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Gumus KZ, Virarkar M, Miyazaki M, Francois CJ, Kee-Sampson J, Gopireddy DR. Non-contrast MR angiography: physical principles and clinical applications in chest, abdomen and pelvis imaging. Abdom Radiol (NY) 2024:10.1007/s00261-024-04500-8. [PMID: 39031182 DOI: 10.1007/s00261-024-04500-8] [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: 05/19/2024] [Revised: 07/11/2024] [Accepted: 07/13/2024] [Indexed: 07/22/2024]
Abstract
This review article focuses on the advancements in non-contrast magnetic resonance angiography (NC-MRA) and its increasing importance in body imaging, especially for patients with renal complications, pregnant women, and children. It highlights the relevance of NC-MRA in chest, abdominal, and pelvis imaging and details various bright-blood NC-MRA techniques like cardiac-gated 3D Fast Spin Echo (FSE), balanced Steady-State Free Precession (bSSFP), Arterial Spin Labeling (ASL), and 4D flow methods. The article explains the operational principles of these techniques, their clinical applications, and their advantages over traditional contrast-enhanced methods. Special attention is given to the utility of these techniques in diverse imaging scenarios, including liver, renal, and pelvic imaging. The article underscores the growing importance of NC-MRA in medical diagnostics, offering insights into current practices and potential future developments. This comprehensive review is a valuable resource for radiologists and clinicians, emphasizing NC-MRA's role in enhancing patient care and diagnostic accuracy across various medical conditions.
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Affiliation(s)
- Kazim Z Gumus
- Department of Radiology, College of Medicine, University of Florida, Jacksonville, FL, USA.
| | - Mayur Virarkar
- Department of Radiology, College of Medicine, University of Florida, Jacksonville, FL, USA
| | - Mitsue Miyazaki
- Department of Radiology, University of California, San Diego, School of Medicine, San Diego, CA, USA
| | | | - Joanna Kee-Sampson
- Department of Radiology, College of Medicine, University of Florida, Jacksonville, FL, USA
| | - Dheeraj R Gopireddy
- Department of Radiology, College of Medicine, University of Florida, Jacksonville, FL, USA
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Ristow I, Hancken-Pauschinger CV, Zhang S, Stark M, Kaul MG, Rickers C, Herrmann J, Adam G, Bannas P, Well L, Weinrich JM. Non-contrast free-breathing 2D CINE compressed SENSE T1-TFE cardiovascular MRI at 3T in sedated young children for assessment of congenital heart disease. PLoS One 2024; 19:e0297314. [PMID: 38330070 PMCID: PMC10852305 DOI: 10.1371/journal.pone.0297314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/03/2024] [Indexed: 02/10/2024] Open
Abstract
Cardiac MRI is a crucial tool for assessing congenital heart disease (CHD). However, its application remains challenging in young children when performed at 3T. The aim of this retrospective single center study was to compare a non-contrast free-breathing 2D CINE T1-weighted TFE-sequence with compressed sensing (FB 2D CINE CS T1-TFE) with 3D imaging for diagnostic accuracy of CHD, image quality, and vessel diameter measurements in sedated young children. FB 2D CINE CS T1-TFE was compared with a 3D non-contrast whole-heart sequence (3D WH) and 3D contrast-enhanced MR angiography (3D CE-MRA) at 3T in 37 CHD patients (20♂, 1.5±1.4 years). Two radiologists independently assessed image quality, type of CHD, and diagnostic confidence. Diameters and measures of contrast and sharpness of the aorta and pulmonary vessels were determined. A non-parametric multi-factorial approach was used to estimate diagnostic accuracy for the diagnosis of CHD. Linear mixed models were calculated to compare contrast and vessel sharpness. Krippendorff's alpha was determined to quantify vessel diameter agreement. FB 2D CINE CS T1-TFE was rated superior regarding image quality, diagnostic confidence, and diagnostic sensitivity for both intra- and extracardiac pathologies compared to 3D WH and 3D CE-MRA (all p<0.05). FB 2D CINE CS T1-TFE showed superior contrast and vessel sharpness (p<0.001) resulting in the highest proportion of measurable vessels (740/740; 100%), compared to 3D WH (530/620; 85.5%) and 3D CE-MRA (540/560; 96.4%). Regarding vessel diameter measurements, FB 2D CINE CS T1-TFE revealed the closest inter-reader agreement (Krippendorff's alpha: 0.94-0.96; 3D WH: 0.78-0.94; 3D CE-MRA: 0.76-0.93). FB 2D CINE CS T1-TFE demonstrates robustness at 3T and delivers high-quality diagnostic results to assess CHD in sedated young children. Its ability to function without contrast injection and respiratory compensation enhances ease of use and could encourage widespread adoption in clinical practice.
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Affiliation(s)
- Inka Ristow
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Caroline-Viktoria Hancken-Pauschinger
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Shuo Zhang
- Philips GmbH Market DACH, Hamburg, Germany
| | - Maria Stark
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael G. Kaul
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Rickers
- University Heart Center, Adult Congenital Heart Disease Unit, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jochen Herrmann
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Bannas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lennart Well
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julius Matthias Weinrich
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kocaoglu M, Pednekar A, Fleck RJ, Dillman JR. Cardiothoracic Magnetic Resonance Angiography. Curr Probl Diagn Radiol 2024; 53:154-165. [PMID: 37891088 DOI: 10.1067/j.cpradiol.2023.10.001] [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: 05/12/2023] [Revised: 09/01/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
Catheter-based angiography is regarded as the clinical reference imaging technique for vessel imaging; however, it is invasive and is currently used for intervention or physiologic measurements. Contrast enhanced magnetic resonance angiography (MRA) with gadolinium-based contrast agents can be performed as a three-dimensional (3D) MRA or as a time resolved 3D (4D) MRA without physiologic synchronization, in which case cardiac and respiratory motion may blur the edges of the vessels and cardiac chambers. Ferumoxytol has recently been a popular contrast agent for MRA in patients with chronic renal failure. Noncontrast 3D MRA with ECG gating and respiratory navigation are safe and accurate noninvasive cross-sectional imaging techniques for the visualization of great vessels of the heart and coronary arteries in a variety of cardiovascular disorders including complex congenital heart diseases. Noncontrast flow dependent MRA techniques such as time of flight, phase contrast, and black-blood MRA techniques can be used as complementary or primary techniques. Here we review both conventional and relatively new contrast enhanced and non-contrast enhanced MRA techniques including ferumoxytol enhanced MRA, and bright-blood and water-fat separation based noncontrast 3D MRA techniques.
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Affiliation(s)
- Murat Kocaoglu
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Amol Pednekar
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Robert J Fleck
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jonathan R Dillman
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Fotaki A, Pushparajah K, Hajhosseiny R, Schneider A, Alam H, Ferreira J, Neji R, Kunze KP, Frigiola A, Botnar RM, Prieto C. Free-breathing, Contrast Agent-free Whole-Heart MTC-BOOST Imaging: Single-Center Validation Study in Adult Congenital Heart Disease. Radiol Cardiothorac Imaging 2023; 5:e220146. [PMID: 36860831 PMCID: PMC9969217 DOI: 10.1148/ryct.220146] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 02/18/2023]
Abstract
Purpose To assess the clinical performance of the three-dimensional, free-breathing, Magnetization Transfer Contrast Bright-and-black blOOd phase-SensiTive (MTC-BOOST) sequence in adult congenital heart disease (ACHD). Materials and Methods In this prospective study, participants with ACHD undergoing cardiac MRI between July 2020 and March 2021 were scanned with the clinical T2-prepared balanced steady-state free precession sequence and proposed MTC-BOOST sequence. Four cardiologists scored their diagnostic confidence on a four-point Likert scale for sequential segmental analysis on images acquired with each sequence. Scan times and diagnostic confidence were compared using the Mann-Whitney test. Coaxial vascular dimensions at three anatomic landmarks were measured, and agreement between the research sequence and the corresponding clinical sequence was assessed with Bland-Altman analysis. Results The study included 120 participants (mean age, 33 years ± 13 [SD]; 65 men). The mean acquisition time of the MTC-BOOST sequence was significantly lower compared with that of the conventional clinical sequence (9 minutes ± 2 vs 14 minutes ± 5; P < .001). Diagnostic confidence was higher for the MTC-BOOST sequence compared with the clinical sequence (mean, 3.9 ± 0.3 vs 3.4 ± 0.7; P < .001). Narrow limits of agreement and mean bias less than 0.08 cm were found between the research and clinical vascular measurements. Conclusion The MTC-BOOST sequence provided efficient, high-quality, and contrast agent-free three-dimensional whole-heart imaging in ACHD, with shorter, more predictable acquisition time and improved diagnostic confidence compared with the reference standard clinical sequence.Keywords: MR Angiography, Cardiac Supplemental material is available for this article. Published under a CC BY 4.0 license.
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Rashid I, Ginami G, Nordio G, Fotaki A, Neji R, Alam H, Pushparajah K, Frigiola A, Valverde I, Botnar RM, Prieto C. Magnetization Transfer BOOST Noncontrast Angiography Improves Pulmonary Vein Imaging in Adults With Congenital Heart Disease. J Magn Reson Imaging 2023; 57:521-531. [PMID: 35642573 PMCID: PMC10084321 DOI: 10.1002/jmri.28280] [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: 01/16/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cardiac MRI plays an important role in the diagnosis and follow-up of patients with congenital heart disease (CHD). Gadolinium-based contrast agents are often needed to overcome flow-related and off-resonance artifacts that can impair the quality of conventional noncontrast 3D imaging. As serial imaging is often required in CHD, the development of robust noncontrast 3D MRI techniques is desirable. PURPOSE To assess the clinical utility of noncontrast enhanced magnetization transfer and inversion recovery prepared 3D free-breathing sequence (MTC-BOOST) compared to conventional 3D whole heart imaging in patients with CHD. STUDY TYPE Prospective, image quality. POPULATION A total of 27 adult patients (44% female, mean age 30.9 ± 14.8 years) with CHD. FIELD STRENGTH/SEQUENCE A 1.5 T; free-breathing 3D MTC-BOOST sequence. ASSESSMENT MTC-BOOST was compared to diaphragmatic navigator-gated, noncontrast T2 prepared 3D whole-heart imaging sequence (T2prep-3DWH) for comparison of vessel dimensions, lumen-to-myocardium contrast ratio (CR), and image quality (vessel wall sharpness and presence and type of artifacts) assessed by two experienced cardiologists on a 5-point scale. STATISTICAL TESTS Mann-Whitney test, paired Wilcoxon signed-rank test, Bland-Altman plots. P < 0.05 was considered statistically significant. RESULTS MTC-BOOST significantly improved image quality and CR of the right-sided pulmonary veins (PV): (CR: right upper PV 1.06 ± 0.50 vs. 0.58 ± 0.74; right lower PV 1.32 ± 0.38 vs. 0.81 ± 0.73) compared to conventional T2prep-3DWH imaging where the PVs were not visualized in some cases due to off-resonance effects. MTC-BOOST demonstrated resistance to degradation of luminal signal (assessed by CR) secondary to accelerated or turbulent flow conditions. T2prep-3DWH had higher image quality scores than MTC-BOOST for the aorta and coronary arteries; however, great vessel dimensions derived from MTC-BOOST showed excellent agreement with standard T2prep-3DWH imaging. DATA CONCLUSION MTC-BOOST allows for improved contrast-free imaging of pulmonary veins and regions characterized by accelerated or turbulent blood flow compared to standard T2prep-3DWH imaging, with excellent agreement of great vessel dimensions. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Imran Rashid
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Giulia Ginami
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Giovanna Nordio
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Anastasia Fotaki
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Radhouene Neji
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
| | - Harith Alam
- Guy's and St Thomas' Hospital, Department of Cardiology, London, UK
| | - Kuberan Pushparajah
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Guy's and St Thomas' Hospital, Department of Cardiology, London, UK
| | | | - Israel Valverde
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Paediatric Cardiology Unit, Hospital Virgen del Rocio and Institute of Biomedicine of Seville, IBIS Ciber-CV, Seville, Spain
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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Fotaki A, Fuin N, Nordio G, Velasco Jimeno C, Qi H, Emmanuel Y, Pushparajah K, Botnar RM, Prieto C. Accelerating 3D MTC-BOOST in patients with congenital heart disease using a joint multi-scale variational neural network reconstruction. Magn Reson Imaging 2022; 92:120-132. [PMID: 35772584 PMCID: PMC9826869 DOI: 10.1016/j.mri.2022.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/12/2022] [Accepted: 06/23/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE Free-breathing Magnetization Transfer Contrast Bright blOOd phase SensiTive (MTC-BOOST) is a prototype balanced-Steady-State Free Precession sequence for 3D whole-heart imaging, that employs the endogenous magnetisation transfer contrast mechanism. This achieves reduction of flow and off-resonance artefacts, that often arise with the clinical T2prepared balanced-Steady-State Free Precession sequence, enabling high quality, contrast-agent free imaging of the thoracic cardiovascular anatomy. Fully-sampled MTC-BOOST acquisition requires long scan times (~10-24 min) and therefore acceleration is needed to permit its clinical incorporation. The aim of this study is to enable and clinically validate the 5-fold accelerated MTC-BOOST acquisition with joint Multi-Scale Variational Neural Network (jMS-VNN) reconstruction. METHODS Thirty-six patients underwent free-breathing, 3D whole-heart imaging with the MTC-BOOST sequence, which is combined with variable density spiral-like Cartesian sampling and 2D image navigators for translational motion estimation. This sequence acquires two differently weighted bright-blood volumes in an interleaved fashion, which are then joined in a phase sensitive inversion recovery reconstruction to obtain a complementary fully co-registered black-blood volume. Data from eighteen patients were used for training, whereas data from the remaining eighteen patients were used for testing/evaluation. The proposed deep-learning based approach adopts a supervised multi-scale variational neural network for joint reconstruction of the two differently weighted bright-blood volumes acquired with the 5-fold accelerated MTC-BOOST. The two contrast images are stacked as different channels in the network to exploit the shared information. The proposed approach is compared to the fully-sampled MTC-BOOST and 5-fold undersampled MTC-BOOST acquisition with Compressed Sensing (CS) reconstruction in terms of scan/reconstruction time and bright-blood image quality. Comparison against conventional 2-fold undersampled T2-prepared 3D bright-blood whole-heart clinical sequence (T2prep-3DWH) is also included. RESULTS Acquisition time was 3.0 ± 1.0 min for the 5-fold accelerated MTC-BOOST versus 9.0 ± 1.1 min for the fully-sampled MTC-BOOST and 11.1 ± 2.6 min for the T2prep-3DWH (p < 0.001 and p < 0.001, respectively). Reconstruction time was significantly lower with the jMS-VNN method compared to CS (10 ± 0.5 min vs 20 ± 2 s, p < 0.001). Image quality was higher for the proposed 5-fold undersampled jMS-VNN versus conventional CS, comparable or higher to the corresponding T2prep-3DWH dataset and similar to the fully-sampled MTC-BOOST. CONCLUSION The proposed 5-fold accelerated jMS-VNN MTC-BOOST framework provides efficient 3D whole-heart bright-blood imaging in fast acquisition and reconstruction time with concomitant reduction of flow and off-resonance artefacts, that are frequently encountered with the clinical sequence. Image quality of the cardiac anatomy and thoracic vasculature is comparable or superior to the clinical scan and 5-fold CS reconstruction in faster reconstruction time, promising potential clinical adoption.
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Affiliation(s)
- Anastasia Fotaki
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.
| | - Niccolo Fuin
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Giovanna Nordio
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Carlos Velasco Jimeno
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Haikun Qi
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Yaso Emmanuel
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Kuberan Pushparajah
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - René M Botnar
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Prieto
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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Greer JS, Hussein MA, Vamsee R, Arar Y, Krueger S, Weiss S, Dillenbeck J, Greil G, Veeram Reddy SR, Hussain T. Improved catheter tracking during cardiovascular magnetic resonance-guided cardiac catheterization using overlay visualization. J Cardiovasc Magn Reson 2022; 24:32. [PMID: 35650624 PMCID: PMC9161533 DOI: 10.1186/s12968-022-00863-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/06/2022] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Cardiovascular magnetic resonance (CMR)-guided cardiac catheterization is becoming more widespread due to the ability to acquire both functional CMR measurements and diagnostic catheterization data without exposing patients to ionizing radiation. However, the real-time imaging sequences used for catheter guidance during these procedures are limited in resolution and the anatomical detail they can provide. In this study, we propose a passive catheter tracking approach which simultaneously improves catheter tracking and visualization of the anatomy. METHODS 60 patients with congenital heart disease underwent CMR-guided cardiac catheterization on a 1.5T CMR scanner (Ingenia, Philips Healthcare, Best the Netherlands) using the Philips iSuite system. The proposed T1-overlay technique uses a commercially available heavily T1-weighted sequence to image the catheter, and overlays it on a high-resolution 3D dataset within iSuite in real-time. Suppressed tissue in the real-time images enables the use of a thick imaging slab to assist in tracking of the catheter. Improvement in catheter visualization time was compared between T1-overlay and the conventional invasive CMR (iCMR) balanced steady state free precession (bSSFP) sequence. This technique also enabled selective angiography visualization for real-time evaluation of blood flow dynamics (such as pulmonary transit time), similar to direct contrast injection under standard fluoroscopy. Estimates of pulmonary transit time using iCMR were validated using x-ray fluoroscopy in 16 patients. RESULTS The T1-overlay approach significantly increased the time that the catheter tip was kept in view by the technologist compared to the bSSFP sequence conventionally used for iCMR. The resulting images received higher ratings for blood/balloon contrast, anatomy visualization, and overall suitability for iCMR guidance by three cardiologists. iCMR selective angiography using T1-overlay also provided accurate estimates of pulmonary transit time that agreed well with x-ray fluoroscopy. CONCLUSION We demonstrate a new passive catheter tracking technique using the iSuite platform that improves visualization of the catheter and cardiac anatomy. These improvements significantly increase the time that the catheter tip is seen throughout the procedure. We also demonstrate the feasibility of iCMR selective angiography for the measurement of pulmonary transit time.
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Affiliation(s)
- Joshua S Greer
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
- Children's Medical Center Dallas, 1935 Medical District Drive, Dallas, TX, 75235, USA.
| | - Mohamed Abdelghafar Hussein
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
- Pediatric Department, Kafrelsheikh University, Kafr el-Sheikh, Egypt
| | - Ravi Vamsee
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Yousef Arar
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Sascha Krueger
- Philips Research Laboratories, Philips GmbH Innovative Technologies, Hamburg, Germany
| | - Steffen Weiss
- Philips Research Laboratories, Philips GmbH Innovative Technologies, Hamburg, Germany
| | - Jeanne Dillenbeck
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Gerald Greil
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Surendranath R Veeram Reddy
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Tarique Hussain
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
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Scannell CM, Hasaneen H, Greil G, Hussain T, Razavi R, Lee J, Pushparajah K, Duong P, Chiribiri A. Automated Quantitative Stress Perfusion Cardiac Magnetic Resonance in Pediatric Patients. Front Pediatr 2021; 9:699497. [PMID: 34540764 PMCID: PMC8446614 DOI: 10.3389/fped.2021.699497] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Myocardial ischemia occurs in pediatrics, as a result of both congenital and acquired heart diseases, and can lead to further adverse cardiac events if untreated. The aim of this work is to assess the feasibility of fully automated, high resolution, quantitative stress myocardial perfusion cardiac magnetic resonance (CMR) in a cohort of pediatric patients and to evaluate its agreement with the coronary anatomical status of the patients. Methods: Fourteen pediatric patients, with 16 scans, who underwent dual-bolus stress perfusion CMR were retrospectively analyzed. All patients also had anatomical coronary assessment with either CMR, CT, or X-ray angiography. The perfusion CMR images were automatically processed and quantified using an analysis pipeline previously developed in adults. Results: Automated perfusion quantification was successful in 15/16 cases. The coronary perfusion territories supplied by vessels affected by a medium/large aneurysm or stenosis (according to the AHA guidelines), induced by Kawasaki disease, an anomalous origin, or interarterial course had significantly reduced myocardial blood flow (MBF) (median (interquartile range), 1.26 (1.05, 1.67) ml/min/g) as compared to territories supplied by unaffected coronaries [2.57 (2.02, 2.69) ml/min/g, p < 0.001] and territories supplied by vessels with a small aneurysm [2.52 (2.45, 2.83) ml/min/g, p = 0.002]. Conclusion: Automatic CMR-derived MBF quantification is feasible in pediatric patients, and the technology could be potentially used for objective non-invasive assessment of ischemia in children with congenital and acquired heart diseases.
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Affiliation(s)
- Cian M. Scannell
- School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, King's College London, London, United Kingdom
| | - Hadeer Hasaneen
- School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, King's College London, London, United Kingdom
| | - Gerald Greil
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Tarique Hussain
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, King's College London, London, United Kingdom
| | - Jack Lee
- School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, King's College London, London, United Kingdom
| | - Kuberan Pushparajah
- School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, King's College London, London, United Kingdom
| | - Phuoc Duong
- School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, King's College London, London, United Kingdom
| | - Amedeo Chiribiri
- School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, King's College London, London, United Kingdom
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Henningsson M, Malik S, Botnar R, Castellanos D, Hussain T, Leiner T. Black-Blood Contrast in Cardiovascular MRI. J Magn Reson Imaging 2020; 55:61-80. [PMID: 33078512 PMCID: PMC9292502 DOI: 10.1002/jmri.27399] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/14/2022] Open
Abstract
MRI is a versatile technique that offers many different options for tissue contrast, including suppressing the blood signal, so‐called black‐blood contrast. This contrast mechanism is extremely useful to visualize the vessel wall with high conspicuity or for characterization of tissue adjacent to the blood pool. In this review we cover the physics of black‐blood contrast and different techniques to achieve blood suppression, from methods intrinsic to the imaging readout to magnetization preparation pulses that can be combined with arbitrary readouts, including flow‐dependent and flow‐independent techniques. We emphasize the technical challenges of black‐blood contrast that can depend on flow and motion conditions, additional contrast weighting mechanisms (T1, T2, etc.), magnetic properties of the tissue, and spatial coverage. Finally, we describe specific implementations of black‐blood contrast for different vascular beds.
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Affiliation(s)
- Markus Henningsson
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Shaihan Malik
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Rene Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Daniel Castellanos
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tarique Hussain
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Division of Pediatric Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tim Leiner
- Department of Radiology, Utrecht University Medical Center, Utrecht, The Netherlands
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10
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Ciancarella P, Ciliberti P, Santangelo TP, Secchi F, Stagnaro N, Secinaro A. Noninvasive imaging of congenital cardiovascular defects. Radiol Med 2020; 125:1167-1185. [PMID: 32955650 DOI: 10.1007/s11547-020-01284-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/03/2020] [Indexed: 12/19/2022]
Abstract
Advances in the treatment have drastically increased the survival rate of congenital heart disease (CHD) patients. Therefore, the prevalence of these patients is growing. Imaging plays a crucial role in the diagnosis and management of this population as a key component of patient care at all stages, especially in those patients who survived into adulthood. Over the last decades, noninvasive imaging techniques, such as cardiac magnetic resonance (CMR) and cardiac computed tomography (CCT), progressively increased their clinical relevance, reaching stronger levels of accuracy and indications in the clinical surveillance of CHD. The current review highlights the main technical aspects and clinical applications of CMR and CCT in the setting of congenital cardiovascular abnormalities, aiming to address a state-of-the-art guidance to every physician and cardiac imager not routinely involved in the field.
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Affiliation(s)
- Paolo Ciancarella
- Department of Imaging, Advanced Cardiovascular Imaging Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Paolo Ciliberti
- Pediatric Cardiology and Pediatric Cardiac Surgery Department, Bambino Gesù Children's Hospital IRCSS, Rome, Italy
| | - Teresa Pia Santangelo
- Department of Imaging, Advanced Cardiovascular Imaging Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Francesco Secchi
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, San Donato Milanese, Italy
| | - Nicola Stagnaro
- Radiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Aurelio Secinaro
- Department of Imaging, Advanced Cardiovascular Imaging Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
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11
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Manning WJ. Journal of Cardiovascular Magnetic Resonance: 2017/2018 in review. J Cardiovasc Magn Reson 2019; 21:79. [PMID: 31884956 PMCID: PMC6936125 DOI: 10.1186/s12968-019-0594-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/14/2022] Open
Abstract
There were 89 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2017, including 76 original research papers, 4 reviews, 5 technical notes, 1 guideline, and 3 corrections. The volume was down slightly from 2017 with a corresponding 15% decrease in manuscript submissions from 405 to 346 and thus reflects a slight increase in the acceptance rate from 25 to 26%. The decrease in submissions for the year followed the initiation of the increased author processing charge (APC) for Society for Cardiovascular Magnetic Resonance (SCMR) members for manuscripts submitted after June 30, 2018. The quality of the submissions continues to be high. The 2018 JCMR Impact Factor (which is published in June 2019) was slightly lower at 5.1 (vs. 5.46 for 2017; as published in June 2018. The 2018 impact factor means that on average, each JCMR published in 2016 and 2017 was cited 5.1 times in 2018. Our 5 year impact factor was 5.82.In accordance with Open-Access publishing guidelines of BMC, the JCMR articles are published on-line in a continuus fashion in the chronologic order of acceptance, with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful for the JCMR audience to annually summarize the publications into broad areas of interest or themes, so that readers can view areas of interest in a single article in relation to each other and contemporaneous JCMR publications. In this publication, the manuscripts are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought within the journal. In addition, as in the past two years, I have used this publication to also convey information regarding the editorial process and as a "State of our JCMR."This is the 12th year of JCMR as an open-access publication with BMC (formerly known as Biomed Central). The timing of the JCMR transition to the open access platform was "ahead of the curve" and a tribute to the vision of Dr. Matthias Friedrich, the SCMR Publications Committee Chair and Dr. Dudley Pennell, the JCMR editor-in-chief at the time. The open-access system has dramatically increased the reading and citation of JCMR publications and I hope that you, our authors, will continue to send your very best, high quality manuscripts to JCMR for consideration. It takes a village to run a journal and I thank our very dedicated Associate Editors, Guest Editors, Reviewers for their efforts to ensure that the review process occurs in a timely and responsible manner. These efforts have allowed the JCMR to continue as the premier journal of our field. This entire process would also not be possible without the dedication and efforts of our managing editor, Diana Gethers. Finally, I thank you for entrusting me with the editorship of the JCMR as I begin my 4th year as your editor-in-chief. It has been a tremendous experience for me and the opportunity to review manuscripts that reflect the best in our field remains a great joy and highlight of my week!
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Affiliation(s)
- Warren J Manning
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
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12
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Zucker EJ. Cross-sectional imaging of congenital pulmonary artery anomalies. Int J Cardiovasc Imaging 2019; 35:1535-1548. [PMID: 31175525 DOI: 10.1007/s10554-019-01643-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 05/31/2019] [Indexed: 02/06/2023]
Abstract
Congenital pulmonary artery (PA) anomalies comprise a rare and heterogeneous spectrum of disease, ranging from abnormal origins to complete atresia. They may present in early infancy or more insidiously in adulthood, often in association with congenital heart disease such as tetralogy of Fallot or other syndromes. In recent years, cross-sectional imaging, including computed tomography (CT) and magnetic resonance imaging (MRI), has become widely utilized for the noninvasive assessment of congenital PA diseases, supplementing echocardiography and at times supplanting invasive angiography. In this article, modern CT and MRI techniques for imaging congenital PA disorders are summarized. The key clinical features, cross-sectional imaging findings, and treatment options for the most commonly encountered entities are then reviewed. Emphasis is placed on the ever-growing role of cross-sectional imaging options in facilitating early and accurate diagnosis and tailored treatment.
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Affiliation(s)
- Evan J Zucker
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Stanford, CA, 94305, USA.
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