1
|
Whitehead JF, Periyasamy S, Laeseke PF, Speidel MA, Wagner MG. Motion-compensation approach for quantitative digital subtraction angiography and its effect on in-vivo blood velocity measurement. J Med Imaging (Bellingham) 2024; 11:013501. [PMID: 38188936 PMCID: PMC10765039 DOI: 10.1117/1.jmi.11.1.013501] [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: 07/21/2023] [Revised: 11/13/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024] Open
Abstract
Purpose Quantitative monitoring of flow-altering interventions has been proposed using algorithms that quantify blood velocity from time-resolved two-dimensional angiograms. These algorithms track the movement of contrast oscillations along a vessel centerline. Vessel motion may occur relative to a statically defined vessel centerline, corrupting the blood velocity measurement. We provide a method for motion-compensated blood velocity quantification. Approach The motion-compensation approach utilizes a vessel segmentation algorithm to perform frame-by-frame vessel registration and creates a dynamic vessel centerline that moves with the vasculature. Performance was evaluated in-vivo through comparison with manually annotated centerlines. The method was also compared to a previous uncompensated method using best- and worst-case static centerlines chosen to minimize and maximize centerline placement accuracy. Blood velocities determined through quantitative DSA (qDSA) analysis for each centerline type were compared through linear regression analysis. Results Centerline distance errors were 0.3 ± 0.1 mm relative to gold standard manual annotations. For the uncompensated approach, the best- and worst-case static centerlines had distance errors of 1.1 ± 0.6 and 2.9 ± 1.2 mm , respectively. Linear regression analysis found a high R -squared between qDSA-derived blood velocities using gold standard centerlines and motion-compensated centerlines (R 2 = 0.97 ) with a slope of 1.15 and a small offset of - 0.6 cm / s . The use of static centerlines resulted in low coefficients of determination for the best case (R 2 = 0.35 ) and worst-case (R 2 = 0.20 ) scenarios, with slopes close to zero. Conclusions In-vivo validation of motion-compensated qDSA analysis demonstrated improved velocity quantification accuracy in vessels with motion, addressing an important clinical limitation of the current qDSA algorithm.
Collapse
Affiliation(s)
- Joseph F. Whitehead
- University of Wisconsin – Madison, Department of Medical Physics, Madison, Wisconsin, United States
| | - Sarvesh Periyasamy
- University of Wisconsin – Madison, Department of Radiology, Madison, Wisconsin, United States
| | - Paul F. Laeseke
- University of Wisconsin – Madison, Department of Radiology, Madison, Wisconsin, United States
| | - Michael A. Speidel
- University of Wisconsin – Madison, Department of Medical Physics, Madison, Wisconsin, United States
- University of Wisconsin – Madison, Department of Medicine, Madison, Wisconsin, United States
| | - Martin G. Wagner
- University of Wisconsin – Madison, Department of Medical Physics, Madison, Wisconsin, United States
- University of Wisconsin – Madison, Department of Radiology, Madison, Wisconsin, United States
| |
Collapse
|
2
|
Bustin A, Witschey WRT, van Heeswijk RB, Cochet H, Stuber M. Magnetic resonance myocardial T1ρ mapping : Technical overview, challenges, emerging developments, and clinical applications. J Cardiovasc Magn Reson 2023; 25:34. [PMID: 37331930 DOI: 10.1186/s12968-023-00940-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
The potential of cardiac magnetic resonance to improve cardiovascular care and patient management is considerable. Myocardial T1-rho (T1ρ) mapping, in particular, has emerged as a promising biomarker for quantifying myocardial injuries without exogenous contrast agents. Its potential as a contrast-agent-free ("needle-free") and cost-effective diagnostic marker promises high impact both in terms of clinical outcomes and patient comfort. However, myocardial T1ρ mapping is still at a nascent stage of development and the evidence supporting its diagnostic performance and clinical effectiveness is scant, though likely to change with technological improvements. The present review aims at providing a primer on the essentials of myocardial T1ρ mapping, and to describe the current range of clinical applications of the technique to detect and quantify myocardial injuries. We also delineate the important limitations and challenges for clinical deployment, including the urgent need for standardization, the evaluation of bias, and the critical importance of clinical testing. We conclude by outlining technical developments to be expected in the future. If needle-free myocardial T1ρ mapping is shown to improve patient diagnosis and prognosis, and can be effectively integrated in cardiovascular practice, it will fulfill its potential as an essential component of a cardiac magnetic resonance examination.
Collapse
Affiliation(s)
- Aurelien Bustin
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Avenue du Haut Lévêque, 33604, Pessac, France.
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604, Pessac, France.
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | | | - Ruud B van Heeswijk
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Hubert Cochet
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Avenue du Haut Lévêque, 33604, Pessac, France
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604, Pessac, France
| | - Matthias Stuber
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Avenue du Haut Lévêque, 33604, Pessac, France
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| |
Collapse
|
3
|
Hajhosseiny R, Munoz C, Cruz G, Khamis R, Kim WY, Prieto C, Botnar RM. Coronary Magnetic Resonance Angiography in Chronic Coronary Syndromes. Front Cardiovasc Med 2021; 8:682924. [PMID: 34485397 PMCID: PMC8416045 DOI: 10.3389/fcvm.2021.682924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/23/2021] [Indexed: 01/14/2023] Open
Abstract
Cardiovascular disease is the leading cause of mortality worldwide, with atherosclerotic coronary artery disease (CAD) accounting for the majority of cases. X-ray coronary angiography and computed tomography coronary angiography (CCTA) are the imaging modalities of choice for the assessment of CAD. However, the use of ionising radiation and iodinated contrast agents remain drawbacks. There is therefore a clinical need for an alternative modality for the early identification and longitudinal monitoring of CAD without these associated drawbacks. Coronary magnetic resonance angiography (CMRA) could be a potential alternative for the detection and monitoring of coronary arterial stenosis, without exposing patients to ionising radiation or iodinated contrast agents. Further advantages include its versatility, excellent soft tissue characterisation and suitability for repeat imaging. Despite the early promise of CMRA, widespread clinical utilisation remains limited due to long and unpredictable scan times, onerous scan planning, lower spatial resolution, as well as motion related image quality degradation. The past decade has brought about a resurgence in CMRA technology, with significant leaps in image acceleration, respiratory and cardiac motion estimation and advanced motion corrected or motion-resolved image reconstruction. With the advent of artificial intelligence, great advances are also seen in deep learning-based motion estimation, undersampled and super-resolution reconstruction promising further improvements of CMRA. This has enabled high spatial resolution (1 mm isotropic), 3D whole heart CMRA in a clinically feasible and reliable acquisition time of under 10 min. Furthermore, latest super-resolution image reconstruction approaches which are currently under evaluation promise acquisitions as short as 1 min. In this review, we will explore the recent technological advances that are designed to bring CMRA closer to clinical reality.
Collapse
Affiliation(s)
- Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Camila Munoz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Ramzi Khamis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Won Yong Kim
- Department of Cardiology and Institute of Clinical Medicine, Aarhus University Hospital, Skejby, Denmark
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - René M. Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Instituto de Ingeniería Biologica y Medica, Pontificia Universidad Catolica de Chile, Santiago, Chile
| |
Collapse
|
4
|
Hajhosseiny R, Bustin A, Munoz C, Rashid I, Cruz G, Manning WJ, Prieto C, Botnar RM. Coronary Magnetic Resonance Angiography: Technical Innovations Leading Us to the Promised Land? JACC Cardiovasc Imaging 2020; 13:2653-2672. [PMID: 32199836 DOI: 10.1016/j.jcmg.2020.01.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 01/03/2020] [Accepted: 01/08/2020] [Indexed: 02/07/2023]
Abstract
Coronary artery disease remains the leading cause of cardiovascular morbidity and mortality. Invasive X-ray angiography and coronary computed tomography angiography are established gold standards for coronary luminography. However, they expose patients to invasive complications, ionizing radiation, and iodinated contrast agents. Among a number of imaging modalities, coronary cardiovascular magnetic resonance (CMR) angiography may be used in some cases as an alternative for the detection and monitoring of coronary arterial stenosis, with advantages including its versatility, excellent soft tissue characterization, and avoidance of ionizing radiation and iodinated contrast agents. In this review, we explore the recent advances in motion correction, image acceleration, and reconstruction technologies that are bringing coronary CMR angiography closer to widespread clinical implementation.
Collapse
Affiliation(s)
- Reza Hajhosseiny
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; National Heart and Lung Institute, Imperial College London, London, United Kingdom.
| | - Aurelien Bustin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Camila Munoz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Imran Rashid
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Warren J Manning
- Department of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom; Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile
| |
Collapse
|
5
|
O'Driscoll BR, Howard LS, Earis J, Mak V. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax 2017; 72:ii1-ii90. [DOI: 10.1136/thoraxjnl-2016-209729] [Citation(s) in RCA: 316] [Impact Index Per Article: 45.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/03/2017] [Accepted: 02/12/2017] [Indexed: 12/15/2022]
|
6
|
Abdominal organ motion during inhalation and exhalation breath-holds: pancreatic motion at different lung volumes compared. Radiother Oncol 2016; 121:268-275. [DOI: 10.1016/j.radonc.2016.09.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/19/2016] [Accepted: 09/25/2016] [Indexed: 11/24/2022]
|
7
|
Lens E, van der Horst A, Versteijne E, Bel A, van Tienhoven G. Considerable pancreatic tumor motion during breath-holding. Acta Oncol 2016; 55:1360-1368. [PMID: 27583771 DOI: 10.1080/0284186x.2016.1221532] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Breath-holding (BH) is often used to reduce abdominal organ motion during radiotherapy. However, for inhale BH, abdominal tumor motion during BH has not yet been investigated. The aim of this study was to quantify tumor motion during inhale BH and tumor position variations between consecutive inhale BHs in pancreatic cancer patients. MATERIAL AND METHODS Twelve patients with intratumoral fiducials were included and asked to perform three consecutive 30-second inhale BHs on each of three measurement days. During BH, lateral fluoroscopic movies were obtained and a two-dimensional (2D) image correlation algorithm was used to track the fiducials and the diaphragm, yielding the tumor and diaphragm motion during each BH. The tumor position variation between consecutive BHs was obtained from the difference in initial tumor position between consecutive BHs on a single measurement day. RESULTS We observed tumor motion during BH with a mean absolute maximum displacement over all BHs of 4.2 mm (range 1.0-11.0 mm) in inferior-superior (IS) direction and 2.7 mm (range 0.5-8.0 mm) in anterior-posterior (AP) direction. We found only a moderate correlation between tumor and diaphragm motion in the IS direction (Pearson's correlation coefficient |r|>0.6 in 45 of 76 BHs). The mean tumor position variation between consecutive BHs was 0.2 [standard deviation (SD) 1.7] mm in the inferior direction and 0.5 (SD 0.8) mm in the anterior direction. CONCLUSION We observed substantial pancreatic tumor motion during BH as well as considerable position variation between consecutive BHs on a single day. We recommend further quantifying these uncertainties before introducing breath-hold during radiation treatment of pancreatic cancer patients. Also, the diaphragm cannot be used as a surrogate for pancreatic tumor motion.
Collapse
Affiliation(s)
- Eelco Lens
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Astrid van der Horst
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Versteijne
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Arjan Bel
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Geertjan van Tienhoven
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
8
|
Roujol S, Basha TA, Akçakaya M, Foppa M, Chan RH, Kissinger KV, Goddu B, Berg S, Manning WJ, Nezafat R. 3D late gadolinium enhancement in a single prolonged breath-hold using supplemental oxygenation and hyperventilation. Magn Reson Med 2013; 72:850-7. [PMID: 24186772 DOI: 10.1002/mrm.24969] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 08/28/2013] [Accepted: 09/04/2013] [Indexed: 11/07/2022]
Abstract
PURPOSE To evaluate the feasibility of three-dimensional (3D) single breath-hold late gadolinium enhancement (LGE) of the left ventricle (LV) using supplemental oxygen and hyperventilation and compressed-sensing acceleration. METHODS Breath-hold metrics [breath-hold duration, diaphragmatic/LV position drift, and maximum variation of R wave to R wave (RR) interval] without and with supplemental oxygen and hyperventilation were assessed in healthy adult subjects using a real-time single shot acquisition. Ten healthy subjects and 13 patients then underwent assessment of the proposed 3D breath-hold LGE acquisition (field of view = 320 × 320 × 100 mm(3) , resolution = 1.6 × 1.6 × 5.0 mm(3) , acceleration rate of 4) and a free-breathing acquisition with right hemidiaphragm navigator (NAV) respiratory gating. Semiquantitative grading of overall image quality, motion artifact, myocardial nulling, and diagnostic value was performed by consensus of two blinded observers. RESULTS Supplemental oxygenation and hyperventilation increased the breath-hold duration (35 ± 11 s to 58 ± 21 s; P < 0.0125) without significant impact on diaphragmatic/LV position drift or maximum variation of RR interval (both P > 0.01). LGE images were of similar quality when compared with free-breathing acquisitions, but with reduced total scan time (85 ± 22 s to 35 ± 6 s; P < 0.001). CONCLUSIONS Supplemental oxygenation and hyperventilation allow for prolonged breath-holding and enable single breath-hold 3D accelerated LGE with similar image quality as free breathing with NAV.
Collapse
Affiliation(s)
- Sébastien Roujol
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Free-breathing single navigator gated cine cardiac magnetic resonance at 3 T: feasibility study in patients. J Comput Assist Tomogr 2011; 35:382-6. [PMID: 21586935 DOI: 10.1097/rct.0b013e31821b0ade] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cardiac magnetic resonance imaging (CMRI) is an important tool to assess cardiac function. However, one of the limitations of CMRI is the need for frequent breath-holding (BH) steps. This may be inconvenient to some patients and limit the use of this modality in patients unable to cooperate because of cognitive reasons or physically incapable of performing the required BH steps. The purpose of this study is to overcome the intrinsic timing and computation limitations of dual-navigator cine imaging and demonstrate the feasibility of free-breathing (FB) cine cardiac left ventricular function with a single-respiratory-navigator gating at 3 T. RESULTS Eight participants underwent cine CMRI with both the conventional 2-dimensional cine BH and FB navigator-gated techniques. Scan parameters were identical, except in the FB technique, in which a respiratory navigator and only 2 signal averages were used. Images were scored for quality. Left ventricular end-systolic volume and end-diastolic volume were calculated. The differences in the end-systolic volume and end-diastolic volume assessed by the BH and FB were not statistically significant with P = 0.9 and 0.2, respectively. There was a good agreement between LV volumes with the limits of agreement (± 2 SD = ± 22.36 mL). Image quality score was not significantly different (P = 0.76). CONCLUSIONS Free-breathing cine imaging utilizing a single-respiratory-navigator gating technique is comparable to conventional BH technique in both qualitative and quantitative imaging measures. Therefore, the FB cine technique can be used as an alternative for children and patients who are unable to hold their breath.
Collapse
|
10
|
Abstract
Coronary MR imaging is a promising noninvasive technique for the combined assessment of coronary artery anatomy and function. Anomalous coronary arteries and aneurysms can reliably be assessed in clinical practice using coronary MR imaging and the presence of significant left main or proximal multivessel coronary artery disease detected. Technical challenges that need to be addressed are further improvements in motion suppression and abbreviated scanning times aimed at improving spatial resolution and patient comfort. The development of new and specific contrast agents, high-field MR imaging with improved spatial resolution, and continued progress in MR imaging methods development will undoubtedly lead to further progress toward the noninvasive and comprehensive assessment of coronary atherosclerotic disease.
Collapse
Affiliation(s)
- Sebastian Kelle
- Division of Cardiology, Department of Medicine, German Heart Institute, Berlin, Germany; Division of Magnetic Resonance Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | |
Collapse
|
11
|
Abstract
Modern rapid magnetic resonance (MR) imaging techniques have led to widespread use of the modality in cardiac imaging. Despite this progress, many MR studies suffer from image degradation due to involuntary motion during the acquisition. This review describes the type and extent of the motion of the heart due to the cardiac and respiratory cycles, which create image artifacts. Methods of eliminating or reducing the problems caused by the cardiac cycle are discussed, including electrocardiogram gating, subject-specific acquisition windows, and section tracking. Similarly, for respiratory motion of the heart, techniques such as breath holding, respiratory gating, section tracking, phase-encoding ordering, subject-specific translational models, and a range of new techniques are considered.
Collapse
Affiliation(s)
- Andrew D Scott
- Cardiovascular Magnetic Resonance Unit, the Royal Brompton Hospital, London, England.
| | | | | |
Collapse
|
12
|
Roes SD, Westenberg JJM, Doornbos J, van der Geest RJ, Angelié E, de Roos A, Stuber M. Aortic vessel wall magnetic resonance imaging at 3.0 Tesla: a reproducibility study of respiratory navigator gated free-breathing 3D black blood magnetic resonance imaging. Magn Reson Med 2009; 61:35-44. [PMID: 19097222 DOI: 10.1002/mrm.21798] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of this study was to evaluate a free-breathing three-dimensional (3D) dual inversion-recovery (DIR) segmented k-space gradient-echo (turbo field echo [TFE]) imaging sequence at 3T for the quantification of aortic vessel wall dimensions. The effect of respiratory motion suppression on image quality was tested. Furthermore, the reproducibility of the aortic vessel wall measurements was investigated. Seven healthy subjects underwent 3D DIR TFE imaging of the aortic vessel wall with and without respiratory navigator. Subsequently, this sequence with respiratory navigator was performed twice in 10 healthy subjects to test its reproducibility. The signal-to-noise (SNR), contrast-to-noise ratio (CNR), vessel wall sharpness, and vessel wall volume (VWV) were assessed. Data were compared using the paired t-test, and the reproducibility of VWV measurements was evaluated using intraclass correlation coefficients (ICCs). SNR, CNR, and vessel wall sharpness were superior in scans performed with respiratory navigator compared to scans performed without. The ICCs concerning intraobserver, interobserver, and interscan reproducibility were excellent (0.99, 0.94, and 0.95, respectively). In conclusion, respiratory motion suppression substantially improves image quality of 3D DIR TFE imaging of the aortic vessel wall at 3T. Furthermore, this optimized technique with respiratory motion suppression enables assessment of aortic vessel wall dimensions with high reproducibility.
Collapse
Affiliation(s)
- Stijntje D Roes
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
13
|
Bluemke DA, Achenbach S, Budoff M, Gerber TC, Gersh B, Hillis LD, Hundley WG, Manning WJ, Printz BF, Stuber M, Woodard PK. Noninvasive coronary artery imaging: magnetic resonance angiography and multidetector computed tomography angiography: a scientific statement from the american heart association committee on cardiovascular imaging and intervention of the council on cardiovascular radiology and intervention, and the councils on clinical cardiology and cardiovascular disease in the young. Circulation 2008; 118:586-606. [PMID: 18586979 DOI: 10.1161/circulationaha.108.189695] [Citation(s) in RCA: 351] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
14
|
Manning WJ, Nezafat R, Appelbaum E, Danias PG, Hauser TH, Yeon SB. Coronary Magnetic Resonance Imaging. Magn Reson Imaging Clin N Am 2007; 15:609-37, vii. [DOI: 10.1016/j.mric.2007.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
Abstract
Coronary magnetic resonance angiography (MRA) is a powerful noninvasive technique with high soft-tissue contrast for the visualization of the coronary anatomy without X-ray exposure. Due to the small dimensions and tortuous nature of the coronary arteries, a high spatial resolution and sufficient volumetric coverage have to be obtained. However, this necessitates scanning times that are typically much longer than one cardiac cycle. By collecting image data during multiple RR intervals, one can successfully acquire coronary MR angiograms. However, constant cardiac contraction and relaxation, as well as respiratory motion, adversely affect image quality. Therefore, sophisticated motion-compensation strategies are needed. Furthermore, a high contrast between the coronary arteries and the surrounding tissue is mandatory. In the present article, challenges and solutions of coronary imaging are discussed, and results obtained in both healthy and diseased states are reviewed. This includes preliminary data obtained with state-of-the-art techniques such as steady-state free precession (SSFP), whole-heart imaging, intravascular contrast agents, coronary vessel wall imaging, and high-field imaging. Simultaneously, the utility of electron beam computed tomography (EBCT) and multidetector computed tomography (MDCT) for the visualization of the coronary arteries is discussed.
Collapse
Affiliation(s)
- Matthias Stuber
- Department of Radiology, Division of Magnetic Resonance Research, Johns Hopkins University, Baltimore, Maryland, USA.
| | | |
Collapse
|
16
|
Abstract
This article highlights the technical challenges and general imaging strategies for coronary MRI. This is followed by a review of the clinical results for the assessment of anomalous CAD, coronary artery aneurysms, native vessel integrity, and coronary artery bypass graft disease using the more commonly applied MRI methods. It concludes with a brief discussion of the advantages/disadvantages and clinical results comparing coronary MRI with multidetector CT (MDCT) coronary angiography.
Collapse
Affiliation(s)
- Warren J Manning
- Departments of Medicine and Radiology, Cardiovascular Division, Harvard-Thorndike Laboratory, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA.
| | | | | | | | | | | |
Collapse
|
17
|
Arnold JF, Mörchel P, Glaser E, Pracht ED, Jakob PM. Lung MRI using an MR-compatible active breathing control (MR-ABC). Magn Reson Med 2007; 58:1092-8. [DOI: 10.1002/mrm.21424] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
18
|
Desai MY, Lima JAC. Imaging of atherosclerosis using magnetic resonance: state of the art and future directions. Curr Atheroscler Rep 2006; 8:131-9. [PMID: 16510047 DOI: 10.1007/s11883-006-0050-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Atherosclerosis is the leading cause of morbidity and mortality in industrialized societies, and its incidence is projected to increase in the future. Because the atherosclerotic process begins in the vessel wall, the focus of cardiovascular imaging is shifting from the arterial lumen to imaging of the vessel wall, with the goal of detecting preclinical atherosclerosis. MRI, because of its high resolution, three-dimensional capabilities, noninvasive nature, and capacity for soft tissue characterization, is emerging as an important modality to assess the atherosclerotic plaque burden in the arterial wall and can monitor atherosclerosis in different arterial beds, including the carotid arteries, aorta, and more recently, the coronary arteries. Furthermore, it has also been successfully utilized to monitor plaque regression following therapeutic interventions. Finally, the emergence of high-resolution MRI and development of sophisticated contrast agents offers tremendous promise for in vivo molecular imaging of the atherosclerotic plaque.
Collapse
Affiliation(s)
- Milind Y Desai
- Division of Cardiology, Johns Hopkins University, Baltimore, MD 21287, USA
| | | |
Collapse
|
19
|
Abstract
Coronary magnetic resonance angiography (coronary MRA) continues to advance rapidly from both a technical and clinical perspective. Coronary MRA has benefited directly from improvements in spatial resolution, contrast definition, and advances in motion correction, which have furthered its routine use in evaluating coronary artery bypass grafts and anomalous coronary arteries. Work in refining the techniques for more accurate identification of coronary artery disease (CAD) continues, with advances in navigator-gated and breath-hold motion correction techniques, novel k-space strategies (e.g., spiral and radial k-space filling), development and application of intravascular contrast agents, and imaging at higher field strengths. Ultimately, these developments may lead to the routine application of coronary MRA as a screening tool for CAD. This article reviews the development of coronary MRA, discusses the requirements and tools necessary for optimal visualization of the coronary arteries, and describes the application of coronary MRA to acquired and congenital CAD.
Collapse
Affiliation(s)
- Scott D Flamm
- Department of Radiology, St. Luke's Episcopal Hospital and Texas Heart Institute, Houston, Texas 77030, USA.
| | | |
Collapse
|
20
|
McCarthy RM, Shea SM, Deshpande VS, Green JD, Pereles FS, Carr JC, Finn JP, Li D. Coronary MR angiography: true FISP imaging improved by prolonging breath holds with preoxygenation in healthy volunteers. Radiology 2003; 227:283-8. [PMID: 12616011 DOI: 10.1148/radiol.2271011415] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In 15 healthy volunteers undergoing coronary magnetic resonance (MR) angiography, the breath-hold duration with and without preoxygenation was measured. The effect of preoxygenation on coronary artery imaging was also evaluated. A three-dimensional magnetization-prepared true fast imaging with steady-state precession sequence was employed for coronary MR angiography. All subjects showed an increase in comfortable breath-hold duration with preoxygenation. This extra imaging time allowed coronary artery imaging with increased spatial resolution.
Collapse
Affiliation(s)
- Richard M McCarthy
- Department of Radiology, Northwestern University Medical School, Suite 700, 448 E Ontario St, Chicago, IL 60611, USA
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Danias PG, Stuber M, Botnar RM, Kissinger KV, Yeon SB, Rofsky NM, Manning WJ. Coronary MR angiography clinical applications and potential for imaging coronary artery disease. Magn Reson Imaging Clin N Am 2003; 11:81-99. [PMID: 12797512 DOI: 10.1016/s1064-9689(02)00022-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Over the past decade, CMRA has emerged as a unique clinical imaging tool with applications in selected populations. Patients with suspected coronary artery anomalies and patients with Kawasaki disease and coronary aneurysms are among those for whom CMRA has demonstrated clinical usefulness. For assessment of patients with atherosclerotic CAD, CMRA is useful for detection of patency of bypass grafts. At centers with appropriate expertise and resources, CMRA also appears to be of value for exclusion of severe proximal multivessel CAD in selected patients. Data from multicenter trials will continue to define the clinical role of CMRA, particularly as it relates to assessment of CAD. Future developments and enhancements of CMRA promise better lumen and coronary artery wall imaging. This may become the new target in noninvasive evaluation of CAD.
Collapse
Affiliation(s)
- Peter G Danias
- Harvard-Thorndike Laboratory of the Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | | | | | | | | | | | | |
Collapse
|
22
|
Plein S, Jones TR, Ridgway JP, Sivananthan MU. Three-dimensional coronary MR angiography performed with subject-specific cardiac acquisition windows and motion-adapted respiratory gating. AJR Am J Roentgenol 2003; 180:505-12. [PMID: 12540462 DOI: 10.2214/ajr.180.2.1800505] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE In coronary MR angiography, data are conventionally accepted in only short and fixed periods of the cardiac and respiratory cycles. We hypothesized that a more flexible and subject-specific approach to cardiac and respiratory gating may shorten scanning times while maintaining image quality. SUBJECTS AND METHODS We implemented an acquisition technique that uses subject-specific acquisition windows in the cardiac cycle and a motion-adapted gating window for respiratory navigator gating. Cardiac acquisition windows and trigger delays were determined individually from a coronary motion scan. Motion-adapted gating used a 2-mm acceptance window for the central 35% of k-space and a 6-mm window for the outer 65% of k-space. In 10 subjects, three-dimensional coronary MR angiograms of the right and left coronary systems were acquired with this technique (the "adaptive technique") as well as a conventional acquisition method, and the scanning times and image quality were compared. The adaptive technique was then applied prospectively to 40 patients who underwent coronary radiographic angiography. RESULTS Scanning times with the adaptive technique were reduced by a factor of 2.3 for the right coronary artery and by a factor of 2.2 for the left coronary artery system compared with the conventional technique, mainly because we were able to use longer subject-specific acquisition windows in patients with low heart rates. Subjective and objective measurements of image quality showed no significant differences between the two techniques. Prospective evaluation of MR angiograms yielded a sensitivity and specificity of 74.3% and 88.2%, respectively, to detect significant coronary artery stenoses. CONCLUSION Coronary MR angiography with subject-specific acquisition windows and motion-adapted respiratory gating reduces scanning times while maintaining image quality and provides high diagnostic accuracy for the detection of coronary artery stenosis.
Collapse
Affiliation(s)
- Sven Plein
- British Heart Foundation-Cardiac MRI Unit, Rm. 170, D Fl., Jubilee Building, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom
| | | | | | | |
Collapse
|
23
|
Affiliation(s)
- P G Danias
- Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory, Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA
| | | | | | | |
Collapse
|
24
|
Stuber M, Spiegel MA, Fischer SE, Scheidegger MB, Danias PG, Pedersen EM, Boesiger P. Single breath-hold slice-following CSPAMM myocardial tagging. MAGMA (NEW YORK, N.Y.) 1999; 9:85-91. [PMID: 10555178 DOI: 10.1007/bf02634597] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Myocardial tagging has shown to be a useful magnetic resonance modality for the assessment and quantification of local myocardial function. Many myocardial tagging techniques suffer from a rapid fading of the tags, restricting their application mainly to systolic phases of the cardiac cycle. However, left ventricular diastolic dysfunction has been increasingly appreciated as a major cause of heart failure. Subtraction based slice-following CSPAMM myocardial tagging has shown to overcome limitations such as fading of the tags. Remaining impediments to this technique, however, are extensive scanning times (approximately 10 min), the requirement of repeated breath-holds using a coached breathing pattern, and the enhanced sensitivity to artifacts related to poor patient compliance or inconsistent depths of end-expiratory breath-holds. We therefore propose a combination of slice-following CSPAMM myocardial tagging with a segmented EPI imaging sequence. Together with an optimized RF excitation scheme, this enables to acquire as many as 20 systolic and diastolic grid-tagged images per cardiac cycle with a high tagging contrast during a short period of sustained respiration.
Collapse
Affiliation(s)
- M Stuber
- Institute of Biomedical Engineering and Medical Informatics, University and ETH Zurich, Switzerland
| | | | | | | | | | | | | |
Collapse
|