocardial infarction (MI) represents a third of all IHD cases, and cardiac magnetic resonance imaging (MRI) is often used to assess its damage to myocardial viability. Late gadolinium enhancement (LGE) is the current gold standard, but the use of gadolinium-based agents limits the clinical applicability in some patients. Spin-lock (SL) dispersion has recently been proposed as a promising non-contrast biomarker for the assessment of MI. However, at 3T, the required range of SL preparations acquired at different amplitudes suffers from specific absorption rate (SAR) limitations and off-resonance artifacts. Relaxation Along a Fictitious Field (RAFF) is an alternative to SL preparations with lower SAR requirements, while still sampling relaxation in the rotating frame. In this study, a single breath-hold simultaneous TRAFF2 and T2 mapping sequence is proposed for SL dispersion mapping at 3T. Excellent reproducibility (coefficient of variations lower than 10%) was achieved in phantom experiments, indicating good intrascan repeatability. The average myocardial TRAFF2, T2, and SL dispersion obtained with the proposed sequence (68.0±10.7 ms, 44.0±4.0 ms, and 0.4±0.2 ×10-4 s2, respectively) were comparable to the reference methods (62.7±11.7 ms, 41.2±2.4 ms, and 0.3±0.2x 10-4s2, respectively). High visual map quality, free of B0 and B1+ related artifacts, for T2, TRAFF2, and SL dispersion maps were obtained in phantoms and in vivo, suggesting promise in clinical use at 3T. Clinical relevance - and imaging promises non-contrast assessment of scar and focal fibrosis in a single breath-hold using approximate spin-lock dispersion mapping.
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12
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Coletti C, Tourais J, Ploem T, van de Steeg-Henzen C, Akcakaya M, Weingartner S. Adiabatic spin-lock preparations enable robust in vivo cardiac T 1ρ-mapping at 3T. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:1690-1693. [PMID: 36085994 PMCID: PMC10964760 DOI: 10.1109/embc48229.2022.9871870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Magnetic Resonance Imaging (MRI) is the clinical gold standard for the assessment of myocardial viability but requires injection of exogenous gadolinium-based contrast agents. Recently, T1ρ-mapping has been proposed as a fully non-invasive alternative for imaging myocardial fibrosis without the need for contrast agent injection. However, its applicability at high fields is hindered by susceptibility to MRI system imperfections, such as inhomogeneities in the B0 and B1+ fields. In this work we propose a single breath-hold ECG-triggered single-shot bSSFP sequence to enable T1ρ-mapping in vivo at 3T. Adiabatic T1ρ preparations are evaluated to reduce B0 and B1+ sensitivity in comparison with conventional spin-lock (SL) modules. Numerical Bloch simulations were performed to identify optimal parameters for the adiabatic pulses. Experiments yield T1ρ values in the myocardium equal to 48.13±54.08 ms for the best adiabatic preparation and 16.01±20.75 ms for the reference non-adiabatic SL, with 26.91% against 89.74% relative difference in T1ρ values across two shimming conditions. Both phantom and in vivo measurements show increased myocardium/blood contrast and improved resilience against system imperfections compared to non-adiabatic T1ρ preparations, enabling the use at 3T. Clinical relevance- Adiabatically-prepared T1ρ-mapping sequences form a promising candidate for non-contrast evaluation of ischemic and non-ischemic cardiomyopathies at 3T.
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Mirmojarabian SA, Lammentausta E, Liukkonen E, Ahvenjärvi L, Junttila J, Nieminen MT, Liimatainen T. Myocardium Assessment by Relaxation along Fictitious Field, Extracellular Volume, Feature Tracking, and Myocardial Strain in Hypertensive Patients with Left Ventricular Hypertrophy. Int J Biomed Imaging 2022; 2022:9198691. [PMID: 35782296 PMCID: PMC9246602 DOI: 10.1155/2022/9198691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022] Open
Abstract
Background Previous research has shown impaired global longitudinal strain (GLS) and slightly elevated extracellular volume fraction (ECV) in hypertensive patients with left ventricular hypertrophy (HTN LVH). Up to now, only little attention has been paid to interactions between macromolecules and free water in hypertrophied myocardium. Purpose To evaluate the feasibility of relaxation along a fictitious field with rank 2 (RAFF2) in HTN LVH patients. Study Type. Single institutional case control. Subjects 9 HTN LVH (age, 69 ± 10 years) and 11 control subjects (age, 54 ± 12 years). Field Strength/Sequence. Relaxation time mapping (T 1, T 1ρ , and T RAFF2 with 11.8 μT maximum radio frequency field amplitude) was performed at 1.5 T using a Siemens Aera (Erlangen, Germany) scanner equipped with an 18-channel body array coil. Assessment. ECV was calculated using pre- and postcontrast T 1, and global strains parameters were assessed by Segment CMR (Medviso AB Co, Sweden). The parametric maps of T 1ρ and T RAFF2 were computed using a monoexponential model, while the Bloch-McConnell equations were solved numerically to model effect of the chemical exchange during radio frequency pulses. Statistical Tests. Parametric maps were averaged over myocardium for each subject to be used in statistical analysis. Kolmogorov-Smirnov was used as the normality test followed by Student's t-test and Pearson's correlation to determine the difference between the HTN LVH patients and controls along with Hedges' g effect size and the association between variables, respectively. Results T RAFF2 decreased statistically (83 ± 2 ms vs 88 ± 6 ms, P < 0.031), and global longitudinal strain was impaired (GLS, -14 ± 3 vs - 18 ± 2, P < 0.002) in HTN LVH patients compared to the controls, respectively. Also, significant negative correlation was found between T RAFF2 and GLS (r = -0.53, P < 0.05). Data Conclusion. Our results suggest that T RAFF2 decrease in HTN LVH patients may be explained by gradual collagen accumulation which can be reflected in GLS changes. Most likely, it increases the water proton interactions and consequently decreases T RAFF2 before myocardial scarring.
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Affiliation(s)
| | | | - Esa Liukkonen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Lauri Ahvenjärvi
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Juhani Junttila
- Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Miika T. Nieminen
- Research Unit of Medical Imaging, Physics, And Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Timo Liimatainen
- Research Unit of Medical Imaging, Physics, And Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
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14
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Qian Y, Hou J, Jiang B, Wong VWS, Lee J, Chan Q, Wang Y, Chu WCW, Chen W. Characterization and correction of the effects of hepatic iron on T 1ρ relaxation in the liver at 3.0T. Magn Reson Med 2022; 88:1828-1839. [PMID: 35608236 DOI: 10.1002/mrm.29310] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/13/2022] [Accepted: 05/02/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE Quantitative T1ρ imaging is an emerging technique to assess the biochemical properties of tissues. In this paper, we report our observation that liver iron content (LIC) affects T1ρ quantification of the liver at 3.0T field strength and develop a method to correct the effect of LIC. THEORY AND METHODS On-resonance R1ρ (1/T1ρ ) is mainly affected by the intrinsic R2 (1/T2 ), which is influenced by LIC. As on-resonance R1ρ is closely related to the Carr-Purcell-Meiboom-Gill (CPMG) R2 , and because the calibration between CPMG R2 and LIC has been reported at 1.5T, a correction method was proposed to correct the R2 contribution to the R1ρ . The correction coefficient was obtained from the calibration results and related transformed factors. To compensate for the difference between CPMG R2 and R1ρ , a scaling factor was determined using the values of CPMG R2 and R1ρ , obtained simultaneously from a single breath-hold from volunteers. The livers of 110 subjects were scanned to validate the correction method. RESULTS LIC was significantly correlated with R1ρ in the liver. However, when the proposed correction method was applied to R1ρ , LIC and the iron-corrected R1ρ were not significantly correlated. CONCLUSION LIC can affect T1ρ in the liver. We developed an iron-correction method for the quantification of T1ρ in the liver at 3.0T.
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Affiliation(s)
- Yurui Qian
- Department of Imaging and Interventional Radiology, the Chinese University of Hong Kong, Hong Kong, China
| | - Jian Hou
- Department of Imaging and Interventional Radiology, the Chinese University of Hong Kong, Hong Kong, China
| | - Baiyan Jiang
- Department of Imaging and Interventional Radiology, the Chinese University of Hong Kong, Hong Kong, China.,Illuminatio Medical Technology Limited, Hong Kong, China
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Hong Kong, China
| | - Jack Lee
- Clinical Trials and Biostatistics Lab, CUHK Shenzhen Research Institute, Shenzhen, China.,Division of Biostatistics, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Yixiang Wang
- Department of Imaging and Interventional Radiology, the Chinese University of Hong Kong, Hong Kong, China
| | - Winnie Chiu-Wing Chu
- Department of Imaging and Interventional Radiology, the Chinese University of Hong Kong, Hong Kong, China
| | - Weitian Chen
- Department of Imaging and Interventional Radiology, the Chinese University of Hong Kong, Hong Kong, China
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15
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Gram M, Gensler D, Albertova P, Gutjahr FT, Lau K, Arias-Loza PA, Jakob PM, Nordbeck P. Quantification correction for free-breathing myocardial T 1ρ mapping in mice using a recursively derived description of a T 1ρ* relaxation pathway. J Cardiovasc Magn Reson 2022; 24:30. [PMID: 35534901 PMCID: PMC9082875 DOI: 10.1186/s12968-022-00864-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Fast and accurate T1ρ mapping in myocardium is still a major challenge, particularly in small animal models. The complex sequence design owing to electrocardiogram and respiratory gating leads to quantification errors in in vivo experiments, due to variations of the T1ρ relaxation pathway. In this study, we present an improved quantification method for T1ρ using a newly derived formalism of a T1ρ* relaxation pathway. METHODS The new signal equation was derived by solving a recursion problem for spin-lock prepared fast gradient echo readouts. Based on Bloch simulations, we compared quantification errors using the common monoexponential model and our corrected model. The method was validated in phantom experiments and tested in vivo for myocardial T1ρ mapping in mice. Here, the impact of the breath dependent spin recovery time Trec on the quantification results was examined in detail. RESULTS Simulations indicate that a correction is necessary, since systematically underestimated values are measured under in vivo conditions. In the phantom study, the mean quantification error could be reduced from - 7.4% to - 0.97%. In vivo, a correlation of uncorrected T1ρ with the respiratory cycle was observed. Using the newly derived correction method, this correlation was significantly reduced from r = 0.708 (p < 0.001) to r = 0.204 and the standard deviation of left ventricular T1ρ values in different animals was reduced by at least 39%. CONCLUSION The suggested quantification formalism enables fast and precise myocardial T1ρ quantification for small animals during free breathing and can improve the comparability of study results. Our new technique offers a reasonable tool for assessing myocardial diseases, since pathologies that cause a change in heart or breathing rates do not lead to systematic misinterpretations. Besides, the derived signal equation can be used for sequence optimization or for subsequent correction of prior study results.
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Affiliation(s)
- Maximilian Gram
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
- Experimental Physics 5, University of Würzburg, Würzburg, Germany
| | - Daniel Gensler
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany
| | - Petra Albertova
- Experimental Physics 5, University of Würzburg, Würzburg, Germany
| | - Fabian Tobias Gutjahr
- Experimental Physics 5, University of Würzburg, Würzburg, Germany
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany
| | - Kolja Lau
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Paula-Anahi Arias-Loza
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | | | - Peter Nordbeck
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.
- Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany.
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Ogier AC, Bustin A, Cochet H, Schwitter J, van Heeswijk RB. The Road Toward Reproducibility of Parametric Mapping of the Heart: A Technical Review. Front Cardiovasc Med 2022; 9:876475. [PMID: 35600490 PMCID: PMC9120534 DOI: 10.3389/fcvm.2022.876475] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/11/2022] [Indexed: 01/02/2023] Open
Abstract
Parametric mapping of the heart has become an essential part of many cardiovascular magnetic resonance imaging exams, and is used for tissue characterization and diagnosis in a broad range of cardiovascular diseases. These pulse sequences are used to quantify the myocardial T1, T2, T2*, and T1ρ relaxation times, which are unique surrogate indices of fibrosis, edema and iron deposition that can be used to monitor a disease over time or to compare patients to one another. Parametric mapping is now well-accepted in the clinical setting, but its wider dissemination is hindered by limited inter-center reproducibility and relatively long acquisition times. Recently, several new parametric mapping techniques have appeared that address both of these problems, but substantial hurdles remain for widespread clinical adoption. This review serves both as a primer for newcomers to the field of parametric mapping and as a technical update for those already well at home in it. It aims to establish what is currently needed to improve the reproducibility of parametric mapping of the heart. To this end, we first give an overview of the metrics by which a mapping technique can be assessed, such as bias and variability, as well as the basic physics behind the relaxation times themselves and what their relevance is in the prospect of myocardial tissue characterization. This is followed by a summary of routine mapping techniques and their variations. The problems in reproducibility and the sources of bias and variability of these techniques are reviewed. Subsequently, novel fast, whole-heart, and multi-parametric techniques and their merits are treated in the light of their reproducibility. This includes state of the art segmentation techniques applied to parametric maps, and how artificial intelligence is being harnessed to solve this long-standing conundrum. We finish up by sketching an outlook on the road toward inter-center reproducibility, and what to expect in the future.
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Affiliation(s)
- Augustin C. Ogier
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Aurelien Bustin
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, France
| | - Hubert Cochet
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, France
| | - Juerg Schwitter
- Cardiac MR Center, Cardiology Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Ruud B. van Heeswijk
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- *Correspondence: Ruud B. van Heeswijk
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Noncontrast T1ρ dispersion imaging is sensitive to diffuse fibrosis: A cardiovascular magnetic resonance study at 3T in hypertrophic cardiomyopathy. Magn Reson Imaging 2022; 91:1-8. [PMID: 35525524 DOI: 10.1016/j.mri.2022.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/30/2022] [Accepted: 05/01/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine the sensitivity of a noncontrast T1 dispersion cardiovascular magnetic resonance technique for detecting diffuse fibrosis in hypertrophic cardiomyopathy (HCM). METHODS Thirty-two adult HCM patients and ten age- and gender-matched healthy volunteers were prospectively included in this study. Patients and controls underwent cine, T1ρ-mapping, and pre- and post-contrast T1-mapping imaging using a 3-T magnetic resonance system. Myocardial extracellular volume fraction (ECV) maps were obtained using pre- and post-contrast T1 maps to determine reference values for diffuse fibrosis. Myocardial T1ρ and T1ρ dispersion maps called myocardial fibrosis index (mFI) maps provided 570 myocardial segments for Pearson or Spearman correlation analysis. The left ventricle myocardia of the HCM patients were divided into 16 segments that were further classified as either normal-thickness myocardium (<15 mm) (HCM-N) or hypertrophic myocardium (≥15 mm) (HCM-H). RESULTS ECV and mFI values increased progressively on a per-segment basis from healthy controls to the HCM-N group and then to the HCM-H group (ECV: 27.4 ± 2.8% vs. 31.1 ± 4.2% vs. 37.6 ± 6.9%, respectively [P < 0.0001]; mFI: 6.1 ± 0.9 ms vs. 8 ± 1.9 ms vs. 11 ± 3.3 ms, respectively [P < 0.0001]). There was a strong positive correlation between the segmented ECV and the mFI (r = 0.878). The mFI was equally or significantly better than the ECV for differentiating fibrosis content in HCM-N and HCM-H according to their receiver operating characteristic curves. CONCLUSION A T1ρ dispersion imaging mFI can sensitively detect diffuse myocardial fibrosis in HCM, even in HCM-N.
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Ismail TF, Strugnell W, Coletti C, Božić-Iven M, Weingärtner S, Hammernik K, Correia T, Küstner T. Cardiac MR: From Theory to Practice. Front Cardiovasc Med 2022; 9:826283. [PMID: 35310962 PMCID: PMC8927633 DOI: 10.3389/fcvm.2022.826283] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/17/2022] [Indexed: 01/10/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading single cause of morbidity and mortality, causing over 17. 9 million deaths worldwide per year with associated costs of over $800 billion. Improving prevention, diagnosis, and treatment of CVD is therefore a global priority. Cardiovascular magnetic resonance (CMR) has emerged as a clinically important technique for the assessment of cardiovascular anatomy, function, perfusion, and viability. However, diversity and complexity of imaging, reconstruction and analysis methods pose some limitations to the widespread use of CMR. Especially in view of recent developments in the field of machine learning that provide novel solutions to address existing problems, it is necessary to bridge the gap between the clinical and scientific communities. This review covers five essential aspects of CMR to provide a comprehensive overview ranging from CVDs to CMR pulse sequence design, acquisition protocols, motion handling, image reconstruction and quantitative analysis of the obtained data. (1) The basic MR physics of CMR is introduced. Basic pulse sequence building blocks that are commonly used in CMR imaging are presented. Sequences containing these building blocks are formed for parametric mapping and functional imaging techniques. Commonly perceived artifacts and potential countermeasures are discussed for these methods. (2) CMR methods for identifying CVDs are illustrated. Basic anatomy and functional processes are described to understand the cardiac pathologies and how they can be captured by CMR imaging. (3) The planning and conduct of a complete CMR exam which is targeted for the respective pathology is shown. Building blocks are illustrated to create an efficient and patient-centered workflow. Further strategies to cope with challenging patients are discussed. (4) Imaging acceleration and reconstruction techniques are presented that enable acquisition of spatial, temporal, and parametric dynamics of the cardiac cycle. The handling of respiratory and cardiac motion strategies as well as their integration into the reconstruction processes is showcased. (5) Recent advances on deep learning-based reconstructions for this purpose are summarized. Furthermore, an overview of novel deep learning image segmentation and analysis methods is provided with a focus on automatic, fast and reliable extraction of biomarkers and parameters of clinical relevance.
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Affiliation(s)
- Tevfik F. Ismail
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Cardiology Department, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Wendy Strugnell
- Queensland X-Ray, Mater Hospital Brisbane, Brisbane, QLD, Australia
| | - Chiara Coletti
- Magnetic Resonance Systems Lab, Delft University of Technology, Delft, Netherlands
| | - Maša Božić-Iven
- Magnetic Resonance Systems Lab, Delft University of Technology, Delft, Netherlands
- Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
| | | | - Kerstin Hammernik
- Lab for AI in Medicine, Technical University of Munich, Munich, Germany
- Department of Computing, Imperial College London, London, United Kingdom
| | - Teresa Correia
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Centre of Marine Sciences, Faro, Portugal
| | - Thomas Küstner
- Medical Image and Data Analysis (MIDAS.lab), Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany
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19
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Velasco C, Cruz G, Lavin B, Hua A, Fotaki A, Botnar RM, Prieto C. Simultaneous T 1 , T 2 , and T 1ρ cardiac magnetic resonance fingerprinting for contrast agent-free myocardial tissue characterization. Magn Reson Med 2021; 87:1992-2002. [PMID: 34799854 DOI: 10.1002/mrm.29091] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE To develop a simultaneous T1 , T2 , and T1ρ cardiac magnetic resonance fingerprinting (MRF) approach to enable comprehensive contrast agent-free myocardial tissue characterization in a single breath-hold scan. METHODS A 2D gradient-echo electrocardiogram-triggered cardiac MRF sequence with low flip angles, varying magnetization preparation, and spiral trajectory was acquired at 1.5 T to encode T1 , T2 , and T1⍴ simultaneously. The MRF images were reconstructed using low-rank inversion, regularized with a multicontrast patch-based higher-order reconstruction. Parametric maps were generated and matched in the singular value domain to extended phase graph-based dictionaries. The proposed approach was tested in phantoms and 10 healthy subjects and compared against conventional methods in terms of coefficients of determination and best fits for the phantom study, and in terms of Bland-Altman agreement, average values and coefficient of variation of T1 , T2 , and T1⍴ for the healthy subjects study. RESULTS The T1 , T2 , and T1⍴ MRF values showed excellent correlation with conventional spin-echo and clinical mapping methods in phantom studies (r2 > 0.97). Measured MRF values in myocardial tissue (mean ± SD) were 1133 ± 33 ms, 38.8 ± 3.5 ms, and 52.0 ± 4.0 ms for T1 , T2 and T1⍴ , respectively, against 1053 ± 47 ms, 50.4 ± 3.9 ms, and 55.9 ± 3.3 ms for T1 modified Look-Locker inversion imaging, T2 gradient and spin echo, and T1⍴ turbo field echo, respectively. CONCLUSION A cardiac MRF approach for simultaneous quantification of myocardial T1 , T2 , and T1ρ in a single breath-hold MR scan of about 16 seconds has been proposed. The approach has been investigated in phantoms and healthy subjects showing good agreement with reference spin echo measurements and conventional clinical maps.
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Affiliation(s)
- Carlos Velasco
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gastão Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Begoña Lavin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain
| | - Alina Hua
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Anastasia Fotaki
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
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20
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Thompson EW, Kamesh Iyer S, Solomon MP, Li Z, Zhang Q, Piechnik S, Werys K, Swago S, Moon BF, Rodgers ZB, Hall A, Kumar R, Reza N, Kim J, Jamil A, Desjardins B, Litt H, Owens A, Witschey WRT, Han Y. Endogenous T1ρ cardiovascular magnetic resonance in hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 2021; 23:120. [PMID: 34689798 PMCID: PMC8543937 DOI: 10.1186/s12968-021-00813-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/13/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy (HCM) is characterized by increased left ventricular wall thickness, cardiomyocyte hypertrophy, and fibrosis. Adverse cardiac risk characterization has been performed using late gadolinium enhancement (LGE), native T1, and extracellular volume (ECV). Relaxation time constants are affected by background field inhomogeneity. T1ρ utilizes a spin-lock pulse to decrease the effect of unwanted relaxation. The objective of this study was to study T1ρ as compared to T1, ECV, and LGE in HCM patients. METHODS HCM patients were recruited as part of the Novel Markers of Prognosis in Hypertrophic Cardiomyopathy study, and healthy controls were matched for comparison. In addition to cardiac functional imaging, subjects underwent T1 and T1ρ cardiovascular magnetic resonance imaging at short-axis positions at 1.5T. Subjects received gadolinium and underwent LGE imaging 15-20 min after injection covering the entire heart. Corresponding basal and mid short axis LGE slices were selected for comparison with T1 and T1ρ. Full-width half-maximum thresholding was used to determine the percent enhancement area in each LGE-positive slice by LGE, T1, and T1ρ. Two clinicians independently reviewed LGE images for presence or absence of enhancement. If in agreement, the image was labeled positive (LGE + +) or negative (LGE --); otherwise, the image was labeled equivocal (LGE + -). RESULTS In 40 HCM patients and 10 controls, T1 percent enhancement area (Spearman's rho = 0.61, p < 1e-5) and T1ρ percent enhancement area (Spearman's rho = 0.48, p < 0.001e-3) correlated with LGE percent enhancement area. T1 and T1ρ percent enhancement areas were also correlated (Spearman's rho = 0.28, p = 0.047). For both T1 and T1ρ, HCM patients demonstrated significantly longer relaxation times compared to controls in each LGE category (p < 0.001 for all). HCM patients also showed significantly higher ECV compared to controls in each LGE category (p < 0.01 for all), and LGE -- slices had lower ECV than LGE + + (p = 0.01). CONCLUSIONS Hyperenhancement areas as measured by T1ρ and LGE are moderately correlated. T1, T1ρ, and ECV were elevated in HCM patients compared to controls, irrespective of the presence of LGE. These findings warrant additional studies to investigate the prognostic utility of T1ρ imaging in the evaluation of HCM patients.
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Affiliation(s)
- Elizabeth W Thompson
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Michael P Solomon
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Zhaohuan Li
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Cardiovascular Ultrasound and Non-Invasive Cardiology Department, Affiliated Hospital of University of Electronic Science and Technology of China, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Qiang Zhang
- Oxford Center for Clinical Magnetic Resonance Research, Oxford BRC NIHR, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Stefan Piechnik
- Oxford Center for Clinical Magnetic Resonance Research, Oxford BRC NIHR, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Konrad Werys
- Circle Cardiovascular Imaging Inc., Calgary, AB, Canada
| | - Sophia Swago
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Brianna F Moon
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Zachary B Rodgers
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Anya Hall
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Rishabh Kumar
- Department of Biophysics, University of Pennsylvania, Philadelphia, PA, USA
| | - Nosheen Reza
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jessica Kim
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alisha Jamil
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Benoit Desjardins
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Harold Litt
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Anjali Owens
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Yuchi Han
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Perelman School of Medicine, University of Pennsylvania, 11-135, South Pavilion, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA.
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21
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Bustin A, Toupin S, Sridi S, Yerly J, Bernus O, Labrousse L, Quesson B, Rogier J, Haïssaguerre M, van Heeswijk R, Jaïs P, Cochet H, Stuber M. Endogenous assessment of myocardial injury with single-shot model-based non-rigid motion-corrected T1 rho mapping. J Cardiovasc Magn Reson 2021; 23:119. [PMID: 34670572 PMCID: PMC8529795 DOI: 10.1186/s12968-021-00781-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance T1ρ mapping may detect myocardial injuries without exogenous contrast agent. However, multiple co-registered acquisitions are required, and the lack of robust motion correction limits its clinical translation. We introduce a single breath-hold myocardial T1ρ mapping method that includes model-based non-rigid motion correction. METHODS A single-shot electrocardiogram (ECG)-triggered balanced steady state free precession (bSSFP) 2D adiabatic T1ρ mapping sequence that collects five T1ρ-weighted (T1ρw) images with different spin lock times within a single breath-hold is proposed. To address the problem of residual respiratory motion, a unified optimization framework consisting of a joint T1ρ fitting and model-based non-rigid motion correction algorithm, insensitive to contrast change, was implemented inline for fast (~ 30 s) and direct visualization of T1ρ maps. The proposed reconstruction was optimized on an ex vivo human heart placed on a motion-controlled platform. The technique was then tested in 8 healthy subjects and validated in 30 patients with suspected myocardial injury on a 1.5T CMR scanner. The Dice similarity coefficient (DSC) and maximum perpendicular distance (MPD) were used to quantify motion and evaluate motion correction. The quality of T1ρ maps was scored. In patients, T1ρ mapping was compared to cine imaging, T2 mapping and conventional post-contrast 2D late gadolinium enhancement (LGE). T1ρ values were assessed in remote and injured areas, using LGE as reference. RESULTS Despite breath holds, respiratory motion throughout T1ρw images was much larger in patients than in healthy subjects (5.1 ± 2.7 mm vs. 0.5 ± 0.4 mm, P < 0.01). In patients, the model-based non-rigid motion correction improved the alignment of T1ρw images, with higher DSC (87.7 ± 5.3% vs. 82.2 ± 7.5%, P < 0.01), and lower MPD (3.5 ± 1.9 mm vs. 5.1 ± 2.7 mm, P < 0.01). This resulted in significantly improved quality of the T1ρ maps (3.6 ± 0.6 vs. 2.1 ± 0.9, P < 0.01). Using this approach, T1ρ mapping could be used to identify LGE in patients with 93% sensitivity and 89% specificity. T1ρ values in injured (LGE positive) areas were significantly higher than in the remote myocardium (68.4 ± 7.9 ms vs. 48.8 ± 6.5 ms, P < 0.01). CONCLUSIONS The proposed motion-corrected T1ρ mapping framework enables a quantitative characterization of myocardial injuries with relatively low sensitivity to respiratory motion. This technique may be a robust and contrast-free adjunct to LGE for gaining new insight into myocardial structural disorders.
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Affiliation(s)
- Aurélien Bustin
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Avenue du Haut Lévêque, 33604, Pessac, France.
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604, Pessac, France.
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Solenn Toupin
- Siemens Healthcare France, 93210, Saint-Denis, France
| | - Soumaya Sridi
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604, Pessac, France
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Olivier Bernus
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Avenue du Haut Lévêque, 33604, Pessac, France
| | - Louis Labrousse
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Avenue du Haut Lévêque, 33604, Pessac, France
- Department of Cardiac Surgery, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604, Pessac, France
| | - Bruno Quesson
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Avenue du Haut Lévêque, 33604, Pessac, France
| | - Julien Rogier
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Avenue du Haut Lévêque, 33604, Pessac, France
| | - Michel Haïssaguerre
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Avenue du Haut Lévêque, 33604, Pessac, France
- Department of Cardiac Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux,, Avenue de Magellan, 33604, Pessac, France
| | - Ruud van Heeswijk
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pierre Jaïs
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Avenue du Haut Lévêque, 33604, Pessac, France
- Department of Cardiac Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux,, Avenue de Magellan, 33604, Pessac, France
| | - Hubert Cochet
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Avenue du Haut Lévêque, 33604, Pessac, France
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604, Pessac, France
| | - Matthias Stuber
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Avenue du Haut Lévêque, 33604, Pessac, France
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
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22
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Fast myocardial T 1ρ mapping in mice using k-space weighted image contrast and a Bloch simulation-optimized radial sampling pattern. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 35:325-340. [PMID: 34491466 PMCID: PMC8995242 DOI: 10.1007/s10334-021-00951-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/17/2022]
Abstract
Purpose T1ρ dispersion quantification can potentially be used as a cardiac magnetic resonance index for sensitive detection of myocardial fibrosis without the need of contrast agents. However, dispersion quantification is still a major challenge, because T1ρ mapping for different spin lock amplitudes is a very time consuming process. This study aims to develop a fast and accurate T1ρ mapping sequence, which paves the way to cardiac T1ρ dispersion quantification within the limited measurement time of an in vivo study in small animals. Methods A radial spin lock sequence was developed using a Bloch simulation-optimized sampling pattern and a view-sharing method for image reconstruction. For validation, phantom measurements with a conventional sampling pattern and a gold standard sequence were compared to examine T1ρ quantification accuracy. The in vivo validation of T1ρ mapping was performed in N = 10 mice and in a reproduction study in a single animal, in which ten maps were acquired in direct succession. Finally, the feasibility of myocardial dispersion quantification was tested in one animal. Results The Bloch simulation-based sampling shows considerably higher image quality as well as improved T1ρ quantification accuracy (+ 56%) and precision (+ 49%) compared to conventional sampling. Compared to the gold standard sequence, a mean deviation of − 0.46 ± 1.84% was observed. The in vivo measurements proved high reproducibility of myocardial T1ρ mapping. The mean T1ρ in the left ventricle was 39.5 ± 1.2 ms for different animals and the maximum deviation was 2.1% in the successive measurements. The myocardial T1ρ dispersion slope, which was measured for the first time in one animal, could be determined to be 4.76 ± 0.23 ms/kHz. Conclusion This new and fast T1ρ quantification technique enables high-resolution myocardial T1ρ mapping and even dispersion quantification within the limited time of an in vivo study and could, therefore, be a reliable tool for improved tissue characterization. Supplementary Information The online version contains supplementary material available at 10.1007/s10334-021-00951-y.
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Qi H, Cruz G, Botnar R, Prieto C. Synergistic multi-contrast cardiac magnetic resonance image reconstruction. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2021; 379:20200197. [PMID: 33966456 DOI: 10.1098/rsta.2020.0197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Cardiac magnetic resonance imaging (CMR) is an important tool for the non-invasive diagnosis of a variety of cardiovascular diseases. Parametric mapping with multi-contrast CMR is able to quantify tissue alterations in myocardial disease and promises to improve patient care. However, magnetic resonance imaging is an inherently slow imaging modality, resulting in long acquisition times for parametric mapping which acquires a series of cardiac images with different contrasts for signal fitting or dictionary matching. Furthermore, extra efforts to deal with respiratory and cardiac motion by triggering and gating further increase the scan time. Several techniques have been developed to speed up CMR acquisitions, which usually acquire less data than that required by the Nyquist-Shannon sampling theorem, followed by regularized reconstruction to mitigate undersampling artefacts. Recent advances in CMR parametric mapping speed up CMR by synergistically exploiting spatial-temporal and contrast redundancies. In this article, we will review the recent developments in multi-contrast CMR image reconstruction for parametric mapping with special focus on low-rank and model-based reconstructions. Deep learning-based multi-contrast reconstruction has recently been proposed in other magnetic resonance applications. These developments will be covered to introduce the general methodology. Current technical limitations and potential future directions are discussed. This article is part of the theme issue 'Synergistic tomographic image reconstruction: part 1'.
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Affiliation(s)
- Haikun Qi
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, London SE1 7EH, UK
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, London SE1 7EH, UK
| | - René Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, London SE1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, London SE1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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López K, Neji R, Bustin A, Rashid I, Hajhosseiny R, Malik SJ, Teixeira RPAG, Razavi R, Prieto C, Roujol S, Botnar RM. Quantitative magnetization transfer imaging for non-contrast enhanced detection of myocardial fibrosis. Magn Reson Med 2020; 85:2069-2083. [PMID: 33201524 DOI: 10.1002/mrm.28577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 09/10/2020] [Accepted: 10/09/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE To develop a novel gadolinium-free model-based quantitative magnetization transfer (qMT) technique to assess macromolecular changes associated with myocardial fibrosis. METHODS The proposed sequence consists of a two-dimensional breath-held dual shot interleaved acquisition of five MT-weighted (MTw) spoiled gradient echo images, with variable MT flip angles (FAs) and off-resonance frequencies. A two-pool exchange model and dictionary matching were used to quantify the pool size ratio (PSR) and bound pool T2 relaxation ( T 2 B ). The signal model was developed and validated using 25 MTw images on a bovine serum albumin (BSA) phantom and in vivo human thigh muscle. A protocol with five MTw images was optimized for single breath-hold cardiac qMT imaging. The proposed sequence was tested in 10 healthy subjects and 5 patients with myocardial fibrosis and compared to late gadolinium enhancement (LGE). RESULTS PSR values in the BSA phantom were within the confidence interval of previously reported values (concentration 10% BSA = 5.9 ± 0.1%, 15% BSA = 9.4 ± 0.2%). PSR and T 2 B in thigh muscle were also in agreement with literature (PSR = 10.9 ± 0.3%, T 2 B = 6.4 ± 0.4 us). In 10 healthy subjects, global left ventricular PSR was 4.30 ± 0.65%. In patients, PSR was reduced in areas associated with LGE (remote: 4.68 ± 0.70% vs. fibrotic: 3.12 ± 0.78 %, n = 5, P < .002). CONCLUSION In vivo model-based qMT mapping of the heart was performed for the first time, with promising results for non-contrast enhanced assessment of myocardial fibrosis.
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Affiliation(s)
- Karina López
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,MR Research Collaboration, Siemens Healthcare Limited, Frimley, UK
| | - Aurelien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Imran Rashid
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Shaihan J Malik
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Rui Pedro A G Teixeira
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Sébastien Roujol
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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Novel Magnetic Resonance Late Gadolinium Enhancement With Fixed Short Inversion Time in Ischemic Myocardial Scars. Invest Radiol 2020; 55:445-450. [DOI: 10.1097/rli.0000000000000655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Qi H, Bustin A, Kuestner T, Hajhosseiny R, Cruz G, Kunze K, Neji R, Botnar RM, Prieto C. Respiratory motion-compensated high-resolution 3D whole-heart T1ρ mapping. J Cardiovasc Magn Reson 2020; 22:12. [PMID: 32014001 PMCID: PMC6998259 DOI: 10.1186/s12968-020-0597-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/03/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) T1ρ mapping can be used to detect ischemic or non-ischemic cardiomyopathy without the need of exogenous contrast agents. Current 2D myocardial T1ρ mapping requires multiple breath-holds and provides limited coverage. Respiratory gating by diaphragmatic navigation has recently been exploited to enable free-breathing 3D T1ρ mapping, which, however, has low acquisition efficiency and may result in unpredictable and long scan times. This study aims to develop a fast respiratory motion-compensated 3D whole-heart myocardial T1ρ mapping technique with high spatial resolution and predictable scan time. METHODS The proposed electrocardiogram (ECG)-triggered T1ρ mapping sequence is performed under free-breathing using an undersampled variable-density 3D Cartesian sampling with spiral-like order. Preparation pulses with different T1ρ spin-lock times are employed to acquire multiple T1ρ-weighted images. A saturation prepulse is played at the start of each heartbeat to reset the magnetization before T1ρ preparation. Image navigators are employed to enable beat-to-beat 2D translational respiratory motion correction of the heart for each T1ρ-weighted dataset, after which, 3D translational registration is performed to align all T1ρ-weighted volumes. Undersampled reconstruction is performed using a multi-contrast 3D patch-based low-rank algorithm. The accuracy of the proposed technique was tested in phantoms and in vivo in 11 healthy subjects in comparison with 2D T1ρ mapping. The feasibility of the proposed technique was further investigated in 3 patients with suspected cardiovascular disease. Breath-hold late-gadolinium enhanced (LGE) images were acquired in patients as reference for scar detection. RESULTS Phantoms results revealed that the proposed technique provided accurate T1ρ values over a wide range of simulated heart rates in comparison to a 2D T1ρ mapping reference. Homogeneous 3D T1ρ maps were obtained for healthy subjects, with septal T1ρ of 58.0 ± 4.1 ms which was comparable to 2D breath-hold measurements (57.6 ± 4.7 ms, P = 0.83). Myocardial scar was detected in 1 of the 3 patients, and increased T1ρ values (87.4 ± 5.7 ms) were observed in the infarcted region. CONCLUSIONS An accelerated free-breathing 3D whole-heart T1ρ mapping technique was developed with high respiratory scan efficiency and near-isotropic spatial resolution (1.7 × 1.7 × 2 mm3) in a clinically feasible scan time of ~ 6 mins. Preliminary patient results suggest that the proposed technique may find applications in non-contrast myocardial tissue characterization.
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Affiliation(s)
- Haikun Qi
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK.
| | - Aurelien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK
| | - Thomas Kuestner
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK
| | - Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK
| | - Karl Kunze
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK
- Siemens Healthcare, MR Research Collaborations, Frimley, UK
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK
- Siemens Healthcare, MR Research Collaborations, Frimley, UK
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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Strijkers GJ, Araujo EC, Azzabou N, Bendahan D, Blamire A, Burakiewicz J, Carlier PG, Damon B, Deligianni X, Froeling M, Heerschap A, Hollingsworth KG, Hooijmans MT, Karampinos DC, Loudos G, Madelin G, Marty B, Nagel AM, Nederveen AJ, Nelissen JL, Santini F, Scheidegger O, Schick F, Sinclair C, Sinkus R, de Sousa PL, Straub V, Walter G, Kan HE. Exploration of New Contrasts, Targets, and MR Imaging and Spectroscopy Techniques for Neuromuscular Disease - A Workshop Report of Working Group 3 of the Biomedicine and Molecular Biosciences COST Action BM1304 MYO-MRI. J Neuromuscul Dis 2020; 6:1-30. [PMID: 30714967 PMCID: PMC6398566 DOI: 10.3233/jnd-180333] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Neuromuscular diseases are characterized by progressive muscle degeneration and muscle weakness resulting in functional disabilities. While each of these diseases is individually rare, they are common as a group, and a large majority lacks effective treatment with fully market approved drugs. Magnetic resonance imaging and spectroscopy techniques (MRI and MRS) are showing increasing promise as an outcome measure in clinical trials for these diseases. In 2013, the European Union funded the COST (co-operation in science and technology) action BM1304 called MYO-MRI (www.myo-mri.eu), with the overall aim to advance novel MRI and MRS techniques for both diagnosis and quantitative monitoring of neuromuscular diseases through sharing of expertise and data, joint development of protocols, opportunities for young researchers and creation of an online atlas of muscle MRI and MRS. In this report, the topics that were discussed in the framework of working group 3, which had the objective to: Explore new contrasts, new targets and new imaging techniques for NMD are described. The report is written by the scientists who attended the meetings and presented their data. An overview is given on the different contrasts that MRI can generate and their application, clinical needs and desired readouts, and emerging methods.
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Affiliation(s)
| | - Ericky C.A. Araujo
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology & NMR Laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | - Noura Azzabou
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology & NMR Laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | | | - Andrew Blamire
- Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK
| | - Jedrek Burakiewicz
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pierre G. Carlier
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology & NMR Laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | - Bruce Damon
- Vanderbilt University Medical Center, Nashville, USA
| | - Xeni Deligianni
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland & Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | | | - Arend Heerschap
- Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | | | | | | | - Benjamin Marty
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology & NMR Laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | - Armin M. Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany & Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - Francesco Santini
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland & Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Olivier Scheidegger
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Fritz Schick
- University of Tübingen, Section on Experimental Radiology, Tübingen, Germany
| | | | | | | | - Volker Straub
- Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK
| | | | - Hermien E. Kan
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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Perez-Terol I, Rios-Navarro C, de Dios E, Morales JM, Gavara J, Perez-Sole N, Diaz A, Minana G, Segura-Sabater R, Bonanad C, Bayés-Genis A, Husser O, Monmeneu JV, Lopez-Lereu MP, Nunez J, Chorro FJ, Ruiz-Sauri A, Bodi V, Monleon D. Magnetic resonance microscopy and correlative histopathology of the infarcted heart. Sci Rep 2019; 9:20017. [PMID: 31882712 PMCID: PMC6934559 DOI: 10.1038/s41598-019-56436-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 12/10/2019] [Indexed: 02/08/2023] Open
Abstract
Delayed enhancement cardiovascular magnetic resonance (MR) is the gold-standard for non-invasive assessment after myocardial infarction (MI). MR microscopy (MRM) provides a level of detail comparable to the macro objective of light microscopy. We used MRM and correlative histopathology to identify infarct and remote tissue in contrast agent-free multi-sequence MRM in swine MI hearts. One control group (n = 3 swine) and two experimental MI groups were formed: 90 min of ischemia followed by 1 week (acute MI = 6 swine) or 1 month (chronic MI = 5 swine) reperfusion. Representative samples of each heart were analysed by contrast agent-free multi-sequence (T1-weighting, T2-weighting, T2*-weighting, T2-mapping, and T2*-mapping). MRM was performed in a 14-Tesla vertical axis imager (Bruker-AVANCE 600 system). Images from MRM and the corresponding histopathological stained samples revealed differences in signal intensities between infarct and remote areas in both MI groups (p-value < 0.001). The multivariable models allowed us to precisely classify regions of interest (acute MI: specificity 92% and sensitivity 80%; chronic MI: specificity 100% and sensitivity 98%). Probabilistic maps based on MRM images clearly delineated the infarcted regions. As a proof of concept, these results illustrate the potential of MRM with correlative histopathology as a platform for exploring novel contrast agent-free MR biomarkers after MI.
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Affiliation(s)
- Itziar Perez-Terol
- Laboratory of Metabolomics, Institute of Health Research-INCLIVA, Valencia, Spain
| | - Cesar Rios-Navarro
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain
| | - Elena de Dios
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain
| | - Jose M Morales
- Laboratory of Metabolomics, Institute of Health Research-INCLIVA, Valencia, Spain.,Unidad Central de Investigación Biomédica, University of Valencia, Valencia, Spain.,Pathology Department, School of Medicine, University of Valencia, Valencia, Spain
| | - Jose Gavara
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain
| | - Nerea Perez-Sole
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain
| | - Ana Diaz
- Unidad Central de Investigación Biomédica, University of Valencia, Valencia, Spain
| | - Gema Minana
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain.,Centro de Investigación Biomédica en Red - Cardiovascular (CIBER-CV), Madrid, Spain.,Medicine Department, School of Medicine, University of Valencia, Valencia, Spain
| | | | - Clara Bonanad
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain.,Medicine Department, School of Medicine, University of Valencia, Valencia, Spain
| | - Antoni Bayés-Genis
- Centro de Investigación Biomédica en Red - Cardiovascular (CIBER-CV), Madrid, Spain.,Cardiology Department and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol. Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oliver Husser
- Department of Cardiology, St.-Johannes-Hospital, Dortmund, Germany
| | - Jose V Monmeneu
- Cardiovascular Magnetic Resonance Unit, ERESA, Valencia, Spain
| | | | - Julio Nunez
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain.,Centro de Investigación Biomédica en Red - Cardiovascular (CIBER-CV), Madrid, Spain.,Medicine Department, School of Medicine, University of Valencia, Valencia, Spain
| | - Francisco J Chorro
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain.,Centro de Investigación Biomédica en Red - Cardiovascular (CIBER-CV), Madrid, Spain.,Medicine Department, School of Medicine, University of Valencia, Valencia, Spain
| | - Amparo Ruiz-Sauri
- Pathology Department, School of Medicine, University of Valencia, Valencia, Spain
| | - Vicente Bodi
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain. .,Centro de Investigación Biomédica en Red - Cardiovascular (CIBER-CV), Madrid, Spain. .,Medicine Department, School of Medicine, University of Valencia, Valencia, Spain.
| | - Daniel Monleon
- Laboratory of Metabolomics, Institute of Health Research-INCLIVA, Valencia, Spain. .,Pathology Department, School of Medicine, University of Valencia, Valencia, Spain. .,Centro de Investigación Biomédica en Red - Fragilidad y Envejecimiento Saludable (CIBER-FES), Madrid, Spain.
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Zhang N, Yang G, Gao Z, Xu C, Zhang Y, Shi R, Keegan J, Xu L, Zhang H, Fan Z, Firmin D. Deep Learning for Diagnosis of Chronic Myocardial Infarction on Nonenhanced Cardiac Cine MRI. Radiology 2019; 291:606-617. [PMID: 31038407 DOI: 10.1148/radiol.2019182304] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Renal impairment is common in patients with coronary artery disease and, if severe, late gadolinium enhancement (LGE) imaging for myocardial infarction (MI) evaluation cannot be performed. Purpose To develop a fully automatic framework for chronic MI delineation via deep learning on non-contrast material-enhanced cardiac cine MRI. Materials and Methods In this retrospective single-center study, a deep learning model was developed to extract motion features from the left ventricle and delineate MI regions on nonenhanced cardiac cine MRI collected between October 2015 and March 2017. Patients with chronic MI, as well as healthy control patients, had both nonenhanced cardiac cine (25 phases per cardiac cycle) and LGE MRI examinations. Eighty percent of MRI examinations were used for the training data set and 20% for the independent testing data set. Chronic MI regions on LGE MRI were defined as ground truth. Diagnostic performance was assessed by analysis of the area under the receiver operating characteristic curve (AUC). MI area and MI area percentage from nonenhanced cardiac cine and LGE MRI were compared by using the Pearson correlation, paired t test, and Bland-Altman analysis. Results Study participants included 212 patients with chronic MI (men, 171; age, 57.2 years ± 12.5) and 87 healthy control patients (men, 42; age, 43.3 years ± 15.5). Using the full cardiac cine MRI, the per-segment sensitivity and specificity for detecting chronic MI in the independent test set was 89.8% and 99.1%, respectively, with an AUC of 0.94. There were no differences between nonenhanced cardiac cine and LGE MRI analyses in number of MI segments (114 vs 127, respectively; P = .38), per-patient MI area (6.2 cm2 ± 2.8 vs 5.5 cm2 ± 2.3, respectively; P = .27; correlation coefficient, r = 0.88), and MI area percentage (21.5% ± 17.3 vs 18.5% ± 15.4; P = .17; correlation coefficient, r = 0.89). Conclusion The proposed deep learning framework on nonenhanced cardiac cine MRI enables the confirmation (presence), detection (position), and delineation (transmurality and size) of chronic myocardial infarction. However, future larger-scale multicenter studies are required for a full validation. Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Leiner in this issue.
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Affiliation(s)
- Nan Zhang
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
| | - Guang Yang
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
| | - Zhifan Gao
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
| | - Chenchu Xu
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
| | - Yanping Zhang
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
| | - Rui Shi
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
| | - Jennifer Keegan
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
| | - Lei Xu
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
| | - Heye Zhang
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
| | - Zhanming Fan
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
| | - David Firmin
- From the Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 2nd Anzhen Road, Chaoyang District, Beijing, China (N.Z., L.X., Z.F.); Cardiovascular Research Centre, Royal Brompton Hospital, London, England (G.Y., R.S., J.K., D.F.); National Heart and Lung Institute, Imperial College London, London, England (G.Y., R.S., J.K., D.F.); Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China (Z.G., H.Z.); Anhui University, Hefei, China (C.X., Y.Z.); and School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, China (H.Z.)
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MR extracellular volume mapping and non-contrast T1ρ mapping allow early detection of myocardial fibrosis in diabetic monkeys. Eur Radiol 2019; 29:3006-3016. [PMID: 30643944 PMCID: PMC6510861 DOI: 10.1007/s00330-018-5950-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 11/04/2018] [Accepted: 12/04/2018] [Indexed: 02/05/2023]
Abstract
Objective To detect diffuse myocardial fibrosis in different severity levels of left ventricular diastolic dysfunction (DD) in spontaneous type 2 diabetes mellitus (T2DM) rhesus monkeys. Methods Eighteen spontaneous T2DM and nine healthy monkeys were studied. Echocardiography was performed for diastolic function classification. Cardiac magnetic resonance (CMR) imaging was performed to obtain extracellular volume fraction (ECV) maps and T1ρ maps at two different spin-locking frequencies. ECV values, T1ρ values, and myocardial fibrosis index (mFI) values which are based on the dispersion of T1ρ, were calculated. Global peak diastolic longitudinal strain rates (GSrL) were also obtained. Results Echocardiography results showed mild DD in nine T2DM monkeys and moderate DD in the other nine. The global ECV values were significantly different among healthy animals as compared with animals with mild DD or moderate DD, and the ECV values of animals with moderate DD were significantly higher as compared with those of mild DD. The mFI values increased progressively from healthy animals to those with mild DD and then to those with moderate DD. Diastolic function indicators (e.g., early diastolic mitral annulus velocity, GSrL) correlated well with ECV and mFI. Conclusions Monkeys with T2DM exhibit increased ECV, T1ρ, and mFI values, which may be indicative of the expansion of extracellular volume and the deposition of excessive collagen. T1ρ mapping may have the potential to be used for diffuse myocardial fibrosis assessment. Key Points • Monkeys with T2DM exhibit increased ECV, T1ρ, and mFI values, which may be indicative of the expansion of extracellular volume and the deposition of excessive collagen. • The relationship between diastolic dysfunction and diffuse myocardial fibrosis may be demonstrated by imaging markers. • Non-contrast T1ρ mapping may have the potential to be used for diffuse myocardial assessment. Electronic supplementary material The online version of this article (10.1007/s00330-018-5950-9) contains supplementary material, which is available to authorized users.
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Kamesh Iyer S, Moon B, Hwuang E, Han Y, Solomon M, Litt H, Witschey WR. Accelerated free-breathing 3D T1ρ cardiovascular magnetic resonance using multicoil compressed sensing. J Cardiovasc Magn Reson 2019; 21:5. [PMID: 30626437 PMCID: PMC6327532 DOI: 10.1186/s12968-018-0507-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 11/13/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Endogenous contrast T1ρ cardiovascular magnetic resonance (CMR) can detect scar or infiltrative fibrosis in patients with ischemic or non-ischemic cardiomyopathy. Existing 2D T1ρ techniques have limited spatial coverage or require multiple breath-holds. The purpose of this project was to develop an accelerated, free-breathing 3D T1ρ mapping sequence with whole left ventricle coverage using a multicoil, compressed sensing (CS) reconstruction technique for rapid reconstruction of undersampled k-space data. METHODS We developed a cardiac- and respiratory-gated, free-breathing 3D T1ρ sequence and acquired data using a variable-density k-space sampling pattern (A = 3). The effect of the transient magnetization trajectory, incomplete recovery of magnetization between T1ρ-preparations (heart rate dependence), and k-space sampling pattern on T1ρ relaxation time error and edge blurring was analyzed using Bloch simulations for normal and chronically infarcted myocardium. Sequence accuracy and repeatability was evaluated using MnCl2 phantoms with different T1ρ relaxation times and compared to 2D measurements. We further assessed accuracy and repeatability in healthy subjects and compared these results to 2D breath-held measurements. RESULTS The error in T1ρ due to incomplete recovery of magnetization between T1ρ-preparations was T1ρhealthy = 6.1% and T1ρinfarct = 10.8% at 60 bpm and T1ρhealthy = 13.2% and T1ρinfarct = 19.6% at 90 bpm. At a heart rate of 60 bpm, error from the combined effects of readout-dependent magnetization transients, k-space undersampling and reordering was T1ρhealthy = 12.6% and T1ρinfarct = 5.8%. CS reconstructions had improved edge sharpness (blur metric = 0.15) compared to inverse Fourier transform reconstructions (blur metric = 0.48). There was strong agreement between the mean T1ρ estimated from the 2D and accelerated 3D data (R2 = 0.99; P < 0.05) acquired on the MnCl2 phantoms. The mean R1ρ estimated from the accelerated 3D sequence was highly correlated with MnCl2 concentration (R2 = 0.99; P < 0.05). 3D T1ρ acquisitions were successful in all human subjects. There was no significant bias between undersampled 3D T1ρ and breath-held 2D T1ρ (mean bias = 0.87) and the measurements had good repeatability (COV2D = 6.4% and COV3D = 7.1%). CONCLUSIONS This is the first report of an accelerated, free-breathing 3D T1ρ mapping of the left ventricle. This technique may improve non-contrast myocardial tissue characterization in patients with heart disease in a scan time appropriate for patients.
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Affiliation(s)
- Srikant Kamesh Iyer
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Brianna Moon
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Eileen Hwuang
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Yuchi Han
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Michael Solomon
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Harold Litt
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Walter R. Witschey
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
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Johnson CP, Wang L, Tóth F, Aruwajoye O, Carlson CS, Kim HKW, Ellermann JM. Quantitative MRI Helps to Detect Hip Ischemia: Preclinical Model of Legg-Calvé-Perthes Disease. Radiology 2018; 289:386-395. [PMID: 30063188 PMCID: PMC6209066 DOI: 10.1148/radiol.2018180497] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/16/2018] [Accepted: 06/04/2018] [Indexed: 12/22/2022]
Abstract
Purpose To determine whether quantitative MRI relaxation time mapping techniques can help to detect ischemic injury to the developing femoral head. Materials and Methods For this prospective animal study conducted from November 2015 to February 2018, 10 male 6-week-old piglets underwent an operation to induce complete right femoral head ischemia. Animals were humanely killed at 48 hours (n = 2) or 4 weeks (n = 8) after the operation, and the operated and contralateral-control femoral heads were harvested and frozen. Thawed specimens were imaged at 9.4-T MRI by using T1, T2, T1 in the rotating frame (T1ρ), adiabatic T1ρ, relaxation along a fictitious field (RAFF), and T2* mapping and evaluated with histologic analysis. Paired relaxation time differences between the operated and control femoral heads were measured in the secondary ossification center (SOC), epiphyseal cartilage, articular cartilage, and metaphysis and were analyzed by using a paired t test. Results In the SOC, T1ρ and RAFF had the greatest percent increases in the operated versus control femoral heads at both 48 hours (112% and 72%, respectively) and 4 weeks (74% and 70%, respectively). In the epiphyseal and articular cartilage, T2, T1ρ, and RAFF were similarly increased at both points (range, 24%-49%). At 4 weeks, T2, T1ρ, adiabatic T1ρ, and RAFF were increased in the SOC (P = .004, .018, < .001, and .001, respectively), epiphyseal cartilage (P = .009, .008, .011, and .007, respectively), and articular cartilage (P = .005, .016, .033, and .018, respectively). Histologic assessment identified necrosis in SOC and deep layer of the epiphyseal cartilage at both points. Conclusion T2, T1 in the rotating frame, adiabatic T1 in the rotating frame, and relaxation along a fictitious field maps are sensitive in helping to detect ischemic injury to the developing femoral head. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Casey P. Johnson
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Luning Wang
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Ferenc Tóth
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Olumide Aruwajoye
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Cathy S. Carlson
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Harry K. W. Kim
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Jutta M. Ellermann
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
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Jiang B, Chen W. On-resonance and off-resonance continuous wave constant amplitude spin-lock and T 1ρ quantification in the presence of B 1 and B 0 inhomogeneities. NMR IN BIOMEDICINE 2018; 31:e3928. [PMID: 29693744 DOI: 10.1002/nbm.3928] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 02/06/2018] [Accepted: 03/06/2018] [Indexed: 06/08/2023]
Abstract
Spin-lock MRI is a valuable diagnostic imaging technology, as it can be used to probe the macromolecule environment of tissues. Quantitative T1ρ imaging is one application of spin-lock MRI that is reported to be promising for a number of clinical applications. Spin-lock is often performed with a continuous RF wave at a constant RF amplitude either on resonance or off resonance. However, both on- and off-resonance spin-lock approaches are susceptible to B1 and B0 inhomogeneities, which results in image artifacts and quantification errors. In this work, we report a continuous wave constant amplitude spin-lock approach that can achieve negligible image artifacts in the presence of B1 and B0 inhomogeneities for both on- and off-resonance spin-lock. Under the adiabatic condition, by setting the maximum B1 amplitude of the adiabatic pulses equal to the B1 amplitude of spin-lock RF pulse, the spins are ensured to align along the effective field throughout the spin-lock process. We show that this results in simultaneous compensation of B1 and B0 inhomogeneities for both on- and off-resonance spin-lock. The relaxation effect during the entire adiabatic half passage (AHP) and reverse AHP, and the stationary solution of the Bloch-McConnell equation present at off-resonance frequency offset, are considered in the revised relaxation model. We demonstrate that these factors create a direct current component to the conventional relaxation model. In contrast to the previously reported dual-acquisition method, the revised relaxation model just requires one acquisition to perform quantification. The simulation, phantom, and in vivo experiments demonstrate that the proposed approach achieves superior image quality compared with the existing methods, and the revised relaxation model can perform T1ρ quantification with one acquisition instead of two.
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Affiliation(s)
- Baiyan Jiang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Weitian Chen
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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Yla-Herttuala E, Laidinen S, Laakso H, Liimatainen T. Quantification of myocardial infarct area based on T RAFFn relaxation time maps - comparison with cardiovascular magnetic resonance late gadolinium enhancement, T 1ρ and T 2 in vivo. J Cardiovasc Magn Reson 2018; 20:34. [PMID: 29879996 PMCID: PMC5992705 DOI: 10.1186/s12968-018-0463-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 05/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Two days after myocardial infarction (MI), the infarct consists mostly on necrotic tissue, and the myocardium is transformed through granulation tissue to scar in two weeks after the onset of ischemia in mice. In the current work, we determined and optimized cardiovascular magnetic resonance (CMR) methods for the detection of MI size during the scar formation without contrast agents in mice. METHODS We characterized MI and remote areas with rotating frame relaxation time mapping including relaxation along fictitious field in nth rotating frame (RAFFn), T1ρ and T2 relaxation time mappings at 1, 3, 7, and 21 days after MI. These results were compared to late gadolinium enhancement (LGE) and Sirius Red-stained histology sections, which were obtained at day 21 after MI. RESULTS All relaxation time maps showed significant differences in relaxation time between the MI and remote area. Areas of increased signal intensities after gadolinium injection and areas with increased TRAFF2 relaxation time were highly correlated with the MI area determined from Sirius Red-stained histology sections (LGE: R2 = 0.92, P < 0.01, TRAFF2: R2 = 0.95, P < 0.001). Infarct area determined based on T1ρ relaxation time correlated highly with Sirius Red histology sections (R2 = 0.97, P < 0.01). The smallest overestimation of the LGE-defined MI area was obtained for TRAFF2 (5.6 ± 4.2%) while for T1ρ overestimation percentage was > 9% depending on T1ρ pulse power. CONCLUSION T1ρ and TRAFF2 relaxation time maps can be used to determine accurately MI area at various time points in the mouse heart. Determination of MI size based on TRAFF2 relaxation time maps could be performed without contrast agents, unlike LGE, and with lower specific absorption rate compared to on-resonance T1ρ relaxation time mapping.
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Affiliation(s)
- Elias Yla-Herttuala
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Svetlana Laidinen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Hanne Laakso
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
- Center for Magnetic Resonance Research, Minneapolis, MN USA
| | - Timo Liimatainen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, University Hospital of Oulu, P.O. Box 50, 90029 OYS Oulu, Finland
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Khan MA, Laakso H, Laidinen S, Kettunen S, Heikura T, Ylä-Herttuala S, Liimatainen T. The follow-up of progressive hypertrophic cardiomyopathy using magnetic resonance rotating frame relaxation times. NMR IN BIOMEDICINE 2018; 31:e3871. [PMID: 29244217 DOI: 10.1002/nbm.3871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/20/2017] [Accepted: 10/29/2017] [Indexed: 06/07/2023]
Abstract
Magnetic resonance rotating frame relaxation times are an alternative non-contrast agent choice for the diagnosis of chronic myocardial infarct. Fibrosis typically occurs in progressive hypertrophic cardiomyopathy. Fibrosis has been imaged in myocardial infarcted tissue using rotating frame relaxation times, which provides the possibility to follow up progressive cardiomyopathy without contrast agents. Mild and severe left ventricular hypertrophy were induced in mice by transverse aortic constriction, and the longitudinal rotating frame relaxation times (T1ρ ) and relaxation along the fictitious field (TRAFF2 , TRAFF3 ) were measured at 5, 10, 24, 62 and 89 days after transverse aortic constriction in vivo. Myocardial fibrosis was verified using Masson's trichrome staining. Increases in the relative relaxation time differences of T1ρ , together with TRAFF2 and TRAFF3 , between fibrotic and remote tissues over time were observed. Furthermore, TRAFF2 and TRAFF3 showed higher relaxation times overall in fibrotic tissue than T1ρ . Relaxation time differences were highly correlated with an excess of histologically verified fibrosis. We found that TRAFF2 and TRAFF3 are more sensitive than T1ρ to hypertrophic cardiomyopathy-related tissue changes and can serve as non-invasive diagnostic magnetic resonance imaging markers to follow up the mouse model of progressive hypertrophic cardiomyopathy.
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Affiliation(s)
- Muhammad Arsalan Khan
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Hanne Laakso
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Svetlana Laidinen
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Sanna Kettunen
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Tommi Heikura
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Seppo Ylä-Herttuala
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
- Heart Center, Kuopio University Hospital, Kuopio, Finland
| | - Timo Liimatainen
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
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Lottonen-Raikaslehto L, Rissanen R, Gurzeler E, Merentie M, Huusko J, Schneider JE, Liimatainen T, Ylä-Herttuala S. Left ventricular remodeling leads to heart failure in mice with cardiac-specific overexpression of VEGF-B 167: echocardiography and magnetic resonance imaging study. Physiol Rep 2017; 5:5/6/e13096. [PMID: 28351964 PMCID: PMC5371547 DOI: 10.14814/phy2.13096] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 10/07/2016] [Accepted: 11/20/2016] [Indexed: 01/24/2023] Open
Abstract
Cardiac-specific overexpression of vascular endothelial growth factor (VEGF)-B167 is known to induce left ventricular hypertrophy due to altered lipid metabolism, in which ceramides accumulate to the heart and cause mitochondrial damage. The aim of this study was to evaluate and compare different imaging methods to find the most sensitive way to diagnose at early stage the progressive left ventricular remodeling leading to heart failure. Echocardiography and cardiovascular magnetic resonance imaging were compared for imaging the hearts of transgenic mice with cardiac-specific overexpression of VEGF-B167 and wild-type mice from 5 to 14 months of age at several time points. Disease progression was verified by molecular biology methods and histology. We showed that left ventricular remodeling is already ongoing at the age of 5 months in transgenic mice leading to heart failure by the age of 14 months. Measurements from echocardiography and cardiovascular magnetic resonance imaging revealed similar changes in cardiac structure and function in the transgenic mice. Changes in histology, gene expressions, and electrocardiography supported the progression of left ventricular hypertrophy. Longitudinal relaxation time in rotating frame (T1ρ ) in cardiovascular magnetic resonance imaging could be suitable for detecting severe fibrosis in the heart. We conclude that cardiac-specific overexpression of VEGF-B167 leads to left ventricular remodeling at early age and is a suitable model to study heart failure development with different imaging methods.
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Affiliation(s)
- Line Lottonen-Raikaslehto
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute for Molecular Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Riina Rissanen
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute for Molecular Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Erika Gurzeler
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute for Molecular Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Mari Merentie
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute for Molecular Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jenni Huusko
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute for Molecular Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jurgen E Schneider
- Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, United kingdom
| | - Timo Liimatainen
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute for Molecular Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Clinical Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Seppo Ylä-Herttuala
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute for Molecular Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland .,Gene Therapy Unit, Kuopio University Hospital, Kuopio, Finland.,Heart Center, Kuopio University Hospital, Kuopio, Finland
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A non-contrast CMR index for assessing myocardial fibrosis. Magn Reson Imaging 2017; 42:69-73. [PMID: 28461132 DOI: 10.1016/j.mri.2017.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/21/2017] [Accepted: 04/27/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE Safe, sensitive, and non-invasive imaging methods to assess the presence, extent, and turnover of myocardial fibrosis are needed for early stratification of risk in patients who might develop heart failure after myocardial infarction. We describe a non-contrast cardiac magnetic resonance (CMR) approach for sensitive detection of myocardial fibrosis using a canine model of myocardial infarction and reperfusion. METHODS Seven dogs had coronary thrombotic occlusion of the left anterior descending coronary arteries followed by fibrinolytic reperfusion. CMR studies were performed at 7days after reperfusion. A CMR spin-locking T1ρ mapping sequence was used to acquire T1ρ dispersion data with spin-lock frequencies of 0 and 511Hz. A fibrosis index map was derived on a pixel-by-pixel basis. CMR native T1 mapping, first-pass myocardial perfusion imaging, and post-contrast late gadolinium enhancement imaging were also performed for assessing myocardial ischemia and fibrosis. Hearts were dissected after CMR for histopathological staining and two myocardial tissue segments from the septal regions of adjacent left ventricular slices were qualitatively assessed to grade the extent of myocardial fibrosis. RESULTS Histopathology of 14 myocardial tissue segments from septal regions was graded as grade 1 (fibrosis area, <20% of a low power field, n=9), grade 2 (fibrosis area, 20-50% of field, n=4), or grade 3 (fibrosis area, >50% of field, n=1). A dramatic difference in fibrosis index (183%, P<0.001) was observed by CMR from grade 1 to 2, whereas differences were much smaller for T1ρ (9%, P=0.14), native T1 (5.5%, P=0.12), and perfusion (-21%, P=0.05). CONCLUSION A non-contrast CMR index based on T1ρ dispersion contrast was shown in preliminary studies to detect and correlate with the extent of myocardial fibrosis identified histopathologically. A non-contrast approach may have important implications for managing cardiac patients with heart failure, particularly in the presence of impaired renal function.
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Fibrosis quantification in Hypertensive Heart Disease with LVH and Non-LVH: Findings from T1 mapping and Contrast-free Cardiac Diffusion-weighted imaging. Sci Rep 2017; 7:559. [PMID: 28373647 PMCID: PMC5428770 DOI: 10.1038/s41598-017-00627-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 03/08/2017] [Indexed: 01/19/2023] Open
Abstract
This study assessed the extent of fibrosis and the relationship between the ADC value and systolic strain in hypertensive patients with left ventricular hypertrophy (HTN LVH) and hypertensive patients without LVH (HTN non-LVH) using cardiac diffusion-weighted imaging and T1 mapping. T1 mapping was performed in 13 HTN LVH (mean age, 56.23 ± 3.30 years), 17 HTN non-LVH (mean age, 56.41 ± 2.78 years), and 12 normal control subjects (mean age, 55.67 ± 3.08 years) with 3.0 T MRI using cardiac diffusion-weighted imaging and T1 mapping. HTN LVH subjects had higher native T1 (1233.12 ± 79.01) compared with controls (1133.88 ± 27.40) (p < 0.05). HTN LVH subjects had higher ECV (0.28 ± 0.03) compared with HTN non-LVH subjects (0.26 ± 0.02) or controls (0.24 ± 0.03) (p < 0.05). HTN LVH subjects had higher ADC (2.23 ± 0.34) compared with HTN non-LVH subjects (1.88 ± 0.27) or controls (1.61 ± 0.38), (p < 0.05). Positive associations were noted between LVMI and ADC (Spearman = 0.450, p < 0.05) and between LVMI and ECV (Spearman = 0.181, p < 0.05). ADC was also related to an increase in ECV (R2 = 0.210). Increased levels of ADC were associated with reduced peak systolic and early diastolic circumferential strain rates across all subjects. Contrast-free DW-CMR is an alternative sequence to ECV for the evaluation of fibrosis extent in HTN LVH and HTN non-LVH, while native T1 has limited value.
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Holzem KM. New cardiac magnetic resonance imaging modalities aid in the detection of myocardial fibrosis. Physiol Rep 2017; 5:5/6/e13135. [PMID: 28351965 PMCID: PMC5371551 DOI: 10.14814/phy2.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Katherine M. Holzem
- Department of Biomedical Engineering; Washington University; St. Louis Missouri 63130
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Stoffers RH, Madden M, Shahid M, Contijoch F, Solomon J, Pilla JJ, Gorman JH, Gorman RC, Witschey WR. Assessment of myocardial injury after reperfused infarction by T1ρ cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2017; 19:17. [PMID: 28196494 PMCID: PMC5310026 DOI: 10.1186/s12968-017-0332-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 01/24/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The evolution of T1ρ and of other endogenous contrast methods (T2, T1) in the first month after reperfused myocardial infarction (MI) is uncertain. We conducted a study of reperfused MI in pigs to serially monitor T1ρ, T2 and T1 relaxation, scar size and transmurality at 1 and 4 weeks post-MI. METHODS Ten Yorkshire swine underwent 90 min of occlusion of the circumflex artery and reperfusion. T1ρ, T2 and native T1 maps and late gadolinium enhanced (LGE) cardiovascular magnetic resonance (CMR) data were collected at 1 week (n = 10) and 4 weeks (n = 5). Semi-automatic FWHM (full width half maximum) thresholding was used to assess scar size and transmurality and compared to histology. Relaxation times and contrast-to-noise ratio were compared in healthy and remote myocardium at 1 and 4 weeks. Linear regression and Bland-Altman was performed to compare infarct size and transmurality. RESULTS Relaxation time differences between infarcted and remote myocardial tissue were ∆T1 (infarct-remote) = 421.3 ± 108.8 (1 week) and 480.0 ± 33.2 ms (4 week), ∆T1ρ = 68.1 ± 11.6 and 74.3 ± 14.2, and ∆T2 = 51.0 ± 10.1 and 59.2 ± 11.4 ms. Contrast-to-noise ratio was CNRT1 = 7.0 ± 3.5 (1 week) and 6.9 ± 2.4 (4 week), CNRT1ρ = 12.0 ± 6.2 and 12.3 ± 3.2, and CNRT2 = 8.0 ± 3.6 and 10.3 ± 5.8. Infarct size was not significantly different for T1ρ, T1 and T2 compared to LGE (p = 0.14) and significantly decreased from 1 to 4 weeks (p < 0.01). Individual infarct size changes were ∆T1ρ = -3.8%, ∆T1 = -3.5% and ∆LGE = -2.8% from 1 - 4 weeks, but there was no observed change in infarct size for T2 or histologically. CONCLUSIONS T1ρ was highly correlated with alterations left ventricle (LV) pathology at 1 and 4 weeks post-MI and therefore it may be a useful method endogenous contrast imaging of infarction.
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Affiliation(s)
- Rutger H. Stoffers
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Silverstein 3400 Spruce Street, Philadelphia, PA USA 19104
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, PA USA
| | - Marie Madden
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Silverstein 3400 Spruce Street, Philadelphia, PA USA 19104
| | - Mohammed Shahid
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Silverstein 3400 Spruce Street, Philadelphia, PA USA 19104
| | - Francisco Contijoch
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, PA USA
| | - Joseph Solomon
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Silverstein 3400 Spruce Street, Philadelphia, PA USA 19104
| | - James J. Pilla
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Silverstein 3400 Spruce Street, Philadelphia, PA USA 19104
| | - Joseph H. Gorman
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, PA USA
| | - Robert C. Gorman
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, PA USA
| | - Walter R.T. Witschey
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Silverstein 3400 Spruce Street, Philadelphia, PA USA 19104
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Peng XG, Wang Y, Zhang S, Bai Y, Mao H, Teng GJ, Ju S. Noninvasive assessment of age, gender, and exercise effects on skeletal muscle: Initial experience with T 1 ρ MRI of calf muscle. J Magn Reson Imaging 2016; 46:61-70. [PMID: 27862560 DOI: 10.1002/jmri.25546] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 10/25/2016] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To prospectively investigate age- and gender-related changes in the fast-twitch (tibialis anterior, TA) and slow-twitch (soleus, SOL) skeletal muscle of healthy rats and volunteers and to compare the exercise-related difference in health volunteers with T1 ρ magnetic resonance imaging (MRI). MATERIALS AND METHODS In all, 18 rats and 70 humans were involved in this study. For the animal study, T1 ρ relaxation times were measured in the TA and SOL rat muscle with a 3.0T MRI scanner and compared to histological data. For the human study, three groups (young, middle-aged, and elderly) of volunteers underwent T1 ρ MRI scans (3.0T) of their calves. To further differentiate the human scans, 18 volunteers were recruited, half of them (n = 9) routinely trained with high-intensity sports, while the other half (n = 9) with no physical training. Statistical analysis was performed via paired t-test, independent-sample t-test, and analysis of variance (ANOVA). Correlations between T1 ρ and age/gender/physical endurance were calculated. RESULTS The average T1 ρ relaxation times of the TA and SOL of female rats were higher than that of male rats (P < 0.001). The T1 ρ relaxation time of TA was significantly lower compared to SOL (P < 0.001). A significant linear correlation was observed between T1 ρ and the type I slow-twitch fiber proportion (%) in SOL (R2 = 0.837, P < 0.001). Similarly, in human studies the average T1 ρ relaxation times of TA were significantly lower than SOL for all age groups (P < 0.001). The higher T1 ρ relaxation times of TA and SOL in the elderly volunteers (P < 0.001) and in the females (P < 0.05) indicated significant age- and gender-dependent differences. In high-intensity sports groups, the higher T1 ρ in SOL (P < 0.01) and lower in TA (P < 0.05) were observed compared with the control group. CONCLUSION This study demonstrated that T1 ρ MRI can be used to display the differences in fast- and slow-twitch skeletal muscle as well as potentially age-, gender-, and exercise-related differences. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:61-70.
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Affiliation(s)
- Xin-Gui Peng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, P.R. China
| | - Yuancheng Wang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, P.R. China
| | - Shijun Zhang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, P.R. China
| | - Yingying Bai
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, P.R. China
| | - Hui Mao
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Gao-Jun Teng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, P.R. China
| | - Shenghong Ju
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, P.R. China
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Single Breath-Hold T1ρ-Mapping of the Heart for Endogenous Assessment of Myocardial Fibrosis. Invest Radiol 2016; 51:505-12. [DOI: 10.1097/rli.0000000000000261] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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43
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van Oorschot JWM, Güçlü F, de Jong S, Chamuleau SAJ, Luijten PR, Leiner T, Zwanenburg JJM. Endogenous assessment of diffuse myocardial fibrosis in patients with T 1ρ -mapping. J Magn Reson Imaging 2016; 45:132-138. [PMID: 27309545 DOI: 10.1002/jmri.25340] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 05/26/2016] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Recently, it was shown that a significantly higher T1ρ is found in compact myocardial fibrosis after chronic myocardial infarction. In this study, we investigated the feasibility of native T1ρ -mapping for the detection of diffuse myocardial fibrosis in patients with dilated cardiomyopathy (DCM). MATERIALS AND METHODS T1ρ -mapping was performed on three explanted hearts from DCM patients at 3 Tesla (T). Histological fibrosis quantification was performed, and compared with the T1ρ -relaxation times in the heart. Furthermore, twenty DCM patients underwent an MRI at 1.5T. Native T1ρ -maps, native T1 -maps, and extracellular volume (ECV)-maps were acquired. Additionally, eight healthy volunteers were scanned for reference values. RESULTS A significant correlation (Pearson r = 0.49; P = 0.005) was found between ex vivo T1ρ -values and fibrosis fraction from histology. Additionally, a significantly higher T1ρ -relaxation time (55.2 ± 2.7 ms) was found in DCM patients compared with healthy control subjects (51.5 ± 1.2 ms) (P = 0.0024). The relation between in vivo T1ρ -values and ECV-values was significant (Pearson r = 0.66). No significant relation was found between native T1 - and ECV-values in this study (P = 0.89). CONCLUSION This study showed proof of principle for the endogenous detection of diffuse myocardial fibrosis with T1ρ -MRI. Ex vivo and in vivo experiments showed promising results that T1ρ -MRI can be used to measure the extent of diffuse myocardial fibrosis in the myocardium. LEVEL OF EVIDENCE 2 J. Magn. Reson. Imaging 2017;45:132-138.
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Affiliation(s)
- Joep W M van Oorschot
- Philips Healthcare, Best, The Netherlands.,Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Fatih Güçlü
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne de Jong
- Department of Medical Physiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Steven A J Chamuleau
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Peter R Luijten
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jaco J M Zwanenburg
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
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Berisha S, Han J, Shahid M, Han Y, Witschey WRT. Measurement of Myocardial T1ρ with a Motion Corrected, Parametric Mapping Sequence in Humans. PLoS One 2016; 11:e0151144. [PMID: 27003184 PMCID: PMC4803208 DOI: 10.1371/journal.pone.0151144] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 02/23/2016] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To develop a robust T1ρ magnetic resonance imaging (MRI) sequence for assessment of myocardial disease in humans. MATERIALS AND METHODS We developed a breath-held T1ρ mapping method using a single-shot, T1ρ-prepared balanced steady-state free-precession (bSSFP) sequence. The magnetization trajectory was simulated to identify sources of T1ρ error. To limit motion artifacts, an optical flow-based image registration method was used to align T1ρ images. The reproducibility and accuracy of these methods was assessed in phantoms and 10 healthy subjects. Results are shown in 1 patient with pre-ventricular contractions (PVCs), 1 patient with chronic myocardial infarction (MI) and 2 patients with hypertrophic cardiomyopathy (HCM). RESULTS In phantoms, the mean bias was 1.0 ± 2.7 msec (100 msec phantom) and 0.9 ± 0.9 msec (60 msec phantom) at 60 bpm and 2.2 ± 3.2 msec (100 msec) and 1.4 ± 0.9 msec (60 msec) at 80 bpm. The coefficient of variation (COV) was 2.2 (100 msec) and 1.3 (60 msec) at 60 bpm and 2.6 (100 msec) and 1.4 (60 msec) at 80 bpm. Motion correction improved the alignment of T1ρ images in subjects, as determined by the increase in Dice Score Coefficient (DSC) from 0.76 to 0.88. T1ρ reproducibility was high (COV < 0.05, intra-class correlation coefficient (ICC) = 0.85-0.97). Mean myocardial T1ρ value in healthy subjects was 63.5 ± 4.6 msec. There was good correspondence between late-gadolinium enhanced (LGE) MRI and increased T1ρ relaxation times in patients. CONCLUSION Single-shot, motion corrected, spin echo, spin lock MRI permits 2D T1ρ mapping in a breath-hold with good accuracy and precision.
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Affiliation(s)
- Sebastian Berisha
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Joyce Han
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Mohammed Shahid
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Yuchi Han
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Walter R. T. Witschey
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Wang L, Yuan J, Zhang SJ, Gao M, Wang YC, Wang YX, Ju S. MyocardialT1rho mapping of patients with end-stage renal disease and its comparison withT1mapping andT2mapping: A feasibility and reproducibility study. J Magn Reson Imaging 2016; 44:723-31. [PMID: 26889749 DOI: 10.1002/jmri.25188] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 01/22/2016] [Indexed: 02/02/2023] Open
Affiliation(s)
- Lin Wang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital; Medical School of Southeast University; Nanjing China
| | - Jing Yuan
- Medical Physics and Research Department; Hong Kong Sanatorium & Hospital; Happy Valley Hong Kong SAR China
| | - Shi-Jun Zhang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital; Medical School of Southeast University; Nanjing China
| | - Min Gao
- Department of Nephology, Zhongda Hospital; Medical School of Southeast University; Nanjing China
| | - Yuan-Cheng Wang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital; Medical School of Southeast University; Nanjing China
| | - Yi-Xiang Wang
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital; the Chinese University of Hong Kong; Shatin Hong Kong SAR China
| | - Shenghong Ju
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital; Medical School of Southeast University; Nanjing China
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Nguyen C, Lu M, Fan Z, Bi X, Kellman P, Zhao S, Li D. Contrast-free detection of myocardial fibrosis in hypertrophic cardiomyopathy patients with diffusion-weighted cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2015; 17:107. [PMID: 26631061 PMCID: PMC4668676 DOI: 10.1186/s12968-015-0214-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/24/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUNDS Previous studies have shown that diffusion-weighted cardiovascular magnetic resonance (DW-CMR) is highly sensitive to replacement fibrosis of chronic myocardial infarction. Despite this sensitivity to myocardial infarction, DW-CMR has not been established as a method to detect diffuse myocardial fibrosis. We propose the application of a recently developed DW-CMR technique to detect diffuse myocardial fibrosis in hypertrophic cardiomyopathy (HCM) patients and compare its performance with established CMR techniques. METHODS HCM patients (N = 23) were recruited and scanned with the following protocol: standard morphological localizers, DW-CMR, extracellular volume (ECV) CMR, and late gadolinium enhanced (LGE) imaging for reference. Apparent diffusion coefficient (ADC) and ECV maps were segmented into 6 American Heart Association (AHA) segments. Positive regions for myocardial fibrosis were defined as: ADC > 2.0 μm(2)/ms and ECV > 30%. Fibrotic and non-fibrotic mean ADC and ECV values were compared as well as ADC-derived and ECV-derived fibrosis burden. In addition, fibrosis regional detection was compared between ADC and ECV calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) using ECV as the gold-standard reference. RESULTS ADC (2.4 ± 0.2 μm(2)/ms) of fibrotic regions (ADC > 2.0 μm(2)/ms) was significantly (p < 0.01) higher than ADC (1.5 ± 0.2 μm(2)/ms) of non-fibrotic regions. Similarly, ECV (35 ± 4%) of fibrotic regions (ECV > 30%) was significantly (p < 0.01) higher than ECV (26 ± 2%) of non-fibrotic regions. In fibrotic regions defined by ECV, ADC (2.2 ± 0.3 μm(2)/ms) was again significantly (p < 0.05) higher than ADC (1.6 ± 0.3 μm(2)/ms) of non-fibrotic regions. In fibrotic regions defined by ADC criterion, ECV (34 ± 5%) was significantly (p < 0.01) higher than ECV (28 ± 3%) in non-fibrotic regions. ADC-derived and ECV-derived fibrosis burdens were in substantial agreement (intra-class correlation = 0.83). Regional detection between ADC and ECV of diffuse fibrosis yielded substantial agreement (κ = 0.66) with high sensitivity, specificity, PPV, NPV, and accuracy (0.80, 0.85, 0.81, 0.85, and 0.83, respectively). CONCLUSION DW-CMR is sensitive to diffuse myocardial fibrosis and is capable of characterizing the extent of fibrosis in HCM patients.
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Affiliation(s)
- Christopher Nguyen
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA.
| | - Minjie Lu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China.
- National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China.
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Xiaoming Bi
- MR R&D, Siemens Healthcare, Los Angeles, CA, USA.
| | - Peter Kellman
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Shihua Zhao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China.
- National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China.
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA.
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Wáng YXJ, Zhang Q, Li X, Chen W, Ahuja A, Yuan J. T1ρ magnetic resonance: basic physics principles and applications in knee and intervertebral disc imaging. Quant Imaging Med Surg 2015; 5:858-85. [PMID: 26807369 PMCID: PMC4700236 DOI: 10.3978/j.issn.2223-4292.2015.12.06] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 12/06/2015] [Indexed: 12/15/2022]
Abstract
T1ρ relaxation time provides a new contrast mechanism that differs from T1- and T2-weighted contrast, and is useful to study low-frequency motional processes and chemical exchange in biological tissues. T1ρ imaging can be performed in the forms of T1ρ-weighted image, T1ρ mapping and T1ρ dispersion. T1ρ imaging, particularly at low spin-lock frequency, is sensitive to B0 and B1 inhomogeneity. Various composite spin-lock pulses have been proposed to alleviate the influence of field inhomogeneity so as to reduce the banding-like spin-lock artifacts. T1ρ imaging could be specific absorption rate (SAR) intensive and time consuming. Efforts to address these issues and speed-up data acquisition are being explored to facilitate wider clinical applications. This paper reviews the T1ρ imaging's basic physic principles, as well as its application for cartilage imaging and intervertebral disc imaging. Compared to more established T2 relaxation time, it has been shown that T1ρ provides more sensitive detection of proteoglycan (PG) loss at early stages of cartilage degeneration. T1ρ has also been shown to provide more sensitive evaluation of annulus fibrosis (AF) degeneration of the discs.
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Zhao F, Yuan J, Lu G, Zhang LH, Chen ZY, Wáng YXJ. T1ρ relaxation time in brain regions increases with ageing: an experimental MRI observation in rats. Br J Radiol 2015; 89:20140704. [PMID: 26529226 DOI: 10.1259/bjr.20140704] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE T1ρ variation is associated with neurodegenerative diseases. This study aims to observe T1ρ relaxation time changes in rat brains associated with normal ageing in Sprague-Dawley (SD) rats, Wistar Kyoto (WKY) rats and spontaneously hypertension rats (SHRs). METHODS 18 male SD rats, 11 male WKY rats and 11 male SHRs were used. T1ρ measurement was performed at 3-T MR with a spin-lock frequency of 500 Hz. SD rats were scanned at the ages of 5, 8, 10 and 15 months. SHRs and WKY rats were scanned at the ages of 6, 9 and 12 months. RESULTS For SD rats, T1ρ at the thalamus, hippocampus and frontal cortices increased significantly from 5 to 15 months (p < 0.05). For the WKY rats and SHRs, the T1ρ values in the thalamus, hippocampus and frontal cortices also increased significantly from 6 to 12 months (p < 0.05). Furthermore, T1ρ in the thalamus, hippocampus and frontal cortices of SHRs were consistently higher than those of WKY rats at the ages of 6, 9 and 12 months (p < 0.05). The percentage regional T1ρ differences between WKY rats and SHRs did not change during ageing. CONCLUSION An increase in T1ρ was associated with age-related changes of the rat brain. ADVANCES IN KNOWLEDGE An age-related and hypertension-related T1ρ increase in rat brain regions was observed in the thalamus, hippocampus and frontal cortical regions of the rat brain.
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Affiliation(s)
- Feng Zhao
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Jing Yuan
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.,2 Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong
| | - Gang Lu
- 3 Division of Neurosurgery, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Li H Zhang
- 4 School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Zhi Y Chen
- 5 Laboratory of Ultrasound Molecular Imaging, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yì-Xiáng J Wáng
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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Abstract
The spin-lattice relaxation time constant in rotating frame (T1rho) is useful for assessment of the properties of macromolecular environment inside tissue. Quantification of T1rho is found promising in various clinical applications. However, T1rho imaging is prone to image artifacts and quantification errors, which remains one of the greatest challenges to adopt this technique in routine clinical practice. The conventional continuous wave spin-lock is susceptible to B1 radiofrequency (RF) and B0 field inhomogeneity, which appears as banding artifacts in acquired images. A number of methods have been reported to modify T1rho prep RF pulse cluster to mitigate this effect. Adiabatic RF pulse can also be used for spin-lock with insensitivity to both B1 RF and B0 field inhomogeneity. Another source of quantification error in T1rho imaging is signal evolution during imaging data acquisition. Care is needed to affirm such error does not take place when specific pulse sequence is used for imaging data acquisition. Another source of T1rho quantification error is insufficient signal-to-noise ratio (SNR), which is common among various quantitative imaging approaches. Measurement of T1rho within an ROI can mitigate this issue, but at the cost of reduced resolution. Noise-corrected methods are reported to address this issue in pixel-wise quantification. For certain tissue type, T1rho quantification can be confounded by magic angle effect and the presence of multiple tissue components. Review of these confounding factors from inherent tissue properties is not included in this article.
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Affiliation(s)
- Weitian Chen
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
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50
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Tarkia M, Stark C, Haavisto M, Kentala R, Vähäsilta T, Savunen T, Strandberg M, Hynninen VV, Saunavaara V, Tolvanen T, Teräs M, Rokka J, Pietilä M, Saukko P, Roivainen A, Saraste A, Knuuti J. Cardiac remodeling in a new pig model of chronic heart failure: Assessment of left ventricular functional, metabolic, and structural changes using PET, CT, and echocardiography. J Nucl Cardiol 2015; 22:655-65. [PMID: 25698475 DOI: 10.1007/s12350-015-0068-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/26/2014] [Indexed: 01/19/2023]
Abstract
AIMS Large animal models are needed to study disease mechanisms in heart failure (HF). In the present study we characterized the functional, metabolic, and structural changes of myocardium in a novel pig model of chronic myocardial infarction (MI) by using multimodality imaging and histology. METHODS AND RESULTS Male farm pigs underwent a two-step occlusion of the left anterior descending coronary artery with concurrent distal ligation and implantation of a proximal ameroid constrictor (HF group), or sham operation (control group). Three months after the operation, cardiac output and wall stress were measured by echocardiography. Left ventricle (LV) volumes and mass were measured by computed tomography (CT). Myocardial perfusion was evaluated by [(15)O]water and oxygen consumption using [(11)C]acetate positron emission tomography, and the efficiency of myocardial work was calculated. Histological examinations were conducted to detect MI, hypertrophy, and fibrosis. Animals in the HF group had a large anterior MI scar. CT showed larger LV diastolic volume and lower ejection fraction in HF pigs than in controls. Perfusion and oxygen consumption in the remote non-infarcted myocardium were preserved in HF pigs as compared to controls. Global LV work and efficiency were significantly lower in HF than control pigs and was associated with increased wall stress. Histology showed myocyte hypertrophy but not increased interstitial fibrosis in the remote segments in HF pigs. CONCLUSIONS The chronic post-infarction model of HF is suitable for studies aimed to evaluate LV remodeling and changes in oxidative metabolism and can be useful for testing new therapies for HF.
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Affiliation(s)
- Miikka Tarkia
- Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland,
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