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Skrabal F, Heymsfield SB, Skrabal K, Weber T, Fruhwald F, Windhaber J, Mady S. Sizing and mending of appendicular muscle mass for hydration during the 12-lead electrocardiogram: True incidence of sarcopenia in heart failure. J Cachexia Sarcopenia Muscle 2024; 15:575-586. [PMID: 38275200 PMCID: PMC10995443 DOI: 10.1002/jcsm.13423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/30/2023] [Accepted: 12/09/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Our aim was to develop and evaluate a method for the measurement of muscle mass during the 12-channel electrocardiogram (ECG), to determine the incidence of sarcopenia in patients with overhydration and to correct it for congestion. METHODS A 12-channel ECG that simultaneously provided multifrequency segmental impedance data was used to measure total body water (TBW), extracellular water (ECW), ECW/TBW ratio and appendicular muscle mass (AppMM), validated by whole-body dual-energy X-ray absorptiometry. The mean ECW/TBW ratio was 0.24 ± 0.018 (SD) and 0.25 ± 0.016 for young (age range 20-25 years) healthy males (n = 77) and females (n = 88), respectively. The deviation of the ECW/TBW ratio from this mean was used to correct AppMM for excess ECW ('dry AppMM') in 869 healthy controls and in 765 patients with chronic heart failure (CHF) New York Heart Association classes II-IV. The association of AppMM and dry AppMM with grip strength was also examined in 443 controls and patients. RESULTS With increasing N-terminal pro-brain natriuretic peptide (NT-proBNP), a continuous decline of AppMM indices is observed, which is more pronounced for dry AppMM indices (for males with NT-proBNP < 125 pg/mL: AppMM index mean = 8.4 ± 1.05, AppMM index dry mean = 8.0 ± 1.46 [n = 201, P < 0.001]; for females with NT-proBNP < 150 pg/mL: AppMM index mean = 6.4 ± 1.0, AppMM index dry mean = 5.8 ± 1.18 [n = 198, P < 0.001]; for males with NT-proBNP > 1000 pg/mL: AppMM index mean = 7.6 ± 0.98, AppMM index dry mean = 6.2 ± 1.11 [n = 137, P < 0.001]; and for females with NT-proBNP > 1000 pg/mL: AppMM index mean = 5.9 ± 0.96, AppMM index dry mean = 4.8 ± 0.94 [n = 109, P < 0.001]). The correlation between AppMM and upper-body AppMM and grip strength (r-value) increased from 0.79 to 0.83 (P < 0.001) and from 0.80 to 0.84 (P < 0.001), respectively, after correction (n = 443). The decline of AppMM with age after correction for ECW is much steeper than appreciated, especially in males: In patients with CHF and sarcopenia, the incidence of sarcopenia may be up to 30% higher after correction for ECW excess according to the European (62% vs. 57%, for males, and 43% vs. 31%, for females) and Foundation for the National Institutes of Health (FNIH) (56% vs. 46%, for males, and 54% vs. 38%, for females) consensus guidelines. CONCLUSIONS The incidence of sarcopenia in CHF as defined by the European Working Group on Sarcopenia and FNIH consensus may be up to 30% higher after correction for ECW excess. This correction improves the correlation between muscle mass and strength. The presented technology will facilitate, on a large scale, screening for sarcopenia, help identify mechanisms and improve understanding of clinical outcomes.
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Affiliation(s)
- Falko Skrabal
- Institute of Cardiovascular and Metabolic MedicineGrazAustria
| | | | | | - Thomas Weber
- Department of CardiologyKlinikum Wels‐GrieskirchenWelsAustria
| | | | - Jana Windhaber
- Department of Paediatric and Adolescent SurgeryMedical University GrazAustria
| | - Samy Mady
- Institute of Cardiovascular and Metabolic MedicineGrazAustria
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2
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Christodoulou AG, Cruz G, Arami A, Weingärtner S, Artico J, Peters D, Seiberlich N. The future of cardiovascular magnetic resonance: All-in-one vs. real-time (Part 1). J Cardiovasc Magn Reson 2024; 26:100997. [PMID: 38237900 PMCID: PMC11211239 DOI: 10.1016/j.jocmr.2024.100997] [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: 12/21/2023] [Accepted: 01/10/2024] [Indexed: 02/26/2024] Open
Abstract
Cardiovascular magnetic resonance (CMR) protocols can be lengthy and complex, which has driven the research community to develop new technologies to make these protocols more efficient and patient-friendly. Two different approaches to improving CMR have been proposed, specifically "all-in-one" CMR, where several contrasts and/or motion states are acquired simultaneously, and "real-time" CMR, in which the examination is accelerated to avoid the need for breathholding and/or cardiac gating. The goal of this two-part manuscript is to describe these two different types of emerging rapid CMR. To this end, the vision of each is described, along with techniques which have been devised and tested along the pathway of clinical implementation. The pros and cons of the different methods are presented, and the remaining open needs of each are detailed. Part 1 will tackle the "all-in-one" approaches, and Part 2 the "real-time" approaches along with an overall summary of these emerging methods.
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Affiliation(s)
- Anthony G Christodoulou
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Gastao Cruz
- Michigan Institute for Imaging Technology and Translation, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Ayda Arami
- Department of Imaging Physics, Delft University of Technology, Delft, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Sebastian Weingärtner
- Department of Imaging Physics, Delft University of Technology, Delft, the Netherlands
| | | | - Dana Peters
- Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Nicole Seiberlich
- Michigan Institute for Imaging Technology and Translation, Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
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3
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Hu P, Tong X, Lin L, Wang LV. Data-driven system matrix manipulation enabling fast functional imaging and intra-image nonrigid motion correction in tomography. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.07.574504. [PMID: 38260429 PMCID: PMC10802502 DOI: 10.1101/2024.01.07.574504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Tomographic imaging modalities are described by large system matrices. Sparse sampling and tissue motion degrade system matrix and image quality. Various existing techniques improve the image quality without correcting the system matrices. Here, we compress the system matrices to improve computational efficiency (e.g., 42 times) using singular value decomposition and fast Fourier transform. Enabled by the efficiency, we propose (1) fast sparsely sampling functional imaging by incorporating a densely sampled prior image into the system matrix, which maintains the critical linearity while mitigating artifacts and (2) intra-image nonrigid motion correction by incorporating the motion as subdomain translations into the system matrix and reconstructing the translations together with the image iteratively. We demonstrate the methods in 3D photoacoustic computed tomography with significantly improved image qualities and clarify their applicability to X-ray CT and MRI or other types of imperfections due to the similarities in system matrices.
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Affiliation(s)
- Peng Hu
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, Department of Electrical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Xin Tong
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, Department of Electrical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Li Lin
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, Department of Electrical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
- Present address: College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China
| | - Lihong V Wang
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, Department of Electrical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
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4
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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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Han P, Chen J, Xiao J, Han F, Hu Z, Yang W, Cao M, Ling DC, Li D, Christodoulou AG, Fan Z. Single projection driven real-time multi-contrast (SPIDERM) MR imaging using pre-learned spatial subspace and linear transformation. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac783e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 06/13/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. To develop and test the feasibility of a novel Single ProjectIon DrivEn Real-time Multi-contrast (SPIDERM) MR imaging technique that can generate real-time 3D images on-the-fly with flexible contrast weightings and a low latency. Approach. In SPIDERM, a ‘prep’ scan is first performed, with sparse k-space sampling periodically interleaved with the central k-space line (navigator data), to learn a subject-specific model, incorporating a spatial subspace and a linear transformation between navigator data and subspace coordinates. A ‘live’ scan is then performed by repeatedly acquiring the central k-space line only to dynamically determine subspace coordinates. With the ‘prep’-learned subspace and ‘live’ coordinates, real-time 3D images are generated on-the-fly with computationally efficient matrix multiplication. When implemented based on a multi-contrast pulse sequence, SPIDERM further allows for data-driven image contrast regeneration to convert real-time contrast-varying images into contrast-frozen images at user’s discretion while maintaining motion states. Both digital phantom and in-vivo experiments were performed to evaluate the technical feasibility of SPIDERM. Main results. The elapsed time from the input of the central k-space line to the generation of real-time contrast-frozen 3D images was approximately 45 ms, permitting a latency of 55 ms or less. Motion displacement measured from SPIDERM and reference images showed excellent correlation (
R
2
≥
0.983
). Geometric variation from the ground truth in the digital phantom was acceptable as demonstrated by pancreas contour analysis (Dice ≥ 0.84, mean surface distance ≤ 0.95 mm). Quantitative image quality metrics showed good consistency between reference images and contrast-varying SPIDREM images in in-vivo studies (mean
NMRSE
=
0.141
,
PSNR
=
3
0.12
,
SSIM
=
0.88
). Significance. SPIDERM is capable of generating real-time multi-contrast 3D images with a low latency. An imaging framework based on SPIDERM has the potential to serve as a standalone package for MR-guided radiation therapy by offering adaptive simulation through a ‘prep’ scan and real-time image guidance through a ‘live’ scan.
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Han P, Zhang R, Wagner S, Xie Y, Cingolani E, Marban E, Christodoulou AG, Li D. Publisher Correction to: Electrocardiogram-less, free-breathing myocardial extracellular volume fraction mapping in small animals at high heart rates using motion-resolved cardiovascular magnetic resonance multitasking: a feasibility study in a heart failure with preserved ejection fraction rat model. J Cardiovasc Magn Reson 2021; 23:41. [PMID: 33752658 PMCID: PMC7986488 DOI: 10.1186/s12968-021-00738-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- Pei Han
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, USA
| | - Rui Zhang
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shawn Wagner
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Eugenio Cingolani
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Eduardo Marban
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Anthony G Christodoulou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, USA.
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