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Sollmann N, Fuderer M, Crameri F, Weingärtner S, Baeßler B, Gulani V, Keenan KE, Mandija S, Golay X, deSouza NM. Color Maps: Facilitating the Clinical Impact of Quantitative MRI. J Magn Reson Imaging 2024. [PMID: 39180202 DOI: 10.1002/jmri.29573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 08/05/2024] [Accepted: 08/05/2024] [Indexed: 08/26/2024] Open
Abstract
Presenting quantitative data using non-standardized color maps potentially results in unrecognized misinterpretation of data. Clinically meaningful color maps should intuitively and inclusively represent data without misleading interpretation. Uniformity of the color gradient for color maps is critically important. Maximal color and lightness contrast, readability for color vision-impaired individuals, and recognizability of the color scheme are highly desirable features. This article describes the use of color maps in five key quantitative MRI techniques: relaxometry, diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE)-MRI, MR elastography (MRE), and water-fat MRI. Current display practice of color maps is reviewed and shortcomings against desirable features are highlighted. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Miha Fuderer
- Radiotherapy, Division Imaging and Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Sebastian Weingärtner
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Bettina Baeßler
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Vikas Gulani
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kathryn E Keenan
- Physical Measurement Laboratory, National Institute of Standards and Technology, Boulder, Colorado, USA
| | - Stefano Mandija
- Radiotherapy, Division Imaging and Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Xavier Golay
- Queen Square Institute of Neurology, University College London, London, UK
- Gold Standard Phantoms, Sheffield, UK
- Bioxydyn, Manchester, UK
| | - Nandita M deSouza
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
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Muser D, Chahal AA, Selvanayagam JB, Nucifora G. Clinical Applications of Cardiac Magnetic Resonance Parametric Mapping. Diagnostics (Basel) 2024; 14:1816. [PMID: 39202304 PMCID: PMC11353869 DOI: 10.3390/diagnostics14161816] [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: 03/15/2024] [Revised: 06/03/2024] [Accepted: 07/01/2024] [Indexed: 09/03/2024] Open
Abstract
Cardiovascular magnetic resonance (CMR) imaging is widely regarded as the gold-standard technique for myocardial tissue characterization, allowing for the detection of structural abnormalities such as myocardial fatty replacement, myocardial edema, myocardial necrosis, and/or fibrosis. Historically, the identification of abnormal myocardial regions relied on variations in tissue signal intensity, often necessitating the use of exogenous contrast agents. However, over the past two decades, innovative parametric mapping techniques have emerged, enabling the direct quantitative assessment of tissue magnetic resonance (MR) properties on a voxel-by-voxel basis. These mapping techniques offer significant advantages by providing comprehensive and precise information that can be translated into color-coded maps, facilitating the identification of subtle or diffuse myocardial abnormalities. As unlikely conventional methods, these techniques do not require a substantial amount of structurally altered tissue to be visually identifiable as an area of abnormal signal intensity, eliminating the reliance on contrast agents. Moreover, these parametric mapping techniques, such as T1, T2, and T2* mapping, have transitioned from being primarily research tools to becoming valuable assets in the clinical diagnosis and risk stratification of various cardiac disorders. In this review, we aim to elucidate the underlying physical principles of CMR parametric mapping, explore its current clinical applications, address potential pitfalls, and outline future directions for research and development in this field.
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Affiliation(s)
- Daniele Muser
- Cardiac Electrophysiology Unit, Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy;
- Cardiac Electrophysiology, Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Anwar A. Chahal
- Center for Inherited Cardiovascular Diseases, WellSpan Health, Lancaster, PA 17601, USA;
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London E1 1BB, UK
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Joseph B. Selvanayagam
- Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, SA 5042, Australia;
| | - Gaetano Nucifora
- Cardiac Imaging Unit, NorthWest Heart Centre, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester M13 9PL, UK
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Lian C, Zhuang L, Wang Z, Liang J, Wu Y, Huang Y, Dai Y, Huang R. The diagnostic performance of T1 mapping in the assessment of breast lesions: A preliminary study. Eur J Radiol 2024; 177:111589. [PMID: 38941821 DOI: 10.1016/j.ejrad.2024.111589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 06/12/2024] [Accepted: 06/24/2024] [Indexed: 06/30/2024]
Abstract
PURPOSE To assess T1 mapping performance in distinguishing between benign and malignant breast lesions and to explore its correlation with histopathologic features in breast cancer. METHODS This study prospectively enrolled 103 participants with a total of 108 lesions, including 25 benign and 83 malignant lesions. T1 mapping, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) were performed. Two radiologists independently outlined the ROIs and analyzed T1 and apparent diffusion coefficient (ADC) values for each lesion, assessing interobserver reliability with the intraclass correlation coefficient (ICC). T1 and ADC values were compared between benign and malignant lesions, across different histopathological characteristics (histological grades, estrogen, progesterone and HER2 receptors expression, Ki67, N status). Receiver operating characteristic (ROC) analysis and Pearson correlation coefficient (ρ) were performed. RESULTS T1 values showed statistically significant differences between benign and malignant groups (P < 0.001), with higher values in the malignant (1817.08 ms ± 126.64) compared to the benign group (1429.31 ms ± 167.66). In addition, T1 values significantly increased in the ER (-) group (P = 0.001). No significant differences were found in T1 values among HER2, Ki67, N status, and histological grades groups. Furthermore, T1 values exhibited a significant correlation (ρ) with ER (P < 0.01) and PR (P = 0.03). The AUC for T1 value in distinguishing benign from malignant lesions was 0.69 (95 % CI: 0.55 - 0.82, P = 0.005), and for evaluating ER status, it was 0.75 (95 % CI: 0.62 - 0.87, P = 0.002). CONCLUSIONS T1 mapping holds the potential as an imaging biomarker to assist in the discrimination of benign and malignant breast lesions and assessing the ER expression status in breast cancer.
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Affiliation(s)
- Chun Lian
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P. R. China
| | - Lulu Zhuang
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P. R. China
| | - Zehao Wang
- Department of Nuclear Medicine, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P. R. China
| | - Jianle Liang
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P. R. China
| | - Yanxia Wu
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P. R. China
| | - Yifan Huang
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P. R. China
| | - Yi Dai
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P. R. China.
| | - Rong Huang
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P. R. China.
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Pan NY, Huang TY, Yu JJ, Peng HH, Chuang TC, Lin YR, Chung HW, Wu MT. Virtual MOLLI Target: Generative Adversarial Networks Toward Improved Motion Correction in MRI Myocardial T1 Mapping. J Magn Reson Imaging 2024. [PMID: 38563660 DOI: 10.1002/jmri.29373] [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: 07/31/2023] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The modified Look-Locker inversion recovery (MOLLI) sequence is commonly used for myocardial T1 mapping. However, it acquires images with different inversion times, which causes difficulty in motion correction for respiratory-induced misregistration to a given target image. HYPOTHESIS Using a generative adversarial network (GAN) to produce virtual MOLLI images with consistent heart positions can reduce respiratory-induced misregistration of MOLLI datasets. STUDY TYPE Retrospective. POPULATION 1071 MOLLI datasets from 392 human participants. FIELD STRENGTH/SEQUENCE Modified Look-Locker inversion recovery sequence at 3 T. ASSESSMENT A GAN model with a single inversion time image as input was trained to generate virtual MOLLI target (VMT) images at different inversion times which were subsequently used in an image registration algorithm. Four VMT models were investigated and the best performing model compared with the standard vendor-provided motion correction (MOCO) technique. STATISTICAL TESTS The effectiveness of the motion correction technique was assessed using the fitting quality index (FQI), mutual information (MI), and Dice coefficients of motion-corrected images, plus subjective quality evaluation of T1 maps by three independent readers using Likert score. Wilcoxon signed-rank test with Bonferroni correction for multiple comparison. Significance levels were defined as P < 0.01 for highly significant differences and P < 0.05 for significant differences. RESULTS The best performing VMT model with iterative registration demonstrated significantly better performance (FQI 0.88 ± 0.03, MI 1.78 ± 0.20, Dice 0.84 ± 0.23, quality score 2.26 ± 0.95) compared to other approaches, including the vendor-provided MOCO method (FQI 0.86 ± 0.04, MI 1.69 ± 0.25, Dice 0.80 ± 0.27, quality score 2.16 ± 1.01). DATA CONCLUSION Our GAN model generating VMT images improved motion correction, which may assist reliable T1 mapping in the presence of respiratory motion. Its robust performance, even with considerable respiratory-induced heart displacements, may be beneficial for patients with difficulties in breath-holding. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Nai-Yu Pan
- Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Teng-Yi Huang
- Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Jui-Jung Yu
- Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Hsu-Hsia Peng
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Tzu-Chao Chuang
- Department of Electrical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Yi-Ru Lin
- Department of Electronic and Computer Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Hsiao-Wen Chung
- Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Ming-Ting Wu
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Roehl M, Conway M, Ghonim S, Ferreira PF, Nielles-Vallespin S, Babu-Narayan SV, Pennell DJ, Gatehouse PD, Scott AD. STEAM-SASHA: a novel approach for blood- and fat-suppressed native T1 measurement in the right ventricular myocardium. MAGMA (NEW YORK, N.Y.) 2024; 37:295-305. [PMID: 38216813 PMCID: PMC10995026 DOI: 10.1007/s10334-023-01141-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE The excellent blood and fat suppression of stimulated echo acquisition mode (STEAM) can be combined with saturation recovery single-shot acquisition (SASHA) in a novel STEAM-SASHA sequence for right ventricular (RV) native T1 mapping. MATERIALS AND METHODS STEAM-SASHA splits magnetization preparation over two cardiac cycles, nulling blood signal and allowing fat signal to decay. Breath-hold T1 mapping was performed in a T1 phantom and twice in 10 volunteers using STEAM-SASHA and a modified Look-Locker sequence at peak systole at 3T. T1 was measured in 3 RV regions, the septum and left ventricle (LV). RESULTS In phantoms, MOLLI under-estimated while STEAM-SASHA over-estimated T1, on average by 3.0% and 7.0% respectively, although at typical 3T myocardial T1 (T1 > 1200 ms) STEAM-SASHA was more accurate. In volunteers, T1 was higher using STEAM-SASHA than MOLLI in the LV and septum (p = 0.03, p = 0.006, respectively), but lower in RV regions (p > 0.05). Inter-study, inter-observer and intra-observer coefficients of variation in all regions were < 15%. Blood suppression was excellent with STEAM-SASHA and noise floor effects were minimal. DISCUSSION STEAM-SASHA provides accurate and reproducible T1 in the RV with excellent blood and fat suppression. STEAM-SASHA has potential to provide new insights into pathological changes in the RV in future studies.
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Affiliation(s)
- Malte Roehl
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Miriam Conway
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sarah Ghonim
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Pedro F Ferreira
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sonia Nielles-Vallespin
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sonya V Babu-Narayan
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Dudley J Pennell
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter D Gatehouse
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andrew D Scott
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, UK.
- National Heart and Lung Institute, Imperial College London, London, UK.
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Liu Y, Wang L, Zhu J, Chen M, Zhu M, Dai Y, Hu C. Prognostic value of native T1 and extracellular volume in patients with immunoglubin light-chain amyloidosis. BMC Cardiovasc Disord 2024; 24:112. [PMID: 38365569 PMCID: PMC10873927 DOI: 10.1186/s12872-024-03756-8] [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: 01/09/2023] [Accepted: 01/30/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Cardiac involvement in patients with immunoglubin light-chain amyloidosis (AL) is a major determinant of treatment choice and prognosis, and early identification of high-risk patients can initiate intensive treatment strategies to achieve better survival. This study aimed to investigate the prognostic value of native T1 and ECV in patients with AL-cardiac amyloidosis (CA). METHODS A total of 38 patients (mean age 59 ± 11 years) with AL diagnosed histopathologically from July 2017 to October 2021 were collected consecutively. All patients were performed 3.0-T cardiac magnetic resonance (CMR) including cine, T1 mapping, and late gadolinium enhancement (LGE). Pre- and post-contrast T1 mapping images were transferred to a dedicated research software package (CVI42 v5.11.3) to create parametric T1 and ECV values. In addition, clinical and laboratory data of all patients were collected, and patients or their family members were regularly followed up by telephone every 3 months. The starting point of follow-up was the time of definitive pathological diagnosis, and the main endpoint was all-cause death. Kaplan-Meier analysis and Cox proportional risk model were used to evaluate the association between native T1 and ECV and death in patients with CA. RESULTS After a median follow-up of 27 (16, 37) months, 12 patients with CA died. Kaplan-Meier analysis showed that elevated native T1 and ECV were closely associated with poor prognosis in patients with CA. The survival rate of patients with ECV > 44% and native T1 > 1389ms were significantly lower than that of patients with ECV ≤ 44% and native T1 ≤ 1389ms (Log-rank P < 0.001), and was not associated with the presence of LGE. After adjusting for clinical risk factors and CMR measurements in a stepwise multivariate Cox regression model, ECV [risk ratio (HR):1.37, 95%CI: 1.09-1.73, P = 0.008] and native T1 (HR:1.01, 95%CI: 1.00-1.02, P = 0.037) remained independent predictors of all-cause mortality in patients with CA. CONCLUSIONS Both native T1 and ECV were independently prognostic for mortality in patients with CA, and can be used as important indicators for clinical prognosis assessment of AL.
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Affiliation(s)
- Yumeng Liu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Lingjie Wang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Jingfen Zhu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Meng Chen
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Mo Zhu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Yingyu Dai
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
| | - Chunhong Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
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Vitouš J, Jiřík R, Stračina T, Hendrych M, Nádeníček J, Macíček O, Tian Y, Krátká L, Dražanová E, Nováková M, Babula P, Panovský R, DiBella E, Starčuk Z. T1 mapping of myocardium in rats using self-gated golden-angle acquisition. Magn Reson Med 2024; 91:368-380. [PMID: 37811699 DOI: 10.1002/mrm.29846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/19/2023] [Accepted: 08/10/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE The aim of this study is to design a method of myocardial T1 quantification in small laboratory animals and to investigate the effects of spatiotemporal regularization and the needed acquisition duration. METHODS We propose a compressed-sensing approach to T1 quantification based on self-gated inversion-recovery radial two/three-dimensional (2D/3D) golden-angle stack-of-stars acquisition with image reconstruction performed using total-variation spatiotemporal regularization. The method was tested on a phantom and on a healthy rat, as well as on rats in a small myocardium-remodeling study. RESULTS The results showed a good match of the T1 estimates with the results obtained using the ground-truth method on a phantom and with the literature values for rats myocardium. The proposed 2D and 3D methods showed significant differences between normal and remodeling myocardium groups for acquisition lengths down to approximately 5 and 15 min, respectively. CONCLUSIONS A new 2D and 3D method for quantification of myocardial T1 in rats was proposed. We have shown the capability of both techniques to distinguish between normal and remodeling myocardial tissue. We have shown the effects of image-reconstruction regularization weights and acquisition length on the T1 estimates.
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Affiliation(s)
- Jiří Vitouš
- Institute of Scientific Instruments, Czech Academy of Sciences, Brno, Czechia
- Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czechia
| | - Radovan Jiřík
- Institute of Scientific Instruments, Czech Academy of Sciences, Brno, Czechia
| | - Tibor Stračina
- Department of Physiology, Masaryk University, Faculty of Medicine, Brno, Czechia
| | - Michal Hendrych
- First Department of Pathology, St. Anne's University Hospital and Faculty of Medicine Masaryk University, Brno, Czechia
| | - Jaroslav Nádeníček
- Department of Physiology, Masaryk University, Faculty of Medicine, Brno, Czechia
| | - Ondřej Macíček
- Institute of Scientific Instruments, Czech Academy of Sciences, Brno, Czechia
| | - Ye Tian
- Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
| | - Lucie Krátká
- Institute of Scientific Instruments, Czech Academy of Sciences, Brno, Czechia
| | - Eva Dražanová
- Institute of Scientific Instruments, Czech Academy of Sciences, Brno, Czechia
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Marie Nováková
- Department of Physiology, Masaryk University, Faculty of Medicine, Brno, Czechia
| | - Petr Babula
- Department of Physiology, Masaryk University, Faculty of Medicine, Brno, Czechia
| | - Roman Panovský
- International Clinical Research Center, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czechia
- 1st Department of Internal Medicine/Cardioangiology, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Edward DiBella
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Zenon Starčuk
- Institute of Scientific Instruments, Czech Academy of Sciences, Brno, Czechia
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Božić‐Iven M, Rapacchi S, Tao Q, Pierce I, Thornton G, Nitsche C, Treibel TA, Schad LR, Weingärtner S. Improved reproducibility for myocardial ASL: Impact of physiological and acquisition parameters. Magn Reson Med 2024; 91:118-132. [PMID: 37667643 PMCID: PMC10962577 DOI: 10.1002/mrm.29834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE To investigate and mitigate the influence of physiological and acquisition-related parameters on myocardial blood flow (MBF) measurements obtained with myocardial Arterial Spin Labeling (myoASL). METHODS A Flow-sensitive Alternating Inversion Recovery (FAIR) myoASL sequence with bSSFP and spoiled GRE (spGRE) readout is investigated for MBF quantification. Bloch-equation simulations and phantom experiments were performed to evaluate how variations in acquisition flip angle (FA), acquisition matrix size (AMS), heart rate (HR) and bloodT 1 $$ {\mathrm{T}}_1 $$ relaxation time (T 1 , B $$ {\mathrm{T}}_{1,B} $$ ) affect quantification of myoASL-MBF. In vivo myoASL-images were acquired in nine healthy subjects. A corrected MBF quantification approach was proposed based on subject-specificT 1 , B $$ {\mathrm{T}}_{1,B} $$ values and, for spGRE imaging, subtracting an additional saturation-prepared baseline from the original baseline signal. RESULTS Simulated and phantom experiments showed a strong dependence on AMS and FA (R 2 $$ {R}^2 $$ >0.73), which was eliminated in simulations and alleviated in phantom experiments using the proposed saturation-baseline correction in spGRE. Only a very mild HR dependence (R 2 $$ {R}^2 $$ >0.59) was observed which was reduced when calculating MBF with individualT 1 , B $$ {\mathrm{T}}_{1,B} $$ . For corrected spGRE, in vivo mean global spGRE-MBF ranged from 0.54 to 2.59 mL/g/min and was in agreement with previously reported values. Compared to uncorrected spGRE, the intra-subject variability within a measurement (0.60 mL/g/min), between measurements (0.45 mL/g/min), as well as the inter-subject variability (1.29 mL/g/min) were improved by up to 40% and were comparable with conventional bSSFP. CONCLUSION Our results show that physiological and acquisition-related factors can lead to spurious changes in myoASL-MBF if not accounted for. Using individualT 1 , B $$ {\mathrm{T}}_{1,B} $$ and a saturation-baseline can reduce these variations in spGRE and improve reproducibility of FAIR-myoASL against acquisition parameters.
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Affiliation(s)
- Maša Božić‐Iven
- Medical Faculty MannheimHeidelberg UniversityMannheimGermany
- Department of Imaging PhysicsDelft University of TechnologyDelftThe Netherlands
| | | | - Qian Tao
- Department of Imaging PhysicsDelft University of TechnologyDelftThe Netherlands
| | - Iain Pierce
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
| | - George Thornton
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
- Institute of Cardiovascular ScienceUniversity College LondonLondonUK
| | - Christian Nitsche
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
- Institute of Cardiovascular ScienceUniversity College LondonLondonUK
- Division of CardiologyMedical University of ViennaViennaAustria
| | - Thomas A. Treibel
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
- Institute of Cardiovascular ScienceUniversity College LondonLondonUK
| | - Lothar R. Schad
- Medical Faculty MannheimHeidelberg UniversityMannheimGermany
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9
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Gröschel J, Trauzeddel RF, Müller M, von Knobelsdorff-Brenkenhoff F, Viezzer D, Hadler T, Blaszczyk E, Daud E, Schulz-Menger J. Multi-site comparison of parametric T1 and T2 mapping: healthy travelling volunteers in the Berlin research network for cardiovascular magnetic resonance (BER-CMR). J Cardiovasc Magn Reson 2023; 25:47. [PMID: 37574535 PMCID: PMC10424349 DOI: 10.1186/s12968-023-00954-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Parametric mapping sequences in cardiovascular magnetic resonance (CMR) allow for non-invasive myocardial tissue characterization. However quantitative myocardial mapping is still limited by the need for local reference values. Confounders, such as field strength, vendors and sequences, make intersite comparisons challenging. This exploratory study aims to assess whether multi-site studies that control confounding factors provide first insights whether parametric mapping values are within pre-defined tolerance ranges across scanners and sites. METHODS A cohort of 20 healthy travelling volunteers was prospectively scanned at three sites with a 3 T scanner from the same vendor using the same scanning protocol and acquisition scheme. A Modified Look-Locker inversion recovery sequence (MOLLI) for T1 and a fast low-angle shot sequence (FLASH) for T2 were used. At one site a scan-rescan was performed to assess the intra-scanner reproducibility. All acquired T1- and T2-mappings were analyzed in a core laboratory using the same post-processing approach and software. RESULTS After exclusion of one volunteer due to an accidentally diagnosed cardiac disease, T1- and T2-maps of 19 volunteers showed no significant differences between the 3 T sites (mean ± SD [95% confidence interval] for global T1 in ms: site I: 1207 ± 32 [1192-1222]; site II: 1207 ± 40 [1184-1225]; site III: 1219 ± 26 [1207-1232]; p = 0.067; for global T2 in ms: site I: 40 ± 2 [39-41]; site II: 40 ± 1 [39-41]; site III 39 ± 2 [39-41]; p = 0.543). CONCLUSION Parametric mapping results displayed initial hints at a sufficient similarity between sites when confounders, such as field strength, vendor diversity, acquisition schemes and post-processing analysis are harmonized. This finding needs to be confirmed in a powered clinical trial. Trial registration ISRCTN14627679 (retrospectively registered).
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Affiliation(s)
- Jan Gröschel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, ECRC Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany
- Working Group On Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Ralf-Felix Trauzeddel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, ECRC Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany
- Working Group On Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Department of Anaesthesiology and Intensive Care Medicine, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Und Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Maximilian Müller
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, ECRC Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany
- Working Group On Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany
| | - Florian von Knobelsdorff-Brenkenhoff
- Working Group On Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany
- KIZ, Kardiologie im Zentrum, Eisenmannstr. 4, 80331, Munich, Deutschland
| | - Darian Viezzer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, ECRC Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany
- Working Group On Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Thomas Hadler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, ECRC Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany
- Working Group On Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Edyta Blaszczyk
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, ECRC Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany
- Working Group On Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Elias Daud
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, ECRC Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany
- Working Group On Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- The Cardiology Department, Galilee Medical Center, Azrieli Faculty of Medicine Bar-Ilan University, Nahariya, Safed, Israel
| | - Jeanette Schulz-Menger
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, ECRC Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany.
- Working Group On Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
- Department of Cardiology and Nephrology, HELIOS Hospital Berlin-Buch, Berlin, Germany.
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10
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Demirel ÖB, Weingärtner S, Moeller S, Akçakaya M. Improved Simultaneous Multi-slice imaging with Composition of k-space Interpolations (SMS-COOKIE) for myocardial T1 mapping. PLoS One 2023; 18:e0283972. [PMID: 37478080 PMCID: PMC10361528 DOI: 10.1371/journal.pone.0283972] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 03/21/2023] [Indexed: 07/23/2023] Open
Abstract
The aim of this study is to develop and evaluate a regularized Simultaneous Multi-Slice (SMS) reconstruction method for improved Cardiac Magnetic Resonance Imaging (CMR). The proposed reconstruction method, SMS with COmpOsition of k-space IntErpolations (SMS-COOKIE) combines the advantages of Iterative Self-consistent Parallel Imaging Reconstruction (SPIRiT) and split slice-Generalized Autocalibrating Partially Parallel Acquisitions (GRAPPA), while allowing regularization for further noise reduction. The proposed SMS-COOKIE was implemented with and without regularization, and validated using a Saturation Pulse-Prepared Heart rate Independent inversion REcovery (SAPPHIRE) myocardial T1 mapping sequence. The performance of the proposed reconstruction method was compared to ReadOut (RO)-SENSE-GRAPPA and split slice-GRAPPA, on both retrospectively and prospectively three-fold SMS-accelerated data with an additional two-fold in-plane acceleration. All SMS reconstruction methods yielded similar T1 values compared to single band imaging. SMS-COOKIE showed lower spatial variability in myocardial T1 with significant improvement over RO-SENSE-GRAPPA and split slice-GRAPPA (P < 10-4). The proposed method with additional locally low rank (LLR) regularization reduced the spatial variability, again with significant improvement over RO-SENSE-GRAPPA and split slice-GRAPPA (P < 10-4). In conclusion, improved reconstruction quality was achieved with the proposed SMS-COOKIE, which also provided lower spatial variability with significant improvement over split slice-GRAPPA.
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Affiliation(s)
- Ömer Burak Demirel
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota, United States of America
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Sebastian Weingärtner
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Steen Moeller
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Mehmet Akçakaya
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota, United States of America
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, United States of America
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11
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Le JV, Mendes JK, McKibben N, Wilson BD, Ibrahim M, DiBella EV, Adluru G. Accelerated cardiac T1 mapping with recurrent networks and cyclic, model-based loss. Med Phys 2022; 49:6986-7000. [PMID: 35703369 PMCID: PMC9742165 DOI: 10.1002/mp.15801] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/03/2022] [Accepted: 06/05/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Using the spin-lattice relaxation time (T1) as a biomarker, the myocardium can be quantitatively characterized using cardiac T1 mapping. The modified Look-Locker inversion (MOLLI) recovery sequences have become the standard clinical method for cardiac T1 mapping. However, the MOLLI sequences require an 11-heartbeat breath-hold that can be difficult for subjects, particularly during exercise or pharmacologically induced stress. Although shorter cardiac T1 mapping sequences have been proposed, these methods suffer from reduced precision. As such, there is an unmet need for accelerated cardiac T1 mapping. PURPOSE To accelerate cardiac T1 mapping MOLLI sequences by using neural networks to estimate T1 maps using a reduced number of T1-weighted images and their corresponding inversion times. MATERIALS AND METHODS In this retrospective study, 911 pre-contrast T1 mapping datasets from 202 subjects (128 males, 56 ± 15 years; 74 females, 54 ± 17 years) and 574 T1 mapping post-contrast datasets from 193 subjects (122 males, 57 ± 15 years; 71 females, 54 ± 17 years) were acquired using the MOLLI-5(3)3 sequence and the MOLLI-4(1)3(1)2 sequence, respectively. All acquisition protocols used similar scan parameters:T R = 2.2 ms $TR\; = \;2.2\;{\rm{ms}}$ ,T E = 1.12 ms $TE\; = \;1.12\;{\rm{ms}}$ , andF A = 35 ∘ $FA\; = \;35^\circ $ , gadoteridol (ProHance, Bracco Diagnostics) dose∼ 0.075 mmol / kg $\sim 0.075\;\;{\rm{mmol/kg}}$ . A bidirectional multilayered long short-term memory (LSTM) network with fully connected output and cyclic model-based loss was used to estimate T1 maps from the first three T1-weighted images and their corresponding inversion times for pre- and post-contrast T1 mapping. The performance of the proposed architecture was compared to the three-parameter T1 recovery model using the same reduction of the number of T1-weighted images and inversion times. Reference T1 maps were generated from the scanner using the full MOLLI sequences and the three-parameter T1 recovery model. Correlation and Bland-Altman plots were used to evaluate network performance in which each point represents averaged regions of interest in the myocardium corresponding to the standard American Heart Association 16-segment model. The precision of the network was examined using consecutively repeated scans. Stress and rest pre-contrast MOLLI studies as well as various disease test cases, including amyloidosis, hypertrophic cardiomyopathy, and sarcoidosis were also examined. Paired t-tests were used to determine statistical significance withp < 0.05 $p < 0.05$ . RESULTS Our proposed network demonstrated similar T1 estimations to the standard MOLLI sequences (pre-contrast:1260 ± 94 ms $1260 \pm 94\;{\rm{ms}}$ vs.1254 ± 91 ms $1254 \pm 91\;{\rm{ms}}$ withp = 0.13 $p\; = \;0.13$ ; post-contrast:484 ± 92 ms $484 \pm 92\;{\rm{ms}}$ vs.493 ± 91 ms $493 \pm 91\;{\rm{ms}}$ withp = 0.07 $p\; = \;0.07$ ). The precision of standard MOLLI sequences was well preserved with the proposed network architecture (24 ± 28 ms $24 \pm 28\;\;{\rm{ms}}$ vs.18 ± 13 ms $18 \pm 13\;{\rm{ms}}$ ). Network-generated T1 reactivities are similar to stress and rest pre-contrast MOLLI studies (5.1 ± 4.0 % $5.1 \pm 4.0\;\% $ vs.4.9 ± 4.4 % $4.9 \pm 4.4\;\% $ withp = 0.84 $p\; = \;0.84$ ). Amyloidosis T1 maps generated using the proposed network are also similar to the reference T1 maps (pre-contrast:1243 ± 140 ms $1243 \pm 140\;\;{\rm{ms}}$ vs.1231 ± 137 ms $1231 \pm 137\;{\rm{ms}}$ withp = 0.60 $p\; = \;0.60$ ; post-contrast:348 ± 26 ms $348 \pm 26\;{\rm{ms}}$ vs.346 ± 27 ms $346 \pm 27\;{\rm{ms}}$ withp = 0.89 $p\; = \;0.89$ ). CONCLUSIONS A bidirectional multilayered LSTM network with fully connected output and cyclic model-based loss was used to generate high-quality pre- and post-contrast T1 maps using the first three T1-weighted images and their corresponding inversion times. This work demonstrates that combining deep learning with cardiac T1 mapping can potentially accelerate standard MOLLI sequences from 11 to 3 heartbeats.
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Affiliation(s)
- Johnathan V. Le
- Utah Center for Advanced Imaging Research (UCAIR), Department of Radiology and Imaging Sciences, University of Utah Salt Lake City, UT, 84108, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Jason K. Mendes
- Utah Center for Advanced Imaging Research (UCAIR), Department of Radiology and Imaging Sciences, University of Utah Salt Lake City, UT, 84108, USA
| | - Nicholas McKibben
- Utah Center for Advanced Imaging Research (UCAIR), Department of Radiology and Imaging Sciences, University of Utah Salt Lake City, UT, 84108, USA
| | - Brent D. Wilson
- Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, 84132, USA
| | - Mark Ibrahim
- Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, 84132, USA
| | - Edward V.R. DiBella
- Utah Center for Advanced Imaging Research (UCAIR), Department of Radiology and Imaging Sciences, University of Utah Salt Lake City, UT, 84108, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Ganesh Adluru
- Utah Center for Advanced Imaging Research (UCAIR), Department of Radiology and Imaging Sciences, University of Utah Salt Lake City, UT, 84108, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
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12
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Weingärtner S, Demirel ÖB, Gama F, Pierce I, Treibel TA, Schulz-Menger J, Akçakaya M. Cardiac phase-resolved late gadolinium enhancement imaging. Front Cardiovasc Med 2022; 9:917180. [PMID: 36247474 PMCID: PMC9557076 DOI: 10.3389/fcvm.2022.917180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022] Open
Abstract
Late gadolinium enhancement (LGE) with cardiac magnetic resonance (CMR) imaging is the clinical reference for assessment of myocardial scar and focal fibrosis. However, current LGE techniques are confined to imaging of a single cardiac phase, which hampers assessment of scar motility and does not allow cross-comparison between multiple phases. In this work, we investigate a three step approach to obtain cardiac phase-resolved LGE images: (1) Acquisition of cardiac phase-resolved imaging data with varying T1 weighting. (2) Generation of semi-quantitative T1* maps for each cardiac phase. (3) Synthetization of LGE contrast to obtain functional LGE images. The proposed method is evaluated in phantom imaging, six healthy subjects at 3T and 20 patients at 1.5T. Phantom imaging at 3T demonstrates consistent contrast throughout the cardiac cycle with a coefficient of variation of 2.55 ± 0.42%. In-vivo results show reliable LGE contrast with thorough suppression of the myocardial tissue is healthy subjects. The contrast between blood and myocardium showed moderate variation throughout the cardiac cycle in healthy subjects (coefficient of variation 18.2 ± 3.51%). Images were acquired at 40–60 ms and 80 ms temporal resolution, at 3T and 1.5, respectively. Functional LGE images acquired in patients with myocardial scar visualized scar tissue throughout the cardiac cycle, albeit at noticeably lower imaging resolution and noise resilience than the reference technique. The proposed technique bears the promise of integrating the advantages of phase-resolved CMR with LGE imaging, but further improvements in the acquisition quality are warranted for clinical use.
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Affiliation(s)
- Sebastian Weingärtner
- Department of Imaging Physics, Delft University of Technology, Delft, Netherlands
- *Correspondence: Sebastian Weingärtner
| | - Ömer B. Demirel
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, United States
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Francisco Gama
- Bart's Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Iain Pierce
- Bart's Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Thomas A. Treibel
- Bart's Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Jeanette Schulz-Menger
- Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Joint Cooperation of the Max-Delbrück-Centrum and Charite-Medical University Berlin, Berlin, Germany
- Department of Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch and DZHK, Berlin, Germany
| | - Mehmet Akçakaya
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, United States
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
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13
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Jarkman C, Carlhäll CJ, Henningsson M. Clinical evaluation of the Multimapping technique for simultaneous myocardial T1 and T2 mapping. Front Cardiovasc Med 2022; 9:960403. [PMID: 36148079 PMCID: PMC9485633 DOI: 10.3389/fcvm.2022.960403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
The Multimapping technique was recently proposed for simultaneous myocardial T1 and T2 mapping. In this study, we evaluate its correlation with clinical reference mapping techniques in patients with a range of cardiovascular diseases (CVDs) and compare image quality and inter- and intra-observer repeatability. Multimapping consists of an ECG-triggered, 2D single-shot bSSFP readout with inversion recovery and T2 preparation modules, acquired across 10 cardiac cycles. The sequence was implemented at 1.5T and compared to clinical reference mapping techniques, modified Look-Locker inversion recovery (MOLLI) and T2 prepared bSSFP with four echo times (T2bSSFP), and compared in 47 patients with CVD (of which 44 were analyzed). In diseased myocardial segments (defined as the presence of late gadolinium enhancement), there was a high correlation between Multimapping and MOLLI for native myocardium T1 (r2 = 0.73), ECV (r2 = 0.91), and blood T1 (r2 = 0.88), and Multimapping and T2bSSFP for native myocardial T2 (r2 = 0.80). In healthy myocardial segments, a bias for native T1 (Multimapping = 1,116 ± 21 ms, MOLLI = 1,002 ± 21, P < 0.001), post-contrast T1 (Multimapping = 479 ± 31 ms, MOLLI = 426 ± 27 ms, 0.001), ECV (Multimapping = 21.5 ± 1.9%, MOLLI = 23.7 ± 2.3%, P = 0.001), and native T2 (Multimapping = 48.0 ± 3.0 ms, T2bSSFP = 53.9 ± 3.5 ms, P < 0.001) was observed. The image quality for Multimapping was scored as higher for all mapping techniques (native T1, post-contrast T1, ECV, and T2bSSFP) compared to the clinical reference techniques. The inter- and intra-observer agreements were excellent (intraclass correlation coefficient, ICC > 0.9) for most measurements, except for inter-observer repeatability of Multimapping native T1 (ICC = 0.87), post-contrast T1 (ICC = 0.73), and T2bSSFP native T2 (ICC = 0.88). Multimapping shows high correlations with clinical reference mapping techniques for T1, T2, and ECV in a diverse cohort of patients with different cardiovascular diseases. Multimapping enables simultaneous T1 and T2 mapping and can be performed in a short breath-hold, with image quality superior to that of the clinical reference techniques.
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Affiliation(s)
- Charlotta Jarkman
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Carl-Johan Carlhäll
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Markus Henningsson
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
- *Correspondence: Markus Henningsson
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14
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Guo R, Chen Z, Amyar A, El-Rewaidy H, Assana S, Rodriguez J, Pierce P, Goddu B, Nezafat R. Improving accuracy of myocardial T 1 estimation in MyoMapNet. Magn Reson Med 2022; 88:2573-2582. [PMID: 35916305 DOI: 10.1002/mrm.29397] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE To improve the accuracy and robustness of T1 estimation by MyoMapNet, a deep learning-based approach using 4 inversion-recovery T1 -weighted images for cardiac T1 mapping. METHODS MyoMapNet is a fully connected neural network for T1 estimation of an accelerated cardiac T1 mapping sequence, which collects 4 T1 -weighted images by a single Look-Locker inversion-recovery experiment (LL4). MyoMapNet was originally trained using in vivo data from the modified Look-Locker inversion recovery sequence, which resulted in significant bias and sensitivity to various confounders. This study sought to train MyoMapNet using signals generated from numerical simulations and phantom MR data under multiple simulated confounders. The trained model was then evaluated by phantom data scanned using new phantom vials that differed from those used for training. The performance of the new model was compared with modified Look-Locker inversion recovery sequence and saturation-recovery single-shot acquisition for measuring native and postcontrast T1 in 25 subjects. RESULTS In the phantom study, T1 values measured by LL4 with MyoMapNet were highly correlated with reference values from the spin-echo sequence. Furthermore, the estimated T1 had excellent robustness to changes in flip angle and off-resonance. Native and postcontrast myocardium T1 at 3 Tesla measured by saturation-recovery single-shot acquisition, modified Look-Locker inversion recovery sequence, and MyoMapNet were 1483 ± 46.6 ms and 791 ± 45.8 ms, 1169 ± 49.0 ms and 612 ± 36.0 ms, and 1443 ± 57.5 ms and 700 ± 57.5 ms, respectively. The corresponding extracellular volumes were 22.90% ± 3.20%, 28.88% ± 3.48%, and 30.65% ± 3.60%, respectively. CONCLUSION Training MyoMapNet with numerical simulations and phantom data will improve the estimation of myocardial T1 values and increase its robustness to confounders while also reducing the overall T1 mapping estimation time to only 4 heartbeats.
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Affiliation(s)
- Rui Guo
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Zhensen Chen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, People's Republic of China
| | - Amine Amyar
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Hossam El-Rewaidy
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Salah Assana
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Jennifer Rodriguez
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Patrick Pierce
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Beth Goddu
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Reza Nezafat
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
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15
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Alfarih M, Augusto JB, Knott KD, Fatih N, Kumar MP, Boubertakh R, Hughes AD, Moon JC, Weingärtner S, Captur G. Saturation-pulse prepared heart-rate independent inversion-recovery (SAPPHIRE) biventricular T1 mapping: inter-field strength, head-to-head comparison of diastolic, systolic and dark-blood measurements. BMC Med Imaging 2022; 22:122. [PMID: 35799139 PMCID: PMC9264718 DOI: 10.1186/s12880-022-00843-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background To assess the feasibility of biventricular SAPPHIRE T1 mapping in vivo across field strengths using diastolic, systolic and dark-blood (DB) approaches. Methods 10 healthy volunteers underwent same-day non-contrast cardiovascular magnetic resonance at 1.5 Tesla (T) and 3 T. Left and right ventricular (LV, RV) T1 mapping was performed in the basal, mid and apical short axis using 4-variants of SAPPHIRE: diastolic, systolic, 0th and 2nd order motion-sensitized DB and conventional modified Look-Locker inversion recovery (MOLLI). Results LV global myocardial T1 times (1.5 T then 3 T results) were significantly longer by diastolic SAPPHIRE (1283 ± 11|1600 ± 17 ms) than any of the other SAPPHIRE variants: systolic (1239 ± 9|1595 ± 13 ms), 0th order DB (1241 ± 10|1596 ± 12) and 2nd order DB (1251 ± 11|1560 ± 20 ms, all p < 0.05). In the mid septum MOLLI and diastolic SAPPHIRE exhibited significant T1 signal contamination (longer T1) at the blood-myocardial interface not seen with the other 3 SAPPHIRE variants (all p < 0.025). Additionally, systolic, 0th order and 2nd order DB SAPPHIRE showed narrower dispersion of myocardial T1 times across the mid septum when compared to diastolic SAPPHIRE (interquartile ranges respectively: 25 ms, 71 ms, 73 ms vs 143 ms, all p < 0.05). RV T1 mapping was achievable using systolic, 0th and 2nd order DB SAPPHIRE but not with MOLLI or diastolic SAPPHIRE. All 4 SAPPHIRE variants showed excellent re-read reproducibility (intraclass correlation coefficients 0.953 to 0.996). Conclusion These small-scale preliminary healthy volunteer data suggest that DB SAPPHIRE has the potential to reduce partial volume effects at the blood-myocardial interface, and that systolic SAPPHIRE could be a feasible solution for right ventricular T1 mapping. Further work is needed to understand the robustness of these sequences and their potential clinical utility. Supplementary Information The online version contains supplementary material available at 10.1186/s12880-022-00843-0.
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Affiliation(s)
- Mashael Alfarih
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK.,Department of Cardiac Technology, College of Applied Medial Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - João B Augusto
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Kristopher D Knott
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Nasri Fatih
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - M Praveen Kumar
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Redha Boubertakh
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK.,UCL MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, UK
| | - James C Moon
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Sebastian Weingärtner
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, USA.,Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Gabriella Captur
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. .,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK. .,UCL MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, UK. .,Cardiology Department, Royal Free Hospital NHS Trust, Pond St, Hampstead, London, NW3 2QG, UK.
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16
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François CJ, Barton GP, Corrado PA, Broman AT, Chesler NC, Eldridge MW, Wieben O, Goss KN. Diffuse Myocardial Fibrosis at Cardiac MRI in Young Adults Born Prematurely: A Cross-sectional Cohort Study. Radiol Cardiothorac Imaging 2022; 4:e210224. [PMID: 35833164 PMCID: PMC9274311 DOI: 10.1148/ryct.210224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 03/04/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022]
Abstract
Purpose To measure native T1 values, a marker of diffuse fibrosis, by using
cardiac MRI (CMR) in young adults born prematurely. Materials and Methods This secondary analysis of a prospective cohort study included young
adults born moderately to extremely preterm and age-matched, term-born
participants. CMR was performed with a 3.0-T imager that included cine
imaging for the quantification of left ventricular (LV) and right
ventricular (RV) volumes and function and native saturation recovery T1
mapping for the assessment of diffuse myocardial fibrosis. Values
between preterm and term were compared by using the Student
t test. Associations between T1 values and other
variables were analyzed by using linear regression and multivariate
regression. Results Of the 50 young-adult participants, 32 were born preterm (mean age, 25.8
years ± 4.2 [SD]; 23 women) and 18 were born at term (mean age,
26.2 years ± 5.4; 10 women). Native T1 values were significantly
higher in participants born preterm than in participants born at term
(1477 msec ± 77 vs 1423 msec ± 71, respectively;
unadjusted P = .0019). Native T1 values appeared to be
positively associated with indexed LV end-diastolic and end-systolic
volumes (β = 2.1, standard error = 0.7 and β = 3.8,
standard error = 1.2, respectively), the RV end-diastolic volume index
(β = 1.3, standard error = 0.6), and the LV mass index (β
= 2.5, standard error = 0.9). Higher T1 values may be associated with
reduced cardiac systolic strain measures and diastolic strain measures.
Five-minute Apgar scores were inversely associated with native T1
values. Conclusion Young adults born moderately to extremely preterm exhibited significantly
higher native T1 values than age-matched, term-born young adults. Keywords: MRI, Cardiac, Heart, Left Ventricle,
Cardiomyopathies Clinical trial registration no. NCT03245723 Published under a CC BY 4.0 license Supplemental material is available for this
article.
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Ansari U, Britsch S, Rogowski S, Duerschmied D, Papavassiliu T. Case Report: Transient Increase of CMR T1 Mapping Indices in a Patient With COVID-19 mRNA Vaccine Induced Acute Myocarditis. Front Cardiovasc Med 2022; 9:880717. [PMID: 35571183 PMCID: PMC9091656 DOI: 10.3389/fcvm.2022.880717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/29/2022] [Indexed: 11/30/2022] Open
Abstract
Background Acute myocarditis is commonly associated with viral infections, including severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Myocarditis following mRNA COVID-19 vaccination has also been reported, however this is rare and usually resolves within days or weeks. We present a case of acute myocarditis reported after vaccination with mRNA-1273 COVID-19 vaccine (Moderna) diagnosed using cardiac magnetic resonance imaging (CMR). This report describes the utility of CMR in the diagnosis and follow-up of such patients using parameters which could suggest the clinical course of myocarditis. Case Summary A 23-year-old male presented in the emergency department with complaints of chest pain radiating to the left arm following vaccination with the second dose of COVID-19 mRNA-1273 vaccine (Moderna). Patient's history revealed an incidence of myocarditis in the past. CMR showed a mid-range left ventricular ejection fraction (38%) and subepicardial late gadolinium enhancement (LGE) in the inferolateral and apical myocardial segments with diffuse elevation of native T1 mapping relaxation times in all myocardial segments. The patient was admitted briefly in the intensive care unit and after a favorable clinical course was discharged from the hospital in stable condition. A follow-up CMR after 3 months revealed normalization of LVEF (57%) and native T1- times in most segments. Scarred myocardium reflecting chronic myocarditis continued to show elevated T1 times. Conclusions Our patient presenting with acute myocarditis after recent COVID-19 mRNA vaccination reported a favorable clinical course. CMR revealed increased T1 mapping relaxation times diffusely spread across the myocardium and an impairment of the left ventricular function (LVEF) during the acute phase. However, the LVEF as well as the T1 times normalized at follow-up in all segments except for myocardium affected by chronic myocarditis.
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Affiliation(s)
- Uzair Ansari
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
- European Center for AngioScience, Mannheim, Germany
- DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany
- *Correspondence: Uzair Ansari
| | - Simone Britsch
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
- European Center for AngioScience, Mannheim, Germany
- DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | | | - Daniel Duerschmied
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
- European Center for AngioScience, Mannheim, Germany
- DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Theano Papavassiliu
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
- European Center for AngioScience, Mannheim, Germany
- DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany
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18
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Mao X, Lee HL, Hu Z, Cao T, Han F, Ma S, Serry FM, Fan Z, Xie Y, Li D, Christodoulou AG. Simultaneous Multi-Slice Cardiac MR Multitasking for Motion-Resolved, Non-ECG, Free-Breathing T1–T2 Mapping. Front Cardiovasc Med 2022; 9:833257. [PMID: 35310971 PMCID: PMC8930916 DOI: 10.3389/fcvm.2022.833257] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/27/2022] [Indexed: 02/05/2023] Open
Abstract
The aim of this study is to simultaneously quantify T1/T2 across three slices of the left-ventricular myocardium without breath-holds or ECG monitoring, all within a 3 min scan. Radial simultaneous multi-slice (SMS) encoding, self-gating, and image reconstruction was incorporated into the cardiovascular magnetic resonance (CMR) Multitasking framework to simultaneously image three short-axis slices. A T2prep-IR FLASH sequence with two flip angles was designed and implemented to allow B1+-robust T1 and T2 mapping. The proposed Multitasking-SMS method was validated in a standardized phantom and 10 healthy volunteers, comparing T1 and T2 measurements and scan-rescan repeatability against corresponding reference methods in one layer of phantom vials and in 16 American Heart Association (AHA) myocardial segments. In phantom, Multitasking-SMS T1/T2 measurements showed substantial correlation (R2 > 0.996) and excellent agreement [intraclass correlation coefficients (ICC) ≥ 0.999)] with reference measurements. In healthy volunteers, Multitasking-SMS T1/T2 maps reported similar myocardial T1/T2 values (1,215 ± 91.0/41.5 ± 6.3 ms) to the reference myocardial T1/T2 values (1,239 ± 67.5/42.7 ± 4.1 ms), with P = 0.347 and P = 0.296, respectively. Bland–Altman analyses also demonstrated good in vivo repeatability in both the multitasking and references, with segment-wise coefficients of variation of 4.7% (multitasking T1), 8.9% (multitasking T2), 2.4% [modified look-locker inversion recovery (MOLLI)], and 4.6% (T2-prep FLASH), respectively. In summary, multitasking-SMS is feasible for free-breathing, non-ECG, myocardial T1/T2 quantification in 16 AHA segments over 3 short-axis slices in 3 min. The method shows the great potential for reducing exam time for quantitative CMR without ECG or breath-holds.
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Affiliation(s)
- Xianglun Mao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Hsu-Lei Lee
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Zhehao Hu
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Radiology, University of Southern California, Los Angeles, CA, United States
| | - Tianle Cao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Fei Han
- Siemens Medical Solutions, Inc., Los Angeles, CA, United States
| | - Sen Ma
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Fardad M. Serry
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Zhaoyang Fan
- Department of Radiology, University of Southern California, Los Angeles, CA, United States
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anthony G. Christodoulou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
- *Correspondence: Anthony G. Christodoulou
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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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Improved cardiac T 1 mapping accuracy and precision with a new hybrid MOLLI and SASHA technique: MOSHA. Magn Reson Imaging 2022; 89:33-41. [PMID: 35181469 DOI: 10.1016/j.mri.2022.02.004] [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: 07/27/2021] [Revised: 01/12/2022] [Accepted: 02/13/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE To develop and validate a new myocardial T1 mapping sequence (MOSHA) which is based on a combination of the modified Look-Locker inversion recovery (MOLLI) and the saturation recovery single-shot acquisition (SASHA) sequences. METHODS Prior studies have shown that myocardial T1 mapping by SASHA is more accurate but less precise than MOLLI. A new myocardial T1 mapping technique (MOSHA) based on single-shot acquisitions is developed by combining the MOLLI and SASHA sequences. Phantom and patient studies on 15 patients (9 males, median age 21 years) were performed to validate and compare MOSHA with the MOLLI and SASHA sequences in terms of accuracy and precision. RESULTS In the phantom study, MOSHA was as accurate as SASHA (P-value = 0.88) and as precise as MOLLI (P-value = 0.59). Similar trends were observed in the patient study. Compared to SASHA, MOSHA accuracy was comparable for blood pre-contrast (P-value≥0.10) and post-contrast (P-value≥0.70), and for myocardium pre-contrast (P-value = 0.70) and post-contrast (P-value = 0.09). Compared to MOLLI, MOSHA precision was lower for blood pre-contrast (P-value<0.01) and higher for blood post-contrast (P-value≤0.01), and comparable for myocardium pre-contrast (P-value = 0.24) and post-contrast (P-value = 0.07). Synthetic Extracellular volume fraction (ECV) calculated by MOSHA was more precise than those of SASHA and MOLLI (P-value ≤0.01). CONCLUSION In phantom studies and patients, MOSHA has comparable accuracy as SASHA and nearly similar precision as MOLLI for T1 mapping. Precision of MOSHA was better than MOLLI and SASHA in synthetic ECV measurements. Therefore, it may be a superior choice in clinical practice for a precise and accurate calculation of T1 and ECV.
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21
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Tribuna L, Oliveira PB, Iruela A, Marques J, Santos P, Teixeira T. Reference Values of Native T1 at 3T Cardiac Magnetic Resonance-Standardization Considerations between Different Vendors. Diagnostics (Basel) 2021; 11:diagnostics11122334. [PMID: 34943571 PMCID: PMC8699831 DOI: 10.3390/diagnostics11122334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 01/13/2023] Open
Abstract
This study aimed at establishing native T1 reference values for a Canon Vantage Galan 3T system and comparing them with previously published values from different vendors. A total of 20 healthy volunteers (55% Women; 33.9 ± 11.1 years) underwent left ventricular T1 mapping at 3T MR. A MOLLI 5(3)3 sequence was used, acquiring three short-axis slices. Native T1 values are shown as means (±standard deviation) and Student’s independent samples t-test was used to test gender differences in T1 values. Pearson’s correlation coefficient analysis was used to compare two processes of T1 analysis. The results show a global native T1 mean value of 1124.9 ± 55.2 ms (exponential analysis), that of women being statistically higher than men (1163 ± 30.5 vs. 1077.9 ± 39.5 ms, respectively; p < 0.001). There were no specific tendencies for T1 times in different ventricular slices. We found a strong correlation (0.977, p < 0.001) with T1 times derived from parametric maps (1136.4 ± 60.2 ms). Native T1 reference values for a Canon 3T scanner were provided, and they are on par with those already reported from other vendors for a similar sequence. We also found a correlation between native T1 and gender, with higher values for women.
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Affiliation(s)
- Liliana Tribuna
- Department of Radiology, Hospital da Luz Aveiro, 3800-009 Aveiro, Portugal; (P.B.O.); (J.M.); (P.S.); (T.T.)
- Correspondence: ; Tel.: +351-918-609-355
| | - Pedro Belo Oliveira
- Department of Radiology, Hospital da Luz Aveiro, 3800-009 Aveiro, Portugal; (P.B.O.); (J.M.); (P.S.); (T.T.)
- Department of Radiology, Centro Hospitalar Universitário de Coimbra, 3004-561 Coimbra, Portugal
| | - Alba Iruela
- Clinical Scientist in MR, Canon Medical Systems Spain and Portugal, 08940 Cornellà de Llobregat, Spain;
| | - João Marques
- Department of Radiology, Hospital da Luz Aveiro, 3800-009 Aveiro, Portugal; (P.B.O.); (J.M.); (P.S.); (T.T.)
| | - Paulo Santos
- Department of Radiology, Hospital da Luz Aveiro, 3800-009 Aveiro, Portugal; (P.B.O.); (J.M.); (P.S.); (T.T.)
| | - Tiago Teixeira
- Department of Radiology, Hospital da Luz Aveiro, 3800-009 Aveiro, Portugal; (P.B.O.); (J.M.); (P.S.); (T.T.)
- Department of Cardiology, Centro Hospitalar de Entre o Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal
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22
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Serry FM, Ma S, Mao X, Han F, Xie Y, Han H, Li D, Christodoulou AG. Dual flip-angle IR-FLASH with spin history mapping for B1+ corrected T1 mapping: Application to T1 cardiovascular magnetic resonance multitasking. Magn Reson Med 2021; 86:3182-3191. [PMID: 34309072 PMCID: PMC8568626 DOI: 10.1002/mrm.28935] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/07/2021] [Accepted: 07/01/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE To develop a single-scan method for B 1 + -corrected T1 mapping and apply it for free-breathing (FB) cardiac MR multitasking without electrocardiogram (ECG) triggering. METHODS One dual flip-angle (2FA) inversion recovery (IR)-FLASH scan provides two observations of T 1 ∗ (apparent T1 ) corresponding to two distinct combinations of the nominal FA α and B 1 + . Spatiotemporally coregistered T1 and B 1 + spin history maps are obtained by fitting the 2FA signal model. T1 estimate accuracy and repeatability for single flip-angle (1FA) and 2FA IR-FLASH sequence MR multitasking were evaluated at 3T. A T1 phantom was first imaged on the scanner table, then on two human subjects' thoraxes in both breath-hold (BH) and FB conditions. IR-turbo spin echo (IR-TSE) static phantom T1 measurements served as reference. In 10 healthy subjects, myocardial T1 was evaluated with ECG-free, FB multitasking sequences alongside ECG-triggered BH MOLLI. RESULTS For phantom-on-table T1 estimates, 2FA agreed better with IR-TSE (intraclass correlation coefficient [ICC] = 0.996, mean error ± SD = -1.6% ± 1.9%) than did 1FA (ICC = 0.922; mean error ± SD = -4.3% ± 12%). For phantom-on-thorax, 2FA was more repeatable and robust to respiration than 1FA (coefficient of variation [CoV] = 1.2% 2FA, = 11.3% 1FA). In vivo, in intrasession T1 repeatability, 2FA (septal CoV = 2.4%, six-segment CoV = 4.4%) outperformed 1FA (septal CoV = 3.1%, six-segment CoV = 5.5%). In six-segment T1 homogeneity, 2FA (CoV = 7.9%) also outperformed 1FA (CoV = 11.1%). CONCLUSION The 2FA IR-FLASH improves T1 estimate accuracy and repeatability over 1FA IR-FLASH, and enables single-scan B 1 + -corrected T1 mapping without BHs or ECG when used with MR multitasking.
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Affiliation(s)
- Fardad Michael Serry
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sen Ma
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Xianglun Mao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Fei Han
- Siemens Medical Solutions USA, Inc., Los Angeles, CA, USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Hui Han
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Weingärtner S, Desmond KL, Obuchowski NA, Baessler B, Zhang Y, Biondetti E, Ma D, Golay X, Boss MA, Gunter JL, Keenan KE, Hernando D. Development, validation, qualification, and dissemination of quantitative MR methods: Overview and recommendations by the ISMRM quantitative MR study group. Magn Reson Med 2021; 87:1184-1206. [PMID: 34825741 DOI: 10.1002/mrm.29084] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/20/2021] [Accepted: 10/27/2021] [Indexed: 12/26/2022]
Abstract
On behalf of the International Society for Magnetic Resonance in Medicine (ISMRM) Quantitative MR Study Group, this article provides an overview of considerations for the development, validation, qualification, and dissemination of quantitative MR (qMR) methods. This process is framed in terms of two central technical performance properties, i.e., bias and precision. Although qMR is confounded by undesired effects, methods with low bias and high precision can be iteratively developed and validated. For illustration, two distinct qMR methods are discussed throughout the manuscript: quantification of liver proton-density fat fraction, and cardiac T1 . These examples demonstrate the expansion of qMR methods from research centers toward widespread clinical dissemination. The overall goal of this article is to provide trainees, researchers, and clinicians with essential guidelines for the development and validation of qMR methods, as well as an understanding of necessary steps and potential pitfalls for the dissemination of quantitative MR in research and in the clinic.
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Affiliation(s)
- Sebastian Weingärtner
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Kimberly L Desmond
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nancy A Obuchowski
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bettina Baessler
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Yuxin Zhang
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Emma Biondetti
- Department of Neuroscience, Imaging and Clinical Sciences, D'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Dan Ma
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Xavier Golay
- Brain Repair & Rehabilitation, Institute of Neurology, University College London, United Kingdom.,Gold Standard Phantoms Limited, Rochester, United Kingdom
| | - Michael A Boss
- Center for Research and Innovation, American College of Radiology, Philadelphia, Pennsylvania, USA
| | | | - Kathryn E Keenan
- National Institute of Standards and Technology, Boulder, Colorado, USA
| | - Diego Hernando
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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24
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Hankiewicz JH, Celinski Z, Camley RE. Measurement of sub-zero temperatures in MRI using T 1 temperature sensitive soft silicone materials: Applications for MRI-guided cryosurgery. Med Phys 2021; 48:6844-6858. [PMID: 34562287 DOI: 10.1002/mp.15252] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/12/2021] [Accepted: 09/17/2021] [Indexed: 11/07/2022] Open
Abstract
PURPOSE One standard method, proton resonance frequency shift, for measuring temperature using magnetic resonance imaging (MRI), in MRI-guided surgeries, fails completely below the freezing point of water. Because of this, we have developed a new methodology for monitoring temperature with MRI below freezing. The purpose of this paper is to show that a strong temperature dependence of the nuclear relaxation time T1 in soft silicone polymers can lead to temperature-dependent changes of MRI intensity acquired with T1 weighting. We propose the use of silicone filaments inserted in tissue for measuring temperature during MRI-guided cryoablations. METHODS The temperature dependence of T1 in bio-compatible soft silicone polymers was measured using nuclear magnetic resonance spectroscopy and MRI. Phantoms, made of bulk silicone materials and put in an MRI-compatible thermal container with dry ice, allowed temperature measurements ranging from -60°C to + 20°C. T1 -weighted gradient echo images of the phantoms were acquired at spatially uniform temperatures and with a gradient in temperature to determine the efficacy of using these materials as temperature indicators in MRI. Ex vivo experiments on silicone rods, 4 mm in diameter, inserted in animal tissue were conducted to assess the practical feasibility of the method. RESULTS Measurements of nuclear relaxation times of protons in soft silicone polymers show a monotonic, nearly linear, change with temperature (R2 > 0.98) and have a significant correlation with temperature (Pearson's r > 0.99, p < 0.01). Similarly, the intensity of the MR images in these materials, taken with a gradient echo sequence, are also temperature dependent. There is again a monotonic change in MRI intensity that correlates well with the measured temperature (Pearson's r < -0.98 and p < 0.01). The MRI experiments show that a temperature change of 3°C can be resolved in a distance of about 2.5 mm. Based on MRI images and external sensor calibrations for a sample with a gradient in temperature, temperature maps with 3°C isotherms are created for a bulk phantom. Experiments demonstrate that these changes in MRI intensity with temperature can also be seen in 4 mm silicone rods embedded in ex vivo animal tissue. CONCLUSIONS We have developed a new method for measuring temperature in MRI that potentially could be used during MRI-guided cryoablation operations, reducing both procedure time and cost, and making these surgeries safer.
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Affiliation(s)
- Janusz H Hankiewicz
- UCCS BioFrontiers Center, University of Colorado at Colorado Springs, USA.,MRX Analytics, PBC, Colorado Springs, Colorado, USA
| | - Zbigniew Celinski
- UCCS BioFrontiers Center, University of Colorado at Colorado Springs, USA.,MRX Analytics, PBC, Colorado Springs, Colorado, USA
| | - Robert E Camley
- UCCS BioFrontiers Center, University of Colorado at Colorado Springs, USA.,MRX Analytics, PBC, Colorado Springs, Colorado, USA
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25
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Hermann I, Kellman P, Demirel OB, Akçakaya M, Schad LR, Weingärtner S. Free-breathing simultaneous T1 , T2 , and T2∗ quantification in the myocardium. Magn Reson Med 2021; 86:1226-1240. [PMID: 33780037 PMCID: PMC8252099 DOI: 10.1002/mrm.28753] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/15/2021] [Accepted: 02/06/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE To implement a free-breathing sequence for simultaneous quantification of T 1 , T 2 , and T 2 ∗ for comprehensive tissue characterization of the myocardium in a single scan using a multi-gradient-echo readout with saturation and T 2 preparation pulses. METHODS In the proposed Saturation And T 2 -prepared Relaxometry with Navigator-gating (SATURN) technique, a series of multi-gradient-echo (GRE) images with different magnetization preparations was acquired during free breathing. A total of 35 images were acquired in 26.5 ± 14.9 seconds using multiple saturation times and T 2 preparation durations and with imaging at 5 echo times. Bloch simulations and phantom experiments were used to validate a 5-parameter fit model for accurate relaxometry. Free-breathing simultaneous T 1 , T 2 , and T 2 ∗ measurements were performed in 10 healthy volunteers and 2 patients using SATURN at 3T and quantitatively compared to conventional single-parameter methods such as SASHA for T 1 , T 2 -prepared bSSFP, and multi-GRE for T 2 ∗ . RESULTS Simulations confirmed accurate fitting with the 5-parameter model. Phantom measurements showed good agreement with the reference methods in the relevant range for in vivo measurements. Compared to single-parameter methods comparable accuracy was achieved. SATURN produced in vivo parameter maps that were visually comparable to single-parameter methods. No significant difference between T 1 , T 2 , and T 2 ∗ times acquired with SATURN and single-parameter methods was shown in quantitative measurements (SATURN T 1 = 1573 ± 86 ms , T 2 = 33.2 ± 3.6 ms , T 2 ∗ = 25.3 ± 6.1 ms ; conventional methods: T 1 = 1544 ± 107 ms , T 2 = 33.2 ± 3.6 ms , T 2 ∗ = 23.8 ± 5.5 ms ; P > . 2 ) CONCLUSION: SATURN enables simultaneous quantification of T 1 , T 2 , and T 2 ∗ in the myocardium for comprehensive tissue characterization with co-registered maps, in a single scan with good agreement to single-parameter methods.
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Affiliation(s)
- Ingo Hermann
- Department of Imaging PhysicsMagnetic Resonance Systems LabDelft University of TechnologyDelftThe Netherlands
- Computer Assisted Clinical MedicineMedical Faculty MannheimHeidelberg UniversityMannheimGermany
| | - Peter Kellman
- National Heart, Lung, and Blood InstituteNational Institutes of Health, DHHSBethesdaMDUSA
| | - Omer B. Demirel
- Department of Electrical and Computer Engineering and Center for Magnetic Resonance ResearchUniversity of MinnesotaMinnesotaMNUSA
| | - Mehmet Akçakaya
- Department of Electrical and Computer Engineering and Center for Magnetic Resonance ResearchUniversity of MinnesotaMinnesotaMNUSA
| | - Lothar R. Schad
- Computer Assisted Clinical MedicineMedical Faculty MannheimHeidelberg UniversityMannheimGermany
| | - Sebastian Weingärtner
- Department of Imaging PhysicsMagnetic Resonance Systems LabDelft University of TechnologyDelftThe Netherlands
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Gaspar AS, Maltês S, Marques H, Nunes RG, Ferreira A. Myocardial T1 mapping with magnetic resonance imaging – a useful tool to understand the diseased heart. Rev Port Cardiol 2021; 41:61-69. [DOI: 10.1016/j.repc.2021.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/17/2021] [Accepted: 04/05/2021] [Indexed: 01/19/2023] Open
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Colbert CM, Le AH, Shao J, Currier JW, Ajijola OA, Hu P, Nguyen KL. Ferumoxytol-enhanced magnetic resonance T1 reactivity for depiction of myocardial hypoperfusion. NMR IN BIOMEDICINE 2021; 34:e4518. [PMID: 33830561 PMCID: PMC8287706 DOI: 10.1002/nbm.4518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 06/02/2023]
Abstract
Myocardial T1 reactivity, defined as the relative change in T1 between rest and vasodilator-induced stress, has been proposed as a magnetic resonance imaging (MRI) biomarker of tissue perfusion. We hypothesize that the superparamagnetic iron-oxide nanoparticle, ferumoxytol, sensitizes T1 to changes in the intramyocardial vascular compartment and improves the sensitivity and specificity of T1 reactivity as an imaging biomarker of tissue perfusion. We aim to assess the diagnostic performance of ferumoxytol-enhanced (FE) myocardial T1 reactivity in swine models of myocardial hypoperfusion. We induced acute myocardial hypoperfusion in 13 swine via percutaneous, transcatheter deployment of a 3D printed intracoronary stenosis implant into the left anterior descending coronary artery. We performed native and FE adenosine stress testing using 5(3)3(3)3 MOLLI and SASHA T1 mapping sequences with bSSFP readout on a clinical 3.0 T magnet. MOLLI T1 maps were fitted using both the conventional MOLLI and the Instantaneous Signal Loss (InSiL) T1-fitting algorithms. Regardless of the MOLLI or SASHA pulse sequence or T1-fitting algorithm, ferumoxytol contrast increased the dynamic range of T1 reactivity in both the remote and ischemic myocardial regions. Relative to remote myocardium, native and FE T1 reactivity were blunted in ischemic myocardium (p < 0.05) with InSiL-MOLLI, MOLLI and SASHA. An InSiL-MOLLI-derived FE T1 reactivity threshold of -4.65% had 73.3% sensitivity and 96.2% specificity for prediction of regional wall motion abnormalities (AUC 0.915, 95% CI 0.786-0.979), whereas a SASHA-derived FE T1 reactivity threshold of -5.25% had 75.0% sensitivity and 95.2% specificity (AUC 0.905, 95% CI 0.751-0.979). Ferumoxytol significantly increased the dynamic range of T1 reactivity as a measure of myocardial hypoperfusion in vasodilator stress T1 mapping studies. FE T1 reactivity maps can be used to quantitatively distinguish ischemic and remote myocardium with high specificity in swine models of acute myocardial hypoperfusion.
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Affiliation(s)
- Caroline M. Colbert
- Physics and Biology in Medicine Graduate Program, David Geffen School of Medicine at UCLA
| | - Anna H. Le
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System
| | - Jiaxin Shao
- Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences, David Geffen School of Medicine at UCLA
| | - Jesse W. Currier
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System
| | - Olujimi A. Ajijola
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System
- UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA
| | - Peng Hu
- Physics and Biology in Medicine Graduate Program, David Geffen School of Medicine at UCLA
- Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences, David Geffen School of Medicine at UCLA
| | - Kim-Lien Nguyen
- Physics and Biology in Medicine Graduate Program, David Geffen School of Medicine at UCLA
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System
- Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences, David Geffen School of Medicine at UCLA
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Burrage MK, Shanmuganathan M, Zhang Q, Hann E, Popescu IA, Soundarajan R, Chow K, Neubauer S, Ferreira VM, Piechnik SK. Cardiac stress T1-mapping response and extracellular volume stability of MOLLI-based T1-mapping methods. Sci Rep 2021; 11:13568. [PMID: 34193894 PMCID: PMC8245629 DOI: 10.1038/s41598-021-92923-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/04/2021] [Indexed: 02/07/2023] Open
Abstract
Stress and rest T1-mapping may assess for myocardial ischemia and extracellular volume (ECV). However, the stress T1 response is method-dependent, and underestimation may lead to misdiagnosis. Further, ECV quantification may be affected by time, as well as the number and dosage of gadolinium (Gd) contrast administered. We compared two commonly available T1-mapping approaches in their stress T1 response and ECV measurement stability. Healthy subjects (n = 10, 50% female, 35 ± 8 years) underwent regadenoson stress CMR (1.5 T) on two separate days. Prototype ShMOLLI 5(1)1(1)1 sequence was used to acquire consecutive mid-ventricular T1-maps at rest, stress and post-Gd contrast to track the T1 time evolution. For comparison, standard MOLLI sequences were used: MOLLI 5(3)3 Low (256 matrix) & High (192 matrix) Heart Rate (HR) to acquire rest and stress T1-maps, and MOLLI 4(1)3(1)2 Low & High HR for post-contrast T1-maps. Stress and rest myocardial blood flow (MBF) maps were acquired after IV Gd contrast (0.05 mmol/kg each). Stress T1 reactivity (delta T1) was defined as the relative percentage increase in native T1 between rest and stress. Myocardial T1 values for delta T1 (dT1) and ECV were calculated. Residuals from the identified time dependencies were used to assess intra-method variability. ShMOLLI achieved a greater stress T1 response compared to MOLLI Low and High HR (peak dT1 = 6.4 ± 1.7% vs. 4.8 ± 1.3% vs. 3.8 ± 1.0%, respectively; both p < 0.0001). ShMOLLI dT1 correlated strongly with stress MBF (r = 0.77, p < 0.001), compared to MOLLI Low HR (r = 0.65, p < 0.01) and MOLLI High HR (r = 0.43, p = 0.07). ShMOLLI ECV was more stable to gadolinium dose with less time drift (0.006-0.04% per minute) than MOLLI variants. Overall, ShMOLLI demonstrated less intra-individual variability than MOLLI variants for stress T1 and ECV quantification. Power calculations indicate up to a fourfold (stress T1) and 7.5-fold (ECV) advantage in sample-size reduction using ShMOLLI. Our results indicate that ShMOLLI correlates strongly with increased MBF during regadenoson stress and achieves a significantly higher stress T1 response, greater effect size, and greater ECV measurement stability compared with the MOLLI variants tested.
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Affiliation(s)
- Matthew K Burrage
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 0, Oxford, OX3 9DU, UK
| | - Mayooran Shanmuganathan
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 0, Oxford, OX3 9DU, UK
| | - Qiang Zhang
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 0, Oxford, OX3 9DU, UK
| | - Evan Hann
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 0, Oxford, OX3 9DU, UK
| | - Iulia A Popescu
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 0, Oxford, OX3 9DU, UK
| | - Rajkumar Soundarajan
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 0, Oxford, OX3 9DU, UK
| | - Kelvin Chow
- Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Chicago, IL, USA
| | - Stefan Neubauer
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 0, Oxford, OX3 9DU, UK
| | - Vanessa M Ferreira
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 0, Oxford, OX3 9DU, UK
| | - Stefan K Piechnik
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 0, Oxford, OX3 9DU, UK.
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Kräuter C, Reiter U, Reiter C, Nizhnikava V, Schmidt A, Stollberger R, Fuchsjäger M, Reiter G. Impact of the Choice of Native T 1 in Pixelwise Myocardial Blood Flow Quantification. J Magn Reson Imaging 2021; 53:755-765. [PMID: 33034120 PMCID: PMC7891429 DOI: 10.1002/jmri.27375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Quantification of myocardial blood flow (MBF) from dynamic contrast-enhanced (DCE) MRI can be performed using a signal intensity model that incorporates T1 values of blood and myocardium. PURPOSE To assess the impact of T1 values on pixelwise MBF quantification, specifically to evaluate the influence of 1) study population-averaged vs. subject-specific, 2) diastolic vs. systolic, and 3) regional vs. global myocardial T1 values. STUDY TYPE Prospective. SUBJECTS Fifteen patients with chronic coronary heart disease. FIELD STRENGTH/SEQUENCE 3T; modified Look-Locker inversion recovery for T1 mapping and saturation recovery gradient echo for DCE imaging, both acquired in a mid-ventricular short-axis slice in systole and diastole. ASSESSMENT MBF was estimated using Fermi modeling and signal intensity nonlinearity correction with different T1 values: study population-averaged blood and myocardial, subject-specific systolic and diastolic, and segmental T1 values. Myocardial segments with perfusion deficits were identified visually from DCE series. STATISTICAL TESTS The relationships between MBF parameters derived by different methods were analyzed by Bland-Altman analysis; corresponding mean values were compared by t-test. RESULTS Using subject-specific diastolic T1 values, global diastolic MBF was 0.61 ± 0.13 mL/(min·g). It did not differ from global MBF derived from the study population-averaged T1 (P = 0.88), but the standard deviation of differences was large (0.07 mL/(min·g), 11% of mean MBF). Global diastolic and systolic MBF did not differ (P = 0.12), whereas global diastolic MBF using systolic (0.62 ± 0.13 mL/(min·g)) and diastolic T1 values differed (P < 0.05). If regional instead of global T1 values were used, segmental MBF was lower in segments with perfusion deficits (bias = -0.03 mL/(min·g), -7% of mean MBF, P < 0.05) but higher in segments without perfusion deficits (bias = 0.01 mL/(min·g), 1% of mean MBF, P < 0.05). DATA CONCLUSION Whereas cardiac phase-specific T1 values have a minor impact on MBF estimates, subject-specific and myocardial segment-specific T1 values substantially affect MBF quantification. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Corina Kräuter
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
- Institute of Medical EngineeringGraz University of TechnologyGrazAustria
| | - Ursula Reiter
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
| | - Clemens Reiter
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
| | - Volha Nizhnikava
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
| | - Albrecht Schmidt
- Division of Cardiology, Department of Internal MedicineMedical University of GrazGrazAustria
| | - Rudolf Stollberger
- Institute of Medical EngineeringGraz University of TechnologyGrazAustria
| | - Michael Fuchsjäger
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
| | - Gert Reiter
- Division of General Radiology, Department of RadiologyMedical University of GrazGrazAustria
- Research and DevelopmentSiemens Healthcare Diagnostics GmbHGrazAustria
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Panovský R, Doubková M, Holeček T, Máchal J, Feitová V, Masárová L, Opatřil L, Mojica-Pisciotti ML, Kincl V. Myocardial T 1 mapping using SMART 1 Map and MOLLI mapping in asymptomatic patients with recent extracardiac sarcoidosis. NMR IN BIOMEDICINE 2020; 33:e4388. [PMID: 32749740 DOI: 10.1002/nbm.4388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Sarcoidosis is a systemic granulomatous disease affecting in particular the respiratory tract. Cardiac magnetic resonance (CMR), including a measurement of T1 relaxation time, could potentially detect early stadia of sarcoidosis of the heart. The study aims to assess T1 mapping in the detection of early cardiac involvement in asymptomatic patients with sarcoidosis. METHODS One hundred and twenty patients with extracardiac sarcoidosis and without any heart disease history were included. One hundred and thirteen of them underwent a CMR examination. The mean time from the diagnosis of sarcoidosis was 0.8 (0.2-3.3) years. Cine images for the assessment of left ventricular (LV) functional parameters and pre- and post-contrast saturation method using adaptive recovery times for cardiac T1 mapping (SMART1 Map) and modified Look-Locker inversion recovery (MOLLI) images were acquired for the assessment of native T1 relaxation time and extracellular volume (ECV). The measured parameters were compared between sarcoidosis patients and 22 controls. RESULTS The sarcoidosis patients had normal global and regional systolic LV function-LV ejection fraction 65 ± 5% versus 66 ± 7% (p NS). The mean native T1 relaxation times were not prolonged-1465 ± 93 ms versus 1480 ± 88 ms (p NS) measured by SMART1 Map and 1317 ± 60 ms versus 1313 ± 83 ms (p NS) measured using a MOLLI sequence. Similarly, the mean ECV values did not increase-16.9 ± 3.9% versus 17.9 ± 3.7% (p NS) measured by SMART1 Map and 30.9 ± 2.9% versus 31.6 ± 8.3% (p NS) measured using a MOLLI sequence. CONCLUSION Myocardial native T1 relaxation times were not prolonged and ECV was not increased in asymptomatic patients with extracardiac sarcoidosis.
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Affiliation(s)
- Roman Panovský
- International Clinical Research Center, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- 1st Department of Internal Medicine/Cardioangiology, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martina Doubková
- Department of Pulmonary Diseases and Tuberculosis, Masaryk University Faculty of Medicine and University Hospital, Brno, Czech Republic
| | - Tomáš Holeček
- International Clinical Research Center, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Medical Imaging, St. Anne's Faculty Hospital, Brno, Czech Republic
| | - Jan Máchal
- International Clinical Research Center, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Věra Feitová
- International Clinical Research Center, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Medical Imaging, St. Anne's Faculty Hospital, Brno, Czech Republic
| | - Lucia Masárová
- International Clinical Research Center, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- 1st Department of Internal Medicine/Cardioangiology, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lukáš Opatřil
- International Clinical Research Center, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- 1st Department of Internal Medicine/Cardioangiology, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Mary Luz Mojica-Pisciotti
- International Clinical Research Center, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Vladimír Kincl
- International Clinical Research Center, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- 1st Department of Internal Medicine/Cardioangiology, St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Popescu IA, Werys K, Zhang Q, Puchta H, Hann E, Lukaschuk E, Ferreira VM, Piechnik SK. Standardization of T1-mapping in cardiovascular magnetic resonance using clustered structuring for benchmarking normal ranges. Int J Cardiol 2020; 326:220-225. [PMID: 33096146 DOI: 10.1016/j.ijcard.2020.10.041] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/09/2020] [Accepted: 10/15/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cardiovascular magnetic resonance T1-mapping is increasingly used for tissue characterization, commonly based on Modified Look-Locker Inversion recovery (MOLLI). However, there are numerous MOLLI variants with differing normal ranges. This lack of standardization presents confusion and difficulty in inter-center comparisons, hindering widespread adoption of T1-mapping. METHODS To address this, we performed a structured literature search for native left ventricular myocardial T1-mapping in healthy humans measured using MOLLI variants at 1.5 and 3 Tesla, across scanner vendors. We then used k-means clustering to structure normal MOLLI-T1 values according to magnetic field strength, and investigated correlations between common imaging parameters: repetition time (TR), echo time (TE), flip angle (FA). RESULTS We analyzed data from 2207 healthy controls in 76 independent reports. Normal MOLLI-T1 standard deviations varied by 11-fold, and dependencies on TE, TR, and FA differed between 1.5 T and 3 T, thwarting meaningful T1 standardization even within a single field strength, including the use of Z-score. However, divergent MOLLI-T1 norms may be structured using data clustering. For 1.5 T, two clusters emerged: Cluster11.5T: T1 = 958 ± 16 ms (n = 1280); Cluster21.5T: T1 = 1027 ± 19 ms (n = 386). For 3 T, three clusters emerged: Cluster13T: T1 = 1160 ± 21 ms (n = 330); Cluster23T: T1 = 1067 ± 18 ms (n = 178); Cluster33T: T1 = 1227 ± 19 ms (n = 41). We then propose the concept of an online calculator for assigning local norms to a known MOLLI-T1 cluster, allowing benchmarking against published norms. CONCLUSION Clustered structuring allows T1 standardization of widely-divergent MOLLI variants, benchmarking local norms (usually based on smaller samples) against published norms (larger samples). This may increase confidence and quality control in method implementation, facilitating wider clinical adoption of T1-mapping.
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Affiliation(s)
- Iulia A Popescu
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.
| | - Konrad Werys
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Qiang Zhang
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Henrike Puchta
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Evan Hann
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Elena Lukaschuk
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Vanessa M Ferreira
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Stefan K Piechnik
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
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Serrao EM, Kessler DA, Carmo B, Beer L, Brindle KM, Buonincontri G, Gallagher FA, Gilbert FJ, Godfrey E, Graves MJ, McLean MA, Sala E, Schulte RF, Kaggie JD. Magnetic resonance fingerprinting of the pancreas at 1.5 T and 3.0 T. Sci Rep 2020; 10:17563. [PMID: 33067515 PMCID: PMC7567885 DOI: 10.1038/s41598-020-74462-6] [Citation(s) in RCA: 8] [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: 04/08/2020] [Accepted: 09/29/2020] [Indexed: 12/18/2022] Open
Abstract
Magnetic resonance imaging of the pancreas is increasingly used as an important diagnostic modality for characterisation of pancreatic lesions. Pancreatic MRI protocols are mostly qualitative due to time constraints and motion sensitivity. MR Fingerprinting is an innovative acquisition technique that provides qualitative data and quantitative parameter maps from a single free-breathing acquisition with the potential to reduce exam times. This work investigates the feasibility of MRF parameter mapping for pancreatic imaging in the presence of free-breathing exam. Sixteen healthy participants were prospectively imaged using MRF framework. Regions-of-interest were drawn in multiple solid organs including the pancreas and T1 and T2 values determined. MRF T1 and T2 mapping was performed successfully in all participants (acquisition time:2.4-3.6 min). Mean pancreatic T1 values were 37-43% lower than those of the muscle, spleen, and kidney at both 1.5 and 3.0 T. For these organs, the mean pancreatic T2 values were nearly 40% at 1.5 T and < 12% at 3.0 T. The feasibility of MRF at 1.5 T and 3 T was demonstrated in the pancreas. By enabling fast and free-breathing quantitation, MRF has the potential to add value during the clinical characterisation and grading of pathological conditions, such as pancreatitis or cancer.
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Affiliation(s)
- Eva M Serrao
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Dimitri A Kessler
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Bruno Carmo
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Lucian Beer
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | - Ferdia A Gallagher
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Edmund Godfrey
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mary A McLean
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | | | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK.
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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Wetscherek M, Rutschke W, Frank C, Stehning C, Lurz P, Grothoff M, Thiele H, Gutberlet M, Lücke C. High inter- and intra-observer agreement in mapping sequences compared to classical Lake Louise Criteria assessment of myocarditis by inexperienced observers. Clin Radiol 2020; 75:796.e17-796.e26. [DOI: 10.1016/j.crad.2020.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 05/08/2020] [Indexed: 11/24/2022]
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Hamilton JI, Jiang Y, Eck B, Griswold M, Seiberlich N. Cardiac cine magnetic resonance fingerprinting for combined ejection fraction, T 1 and T 2 quantification. NMR IN BIOMEDICINE 2020; 33:e4323. [PMID: 32500541 PMCID: PMC7772953 DOI: 10.1002/nbm.4323] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 05/07/2023]
Abstract
This study introduces a technique called cine magnetic resonance fingerprinting (cine-MRF) for simultaneous T1 , T2 and ejection fraction (EF) quantification. Data acquired with a free-running MRF sequence are retrospectively sorted into different cardiac phases using an external electrocardiogram (ECG) signal. A low-rank reconstruction with a finite difference sparsity constraint along the cardiac motion dimension yields images resolved by cardiac phase. To improve SNR and precision in the parameter maps, these images are nonrigidly registered to the same phase and matched to a dictionary to generate T1 and T2 maps. Cine images for computing left ventricular volumes and EF are also derived from the same data. Cine-MRF was tested in simulations using a numerical relaxation phantom. Phantom and in vivo scans of 19 subjects were performed at 3 T during a 10.9 seconds breath-hold with an in-plane resolution of 1.6 x 1.6 mm2 and 24 cardiac phases. Left ventricular EF values obtained with cine-MRF agreed with the conventional cine images (mean bias -1.0%). Average myocardial T1 times in diastole/systole were 1398/1391 ms with cine-MRF, 1394/1378 ms with ECG-triggered cardiac MRF (cMRF) and 1234/1212 ms with MOLLI; and T2 values were 30.7/30.3 ms with cine-MRF, 32.6/32.9 ms with ECG-triggered cMRF and 37.6/41.0 ms with T2 -prepared FLASH. Cine-MRF and ECG-triggered cMRF relaxation times were in good agreement. Cine-MRF T1 values were significantly longer than MOLLI, and cine-MRF T2 values were significantly shorter than T2 -prepared FLASH. In summary, cine-MRF can potentially streamline cardiac MRI exams by combining left ventricle functional assessment and T1 -T2 mapping into one time-efficient acquisition.
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Affiliation(s)
- Jesse I. Hamilton
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- Corresponding author at 1137 Catherine Street, Room 1590B, Ann Arbor, MI 48109, JI Hamilton –
| | - Yun Jiang
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Brendan Eck
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Mark Griswold
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Nicole Seiberlich
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Guo R, Cai X, Kucukseymen S, Rodriguez J, Paskavitz A, Pierce P, Goddu B, Nezafat R. Free-breathing whole-heart multi-slice myocardial T 1 mapping in 2 minutes. Magn Reson Med 2020; 85:89-102. [PMID: 32662908 DOI: 10.1002/mrm.28402] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/13/2020] [Accepted: 06/08/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE To develop and validate a saturation-delay-inversion recovery preparation, slice tracking and multi-slice based sequence for measuring whole-heart native T1 . METHOD The proposed free-breathing sequence performs T1 mapping of multiple left-ventricular slices by slice-interleaved acquisition to collect 10 electrocardiogram-triggered single-shot slice-selective images for each slice. A saturation-delay-inversion recovery pulse is used for T1 preparation. Prospective slice tracking by the diaphragm navigator and retrospective registration are used to reduce through-plane and in-plane motion, respectively. The proposed sequence was validated in both phantom and human subjects (12 healthy subjects and 15 patients who were referred for a clinical cardiac MR exam) and compared with saturation recovery single-shot acquisition (SASHA) and modified Look-Locker inversion recovery (MOLLI). RESULTS Phantom T1 measured by the proposed sequence had excellent agreement (R2 = 0.99) with the ground-truth T1 and was insensitive to heart rate. In both healthy subjects and patients, the proposed sequence yielded nine left-ventricular T1 maps per volume in less than 2 minutes (healthy volunteers: 1.8 ± 0.4 minutes; patients: 1.9 ± 0.2 minutes). The average T1 of whole left ventricle for all healthy subjects and patients were 1560 ± 61 and 1535 ± 49 ms by SASHA, 1208 ± 42 and 1233 ± 56 ms by MOLLI5(3)3, and 1397 ± 34 and 1433 ± 56 ms by the proposed sequence, respectively. The corresponding coefficient of variation of T1 were 6.2 ± 1.4% and 5.8 ± 1.6%, 5.3 ± 1.1% and 5.1 ± 0.8%, and 4.9 ± 0.8% and 4.5 ± 0.8%, respectively. CONCLUSION The proposed sequence enables quantification of whole heart T1 with good accuracy and precision in less than 2 minutes during free breathing.
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Affiliation(s)
- Rui Guo
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Xiaoying Cai
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.,Siemens Medical Solutions USA, Inc., Boston, MA, USA
| | - Selcuk Kucukseymen
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Jennifer Rodriguez
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Amanda Paskavitz
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Patrick Pierce
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Beth Goddu
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Reza Nezafat
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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Hermann I, Uhrig T, Chacon-Caldera J, Akçakaya M, Schad LR, Weingärtner S. Towards measuring the effect of flow in blood T 1 assessed in a flow phantom and in vivo. Phys Med Biol 2020; 65:095001. [PMID: 32160594 DOI: 10.1088/1361-6560/ab7ef1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Measurement of the blood T 1 time using conventional myocardial T 1 mapping methods has gained clinical significance in the context of extracellular volume (ECV) mapping and synthetic hematocrit (Hct). However, its accuracy is potentially compromised by in-flow of non-inverted/non-saturated spins and in-flow of spins which are not partially saturated from previous imaging pulses. Bloch simulations were used to analyze various flow effects separately. T 1 measurements of gadolinium doped water were performed using a flow phantom with adjustable flow velocities at 3 T. Additionally, in vivo blood T 1 measurements were performed in 6 healthy subjects (26 ± 5 years, 2 female). To study the T 1 time as a function of the instantaneous flow velocity, T 1 times were evaluated in an axial imaging slice of the descending aorta. Velocity encoded cine measurements were performed to quantify the flow velocity throughout the cardiac cycle. Simulation results show more than 30% loss in accuracy for 10% non-prepared in-flowing spins. However, in- and out-flow to the imaging plane only demonstrated minor impact on the T 1 time. Phantom T 1 times were decreased by up to 200 ms in the flow phantom, due to in-flow of non-prepared spins. High flow velocities cause in-flow of spins that lack partial saturation from the imaging pulses but only lead to negligible T 1 time deviation (less than 30 ms). In vivo measurements confirm a substantial variation of the T 1 time depending on the flow velocity. The highest aortic T 1 times are observed at the time point of minimal flow with increased flow velocity leading to reduction of the measured T 1 time by up to [Formula: see text] at peak velocity. In this work we attempt to dissect the effects of flow on T 1 times, by using simulations, well-controlled, simplified phantom setup and the linear flow pattern in the descending aorta in vivo.
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Affiliation(s)
- Ingo Hermann
- Magnetic Resonance Systems Lab, Department of Imaging Physics, Delft University of Technology, Lorentzweg 1, 2628 Delft, Netherlands. Computer Assisted Clinical Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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Javed A, Nayak KS. Single-shot EPI for ASL-CMR. Magn Reson Med 2020; 84:738-750. [PMID: 32060949 DOI: 10.1002/mrm.28165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 11/23/2019] [Accepted: 12/15/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate single-shot echo planar imaging (SS-EPI), as an alternative to snapshot balanced steady state free precession (bSSFP) imaging, for arterial-spin-labeled cardiac MR (ASL-CMR). This study presents a practical implementation SS-EPI tailored to the needs of ASL-CMR at 3T and demonstrates sequential multi-slice ASL with no increase in scan time. METHODS Reduced field of view SS-EPI was performed using a 2DRF pulse. A spin-echo was used with crushers optimized to maximize blood suppression and minimize myocardial signal loss, based on experiments in 4 healthy volunteers. SS-EPI was evaluated against the widely used bSSFP reference method in single-slice ASL-CMR in 4 healthy volunteers, during both systole and diastole. Sequential multi-slice ASL-CMR with SS-EPI was demonstrated during diastole (3 slices: basal, mid, and apical short-axis) and during systole (2 slices: mid and apical short-axis), in 3 volunteers. RESULTS Global myocardial perfusion for diastolic SS-EPI (1.66 ± 0.73 mL/g/min) and systolic SS-EPI (1.50 ± 0.36 mL/g/min) were found to be statistically equivalent (2 one-sided test with a difference of 0.4 mL/g/min) to diastolic bSSFP (duration of 1 cardiac cycle, 1.60 ± 0.80 mL/g/min) with P-values of 0.022 and 0.031, respectively. Global myocardial perfusion for sequential multi-slice experiments was 1.64 ± 0.47, 1.34 ± 0.29, and 1.88 ± 0.58 for basal, mid, and apical SAX slices during diastole and was 1.61 ± 0.35, and 1.66 ± 0.49 for mid and apical slice during systole. These values are comparable to published ASL-CMR and positron emission tomography studies. CONCLUSION SS-EPI is a promising alternative to bSSFP imaging for ASL-CMR and can potentially improve the spatial coverage of ASL-CMR by 3-fold during diastole and 2-fold during systole, without increasing scan time.
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Affiliation(s)
- Ahsan Javed
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, California
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, California
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Javed A, Yoon A, Cen S, Nayak KS, Garg P. Feasibility of coronary endothelial function assessment using arterial spin labeled CMR. NMR IN BIOMEDICINE 2020; 33:e4183. [PMID: 31799707 PMCID: PMC6980265 DOI: 10.1002/nbm.4183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 06/10/2023]
Abstract
Coronary endothelial dysfunction (CED) is an independent predictor of cardiovascular disease, but its assessment has been limited to invasive coronary angiography. Myocardial perfusion imaging using arterial spin labeled (ASL) cardiac magnetic resonance (CMR) may be an effective non-invasive alternative for detection of CED. Thirty-four patients were recruited: 10 healthy volunteers, 13 at high-risk for coronary artery disease (CAD), and 11 with established CAD. ASL-CMR was performed continuously in a single mid-short axis slice during rest, stress, and recovery. Stress was induced with sustained isometric handgrip exercise, an endothelial dependent stressor. Myocardial perfusion (MP) during rest, peak stress, and recovery were calculated and compared. After excluding subjects unable to complete the protocol or who exhibited poor data quality, 6 healthy, 10 high-risk, and 7 CAD patients were included in the analysis. Average MP (ml/g/min) was 1.31 ± 1.23, 1.61 ± 1.12, and 1.40 ± 0.97 at rest, and 1.64 ± 1.49, 2.31 ± 1.61, and 2.84 ± 1.77 during stress, for the CAD, high-risk and healthy group, respectively. The average MP response (MPstress - MPrest , ml/g/min) was 0.32 ± 1.93, 0.69 ± 1.34, and 1.44 ± 1.46 for CAD, high-risk and healthy group, respectively. MP during handgrip stress was significantly lower for both the CAD (p = 0.0005) and high-risk groups (p = 0.05) compared to the healthy volunteers. In only the healthy subjects, MP was significantly higher in stress compared to rest (p = 0.0002). Participants with CAD had significantly lower MP response compared to healthy volunteers, as detected by ASL-CMR. These findings support the feasibility of ASL-CMR for non-invasive assessment of CED.
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Affiliation(s)
- Ahsan Javed
- Ming Hsieh Department of Electrical and computer Engineering, University of Southern California, Los Angeles, California, USA
| | - Andrew Yoon
- Division of Cardiovascular Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Steven Cen
- Department of Neurology and Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical and computer Engineering, University of Southern California, Los Angeles, California, USA
| | - Parveen Garg
- Division of Cardiovascular Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Yaman B, Weingärtner S, Kargas N, Sidiropoulos ND, Akçakaya M. Low-Rank Tensor Models for Improved Multi-Dimensional MRI: Application to Dynamic Cardiac T 1 Mapping. IEEE TRANSACTIONS ON COMPUTATIONAL IMAGING 2019; 6:194-207. [PMID: 32206691 PMCID: PMC7087548 DOI: 10.1109/tci.2019.2940916] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Multi-dimensional, multi-contrast magnetic resonance imaging (MRI) has become increasingly available for comprehensive and time-efficient evaluation of various pathologies, providing large amounts of data and offering new opportunities for improved image reconstructions. Recently, a cardiac phase-resolved myocardial T 1 mapping method has been introduced to provide dynamic information on tissue viability. Improved spatio-temporal resolution in clinically acceptable scan times is highly desirable but requires high acceleration factors. Tensors are well-suited to describe inter-dimensional hidden structures in such multi-dimensional datasets. In this study, we sought to utilize and compare different tensor decomposition methods, without the use of auxiliary navigator data. We explored multiple processing approaches in order to enable high-resolution cardiac phase-resolved myocardial T 1 mapping. Eight different low-rank tensor approximation and processing approaches were evaluated using quantitative analysis of accuracy and precision in T 1 maps acquired in six healthy volunteers. All methods provided comparable T 1 values. However, the precision was significantly improved using local processing, as well as a direct tensor rank approximation. Low-rank tensor approximation approaches are well-suited to enable dynamic T 1 mapping at high spatio-temporal resolutions.
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Affiliation(s)
- Burhaneddin Yaman
- Department of Electrical and Computer Engineering, and Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, 55455
| | - Sebastian Weingärtner
- Department of Electrical and Computer Engineering, and Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, 55455
| | - Nikolaos Kargas
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, 55455
| | - Nicholas D Sidiropoulos
- Department of Electrical and Computer Engineering, University of Virginia, Charlottesville, VA, 22904
| | - Mehmet Akçakaya
- Department of Electrical and Computer Engineering, and Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, 55455
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Deborde E, Dubourg B, Bejar S, Brehin AC, Normant S, Michelin P, Dacher JN. Differentiation between Fabry disease and hypertrophic cardiomyopathy with cardiac T1 mapping. Diagn Interv Imaging 2019; 101:59-67. [PMID: 31519470 DOI: 10.1016/j.diii.2019.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 08/03/2019] [Accepted: 08/27/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE To evaluate the potential of non-contrast myocardial T1 mapping on cardiovascular magnetic resonance examination (CMR) in differentiating patients with Fabry disease (FD) from those with hypertrophic cardiomyopathy (HCM) and healthy control subjects. MATERIALS AND METHODS Seventeen patients with FD (8 men, 9 women; mean age, 48 ±18 [SD] years; [range: 19-73 years]; 53% with left ventricular hypertrophy [LVH]) were matched with 36 patients with hypertrophic cardiomyopathy (HCM) (22 men, 14 women; mean age, 57±16 [SD] years; [range: 22-85 years]) and 70 healthy control subjects (34 men, 36 women; mean age, 38 ±15 [SD] years; [range: 18-65 years]). Cardiac T1 mapping was performed using the modified Look-Locker inversion (MOLLI®) sequence on a 1.5-T magnet. T1 values were calculated, on midventricular section, for septal left ventricular segments (S8-S9) and all mid-ventricular ones (global T1 values; S7-S12). Statistical analysis included unpaired Mann-Whitney test, receiver operating characteristic curve and likelihood ratios. RESULTS Septal native T1 values were significantly decreased in patients with FD (889±61 [SD] ms; range: 784-980ms) compared to those with HCM (995±48 [SD] ms; range: 935-1125ms) (P<0.001) and versus healthy controls (965±29 [SD] ms; range: 910-1028ms) (P<0.001). Global native T1 values were also significantly decreased in patients with FD (891±49 [SD] ms; range 794-970ms) compared to those with HCM (995±34 [SD] ms; range: 952-1086ms) (P<0.001) and versus healthy controls (966±27 [SD] ms; range: 920-1042ms) (P<0.001). A septal left ventricular native T1 cutoff value of 940ms could distinguish FD from HCM with 88% sensitivity (95% CI: 73-100%) and 92% specificity (95% CI: 83-100%). Positive likelihood ratio was 11, negative likelihood ratio was 0.12. Compared to controls, the same threshold could distinguish FD with 88% sensitivity (95% CI: 73-100%) and 86% specificity (95% CI: 78-94%). Positive likelihood ratio was 6.3, negative likelihood ratio was 0.14. T1 value was abnormal in 4 of 8 (50%) of FD patients who did not have LVH. CONCLUSION Native T1 values are significantly lower in patients with FD by comparison with those with HCM and healthy volunteers.
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Affiliation(s)
- E Deborde
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; Department of Radiology, University Hospital of Strasbourg, 67098 Strasbourg, France.
| | - B Dubourg
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; INSERM U1096, UFR Médecine Pharmacie, 76183 Rouen, France; Institute for Research and Innovation in Biomedicine, University of Rouen, 76000 Rouen, France
| | - S Bejar
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France
| | - A-C Brehin
- Department of Genetics, University Hospital of Rouen, 76031 Rouen, France
| | - S Normant
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France
| | - P Michelin
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France
| | - J-N Dacher
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; INSERM U1096, UFR Médecine Pharmacie, 76183 Rouen, France; Institute for Research and Innovation in Biomedicine, University of Rouen, 76000 Rouen, France
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Becker KM, Blaszczyk E, Funk S, Nuesslein A, Schulz‐Menger J, Schaeffter T, Kolbitsch C. Fast myocardial T
1
mapping using cardiac motion correction. Magn Reson Med 2019; 83:438-451. [DOI: 10.1002/mrm.27935] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/11/2019] [Accepted: 07/16/2019] [Indexed: 01/05/2023]
Affiliation(s)
- Kirsten M. Becker
- Physikalisch‐Technische Bundesanstalt (PTB) Braunschweig and Berlin Germany
| | - Edyta Blaszczyk
- Charité Medical Faculty University Medicine Berlin Germany
- Working Group on Cardiovascular Magnetic Resonance Experimental and Clinical Research Center (ECRC) Charité Humboldt University Berlin, DZHK partner site Berlin Berlin Germany
- Department of Cardiology and Nephrology HELIOS Klinikum Berlin Buch Berlin Germany
| | - Stephanie Funk
- Charité Medical Faculty University Medicine Berlin Germany
- Working Group on Cardiovascular Magnetic Resonance Experimental and Clinical Research Center (ECRC) Charité Humboldt University Berlin, DZHK partner site Berlin Berlin Germany
- Department of Cardiology and Nephrology HELIOS Klinikum Berlin Buch Berlin Germany
| | - André Nuesslein
- Physikalisch‐Technische Bundesanstalt (PTB) Braunschweig and Berlin Germany
| | - Jeanette Schulz‐Menger
- Charité Medical Faculty University Medicine Berlin Germany
- Working Group on Cardiovascular Magnetic Resonance Experimental and Clinical Research Center (ECRC) Charité Humboldt University Berlin, DZHK partner site Berlin Berlin Germany
- Department of Cardiology and Nephrology HELIOS Klinikum Berlin Buch Berlin Germany
| | - Tobias Schaeffter
- Physikalisch‐Technische Bundesanstalt (PTB) Braunschweig and Berlin Germany
- School of Biomedical Engineering and Imaging Sciences King's College London London United Kingdom
| | - Christoph Kolbitsch
- Physikalisch‐Technische Bundesanstalt (PTB) Braunschweig and Berlin Germany
- School of Biomedical Engineering and Imaging Sciences King's College London London United Kingdom
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Triadyaksa P, Kuijpers D, Akinci D'Antonoli T, Overbosch J, Rook M, van Swieten JM, Oudkerk M, Sijens PE. Early detection of heart function abnormality by native T1: a comparison of two T1 quantification methods. Eur Radiol 2019; 30:652-662. [PMID: 31410603 PMCID: PMC6890701 DOI: 10.1007/s00330-019-06364-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/25/2019] [Accepted: 07/10/2019] [Indexed: 02/02/2023]
Abstract
Objective To compare the robustness of native T1 mapping using mean and median pixel-wise quantification methods. Methods Fifty-seven consecutive patients without overt signs of heart failure were examined in clinical routine for suspicion of cardiomyopathy. MRI included the acquisition of native T1 maps by a motion-corrected modified Look-Locker inversion recovery sequence at 1.5 T. Heart function status according to four established volumetric left ventricular (LV) cardio MRI parameter thresholds was used for retrospective separation into subgroups of normal (n = 26) or abnormal heart function (n = 31). Statistical normality of pixel-wise T1 was tested on each myocardial segment and mean and median segmental T1 values were assessed. Results Segments with normally distributed pixel-wise T1 (57/58%) showed no difference between mean and median quantification in either patient group, while differences were highly significant (p < 0.001) for the respective 43/42% non-normally distributed segments. Heart function differentiation between two patient groups was significant in 14 myocardial segments (p < 0.001–0.040) by median quantification compared with six (p < 0.001–0.042) by using the mean. The differences by median quantification were observed between the native T1 values of the three coronary artery territories of normal heart function patients (p = 0.023) and insignificantly in the abnormal patients (p = 0.053). Conclusion Median quantification increases the robustness of myocardial native T1 definition, regardless of statistical normality of the data. Compared with the currently prevailing method of mean quantification, differentiation between LV segments and coronary artery territories is better and allows for earlier detection of heart function impairment. Key Points • Median pixel-wise quantification of native T1 maps is robust and can be applied regardless of the statistical distribution of data points. • Median quantification is more sensitive to early heart function abnormality compared with mean quantification. • The new method yields significant native T1 value differentiation between the three coronary artery territories. Electronic supplementary material The online version of this article (10.1007/s00330-019-06364-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pandji Triadyaksa
- University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
- Department of Physics, Diponegoro University, Prof. Sudharto street, Semarang, 50275, Indonesia
| | - Dirkjan Kuijpers
- Department of Radiology, HMC-Bronovo, Bronovolaan 5, The Hague, 2597 AX, The Netherlands
| | - Tugba Akinci D'Antonoli
- University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
- University Hospital Basel, Clinic of Radiology & Nuclear Medicine, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Jelle Overbosch
- Department of Radiology, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - Mieneke Rook
- University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - J Martijn van Swieten
- Department of Radiology, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - Matthijs Oudkerk
- University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
- Institute for Diagnostic Accuracy, Groningen, The Netherlands
| | - Paul E Sijens
- University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands.
- Department of Radiology, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands.
- Department of Radiology, EB45, University Medical Center Groningen, P.O. Box 30001, 9700 RB, Groningen, The Netherlands.
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Heidenreich JF, Weng AM, Donhauser J, Greiser A, Chow K, Nordbeck P, Bley TA, Köstler H. T1- and ECV-mapping in clinical routine at 3 T: differences between MOLLI, ShMOLLI and SASHA. BMC Med Imaging 2019; 19:59. [PMID: 31370821 PMCID: PMC6676542 DOI: 10.1186/s12880-019-0362-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND T1 mapping sequences such as MOLLI, ShMOLLI and SASHA make use of different technical approaches, bearing strengths and weaknesses. It is well known that obtained T1 relaxation times differ between the sequence techniques as well as between different hardware. Yet, T1 quantification is a promising tool for myocardial tissue characterization, disregarding the absence of established reference values. The purpose of this study was to evaluate the feasibility of native and post-contrast T1 mapping methods as well as ECV maps and its diagnostic benefits in a clinical environment when scanning patients with various cardiac diseases at 3 T. METHODS Native and post-contrast T1 mapping data acquired on a 3 T full-body scanner using the three pulse sequences 5(3)3 MOLLI, ShMOLLI and SASHA in 19 patients with clinical indication for contrast enhanced MRI were compared. We analyzed global and segmental T1 relaxation times as well as respective extracellular volumes and compared the emerged differences between the used pulse sequences. RESULTS T1 times acquired with MOLLI and ShMOLLI exhibited systematic T1 deviation compared to SASHA. Myocardial MOLLI T1 times were 19% lower and ShMOLLI T1 times 25% lower compared to SASHA. Native blood T1 times from MOLLI were 13% lower than SASHA, while post-contrast MOLLI T1-times were only 5% lower. ECV values exhibited comparably biased estimation with MOLLI and ShMOLLI compared to SASHA in good agreement with results reported in literature. Pathology-suspect segments were clearly differentiated from remote myocardium with all three sequences. CONCLUSION Myocardial T1 mapping yields systematically biased pre- and post-contrast T1 times depending on the applied pulse sequence. Additionally calculating ECV attenuates this bias, making MOLLI, ShMOLLI and SASHA better comparable. Therefore, myocardial T1 mapping is a powerful clinical tool for classification of soft tissue abnormalities in spite of the absence of established reference values.
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Affiliation(s)
- Julius F Heidenreich
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany. .,Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany.
| | - Andreas M Weng
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Julian Donhauser
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | | | | | - Peter Nordbeck
- Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany.,Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Wurzburg, Germany
| | - Thorsten A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.,Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany
| | - Herbert Köstler
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.,Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany
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44
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Huang L, Neji R, Nazir MS, Whitaker J, Duong P, Reid F, Bosio F, Chiribiri A, Razavi R, Roujol S. FASt single-breathhold 2D multislice myocardial T 1 mapping (FAST1) at 1.5T for full left ventricular coverage in three breathholds. J Magn Reson Imaging 2019; 51:492-504. [PMID: 31342614 PMCID: PMC6954880 DOI: 10.1002/jmri.26869] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/02/2019] [Indexed: 12/28/2022] Open
Abstract
Background Conventional myocardial T1 mapping techniques such as modified Look–Locker inversion recovery (MOLLI) generate one T1 map per breathhold. T1 mapping with full left ventricular coverage may be desirable when spatial T1 variations are expected. This would require multiple breathholds, increasing patient discomfort and prolonging scan time. Purpose To develop and characterize a novel FASt single‐breathhold 2D multislice myocardial T1 mapping (FAST1) technique for full left ventricular coverage. Study Type Prospective. Population/Phantom Numerical simulation, agarose/NiCl2 phantom, 9 healthy volunteers, and 17 patients. Field Strength/Sequence 1.5T/FAST1. Assessment Two FAST1 approaches, FAST1‐BS and FAST1‐IR, were characterized and compared with standard 5‐(3)‐3 MOLLI in terms of accuracy, precision/spatial variability, and repeatability. Statistical Tests Kruskal‐Wallis, Wilcoxon signed rank tests, intraclass correlation coefficient analysis, analysis of variance, Student's t‐tests, Pearson correlation analysis, and Bland–Altman analysis. Results In simulation/phantom, FAST1‐BS, FAST1‐IR, and MOLLI had an accuracy (expressed as T1 error) of 0.2%/4%, 6%/9%, and 4%/7%, respectively, while FAST1‐BS and FAST1‐IR had a precision penalty of 1.7/1.5 and 1.5/1.4 in comparison with MOLLI, respectively. In healthy volunteers, FAST1‐BS/FAST1‐IR/MOLLI led to different native myocardial T1 times (1016 ± 27 msec/952 ±22 msec/987 ± 23 msec, P < 0.0001) and spatial variability (66 ± 10 msec/57 ± 8 msec/46 ± 7 msec, P < 0.001). There were no statistically significant differences between all techniques for T1 repeatability (P = 0.18). In vivo native and postcontrast myocardial T1 times in both healthy volunteers and patients using FAST1‐BS/FAST1‐IR were highly correlated with MOLLI (Pearson correlation coefficient ≥0.93). Data Conclusion FAST1 enables myocardial T1 mapping with full left ventricular coverage in three separated breathholds. In comparison with MOLLI, FAST1 yield a 5‐fold increase of spatial coverage, limited penalty of T1 precision/spatial variability, no significant difference of T1 repeatability, and highly correlated T1 times. FAST1‐IR provides improved T1 precision/spatial variability but reduced accuracy when compared with FAST1‐BS. Level of Evidence: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;51:492–504.
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Affiliation(s)
- Li Huang
- The School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Radhouene Neji
- The School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
| | - Muhummad Sohaib Nazir
- The School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - John Whitaker
- The School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Phuoc Duong
- The School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Fiona Reid
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Filippo Bosio
- The School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Amedeo Chiribiri
- The School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Reza Razavi
- The School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Sébastien Roujol
- The School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Weingartner S, Demirel OB, Shenoy C, Schad LR, Schulz-Menger J, Akcakaya M. Functional LGE Imaging: Cardiac Phase-Resolved Assessment of Focal Fibrosis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:3999-4003. [PMID: 31946748 PMCID: PMC6986779 DOI: 10.1109/embc.2019.8857759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cardiac Magnetic Resonance Imaging (CMR) is a central tool for diagnosis of various ischemic and non-ischemic cardiomyopathies. CMR protocols commonly comprise assessment of functional properties using cardiac phase-resolved CINE MRI and characterization of myocardial viability using late gadolinium enhancement (LGE) imaging. Conventional LGE imaging requires inversion recovery preparation with a specific inversion time to null the healthy myocardium, which restricts the acquisition to a single cardiac phase. In turn, this necessitates separate scans for cardiac function and viability. In this work, we develop a new method for functional LGE imaging in a single breath-hold using a three-step approach: 1) ECG-triggered multi-contrast data is acquired for each cardiac phase, 2) semi-quantitative relaxation maps are generated, 3) LGE imaging contrast is synthesized based on the semi-quantitative maps. The proposed functional LGE method is evaluated in four healthy subject and 20 patients at 1.5T and 3T. Thorough suppression of the healthy myocardium, as well as 40-80ms temporal resolution are achieved, with no visually apparent temporal blurring at tissue interfaces. Functional LGE in patients with focal scar demonstrates robust hyperenhancement in the scar area throughout all cardiac phases, allowing for visual assessment of scar motility. The proposed technique bears the potential to simplify and speedup common cardiac imaging protocols, while enabling improved data fusion of functional and viability information for improved evaluation of CMR.
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46
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Obmann VC, Mertineit N, Marx C, Berzigotti A, Ebner L, Heverhagen JT, Christe A, Huber AT. Liver MR relaxometry at 3T - segmental normal T 1 and T 2* values in patients without focal or diffuse liver disease and in patients with increased liver fat and elevated liver stiffness. Sci Rep 2019; 9:8106. [PMID: 31147588 PMCID: PMC6542826 DOI: 10.1038/s41598-019-44377-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 05/10/2019] [Indexed: 02/07/2023] Open
Abstract
Magnetic resonance (MR) T1 and T2* mapping allows quantification of liver relaxation times for non-invasive characterization of diffuse liver disease. We hypothesized that liver relaxation times are not only influenced by liver fibrosis, inflammation and fat, but also by air in liver segments adjacent to the lung – especially in MR imaging at 3T. A total of 161 study participants were recruited, while 6 patients had to be excluded due to claustrophobia or technically uninterpretable MR elastography. Resulting study population consisted of 12 healthy volunteers and 143 patients who prospectively underwent multiparametric MR imaging at 3T. Of those 143 patients, 79 had normal liver stiffness in MR elastography (shear modulus <2.8 kPa, indicating absence of fibrosis) and normal proton density fat fraction (PDFF < 10%, indicating absence of steatosis), defined as reference population. T1 relaxation times in these patients were significantly shorter in liver segments adjacent to the lung than in those not adjacent to the lung (p < 0.001, mean of differences 33 ms). In liver segments not adjacent to the lung, T1 allowed to differentiate significantly between the reference population and patients with steatosis and/or fibrosis (p ≤ 0.011), while there was no significant difference of T1 between the reference population and healthy volunteers. In conclusion, we propose to measure T1 relaxation times in liver segments not adjacent to the lung. Otherwise, we recommend taking into account slightly shorter T1 values in liver segments adjacent to the lung.
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Affiliation(s)
- V C Obmann
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, INO B, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - N Mertineit
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, INO B, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - C Marx
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, INO B, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - A Berzigotti
- Hepatology, Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, INO A, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - L Ebner
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, INO B, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - J T Heverhagen
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, INO B, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - A Christe
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, INO B, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - A T Huber
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, INO B, Freiburgstrasse 10, 3010, Bern, Switzerland.
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Sardanelli F, Schiaffino S, Zanardo M, Secchi F, Cannaò PM, Ambrogi F, Di Leo G. Point estimate and reference normality interval of MRI-derived myocardial extracellular volume in healthy subjects: a systematic review and meta-analysis. Eur Radiol 2019; 29:6620-6633. [DOI: 10.1007/s00330-019-06185-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/04/2019] [Accepted: 03/20/2019] [Indexed: 12/11/2022]
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48
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Matsumoto S, Okuda S, Yamada Y, Suzuki T, Tanimoto A, Nozaki A, Jinzaki M. Myocardial T1 values in healthy volunteers measured with saturation method using adaptive recovery times for T1 mapping (SMART1Map) at 1.5 T and 3 T. Heart Vessels 2019; 34:1889-1894. [DOI: 10.1007/s00380-019-01401-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/05/2019] [Indexed: 10/27/2022]
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49
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Contti MM, Barbosa MF, del Carmen Villanueva Mauricio A, Nga HS, Valiatti MF, Takase HM, Bravin AM, de Andrade LGM. Kidney transplantation is associated with reduced myocardial fibrosis. A cardiovascular magnetic resonance study with native T1 mapping. J Cardiovasc Magn Reson 2019; 21:21. [PMID: 30917836 PMCID: PMC6437926 DOI: 10.1186/s12968-019-0531-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 03/07/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The measurement of native T1 through cardiovascular magnetic resonance (CMR) is a noninvasive method of assessing myocardial fibrosis without gadolinium contrast. No studies so far have evaluated native T1 after renal transplantation. The primary aim of the current study is to assess changes in the myocardium native T1 6 months after renal transplantation. METHODS We prospectively evaluated 44 renal transplant patients with 3 T CMR exams: baseline at the beginning of transplantation and at 6 months after transplantation. RESULTS The native T1 time was measured in the midventricular septum and decreased significantly from 1331 ± 52 ms at the baseline to 1298 ± 42 ms 6 months after transplantation (p = 0.001). The patients were split into two groups through a two-step cluster algorithm: In cluster-1 (n = 30) the left ventricular (LV) mass index and the prevalence of diabetes were lower. In cluster-2 (n = 14) the LV mass index and diabetes prevalence were higher. Decrease in native T1 values was significant only in the patients in cluster-1 (p = 0.001). CONCLUSIONS The native myocardial T1 time decreased significantly 6 months after renal transplant, which may be associated with the regression of the reactive fibrosis. The patients with greater baseline LV mass index and the diabetic group did not reach a significant decrease in T1.
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Affiliation(s)
- Mariana Moraes Contti
- Department of Internal Medicine, UNESP, Univ Estadual Paulista, Rubião Jr, s/n, Botucatu/SP, 18.618-970 Brazil
| | | | | | - Hong Si Nga
- Department of Internal Medicine, UNESP, Univ Estadual Paulista, Rubião Jr, s/n, Botucatu/SP, 18.618-970 Brazil
| | - Mariana Farina Valiatti
- Department of Internal Medicine, UNESP, Univ Estadual Paulista, Rubião Jr, s/n, Botucatu/SP, 18.618-970 Brazil
| | - Henrique Mochida Takase
- Department of Internal Medicine, UNESP, Univ Estadual Paulista, Rubião Jr, s/n, Botucatu/SP, 18.618-970 Brazil
| | - Ariane Moyses Bravin
- Department of Internal Medicine, UNESP, Univ Estadual Paulista, Rubião Jr, s/n, Botucatu/SP, 18.618-970 Brazil
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Beitzke D, Wielandner A, Wollenweber T, Vraka C, Pichler V, Uyanik-Uenal K, Zuckermann A, Greiser A, Hacker M, Loewe C. Assessment of sympathetic reinnervation after cardiac transplantation using hybrid cardiac PET/MRI: A pilot study. J Magn Reson Imaging 2019; 50:1326-1335. [PMID: 30892777 PMCID: PMC6766915 DOI: 10.1002/jmri.26722] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/01/2019] [Accepted: 03/02/2019] [Indexed: 12/12/2022] Open
Abstract
Background Sympathetic reinnervation after heart transplantation (HTX) is a known phenomenon, which has an impact on patient heart rate variability and exercise capacity. The impact of reinnervation on myocardial structure has not been evaluated yet. Propose To evaluate the feasibility of simultaneous imaging of cardiac reinnervation and cardiac structure using a hybrid PET/MRI system. Study type Prospective / pilot study. Subjects Ten patients, 4–21 years after cardiac transplantation. Field Strength/Sequence 3 T hybrid PET/MRI system. Cine SSFP, T1 mapping (modified Look–Locker inversion recovery sequence) pre/postcontrast as well as dynamic [11C]meta‐hydroxyephedrine ([11C]mHED) PET. Assessment All MRI and PET parameters were evaluated by experienced readers using dedicated postprocessing software packages for cardiac MRI and PET. For all parameters a 16‐segment model for the left ventricle was applied. Statistical Tests Mann–Whitney U‐test; Spearman correlations. Results Thirty‐six of 160 myocardial segments showed evidence of reinnervation by PET. On a segment‐based analysis, mean native T1 relaxation times were nonsignificantly altered in segments with evidence of reinnervation (1305 ± 151 msec vs. 1270 ± 112 msec; P = 0.1), whereas mean extracellular volume (ECV) was significantly higher in segments with evidence of reinnervation (35.8 ± 11% vs. 30.9 ± 7%; P = 0.019). There were no significant differences in wall motion (WM) and wall thickening (WT) between segments with or without reinnervation (mean WM: 7.6 ± 4 mm vs. group B: 9.3 ± 7 mm [P = 0.13]; WT: 79 ± 63% vs. 94 ± 74% [P = 0.27]) under resting conditions. Data Conclusion The assessment of cardiac reinnervation using a hybrid PET/MRI system is feasible. Segments with evidence of reinnervation by PET showed nonsignificantly higher T1 relaxation times and a significantly higher ECV, suggesting a higher percentage of diffuse fibrosis in these segments, without impairment of rest WM and WT. Level of Evidence: 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:1326–1335.
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Affiliation(s)
- Dietrich Beitzke
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria
| | - Alice Wielandner
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria
| | - Tim Wollenweber
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Chrysoula Vraka
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Verena Pichler
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Keziban Uyanik-Uenal
- Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Andreas Zuckermann
- Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Marcus Hacker
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Christian Loewe
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria
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