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Masutani EM, Chandrupatla RS, Wang S, Zocchi C, Hahn LD, Horowitz M, Jacobs K, Kligerman S, Raimondi F, Patel A, Hsiao A. Deep Learning Synthetic Strain: Quantitative Assessment of Regional Myocardial Wall Motion at MRI. Radiol Cardiothorac Imaging 2023; 5:e220202. [PMID: 37404797 PMCID: PMC10316298 DOI: 10.1148/ryct.220202] [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: 09/22/2022] [Revised: 03/07/2023] [Accepted: 03/20/2023] [Indexed: 07/06/2023]
Abstract
Purpose To assess the feasibility of a newly developed algorithm, called deep learning synthetic strain (DLSS), to infer myocardial velocity from cine steady-state free precession (SSFP) images and detect wall motion abnormalities in patients with ischemic heart disease. Materials and Methods In this retrospective study, DLSS was developed by using a data set of 223 cardiac MRI examinations including cine SSFP images and four-dimensional flow velocity data (November 2017 to May 2021). To establish normal ranges, segmental strain was measured in 40 individuals (mean age, 41 years ± 17 [SD]; 30 men) without cardiac disease. Then, DLSS performance in the detection of wall motion abnormalities was assessed in a separate group of patients with coronary artery disease, and these findings were compared with consensus results of four independent cardiothoracic radiologists (ground truth). Algorithm performance was evaluated by using receiver operating characteristic curve analysis. Results Median peak segmental radial strain in individuals with normal cardiac MRI findings was 38% (IQR: 30%-48%). Among patients with ischemic heart disease (846 segments in 53 patients; mean age, 61 years ± 12; 41 men), the Cohen κ among four cardiothoracic readers for detecting wall motion abnormalities was 0.60-0.78. DLSS achieved an area under the receiver operating characteristic curve of 0.90. Using a fixed 30% threshold for abnormal peak radial strain, the algorithm achieved a sensitivity, specificity, and accuracy of 86%, 85%, and 86%, respectively. Conclusion The deep learning algorithm had comparable performance with subspecialty radiologists in inferring myocardial velocity from cine SSFP images and identifying myocardial wall motion abnormalities at rest in patients with ischemic heart disease.Keywords: Neural Networks, Cardiac, MR Imaging, Ischemia/Infarction Supplemental material is available for this article. © RSNA, 2023.
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Raj V, Gowda S, Kothari R. Myocardial tissue characterization by cardiac magnetic resonance: A primer for the clinician. JOURNAL OF THE INDIAN ACADEMY OF ECHOCARDIOGRAPHY & CARDIOVASCULAR IMAGING 2023. [DOI: 10.4103/jiae.jiae_44_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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3
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Farrell C, Balasubramanian A, Hays AG, Hsu S, Rowe S, Zimmerman SL, Hassoun PM, Mathai SC, Mukherjee M. A Clinical Approach to Multimodality Imaging in Pulmonary Hypertension. Front Cardiovasc Med 2022; 8:794706. [PMID: 35118142 PMCID: PMC8804287 DOI: 10.3389/fcvm.2021.794706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/22/2021] [Indexed: 11/24/2022] Open
Abstract
Pulmonary hypertension (PH) is a clinical condition characterized by progressive elevations in mean pulmonary artery pressures and right ventricular dysfunction, associated with significant morbidity and mortality. For resting PH to develop, ~50-70% of the pulmonary vasculature must be affected, suggesting that even mild hemodynamic abnormalities are representative of advanced pulmonary vascular disease. The definitive diagnosis of PH is based upon hemodynamics measured by right heart catheterization; however this is an invasive and resource intense study. Early identification of pulmonary vascular disease offers the opportunity to improve outcomes by instituting therapies that slow, reverse, or potentially prevent this devastating disease. Multimodality imaging, including non-invasive modalities such as echocardiography, computed tomography, ventilation perfusion scans, and cardiac magnetic resonance imaging, has emerged as an integral tool for screening, classifying, prognosticating, and monitoring response to therapy in PH. Additionally, novel imaging modalities such as echocardiographic strain imaging, 3D echocardiography, dual energy CT, FDG-PET, and 4D flow MRI are actively being investigated to assess the severity of right ventricular dysfunction in PH. In this review, we will describe the utility and clinical application of multimodality imaging techniques across PH subtypes as it pertains to screening and monitoring of PH.
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Affiliation(s)
- Christine Farrell
- Division of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Aparna Balasubramanian
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Allison G. Hays
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
| | - Steven Hsu
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
| | - Steven Rowe
- Division of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | - Stefan L. Zimmerman
- Division of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | - Paul M. Hassoun
- Division of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Stephen C. Mathai
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Monica Mukherjee
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
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4
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Carruth ED, Fielden SW, Nevius CD, Fornwalt BK, Haggerty CM. 3D-Encoded DENSE MRI with Zonal Excitation for Quantifying Biventricular Myocardial Strain During a Breath-Hold. Cardiovasc Eng Technol 2021; 12:589-597. [PMID: 34244904 DOI: 10.1007/s13239-021-00561-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/25/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Right ventricular (RV) function is increasingly recognized for its prognostic value in many disease states. As with the left ventricle (LV), strain-based measurements may have better prognostic value than typical chamber volumes or ejection fraction. Complete functional characterization of the RV requires high-resolution, 3D displacement tracking methods, which have been prohibitively challenging to implement. Zonal excitation during Displacement ENcoding with Stimulated Echoes (DENSE) magnetic resonance imaging (MRI) has helped reduce scan time for 2D LV strain quantification. We hypothesized that zonal excitation could alternatively be used to reproducibly acquire higher resolution, 3D-encoded DENSE images for quantification of bi-ventricular strain within a single breath-hold. METHODS We modified sequence parameters for a 3D zonal excitation DENSE sequence to achieve in-plane resolution < 2 mm and acquired two sets of images in eight healthy adult male volunteers with median (IQR) age 32.5 (32.0-33.8) years. We assessed the inter-test reproducibility of this technique, and compared computed strains and torsion with previously published data. RESULTS Data for one subject was excluded based on image artifacts. Reproducibility for LV (CoV: 6.1-9.0%) and RV normal strains (CoV: 6.3-8.2%) and LV torsion (CoV = 7.1%) were all very good. Reproducibility of RV torsion was lower (CoV = 16.7%), but still within acceptable limits. Computed global strains and torsion were within reasonable agreement with published data, but further studies in larger cohorts are needed to confirm. CONCLUSION Reproducible acquisition of 3D-encoded biventricular myocardial strain data in a breath-hold is feasible using DENSE with zonal excitation.
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Affiliation(s)
- Eric D Carruth
- Department of Translational Data Science and Informatics, Geisinger, Danville, PA, USA
| | - Samuel W Fielden
- Department of Translational Data Science and Informatics, Geisinger, Danville, PA, USA.,Medical and Health Physics, Geisinger, Danville, PA, USA
| | - Christopher D Nevius
- Department of Translational Data Science and Informatics, Geisinger, Danville, PA, USA
| | - Brandon K Fornwalt
- Department of Translational Data Science and Informatics, Geisinger, Danville, PA, USA.,The Heart Institute, Geisinger, Danville, PA, USA.,Department of Radiology, Geisinger, Danville, PA, USA
| | - Christopher M Haggerty
- Department of Translational Data Science and Informatics, Geisinger, Danville, PA, USA. .,The Heart Institute, Geisinger, Danville, PA, USA.
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5
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Yao Q, Hu XH, He LL. Cardiac magnetic resonance feature tracking of the right ventricle in convalescent Kawasaki disease in a large single center. Clin Cardiol 2020; 44:108-115. [PMID: 33179816 PMCID: PMC7803351 DOI: 10.1002/clc.23512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 12/19/2022] Open
Abstract
Background The changes in right ventricular (RV) contractility of Kawasaki disease (KD) still remain unclear. Hypothesis We aimed to determine whether RV systolic dysfunction can be detected by cardiac magnetic resonance (CMR) feature tracking and to find its association with coronary artery lesions (aneurysm, thrombosis and stenosis). Methods Peak systolic myocardial longitudinal, radial and circumferential strain and the strain rate (RVSL, RVSR, RVSC, RVSRL, RVSRR and RVSRC) in the global RV and three levels (basal, middle and apical) were measured in 66 patients with convalescent KD. A total of 20 controls were included. Comparisons were made with controls and among KD subgroups divided with coronary artery lesions. Results RVSC (−10.575% vs. −10.760%), RVSL (−18.150% vs. −18.712%) and RVSRC (−0.815/s vs. −0.924/s) were slightly lower in KD group without significant difference. All the strain and strain rate presented lowest in the basal level. In subgroup comparison, lower RVSL and RVSRL were observed in the giant coronary artery aneurysm (CAA) group; RVSR (15.844% vs. 16.897%), RVSRR (1.245/s vs. 1.322/s) and RVSRC (−0.715/s vs. −0.895/s) were lower in thrombosed group; RVSRL (−1.27/s vs. −1.503/s) were lower in stenosis group. All the comparison in subgroups did not reach significant difference. From the analysis of receiver operating characteristic curve, RVSRL had a better ability to identify KD with giant CAA and stenosis. For the identification of thrombosis, RVSRC had a better ability. Conclusions Lower strain and strain rates of RV were detected in convalescent KD. More pronounced in those with persisting coronary artery lesions.
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Affiliation(s)
- Qiong Yao
- Department of Radiology, Children's Hospital of Fudan University, Shanghai, China
| | - Xi-Hong Hu
- Department of Radiology, Children's Hospital of Fudan University, Shanghai, China
| | - Li-Li He
- Department of Ultrasound, Children's Hospital of Fudan University, Shanghai, China
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6
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Espe EKS, Aronsen JM, Nordén ES, Zhang L, Sjaastad I. Regional right ventricular function in rats: a novel magnetic resonance imaging method for measurement of right ventricular strain. Am J Physiol Heart Circ Physiol 2020; 318:H143-H153. [DOI: 10.1152/ajpheart.00357.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The function of the right ventricle (RV) is linked to clinical outcome in many cardiovascular diseases, but its role in experimental heart failure remains largely unexplored due to difficulties in measuring RV function in vivo. We aimed to advance RV imaging by establishing phase-contrast MRI (PC-MRI) as a robust method for measuring RV function in rodents. A total of 46 Wistar-Hannover rats with left ventricular (LV) myocardial infarction and 10 control rats (sham) were examined 6 wk after surgery. Using a 9.4-T preclinical MRI system, we utilized PC-MRI to measure strain/strain rate in the RV free wall under isoflurane anesthesia. Cine MRI was used to measure RV volumes. LV end-diastolic pressure (LVEDP) was measured and used to identify pulmonary congestion. The infarct rats were divided into two groups: those with signs of pulmonary congestion (PC), with LVEDP ≥ 15 mmHg ( n = 26) and those without signs of pulmonary congestion (NPC), with LVEDP < 15 mmHg ( n = 20). The NPC rats exhibited preserved RV strains/strain rates, whereas the PC rats exhibited reduced strains/strain rates (26–48% lower than sham). Of the strain parameters, longitudinal strain and strain rate exhibited the highest correlations to LVEDP and lung weight (rho = 0.65–0.72, P < 0.001). Basal longitudinal strain was most closely associated with signs of pulmonary congestion and indexes of RV remodeling. Longitudinal RV strain had higher area under the curve than ejection fraction for detecting subtle RV dysfunction (area under the curve = 0.85 vs. 0.67). In conclusion, we show for the first time that global and regional RV myocardial strain can be measured robustly in rodents. Reduced RV strain was closely associated with indexes of pulmonary congestion and molecular markers of RV remodeling. NEW & NOTEWORTHY Global and regional right ventricular myocardial strain can be measured with high reproducibility and low interobserver variability in rodents using tissue phase mapping MRI. Reduced right ventricular strain was associated with indexes of pulmonary congestion and molecular markers of right ventricular remodeling. Regional strain in the basal myocardium was considerably higher than in the apical myocardium.
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Affiliation(s)
- Emil K. S. Espe
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Jan M. Aronsen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- Bjørknes College, Oslo, Norway
| | - Einar S. Nordén
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
- Bjørknes College, Oslo, Norway
| | - Lili Zhang
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Ivar Sjaastad
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
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Hu BY, Wang J, Yang ZG, Ren Y, Jiang L, Xie LJ, Liu X, Gao Y, Shen MT, Xu HY, Shi K, Li ZL, Xia CC, Peng WL, Deng MY, Li H, Guo YK. Cardiac magnetic resonance feature tracking for quantifying right ventricular deformation in type 2 diabetes mellitus patients. Sci Rep 2019; 9:11148. [PMID: 31366951 PMCID: PMC6668453 DOI: 10.1038/s41598-019-46755-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 06/14/2019] [Indexed: 02/05/2023] Open
Abstract
To determine the feasibility of deformation analysis in the right ventricle (RV) using cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) in type 2 diabetes mellitus (T2DM) patients. We enrolled 104 T2DM patients, including 14 with impaired right ventricular ejection fraction (RVEF) and 90 with preserved RVEF, and 26 healthy controls in this prospective study. CMR was used to determine RV feature-tracking parameters. RV strain parameters were compared among the controls, patients with preserved and reduced RVEF. Binary logistic regression was used to predict RV dysfunction. Receiver operating characteristic analysis was used to assess the diagnostic accuracy. The agreement was tested by Bland–Altman analysis. Compared with controls, longitudinal and circumferential global peak strain (PS) and PS at mid-ventricular, apical slices were significantly decreased in T2DM patients with or without reduced RVEF (p < 0.05). Within the T2DM patients, the global longitudinal PS (GLPS) and the longitudinal PS at mid-ventricular segments were significantly reduced in the reduced RVEF group than in preserved RVEF groups (p < 0.05). GLPS was an independent predictor of RV dysfunction (odds ratio: 1.246, 95% CI: 1.037–1.496; p = 0.019). The GLPS demonstrated greater diagnostic accuracy (area under curve: 0.716) to predict RV dysfunction. On Bland-Altman analysis, global circumferential PS and GLPS had the best intra- and inter-observer agreement, respectively. In T2DM patients, CMR-FT could quantify RV deformation and identify subclinical RV dysfunction in those with normal RVEF. Further, RV strain parameters are potential predictors for RV dysfunction in T2DM patients.
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Affiliation(s)
- Bi-Yue Hu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China.,Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jin Wang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China.
| | - Yan Ren
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Li Jiang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Lin-Jun Xie
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xi Liu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Yue Gao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Meng-Ting Shen
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Hua-Yan Xu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Zhen-Lin Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Chun-Chao Xia
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Wan-Lin Peng
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Ming-Yan Deng
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Hong Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
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8
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Impact of age and cardiac disease on regional left and right ventricular myocardial motion in healthy controls and patients with repaired tetralogy of fallot. Int J Cardiovasc Imaging 2019; 35:1119-1132. [PMID: 30715669 DOI: 10.1007/s10554-019-01544-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 01/21/2019] [Indexed: 12/29/2022]
Abstract
The assessment of both left (LV) and right ventricular (RV) motion is important to understand the impact of heart disease on cardiac function. The MRI technique of tissue phase mapping (TPM) allows for the quantification of regional biventricular three-directional myocardial velocities. The goal of this study was to establish normal LV and RV velocity parameters across a wide range of pediatric to adult ages and to investigate the feasibility of TPM for detecting impaired regional biventricular function in patients with repaired tetralogy of Fallot (TOF). Thirty-six healthy controls (age = 1-75 years) and 12 TOF patients (age = 5-23 years) underwent cardiac MRI including TPM in short-axis locations (base, mid, apex). For ten adults, a second TPM scan was used to assess test-retest reproducibility. Data analysis included the calculation of biventricular radial, circumferential, and long-axis velocity components, quantification of systolic and diastolic peak velocities in an extended 16 + 10 LV + RV segment model, and assessment of inter-ventricular dyssynchrony. Biventricular velocities showed good test-retest reproducibility (mean bias ≤ 0.23 cm/s). Diastolic radial and long-axis peak velocities for LV and RV were significantly reduced in adults compared to children (19-61%, p < 0.001-0.02). In TOF patients, TPM identified significantly reduced systolic and diastolic LV and RV long-axis peak velocities (20-50%, p < 0.001-0.05) compared to age-matched controls. In conclusion, tissue phase mapping enables comprehensive analysis of global and regional biventricular myocardial motion. Changes in myocardial velocities associated with age underline the importance of age-matched controls. This pilot study in TOF patients shows the feasibility to detect regionally abnormal LV and RV motion.
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Abstract
PURPOSE OF REVIEW This article will review the current techniques in cardiac magnetic resonance imaging (CMR) for diagnosing and assessing primary valvular heart disease. RECENT FINDINGS The recent advancements in CMR have led to an increased role of this modality for qualifying and quantifying various native valve diseases. Phase-contrast velocity encoded imaging is a well-established technique that can be used to quantify aortic and pulmonic flow. This technique, combined with the improved ability for CMR to obtain accurate left and right ventricular volumetrics, has allowed for increased accuracy and reproducibility in assessing valvular dysfunction. Advancements in CMR technology also allows for improved spatial and temporal resolution imaging of various valves and their regurgitant or stenotic jets. Therefore, CMR can be a powerful tool in evaluation of native valvular heart disease. The role of CMR in assessing valvular heart disease is growing and being recognized in recent guidelines. CMR has the ability to assess valve morphology along with qualifying and quantifying valvular disease. In addition, the ability to obtain accurate volumetric measurements may improve more precise management strategies and may lead to improvements in mortality and morbidity.
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10
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Wehner GJ, Suever JD, Fielden SW, Powell DK, Hamlet SM, Vandsburger MH, Haggerty CM, Zhong X, Fornwalt BK. Typical readout durations in spiral cine DENSE yield blurred images and underestimate cardiac strains at both 3.0 T and 1.5 T. Magn Reson Imaging 2018; 54:90-100. [PMID: 30099059 DOI: 10.1016/j.mri.2018.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/10/2018] [Accepted: 08/08/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Displacement encoding with stimulated echoes (DENSE) is a phase contrast technique that encodes tissue displacement into phase images, which are typically processed into measures of cardiac function such as strains. For improved signal to noise ratio and spatiotemporal resolution, DENSE is often acquired with a spiral readout using an 11.1 ms readout duration. However, long spiral readout durations are prone to blurring due to common phenomena such as off-resonance and T2* decay, which may alter the resulting quantifications of strain. We hypothesized that longer readout durations would reduce image quality and underestimate cardiac strains at both 3.0 T and 1.5 T and that using short readout durations could overcome these limitations. MATERIAL AND METHODS Computational simulations were performed to investigate the relationship between off-resonance and T2* decay, the spiral cine DENSE readout duration, and measured radial and circumferential strain. Five healthy participants subsequently underwent 2D spiral cine DENSE at both 3.0 T and 1.5 T with several different readout durations 11.1 ms and shorter. Pearson correlations were used to assess the relationship between cardiac strains and the spiral readout duration. RESULTS Simulations demonstrated that long readout durations combined with off-resonance and T2* decay yield blurred images and underestimate strains. With the typical 11.1 ms DENSE readout, blurring was present in the anterior and lateral left ventricular segments of participants and was markedly improved with shorter readout durations. Radial and circumferential strains from those segments were significantly correlated with the readout duration. Compared to the 1.9 ms readout, the 11.1 ms readout underestimated radial and circumferential strains in those segments at both field strengths by up to 19.6% and 1.5% (absolute), or 42% and 7% (relative), respectively. CONCLUSIONS Blurring is present in spiral cine DENSE images acquired at both 3.0 T and 1.5 T using the typical 11.1 ms readout duration, which yielded substantially reduced radial strains and mildly reduced circumferential strains. Clinical studies using spiral cine DENSE should consider these limitations, while future technical advances may need to leverage accelerated techniques to improve the robustness and accuracy of the DENSE acquisition rather than focusing solely on reduced acquisition time.
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Affiliation(s)
- Gregory J Wehner
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, United States.
| | - Jonathan D Suever
- Department of Imaging Science and Innovation, Geisinger, Danville, PA, United States.
| | - Samuel W Fielden
- Department of Imaging Science and Innovation, Geisinger, Danville, PA, United States; Department of Medical & Health Physics, Geisinger, Danville, PA, United States.
| | - David K Powell
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, United States.
| | - Sean M Hamlet
- Department of Electrical Engineering, University of Kentucky, Lexington, KY, United States.
| | - Moriel H Vandsburger
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, United States; Department of Physiology, University of Kentucky, Lexington, KY, United States.
| | | | - Xiaodong Zhong
- MR R&D Collaborations, Siemens Healthcare, Atlanta, GA, United States.
| | - Brandon K Fornwalt
- Department of Imaging Science and Innovation, Geisinger, Danville, PA, United States; Department of Radiology, Geisinger, Danville, PA, United States.
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11
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Abstract
The objective assessments of left ventricular (LV) and right ventricular (RV) ejection fractions (EFs) are the main important tasks of routine cardiovascular magnetic resonance (CMR). Over the years, CMR has emerged as the reference standard for the evaluation of biventricular morphology and function. However, changes in EF may occur in the late stages of the majority of cardiac diseases, and being a measure of global function, it has limited sensitivity for identifying regional myocardial impairment. On the other hand, current wall motion evaluation is done on a subjective basis and subjective, qualitative analysis has a substantial error rate. In an attempt to better quantify global and regional LV function; several techniques, to assess myocardial deformation, have been developed, over the past years. The aim of this review is to provide a comprehensive compendium of all the CMR techniques to assess myocardial deformation parameters as well as the application in different clinical scenarios.
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Affiliation(s)
- A Scatteia
- Cardiac Magnetic Resonance Unit, Bristol Heart Institute, NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK.,Division of Cardiology, Ospedale Medico-Chirurgico Accreditato Villa dei Fiori, Acerra, Naples, Italy
| | - A Baritussio
- Cardiac Magnetic Resonance Unit, Bristol Heart Institute, NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK
| | - C Bucciarelli-Ducci
- Cardiac Magnetic Resonance Unit, Bristol Heart Institute, NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK.
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12
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Menza M, Föll D, Hennig J, Jung B. Segmental biventricular analysis of myocardial function using high temporal and spatial resolution tissue phase mapping. MAGMA (NEW YORK, N.Y.) 2017; 31:61-73. [PMID: 29143137 DOI: 10.1007/s10334-017-0661-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/13/2017] [Accepted: 10/30/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Myocardial dysfunction of the right ventricle (RV) is an important indicator of RV diseases, e.g. RV infarction or pulmonary hypertension. Tissue phase mapping (TPM) has been widely used to determine function of the left ventricle (LV) by analyzing myocardial velocities. The analysis of RV motion is more complicated due to the different geometry and smaller wall thickness. The aim of this work was to adapt and optimize TPM to the demands of the RV. MATERIALS AND METHODS TPM measurements were acquired in 25 healthy volunteers using a velocity-encoded phase-contrast sequence and kt-accelerated parallel imaging in combination with optimized navigator strategy and blood saturation. Post processing was extended by a 10-segment RV model and a detailed biventricular analysis of myocardial velocities was performed. RESULTS High spatio-temporal resolution (1.0 × 1.0 × 6 mm3, 21.3 ms) and the optimized blood saturation enabled good delineation of the RV and its velocities. Global and segmental velocities, as well as time to peak velocities showed significant differences between the LV and RV. Furthermore, complex timing of the RV could be demonstrated by segmental time to peak analysis. CONCLUSION High spatio-temporal resolution TPM enables a detailed biventricular analysis of myocardial motion and might provide a reliable tool for description and detection of diseases affecting left and right ventricular function.
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Affiliation(s)
- Marius Menza
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 60a, 79106, Freiburg, Germany.
| | - Daniela Föll
- Department of Cardiology and Angiology I, Heart Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jürgen Hennig
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 60a, 79106, Freiburg, Germany
| | - Bernd Jung
- Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Bern, Switzerland
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13
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Abstract
BACKGROUND Long-term intensive training leads to morphological and mechanical changes in the heart generally known as "athlete's heart". Previous studies have suggested that the diastolic and systolic function of the ventricles is unaltered in athletes compared to sedentary. The purpose of this study was to investigate myocardial performance index (MPI) by pulsed wave Doppler (PWD) and by tissue Doppler imaging (TDI) in female elite athletes compared to sedentary controls. METHODS The study consisted of 32 athletes (mean age 20 ± 2 years) and 34 sedentary controls (mean age 23 ± 2 years). MPI by PWD and TDI were measured in the left (LV) and right ventricle (RV) in both groups. Moreover, comparisons of MPI by the two methods and between the LV and RV within the two groups were made. RESULTS There were no significant differences in MPI between athletes and controls (p > 0.05), whereas the LV had significantly higher MPI compared to RV (p < 0.001, in athletes and controls). The agreement and the correlation between the two methods measuring MPI showed low agreement and no correlation (athletes RV r = -0.027, LV r = 0.12; controls RV r = 0.20, LV r = 0.30). CONCLUSION The global function of the LV and RV measured by MPI with PWD and TDI is similar in female athletes compared to sedentary controls. Conversely, both MPI by PWD and by TDI shows a significant difference between the LV and RV. However, the agreement and correlation between conventional methods of measuring MPI by PWD compared to MPI by TDI is very poor in both these populations.
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14
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Satriano A, Heydari B, Narous M, Exner DV, Mikami Y, Attwood MM, Tyberg JV, Lydell CP, Howarth AG, Fine NM, White JA. Clinical feasibility and validation of 3D principal strain analysis from cine MRI: comparison to 2D strain by MRI and 3D speckle tracking echocardiography. Int J Cardiovasc Imaging 2017; 33:1979-1992. [PMID: 28685315 PMCID: PMC5698377 DOI: 10.1007/s10554-017-1199-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 06/22/2017] [Indexed: 11/29/2022]
Abstract
Two-dimensional (2D) strain analysis is constrained by geometry-dependent reference directions of deformation (i.e. radial, circumferential, and longitudinal) following the assumption of cylindrical chamber architecture. Three-dimensional (3D) principal strain analysis may overcome such limitations by referencing intrinsic (i.e. principal) directions of deformation. This study aimed to demonstrate clinical feasibility of 3D principal strain analysis from routine 2D cine MRI with validation to strain from 2D tagged cine analysis and 3D speckle tracking echocardiography. Thirty-one patients undergoing cardiac MRI were studied. 3D strain was measured from routine, multi-planar 2D cine SSFP images using custom software designed to apply 4D deformation fields to 3D cardiac models to derive principal strain. Comparisons of strain estimates versus those by 2D tagged cine, 2D non-tagged cine (feature tracking), and 3D speckle tracking echocardiography (STE) were performed. Mean age was 51 ± 14 (36% female). Mean LV ejection fraction was 66 ± 10% (range 37–80%). 3D principal strain analysis was feasible in all subjects and showed high inter- and intra-observer reproducibility (ICC range 0.83–0.97 and 0.83–0.98, respectively—p < 0.001 for all directions). Strong correlations of minimum and maximum principal strain were respectively observed versus the following: 3D STE estimates of longitudinal (r = 0.81 and r = −0.64), circumferential (r = 0.76 and r = −0.58) and radial (r = −0.80 and r = 0.63) strain (p < 0.001 for all); 2D tagged cine estimates of longitudinal (r = 0.81 and r = −0.81), circumferential (r = 0.87 and r = −0.85), and radial (r = −0.76 and r = 0.81) strain (p < 0.0001 for all); and 2D cine (feature tracking) estimates of longitudinal (r = 0.85 and −0.83), circumferential (r = 0.88 and r = −0.87), and radial strain (r = −0.79 and r = 0.84, p < 0.0001 for all). 3D principal strain analysis is feasible using routine, multi-planar 2D cine MRI and shows high reproducibility with strong correlations to 2D conventional strain analysis and 3D STE-based analysis. Given its independence from geometry-related directions of deformation this technique may offer unique benefit for the detection and prognostication of myocardial disease, and warrants expanded investigation.
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Affiliation(s)
- Alessandro Satriano
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Bobak Heydari
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Mariam Narous
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Derek V Exner
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Yoko Mikami
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada
| | - Monica M Attwood
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - John V Tyberg
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Carmen P Lydell
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Department of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada
| | - Andrew G Howarth
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Nowell M Fine
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - James A White
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada. .,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.
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15
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Horvath MA, Wamala I, Rytkin E, Doyle E, Payne CJ, Thalhofer T, Berra I, Solovyeva A, Saeed M, Hendren S, Roche ET, Del Nido PJ, Walsh CJ, Vasilyev NV. An Intracardiac Soft Robotic Device for Augmentation of Blood Ejection from the Failing Right Ventricle. Ann Biomed Eng 2017; 45:2222-2233. [PMID: 28512702 DOI: 10.1007/s10439-017-1855-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 05/11/2017] [Indexed: 01/04/2023]
Abstract
We introduce an implantable intracardiac soft robotic right ventricular ejection device (RVED) for dynamic approximation of the right ventricular (RV) free wall and the interventricular septum (IVS) in synchrony with the cardiac cycle to augment blood ejection in right heart failure (RHF). The RVED is designed for safe and effective intracardiac operation and consists of an anchoring system deployed across the IVS, an RV free wall anchor, and a pneumatic artificial muscle linear actuator that spans the RV chamber between the two anchors. Using a ventricular simulator and a custom controller, we characterized ventricular volume ejection, linear approximation against different loads and the effect of varying device actuation periods on volume ejection. The RVED was then tested in vivo in adult pigs (n = 5). First, we successfully deployed the device into the beating heart under 3D echocardiography guidance (n = 4). Next, we performed a feasibility study to evaluate the device's ability to augment RV ejection in an experimental model of RHF (n = 1). RVED actuation augmented RV ejection during RHF; while further chronic animal studies will provide details about the efficacy of this support device. These results demonstrate successful design and implementation of the RVED and its deployment into the beating heart. This soft robotic ejection device has potential to serve as a rapidly deployable system for mechanical circulatory assistance in RHF.
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Affiliation(s)
- Markus A Horvath
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA, USA.,Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA
| | - Isaac Wamala
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Eric Rytkin
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Christopher J Payne
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA, USA.,Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA
| | - Thomas Thalhofer
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA, USA
| | - Ignacio Berra
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anna Solovyeva
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mossab Saeed
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Ellen T Roche
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA, USA.,Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA
| | - Pedro J Del Nido
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Conor J Walsh
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA, USA.,Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA
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16
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Suever JD, Wehner GJ, Jing L, Powell DK, Hamlet SM, Grabau JD, Mojsejenko D, Andres KN, Haggerty CM, Fornwalt BK. Right Ventricular Strain, Torsion, and Dyssynchrony in Healthy Subjects Using 3D Spiral Cine DENSE Magnetic Resonance Imaging. IEEE TRANSACTIONS ON MEDICAL IMAGING 2017; 36:1076-1085. [PMID: 28055859 PMCID: PMC5711416 DOI: 10.1109/tmi.2016.2646321] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Mechanics of the left ventricle (LV) are important indicators of cardiac function. The role of right ventricular (RV) mechanics is largely unknown due to the technical limitations of imaging its thin wall and complex geometry and motion. By combining 3D Displacement Encoding with Stimulated Echoes (DENSE) with a post-processing pipeline that includes a local coordinate system, it is possible to quantify RV strain, torsion, and synchrony. In this study, we sought to characterize RV mechanics in 50 healthy individuals and compare these values to their LV counterparts. For each cardiac frame, 3D displacements were fit to continuous and differentiable radial basis functions, allowing for the computation of the 3D Cartesian Lagrangian strain tensor at any myocardial point. The geometry of the RV was extracted via a surface fit to manually delineated endocardial contours. Throughout the RV, a local coordinate system was used to transform from a Cartesian strain tensor to a polar strain tensor. It was then possible to compute peak RV torsion as well as peak longitudinal and circumferential strain. A comparable analysis was performed for the LV. Dyssynchrony was computed from the standard deviation of regional activation times. Global circumferential strain was comparable between the RV and LV (-18.0% for both) while longitudinal strain was greater in the RV (-18.1% vs. -15.7%). RV torsion was comparable to LV torsion (6.2 vs. 7.1 degrees, respectively). Regional activation times indicated that the RV contracted later but more synchronously than the LV. 3D spiral cine DENSE combined with a post-processing pipeline that includes a local coordinate system can resolve both the complex geometry and 3D motion of the RV.
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17
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Affiliation(s)
- Sara L. Partington
- From the Philadelphia Adult Congenital Heart Disease Program, A Joint Program of the Hospital of the University of Pennsylvania and Children’s Hospital of Philadelphia (S.L.P.); and CMR Unit, Royal Brompton Hospital and Imperial College, London, United Kingdom (P.J.K.)
| | - Philip J. Kilner
- From the Philadelphia Adult Congenital Heart Disease Program, A Joint Program of the Hospital of the University of Pennsylvania and Children’s Hospital of Philadelphia (S.L.P.); and CMR Unit, Royal Brompton Hospital and Imperial College, London, United Kingdom (P.J.K.)
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18
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Dawes TJW, de Marvao A, Shi W, Fletcher T, Watson GMJ, Wharton J, Rhodes CJ, Howard LSGE, Gibbs JSR, Rueckert D, Cook SA, Wilkins MR, O'Regan DP. Machine Learning of Three-dimensional Right Ventricular Motion Enables Outcome Prediction in Pulmonary Hypertension: A Cardiac MR Imaging Study. Radiology 2017; 283:381-390. [PMID: 28092203 PMCID: PMC5398374 DOI: 10.1148/radiol.2016161315] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Applying machine learning of complex motion phenotypes obtained from cardiac MR images allows more accurate prediction of patient outcomes in pulmonary hypertension. Purpose To determine if patient survival and mechanisms of right ventricular failure in pulmonary hypertension could be predicted by using supervised machine learning of three-dimensional patterns of systolic cardiac motion. Materials and Methods The study was approved by a research ethics committee, and participants gave written informed consent. Two hundred fifty-six patients (143 women; mean age ± standard deviation, 63 years ± 17) with newly diagnosed pulmonary hypertension underwent cardiac magnetic resonance (MR) imaging, right-sided heart catheterization, and 6-minute walk testing with a median follow-up of 4.0 years. Semiautomated segmentation of short-axis cine images was used to create a three-dimensional model of right ventricular motion. Supervised principal components analysis was used to identify patterns of systolic motion that were most strongly predictive of survival. Survival prediction was assessed by using difference in median survival time and area under the curve with time-dependent receiver operating characteristic analysis for 1-year survival. Results At the end of follow-up, 36% of patients (93 of 256) died, and one underwent lung transplantation. Poor outcome was predicted by a loss of effective contraction in the septum and free wall, coupled with reduced basal longitudinal motion. When added to conventional imaging and hemodynamic, functional, and clinical markers, three-dimensional cardiac motion improved survival prediction (area under the receiver operating characteristic curve, 0.73 vs 0.60, respectively; P < .001) and provided greater differentiation according to difference in median survival time between high- and low-risk groups (13.8 vs 10.7 years, respectively; P < .001). Conclusion A machine-learning survival model that uses three-dimensional cardiac motion predicts outcome independent of conventional risk factors in patients with newly diagnosed pulmonary hypertension. Online supplemental material is available for this article.
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Affiliation(s)
- Timothy J W Dawes
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - Antonio de Marvao
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - Wenzhe Shi
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - Tristan Fletcher
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - Geoffrey M J Watson
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - John Wharton
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - Christopher J Rhodes
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - Luke S G E Howard
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - J Simon R Gibbs
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - Daniel Rueckert
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - Stuart A Cook
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - Martin R Wilkins
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
| | - Declan P O'Regan
- From the MRC Clinical Sciences Centre, Du Cane Rd, London W12 0NN, England (T.J.W.D., A.d.M., W.S., T.F., S.A.C., D.P.O.); Division of Experimental Medicine, Department of Medicine (T.J.W.D, T.F., G.M.J.W., J.W., C.J.R., M.R.W.), Department of Computing (W.S., D.R.), and National Heart and Lung Institute (J.S.R.G.), Imperial College London, London, England; National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore (S.A.C.); and Department of Cardiology, National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, England (L.S.G.E.H., J.S.R.G.)
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19
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Hamlet SM, Haggerty CM, Suever JD, Wehner GJ, Andres KN, Powell DK, Zhong X, Fornwalt BK. Optimal configuration of respiratory navigator gating for the quantification of left ventricular strain using spiral cine displacement encoding with stimulated echoes (DENSE) MRI. J Magn Reson Imaging 2016; 45:786-794. [PMID: 27458823 DOI: 10.1002/jmri.25389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 06/29/2016] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To determine the optimal respiratory navigator gating configuration for the quantification of left ventricular strain using spiral cine displacement encoding with stimulated echoes (DENSE) MRI. MATERIALS AND METHODS Two-dimensional spiral cine DENSE was performed on a 3 Tesla MRI using two single-navigator configurations (retrospective, prospective) and a combined "dual-navigator" configuration in 10 healthy adults and 20 healthy children. The adults also underwent breathhold DENSE as a reference standard for comparisons. Peak left ventricular strains, signal-to-noise ratio (SNR), and navigator efficiency were compared. Subjects also underwent dual-navigator gating with and without visual feedback to determine the effect on navigator efficiency. RESULTS There were no differences in circumferential, radial, and longitudinal strains between navigator-gated and breathhold DENSE (P = 0.09-0.95) (as confidence intervals, retrospective: [-1.0%-1.1%], [-7.4%-2.0%], [-1.0%-1.2%]; prospective: [-0.6%-2.7%], [-2.8%-8.3%], [-0.3%-2.9%]; dual: [-1.6%-0.5%], [-8.3%-3.2%], [-0.8%-1.9%], respectively). The dual configuration maintained SNR compared with breathhold acquisitions (16 versus 18, P = 0.06). SNR for the prospective configuration was lower than for the dual navigator in adults (P = 0.004) and children (P < 0.001). Navigator efficiency was higher (P < 0.001) for both retrospective (54%) and prospective (56%) configurations compared with the dual configuration (35%). Visual feedback improved the dual configuration navigator efficiency to 55% (P < 0.001). CONCLUSION When quantifying left ventricular strains using spiral cine DENSE MRI, a dual navigator configuration results in the highest SNR in adults and children. In adults, a retrospective configuration has good navigator efficiency without a substantial drop in SNR. Prospective gating should be avoided because it has the lowest SNR. Visual feedback represents an effective option to maintain navigator efficiency while using a dual navigator configuration. LEVEL OF EVIDENCE 2 J. Magn. Reson. Imaging 2017;45:786-794.
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Affiliation(s)
- Sean M Hamlet
- Department of Electrical and Computer Engineering, University of Kentucky, Lexington, Kentucky, USA.,Department of Pediatrics, University of Kentucky, Lexington, KY, USA
| | - Christopher M Haggerty
- Department of Pediatrics, University of Kentucky, Lexington, KY, USA.,Institute for Advanced Application, Geisinger Health System, Danville, Pennsylvania, USA
| | - Jonathan D Suever
- Department of Pediatrics, University of Kentucky, Lexington, KY, USA.,Institute for Advanced Application, Geisinger Health System, Danville, Pennsylvania, USA
| | - Gregory J Wehner
- Department of Pediatrics, University of Kentucky, Lexington, KY, USA.,Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky, USA
| | - Kristin N Andres
- Department of Pediatrics, University of Kentucky, Lexington, KY, USA
| | - David K Powell
- Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky, USA
| | - Xiaodong Zhong
- MR R&D Collaborations, Siemens Healthcare, Atlanta, GA, USA
| | - Brandon K Fornwalt
- Department of Pediatrics, University of Kentucky, Lexington, KY, USA.,Institute for Advanced Application, Geisinger Health System, Danville, Pennsylvania, USA.,Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky, USA.,Department of Physiology, University of Kentucky, Lexington, Kentucky, USA.,Department of Medicine, University of Kentucky, Lexington, Kentucky, USA
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20
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Li M, Gupta H, Lloyd SG, Dell'Italia LJ, Denney TS. A graph theoretic approach for computing 3D+time biventricular cardiac strain from tagged MRI data. Med Image Anal 2016; 35:46-57. [PMID: 27318591 DOI: 10.1016/j.media.2016.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 04/11/2016] [Accepted: 06/09/2016] [Indexed: 01/27/2023]
Abstract
Tagged magnetic resonance imaging (tMRI) is a well-established method for evaluating regional mechanical function of the heart. Many techniques have been developed to compute 2D or 3D cardiac deformation and strain from tMRI images. In this paper, we present a new method for measuring 3D plus time biventricular myocardial strain from tMRI data. The method is composed of two parts. First, we use a Gabor filter bank to extract tag points along tag lines. Second, each tag point is classified to one of a set of indexed reference tag lines using a point classification with graph cuts (PCGC) algorithm and a motion compensation technique. 3D biventricular deformation and strain is computed at each image time frame from the classified tag points using a previously published finite difference method. The strain computation is fully automatic after myocardial contours are defined near end-diastole and end-systole. An in-vivo dataset composed of 30 human imaging studies with a range of pathologies was used for validation. Strains computed with the PCGC method with no manual corrections were compared to strains computed from both manually placed tag points and a manually-corrected unwrapped phase method. A typical cardiac imaging study with 10 short-axis slices and 6 long-axis slices required 30 min for contouring followed by 44 min of automated processing. The results demonstrate that the proposed method can reconstruct accurate 3D plus time cardiac strain maps with minimal user intervention.
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Affiliation(s)
- Ming Li
- Auburn University MRI Research Center, Auburn University, Auburn, Alabama, United States; Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, United States.
| | - Himanshu Gupta
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, United States.
| | - Steven G Lloyd
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, United States.
| | - Louis J Dell'Italia
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, United States.
| | - Thomas S Denney
- Auburn University MRI Research Center, Auburn University, Auburn, Alabama, United States; Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, United States.
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21
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Wehner GJ, Grabau JD, Suever JD, Haggerty CM, Jing L, Powell DK, Hamlet SM, Vandsburger MH, Zhong X, Fornwalt BK. 2D cine DENSE with low encoding frequencies accurately quantifies cardiac mechanics with improved image characteristics. J Cardiovasc Magn Reson 2015; 17:93. [PMID: 26538111 PMCID: PMC4634910 DOI: 10.1186/s12968-015-0196-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 10/26/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Displacement Encoding with Stimulated Echoes (DENSE) encodes displacement into the phase of the magnetic resonance signal. The encoding frequency (ke) maps the measured phase to tissue displacement while the strength of the encoding gradients affects image quality. 2D cine DENSE studies have used a ke of 0.10 cycles/mm, which is high enough to remove an artifact-generating echo from k-space, provide high sensitivity to tissue displacements, and dephase the blood pool. However, through-plane dephasing can remove the unwanted echo and dephase the blood pool without relying on high ke. Additionally, the high sensitivity comes with the costs of increased phase wrapping and intra-voxel dephasing. We hypothesized that ke below 0.10 cycles/mm can be used to improve image characteristics and provide accurate measures of cardiac mechanics. METHODS Spiral cine DENSE images were obtained for 10 healthy subjects and 10 patients with a history of heart disease on a 3 T Siemens Trio. A mid-ventricular short-axis image was acquired with different ke: 0.02, 0.04, 0.06, 0.08, and 0.10 cycles/mm. Peak twist, circumferential strain, and radial strain were compared between acquisitions employing different ke using Bland-Altman analyses and coefficients of variation. The percentage of wrapped pixels in the phase images at end-systole was calculated for each ke. The dephasing of the blood signal and signal to noise ratio (SNR) were also calculated and compared. RESULTS Negligible differences were seen in strains and twist for all ke between 0.04 and 0.10 cycles/mm. These differences were of the same magnitude as inter-test differences. Specifically, the acquisitions with 0.04 cycles/mm accurately quantified cardiac mechanics and had zero phase wrapping. Compared to 0.10 cycles/mm, the acquisitions with 0.04 cycles/mm had 9 % greater SNR and negligible differences in blood pool dephasing. CONCLUSIONS For 2D cine DENSE with through-plane dephasing, the encoding frequency can be lowered to 0.04 cycles/mm without compromising the quantification of twist or strain. The amount of wrapping can be reduced with this lower value to greatly simplify the input to unwrapping algorithms. The strain and twist results from studies using different encoding frequencies can be directly compared.
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Affiliation(s)
- Gregory J Wehner
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA.
| | - Jonathan D Grabau
- Department of Pediatrics, University of Kentucky, Lexington, KY, USA.
| | - Jonathan D Suever
- Department of Pediatrics, University of Kentucky, Lexington, KY, USA.
- Institute for Advanced Application, Geisinger Health System, Danville, PA, USA.
| | - Christopher M Haggerty
- Department of Pediatrics, University of Kentucky, Lexington, KY, USA.
- Institute for Advanced Application, Geisinger Health System, Danville, PA, USA.
| | - Linyuan Jing
- Department of Pediatrics, University of Kentucky, Lexington, KY, USA.
- Institute for Advanced Application, Geisinger Health System, Danville, PA, USA.
| | - David K Powell
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA.
| | - Sean M Hamlet
- Department of Electrical Engineering, University of Kentucky, Lexington, KY, USA.
| | | | - Xiaodong Zhong
- MR R&D Collaborations, Siemens Healthcare, Atlanta, GA, USA.
| | - Brandon K Fornwalt
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA.
- Department of Pediatrics, University of Kentucky, Lexington, KY, USA.
- Department of Physiology, University of Kentucky, Lexington, KY, USA.
- Department of Medicine, University of Kentucky, Lexington, KY, USA.
- Institute for Advanced Application, Geisinger Health System, Danville, PA, USA.
- Institute for Advanced Application, Geisinger Clinic, 100 North Academy Avenue, Danville, PA, 17822-4400, USA.
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22
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23
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Wehner GJ, Suever JD, Haggerty CM, Jing L, Powell DK, Hamlet SM, Grabau JD, Mojsejenko WD, Zhong X, Epstein FH, Fornwalt BK. Validation of in vivo 2D displacements from spiral cine DENSE at 3T. J Cardiovasc Magn Reson 2015; 17:5. [PMID: 25634468 PMCID: PMC4311418 DOI: 10.1186/s12968-015-0119-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 01/13/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Displacement Encoding with Stimulated Echoes (DENSE) encodes displacement into the phase of the magnetic resonance signal. Due to the stimulated echo, the signal is inherently low and fades through the cardiac cycle. To compensate, a spiral acquisition has been used at 1.5T. This spiral sequence has not been validated at 3T, where the increased signal would be valuable, but field inhomogeneities may result in measurement errors. We hypothesized that spiral cine DENSE is valid at 3T and tested this hypothesis by measuring displacement errors at both 1.5T and 3T in vivo. METHODS Two-dimensional spiral cine DENSE and tagged imaging of the left ventricle were performed on ten healthy subjects at 3T and six healthy subjects at 1.5T. Intersection points were identified on tagged images near end-systole. Displacements from the DENSE images were used to project those points back to their origins. The deviation from a perfect grid was used as a measure of accuracy and quantified as root-mean-squared error. This measure was compared between 3T and 1.5T with the Wilcoxon rank sum test. Inter-observer variability of strains and torsion quantified by DENSE and agreement between DENSE and harmonic phase (HARP) were assessed by Bland-Altman analyses. The signal to noise ratio (SNR) at each cardiac phase was compared between 3T and 1.5T with the Wilcoxon rank sum test. RESULTS The displacement accuracy of spiral cine DENSE was not different between 3T and 1.5T (1.2 ± 0.3 mm and 1.2 ± 0.4 mm, respectively). Both values were lower than the DENSE pixel spacing of 2.8 mm. There were no substantial differences in inter-observer variability of DENSE or agreement of DENSE and HARP between 3T and 1.5T. Relative to 1.5T, the SNR at 3T was greater by a factor of 1.4 ± 0.3. CONCLUSIONS The spiral cine DENSE acquisition that has been used at 1.5T to measure cardiac displacements can be applied at 3T with equivalent accuracy. The inter-observer variability and agreement of DENSE-derived peak strains and torsion with HARP is also comparable at both field strengths. Future studies with spiral cine DENSE may take advantage of the additional SNR at 3T.
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Affiliation(s)
- Gregory J Wehner
- />Department of Biomedical Engineering, University of Kentucky, 741 S Limestone, BBSRB B353, Lexington, KY 40509 USA
| | | | | | - Linyuan Jing
- />Department of Pediatrics, University of Kentucky, Lexington, USA
| | - David K Powell
- />Department of Biomedical Engineering, University of Kentucky, 741 S Limestone, BBSRB B353, Lexington, KY 40509 USA
| | - Sean M Hamlet
- />Department of Electrical Engineering, University of Kentucky, Lexington, USA
| | | | | | - Xiaodong Zhong
- />MR R&D Collaborations, Siemens Healthcare, Atlanta, GA USA
| | - Frederick H Epstein
- />Department of Biomedical Engineering, University of Virginia, Charlottesville, VA USA
| | - Brandon K Fornwalt
- />Department of Biomedical Engineering, University of Kentucky, 741 S Limestone, BBSRB B353, Lexington, KY 40509 USA
- />Department of Pediatrics, University of Kentucky, Lexington, USA
- />Departments of Physiology and Medicine, University of Kentucky, Lexington, USA
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24
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Evin M, Cluzel P, Lamy J, Rosenbaum D, Kusmia S, Defrance C, Soulat G, Mousseaux E, Roux C, Clement K, Hatem SN, Redheuil A, Kachenoura N. Assessment of left atrial function by MRI myocardial feature tracking. J Magn Reson Imaging 2015; 42:379-89. [PMID: 25630749 DOI: 10.1002/jmri.24851] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 12/26/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Left atrium (LA) volumes and function are predictors of cardiovascular events. Because LA function cannot be assessed from cardiovascular magnetic resonance imaging (MRI) using the well-established left ventricular tagging techniques, we hypothesized that adequate feature tracking (FT) applied to conventional cine MRI data could characterize LA function accurately. METHODS We studied 10 young (28 ± 7 years) and 10 elderly (64 ± 6 years) healthy subjects, as well as 20 patients with moderate to severe aortic valve stenosis (AVS; 73 ± 15 years, effective aortic valve area: 0.67 ± 0.36 cm(2) ). MRI cine two-, three-, and four-chamber views were analyzed using a newly proposed FT method based on spatial correlation and endocardial detection resulting in: regional and global longitudinal strain and strain rate, radial motion fraction and relative velocity for the three LA motion phases including reservoir, conduit, and LA contraction. RESULTS FT reliability was indicated by a good overlap between tracking results and manual LA endocardial borders, the low error for comparison against theoretical strains introduced in a synthetic phantom and the good inter-observer reproducibility (coefficient of variation < 15%). While all LA functional parameters were significantly impaired in AVS patients (p < 0.04), subclinical age-related variations induced a decreasing trend on all LA parameters but were significant only for radial conduit function parameters (p < 0.03). Finally, LA functional parameters characterized LA alteration in AVS with higher sensitivity than conventional LA volumetric parameters. CONCLUSIONS Left atrial FT is feasible on MRI cine images and its addition to conventional analysis tools might enhance the diagnosis value of MRI in many heart diseases.
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Affiliation(s)
- Morgane Evin
- Institute of Cardiometabolism and Nutrition, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,INSERM, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Philippe Cluzel
- Institute of Cardiometabolism and Nutrition, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,INSERM, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, France.,Department of Cardiovascular Radiology, Institut of Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jerôme Lamy
- Institute of Cardiometabolism and Nutrition, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,INSERM, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - David Rosenbaum
- Institute of Cardiometabolism and Nutrition, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,INSERM, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Slawek Kusmia
- Institute of Cardiometabolism and Nutrition, Paris, France.,ICAN Imaging Core Lab, Paris, France
| | - Carine Defrance
- Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,INSERM, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, France
| | | | - Elie Mousseaux
- Cardiology Departement, European Hospital Georges Pompidou, Paris, France
| | - Charles Roux
- Institute of Cardiometabolism and Nutrition, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,INSERM, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Karine Clement
- Institute of Cardiometabolism and Nutrition, Paris, France
| | - Stéphane N Hatem
- Institute of Cardiometabolism and Nutrition, Paris, France.,INSERM, UMRS 1166, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Alban Redheuil
- Institute of Cardiometabolism and Nutrition, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,INSERM, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, France.,Department of Cardiovascular Radiology, Institut of Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Nadjia Kachenoura
- Institute of Cardiometabolism and Nutrition, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR 7371, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,INSERM, UMRS 1146, Laboratoire d'Imagerie Biomédicale, Paris, France.,CNRS, UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, France
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25
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Pennell DJ, Baksi AJ, Kilner PJ, Mohiaddin RH, Prasad SK, Alpendurada F, Babu-Narayan SV, Neubauer S, Firmin DN. Review of Journal of Cardiovascular Magnetic Resonance 2013. J Cardiovasc Magn Reson 2014; 16:100. [PMID: 25475898 PMCID: PMC4256918 DOI: 10.1186/s12968-014-0100-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 11/21/2014] [Indexed: 01/19/2023] Open
Abstract
There were 109 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2013, which is a 21% increase on the 90 articles published in 2012. The quality of the submissions continues to increase. The editors are delighted to report that the 2012 JCMR Impact Factor (which is published in June 2013) has risen to 5.11, up from 4.44 for 2011 (as published in June 2012), a 15% increase and taking us through the 5 threshold for the first time. The 2012 impact factor means that the JCMR papers that were published in 2010 and 2011 were cited on average 5.11 times in 2012. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, the progress of the journal's impact over the last 5 years has been impressive. Our acceptance rate is <25% and has been falling because the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication.
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Affiliation(s)
- Dudley John Pennell
- />Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP UK
- />Imperial College, London, UK
| | - Arun John Baksi
- />Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP UK
- />Imperial College, London, UK
| | - Philip John Kilner
- />Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP UK
- />Imperial College, London, UK
| | - Raad Hashem Mohiaddin
- />Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP UK
- />Imperial College, London, UK
| | - Sanjay Kumar Prasad
- />Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP UK
- />Imperial College, London, UK
| | - Francisco Alpendurada
- />Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP UK
- />Imperial College, London, UK
| | - Sonya Vidya Babu-Narayan
- />Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP UK
- />Imperial College, London, UK
| | | | - David Nigel Firmin
- />Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP UK
- />Imperial College, London, UK
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26
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Suever JD, Wehner GJ, Haggerty CM, Jing L, Hamlet SM, Binkley CM, Kramer SP, Mattingly AC, Powell DK, Bilchick KC, Epstein FH, Fornwalt BK. Simplified post processing of cine DENSE cardiovascular magnetic resonance for quantification of cardiac mechanics. J Cardiovasc Magn Reson 2014; 16:94. [PMID: 25430079 PMCID: PMC4246464 DOI: 10.1186/s12968-014-0094-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 11/14/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance using displacement encoding with stimulated echoes (DENSE) is capable of assessing advanced measures of cardiac mechanics such as strain and torsion. A potential hurdle to widespread clinical adoption of DENSE is the time required to manually segment the myocardium during post-processing of the images. To overcome this hurdle, we proposed a radical approach in which only three contours per image slice are required for post-processing (instead of the typical 30-40 contours per image slice). We hypothesized that peak left ventricular circumferential, longitudinal and radial strains and torsion could be accurately quantified using this simplified analysis. METHODS AND RESULTS We tested our hypothesis on a large multi-institutional dataset consisting of 541 DENSE image slices from 135 mice and 234 DENSE image slices from 62 humans. We compared measures of cardiac mechanics derived from the simplified post-processing to those derived from original post-processing utilizing the full set of 30-40 manually-defined contours per image slice. Accuracy was assessed with Bland-Altman limits of agreement and summarized with a modified coefficient of variation. The simplified technique showed high accuracy with all coefficients of variation less than 10% in humans and 6% in mice. The accuracy of the simplified technique was also superior to two previously published semi-automated analysis techniques for DENSE post-processing. CONCLUSIONS Accurate measures of cardiac mechanics can be derived from DENSE cardiac magnetic resonance in both humans and mice using a simplified technique to reduce post-processing time by approximately 94%. These findings demonstrate that quantifying cardiac mechanics from DENSE data is simple enough to be integrated into the clinical workflow.
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Affiliation(s)
- Jonathan D Suever
- />Department of Pediatrics and Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY USA
| | - Gregory J Wehner
- />Department of Pediatrics and Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY USA
- />Department of Biomedical Engineering, University of Kentucky, Lexington, KY USA
| | - Christopher M Haggerty
- />Department of Pediatrics and Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY USA
| | - Linyuan Jing
- />Department of Pediatrics and Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY USA
| | - Sean M Hamlet
- />Department of Pediatrics and Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY USA
- />Department of Electrical Engineering, University of Kentucky, Lexington, KY USA
| | - Cassi M Binkley
- />Department of Pediatrics and Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY USA
| | - Sage P Kramer
- />Department of Pediatrics and Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY USA
| | - Andrea C Mattingly
- />Department of Pediatrics and Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY USA
| | - David K Powell
- />Department of Biomedical Engineering, University of Kentucky, Lexington, KY USA
| | - Kenneth C Bilchick
- />Department of Medicine, University of Virginia, Charlottesville, VA USA
| | - Frederick H Epstein
- />Department of Biomedical Engineering, University of Virginia, Charlottesville, VA USA
| | - Brandon K Fornwalt
- />Department of Pediatrics and Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY USA
- />Department of Biomedical Engineering, University of Kentucky, Lexington, KY USA
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27
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Heermann P, Hedderich DM, Paul M, Schülke C, Kroeger JR, Baeßler B, Wichter T, Maintz D, Waltenberger J, Heindel W, Bunck AC. Biventricular myocardial strain analysis in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) using cardiovascular magnetic resonance feature tracking. J Cardiovasc Magn Reson 2014; 16:75. [PMID: 25315082 PMCID: PMC4189682 DOI: 10.1186/s12968-014-0075-z] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 08/28/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fibrofatty degeneration of myocardium in ARVC is associated with wall motion abnormalities. The aim of this study was to examine whether Cardiovascular Magnetic Resonance (CMR) based strain analysis using feature tracking (FT) can serve as a quantifiable measure to confirm global and regional ventricular dysfunction in ARVC patients and support the early detection of ARVC. METHODS We enrolled 20 patients with ARVC, 30 with borderline ARVC and 22 subjects with a positive family history but no clinical signs of a manifest ARVC. 10 healthy volunteers (HV) served as controls. 15 ARVC patients received genotyping for Plakophilin-2 mutation (PKP-2), of which 7 were found to be positive. Cine MR datasets of all subjects were assessed for myocardial strain using FT (TomTec Diogenes Software). Global strain and strain rate in radial, circumferential and longitudinal mode were assessed for the right and left ventricle. In addition strain analysis at a segmental level was performed for the right ventricular free wall. RESULTS RV global longitudinal strain rates in ARVC (-0.68 ± 0.36 sec⁻¹) and borderline ARVC (-0.85 ± 0.36 sec⁻¹) were significantly reduced in comparison with HV (-1.38 ± 0.52 sec⁻¹, p ≤ 0.05). Furthermore, in ARVC patients RV global circumferential strain and strain rates at the basal level were significantly reduced compared with HV (strain: -5.1 ± 2.7 vs. -9.2 ± 3.6%; strain rate: -0.31 ± 0.13 sec(-1) vs. -0.61 ± 0.21 sec⁻¹). Even for patients with ARVC or borderline ARVC and normal RV ejection fraction (n=30) global longitudinal strain rate proved to be significantly reduced compared with HV (-0.9 ± 0.3 vs. -1.4 ± 0.5 sec(-1); p < 0.005). In ARVC patients with PKP-2 mutation there was a clear trend towards a more pronounced impairment in RV global longitudinal strain rate. On ROC analysis RV global longitudinal strain rate and circumferential strain rate at the basal level proved to be the best discriminators between ARVC patients and HV (AUC: 0.9 and 0.92, respectively). CONCLUSION CMR based strain analysis using FT is an objective and useful measure for quantification of wall motion abnormalities in ARVC. It allows differentiation between manifest or borderline ARVC and HV, even if ejection fraction is still normal.
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Affiliation(s)
- Philipp Heermann
- Department of Clinical Radiology, University Hospital of Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
| | - Dennis M Hedderich
- Department of Radiology, University Hospital of Cologne, Cologne, Germany.
| | - Matthias Paul
- Department of Cardiology, University Hospital of Muenster, Münster, Germany.
| | - Christoph Schülke
- Department of Clinical Radiology, University Hospital of Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
| | - Jan Robert Kroeger
- Department of Radiology, University Hospital of Cologne, Cologne, Germany.
| | - Bettina Baeßler
- Department of Radiology, University Hospital of Cologne, Cologne, Germany.
| | - Thomas Wichter
- Department of Cardiology, Niels-Stensen-Kliniken, Marienhospital Osnabrueck, Osnabrueck, Germany.
| | - David Maintz
- Department of Clinical Radiology, University Hospital of Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
- Department of Radiology, University Hospital of Cologne, Cologne, Germany.
| | | | - Walter Heindel
- Department of Clinical Radiology, University Hospital of Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
| | - Alexander C Bunck
- Department of Clinical Radiology, University Hospital of Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
- Department of Radiology, University Hospital of Cologne, Cologne, Germany.
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28
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Jing L, Haggerty CM, Suever JD, Alhadad S, Prakash A, Cecchin F, Skrinjar O, Geva T, Powell AJ, Fornwalt BK. Patients with repaired tetralogy of Fallot suffer from intra- and inter-ventricular cardiac dyssynchrony: a cardiac magnetic resonance study. Eur Heart J Cardiovasc Imaging 2014; 15:1333-43. [PMID: 24996664 DOI: 10.1093/ehjci/jeu123] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
AIMS Patients with repaired tetralogy of Fallot (rTOF) frequently have right bundle branch block. To better understand the contribution of cardiac dyssynchrony to dysfunction, we developed a method to quantify left (LV), right (RV), and inter-ventricular dyssynchrony using standard cine cardiac magnetic resonance (CMR). METHODS AND RESULTS Thirty patients with rTOF and 17 healthy controls underwent cine CMR. Patients were imaged twice to assess inter-test reproducibility. Circumferential strain curves were generated with a custom feature-tracking algorithm for 12 LV and 12 RV segments in each of 4-7 short-axis slices encompassing the ventricles. Temporal offsets (TOs, in ms) of the strain curves relative to a patient-specific reference curve were calculated. The intra-ventricular dyssynchrony index (DI) for each ventricle was computed as the standard deviation of the TOs. The inter-ventricular DI was calculated as the difference in median RV and median LV TOs. Compared with controls, patients had a greater LV DI (21 ± 8 vs. 11 ± 5 ms, P < 0.001) and RV DI (60 ± 19 vs. 47 ± 17 ms, P = 0.02). RV contraction was globally delayed in patients, resulting in a greater inter-ventricular DI with the RV contracting 45 ± 25 ms later than the LV vs. 12 ± 29 ms earlier in controls (P < 0.001). Inter-test reproducibility was moderate with all coefficients of variation ≤22%. Both LV and RV DIs were correlated with measures of LV, but not RV, function. CONCLUSION Patients with rTOF have intra- and inter-ventricular dyssynchrony, which can be quantified from standard cine CMR. This new approach can potentially help determine the contribution of dyssynchrony to ventricular dysfunction in future studies.
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Affiliation(s)
- Linyuan Jing
- Departments of Pediatrics, Physiology, Biomedical Engineering and Medicine, University of Kentucky, UK Chandler Hospital, 741 S Limestone, BBSRB B353, Lexington, KY 40536, USA
| | - Christopher M Haggerty
- Departments of Pediatrics, Physiology, Biomedical Engineering and Medicine, University of Kentucky, UK Chandler Hospital, 741 S Limestone, BBSRB B353, Lexington, KY 40536, USA
| | - Jonathan D Suever
- Departments of Pediatrics, Physiology, Biomedical Engineering and Medicine, University of Kentucky, UK Chandler Hospital, 741 S Limestone, BBSRB B353, Lexington, KY 40536, USA
| | - Sudad Alhadad
- Departments of Pediatrics, Physiology, Biomedical Engineering and Medicine, University of Kentucky, UK Chandler Hospital, 741 S Limestone, BBSRB B353, Lexington, KY 40536, USA
| | - Ashwin Prakash
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Frank Cecchin
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Oskar Skrinjar
- Scientific Imaging and Visualization LLC, Atlanta, GA, USA
| | - Tal Geva
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Brandon K Fornwalt
- Departments of Pediatrics, Physiology, Biomedical Engineering and Medicine, University of Kentucky, UK Chandler Hospital, 741 S Limestone, BBSRB B353, Lexington, KY 40536, USA
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Gomez AD, Merchant SS, Hsu EW. Accurate high-resolution measurements of 3-D tissue dynamics with registration-enhanced displacement encoded MRI. IEEE TRANSACTIONS ON MEDICAL IMAGING 2014; 33:1350-62. [PMID: 24771572 PMCID: PMC4163496 DOI: 10.1109/tmi.2014.2311755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Displacement fields are important to analyze deformation, which is associated with functional and material tissue properties often used as indicators of health. Magnetic resonance imaging (MRI) techniques like DENSE and image registration methods like Hyperelastic Warping have been used to produce pixel-level deformation fields that are desirable in high-resolution analysis. However, DENSE can be complicated by challenges associated with image phase unwrapping, in particular offset determination. On the other hand, Hyperelastic Warping can be hampered by low local image contrast. The current work proposes a novel approach for measuring tissue displacement with both DENSE and Hyperelastic Warping, incorporating physically accurate displacements obtained by the latter to improve phase characterization in DENSE. The validity of the proposed technique is demonstrated using numerical and physical phantoms, and in vivo small animal cardiac MRI.
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Affiliation(s)
- Arnold D. Gomez
- Bioengineering Department, University of Utah, Salt Lake City, UT 84102 USA, and also with the Cardiothoracic Surgery Division, School of Medicine, University of Utah, UT 84102 USA
| | - Samer S. Merchant
- Bioengineering Department at the University of Utah, Salt Lake City, UT 84102 USA
| | - Edward W. Hsu
- Bioengineering Department at the University of Utah, Salt Lake City, UT 84102 USA
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Auger DA, Zhong X, Epstein FH, Meintjes EM, Spottiswoode BS. Semi-automated left ventricular segmentation based on a guide point model approach for 3D cine DENSE cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2014; 16:8. [PMID: 24423129 PMCID: PMC3903450 DOI: 10.1186/1532-429x-16-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 12/03/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The most time consuming and limiting step in three dimensional (3D) cine displacement encoding with stimulated echoes (DENSE) MR image analysis is the demarcation of the left ventricle (LV) from its surrounding anatomical structures. The aim of this study is to implement a semi-automated segmentation algorithm for 3D cine DENSE CMR using a guide point model approach. METHODS A 3D mathematical model is fitted to guide points which were interactively placed along the LV borders at a single time frame. An algorithm is presented to robustly propagate LV epicardial and endocardial surfaces of the model using the displacement information encoded in the phase images of DENSE data. The accuracy, precision and efficiency of the algorithm are tested. RESULTS The model-defined contours show good accuracy when compared to the corresponding manually defined contours as similarity coefficients Dice and Jaccard consist of values above 0.7, while false positive and false negative measures show low percentage values. This is based on a measure of segmentation error on intra- and inter-observer spatial overlap variability. The segmentation algorithm offers a 10-fold reduction in the time required to identify LV epicardial and endocardial borders for a single 3D DENSE data set. CONCLUSION A semi-automated segmentation method has been developed for 3D cine DENSE CMR. The algorithm allows for contouring of the first cardiac frame where blood-myocardium contrast is almost nonexistent and reduces the time required to segment a 3D DENSE data set significantly.
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Affiliation(s)
- Daniel A Auger
- MRC/UCT Medical Imaging Research Unit, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Xiaodong Zhong
- MR R&D Collaborations, Siemens Medical Solutions, Atlanta, GA, USA
| | - Frederick H Epstein
- Departments of Radiology and Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Ernesta M Meintjes
- MRC/UCT Medical Imaging Research Unit, Department of Human Biology, University of Cape Town, Cape Town, South Africa
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Haggerty CM, Kramer SP, Skrinjar O, Binkley CM, Powell DK, Mattingly AC, Epstein FH, Fornwalt BK. Quantification of left ventricular volumes, mass, and ejection fraction using cine displacement encoding with stimulated echoes (DENSE) MRI. J Magn Reson Imaging 2013; 40:398-406. [PMID: 24923710 DOI: 10.1002/jmri.24350] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 07/25/2013] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To test the hypothesis that magnitude images from cine displacement encoding with stimulated echoes (DENSE) magnetic resonance imaging (MRI) can accurately quantify left ventricular (LV) volumes, mass, and ejection fraction (EF). MATERIALS AND METHODS Thirteen mice (C57BL/6J) were imaged using a 7T ClinScan MRI. A short-axis stack of cine T2-weighted black blood (BB) images was acquired for calculation of LV volumes, mass, and EF using the gold standard sum-of-slices methodology. DENSE images were acquired during the same imaging session in three short-axis (basal, mid, apical) and two long-axis orientations. A custom surface fitting algorithm was applied to epicardial and endocardial borders from the DENSE magnitude images to calculate volumes, mass, and EF. Agreement between the DENSE-derived measures and BB-derived measures was assessed via coefficient of variation (CoV). RESULTS 3D surface reconstruction was completed on the order of seconds from segmented images, and required fewer slices to be segmented. Volumes, mass, and EF from DENSE-derived surfaces matched well with BB data (CoVs ≤11%). CONCLUSION LV mass, volumes, and EF in mice can be quantified through sparse (five slices) sampling with DENSE. This consolidation significantly reduces the time required to assess both mass/volume-based measures of cardiac function and advanced cardiac mechanics.
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Affiliation(s)
- Christopher M Haggerty
- University of Kentucky, Departments of Pediatrics, Physiology and Medicine, Lexington, Kentucky, USA
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Pennell DJ, Baksi AJ, Carpenter JP, Firmin DN, Kilner PJ, Mohiaddin RH, Prasad SK. Review of Journal of Cardiovascular Magnetic Resonance 2012. J Cardiovasc Magn Reson 2013; 15:76. [PMID: 24006874 PMCID: PMC3847143 DOI: 10.1186/1532-429x-15-76] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 08/22/2013] [Indexed: 02/07/2023] Open
Abstract
There were 90 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2012, which is an 8% increase in the number of articles since 2011. The quality of the submissions continues to increase. The editors are delighted to report that the 2011 JCMR Impact Factor (which is published in June 2012) has risen to 4.44, up from 3.72 for 2010 (as published in June 2011), a 20% increase. The 2011 impact factor means that the JCMR papers that were published in 2009 and 2010 were cited on average 4.44 times in 2011. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, the progress of the journal's impact over the last 5 years has been impressive. Our acceptance rate is approximately 25%, and has been falling as the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication.
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Affiliation(s)
- Dudley J Pennell
- Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- Imperial College, London, UK
| | - A John Baksi
- Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- Imperial College, London, UK
| | - John Paul Carpenter
- Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- Imperial College, London, UK
| | - David N Firmin
- Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- Imperial College, London, UK
| | - Philip J Kilner
- Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- Imperial College, London, UK
| | - Raad H Mohiaddin
- Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- Imperial College, London, UK
| | - Sanjay K Prasad
- Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- Imperial College, London, UK
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Haggerty CM, Kramer SP, Binkley CM, Powell DK, Mattingly AC, Charnigo R, Epstein FH, Fornwalt BK. Reproducibility of cine displacement encoding with stimulated echoes (DENSE) cardiovascular magnetic resonance for measuring left ventricular strains, torsion, and synchrony in mice. J Cardiovasc Magn Reson 2013; 15:71. [PMID: 23981339 PMCID: PMC3765995 DOI: 10.1186/1532-429x-15-71] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 08/06/2013] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Advanced measures of cardiac function are increasingly important to clinical assessment due to their superior diagnostic and predictive capabilities. Cine DENSE cardiovascular magnetic resonance (CMR) is ideal for quantifying advanced measures of cardiac function based on its high spatial resolution and streamlined post-processing. While many studies have utilized cine DENSE in both humans and small-animal models, the inter-test and inter-observer reproducibility for quantification of advanced cardiac function in mice has not been evaluated. This represents a critical knowledge gap for both understanding the capabilities of this technique and for the design of future experiments. We hypothesized that cine DENSE CMR would show excellent inter-test and inter-observer reproducibility for advanced measures of left ventricular (LV) function in mice. METHODS Five normal mice (C57BL/6) and four mice with depressed cardiac function (diet-induced obesity) were imaged twice, two days apart, on a 7T ClinScan MR system. Images were acquired with 15-20 frames per cardiac cycle in three short-axis (basal, mid, apical) and two long-axis orientations (4-chamber and 2-chamber). LV strain, twist, torsion, and measures of synchrony were quantified. Images from both days were analyzed by one observer to quantify inter-test reproducibility, while inter-observer reproducibility was assessed by a second observer's analysis of day-1 images. The coefficient of variation (CoV) was used to quantify reproducibility. RESULTS LV strains and torsion were highly reproducible on both inter-observer and inter-test bases with CoVs ≤ 15%, and inter-observer reproducibility was generally better than inter-test reproducibility. However, end-systolic twist angles showed much higher variance, likely due to the sensitivity of slice location within the sharp longitudinal gradient in twist angle. Measures of synchrony including the circumferential (CURE) and radial (RURE) uniformity of strain indices, showed excellent reproducibility with CoVs of 1% and 3%, respectively. Finally, peak measures (e.g., strains) were generally more reproducible than the corresponding rates of change (e.g., strain rate). CONCLUSIONS Cine DENSE CMR is a highly reproducible technique for quantification of advanced measures of left ventricular cardiac function in mice including strains, torsion and measures of synchrony. However, myocardial twist angles are not reproducible and future studies should instead report torsion.
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Affiliation(s)
- Christopher M Haggerty
- Departments of Pediatrics, Physiology and Medicine, University of Kentucky, Lexington, KY, USA
| | - Sage P Kramer
- Departments of Pediatrics, Physiology and Medicine, University of Kentucky, Lexington, KY, USA
| | - Cassi M Binkley
- Departments of Pediatrics, Physiology and Medicine, University of Kentucky, Lexington, KY, USA
| | - David K Powell
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - Andrea C Mattingly
- Departments of Pediatrics, Physiology and Medicine, University of Kentucky, Lexington, KY, USA
| | - Richard Charnigo
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - Frederick H Epstein
- Departments of Biomedical Engineering and Radiology, University of Virginia, Charlottesville, VA, USA
| | - Brandon K Fornwalt
- Departments of Pediatrics, Physiology and Medicine, University of Kentucky, Lexington, KY, USA
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
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Fabritz L, Fortmüller L, Yu TY, Paul M, Kirchhof P. Can preload-reducing therapy prevent disease progression in arrhythmogenic right ventricular cardiomyopathy? Experimental evidence and concept for a clinical trial. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2012; 110:340-6. [PMID: 22944071 DOI: 10.1016/j.pbiomolbio.2012.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 08/09/2012] [Indexed: 12/28/2022]
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy and a leading cause of sudden cardiac death in a young population. ARVC is especially common in young athletes. Mutations in different desmosomal genes have been identified causing dysfunctional cell-cell contacts. Reduced myocardial expression of plakoglobin in cell-cell contact complexes appears to associate with disease manifestation in patients harbouring mutations within other cell-cell contact genes. Experimental data suggest that preload reduction may be a simple and effective intervention to prevent disease progression and ventricular arrhythmias in ARVC. This review discusses the potential effects of this innovative approach and describes the design of the first controlled trial of preload-reducing therapy in patients with ARVC.
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Affiliation(s)
- Larissa Fabritz
- Centre for Cardiovascular Sciences, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, United Kingdom.
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