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Dehghani S, Shirani S, Jazayeri Gharebagh E. Enhanced Myocardial Tissue Visualization: A Comparative Cardiovascular Magnetic Resonance Study of Gradient-Spin Echo-STIR and Conventional STIR Imaging. Int J Biomed Imaging 2024; 2024:8456669. [PMID: 38590625 PMCID: PMC11001468 DOI: 10.1155/2024/8456669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose This study is aimed at evaluating the efficacy of the gradient-spin echo- (GraSE-) based short tau inversion recovery (STIR) sequence (GraSE-STIR) in cardiovascular magnetic resonance (CMR) imaging compared to the conventional turbo spin echo- (TSE-) based STIR sequence, specifically focusing on image quality, specific absorption rate (SAR), and image acquisition time. Methods In a prospective study, we examined forty-four normal volunteers and seventeen patients referred for CMR imaging using conventional STIR and GraSE-STIR techniques. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image quality, T2 signal intensity (SI) ratio, SAR, and image acquisition time were compared between both sequences. Results GraSE-STIR showed significant improvements in image quality (4.15 ± 0.8 vs. 3.34 ± 0.9, p = 0.024) and cardiac motion artifact reduction (7 vs. 18 out of 53, p = 0.038) compared to conventional STIR. Furthermore, the acquisition time (27.17 ± 3.53 vs. 36.9 ± 4.08 seconds, p = 0.041) and the local torso SAR (<13% vs. <17%, p = 0.047) were significantly lower for GraSE-STIR compared to conventional STIR in short-axis plan. However, no significant differences were shown in T2 SI ratio (p = 0.141), SNR (p = 0.093), CNR (p = 0.068), and SAR (p = 0.071) between these two sequences. Conclusions GraSE-STIR offers notable advantages over conventional STIR sequence, with improved image quality, reduced motion artifacts, and shorter acquisition times. These findings highlight the potential of GraSE-STIR as a valuable technique for routine clinical CMR imaging.
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Affiliation(s)
- Sadegh Dehghani
- Radiation Sciences Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Shapoor Shirani
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Jazayeri Gharebagh
- Radiation Sciences Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Li H, Daniel AJ, Buchanan CE, Nery F, Morris DM, Li S, Huang Y, Sousa JA, Sourbron S, Mendichovszky IA, Thomas DL, Priest AN, Francis ST. Improvements in Between-Vendor MRI Harmonization of Renal T 2 Mapping using Stimulated Echo Compensation. J Magn Reson Imaging 2024. [PMID: 38380700 DOI: 10.1002/jmri.29282] [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: 11/09/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND T2 mapping is valuable to evaluate pathophysiology in kidney disease. However, variations in T2 relaxation time measurements across MR scanners and vendors may occur requiring additional correction. PURPOSE To harmonize renal T2 measurements between MR vendor platforms, and use an extended-phase-graph-based fitting method ("StimFit") to correct stimulated echoes and reduce between-vendor variations. STUDY TYPE Prospective. SUBJECTS 8 healthy "travelling" volunteers (37.5% female, 32 ± 6 years) imaged on four MRI systems across three vendors at four sites, 10 healthy volunteers (50% female, 32 ± 8 years) scanned multiple times on a given MR scanner for repeatability evaluation. ISMRM/NIST system phantom scanned for evaluation of T2 accuracy. FIELD STRENGTH/SEQUENCE 3T, multiecho spin-echo sequence. ASSESSMENT T2 images fit using conventional monoexponential fitting and "StimFit." Mean absolute percentage error (MAPE) of phantom measurements with reference T2 values. Average cortex and medulla T2 values compared between MR vendors, with masks obtained from T2 -weighted images and T1 maps. Full-width-at-half-maximum (FWHM) T2 distributions to evaluate local homogeneity of measurements. STATISTICAL TESTS Coefficient of variation (CV), linear mixed-effects model, analysis of variance, student's t-tests, Bland-Altman plots, P-value <0.05 considered statistically significant. RESULTS In the ISMRM/NIST phantom, "StimFit" reduced the MAPE from 4.9%, 9.1%, 24.4%, and 18.1% for the four sites (three vendors) to 3.3%, 3.0%, 6.6%, and 4.1%, respectively. In vivo, there was a significant difference in kidney T2 measurements between vendors using a monoexponential fit, but not with "StimFit" (P = 0.86 and 0.92, cortex and medulla, respectively). The intervendor CVs of T2 measures were reduced from 8.0% to 2.6% (cortex) and 7.1% to 2.8% (medulla) with StimFit, resulting in no significant differences for the CVs of intravendor repeat acquisitions (P = 0.13 and 0.05). "StimFit" significantly reduced the FWHM of T2 distributions in the cortex and whole kidney. DATA CONCLUSION Stimulated-echo correction reduces renal T2 variation across MR vendor platforms. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Hao Li
- The Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Alexander J Daniel
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | | | - Fábio Nery
- Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, London, UK
| | - David M Morris
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Shaohang Li
- The Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Yuan Huang
- Department of Radiology, University of Cambridge, Cambridge, UK
- EPSRC Cambridge Mathematics of Information in Healthcare Hub, University of Cambridge, Cambridge, UK
| | - João A Sousa
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Steven Sourbron
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Iosif A Mendichovszky
- Department of Radiology, University of Cambridge, Cambridge, UK
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - David L Thomas
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Andrew N Priest
- Department of Radiology, University of Cambridge, Cambridge, UK
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK
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Yamaguchi S, Oda S, Kidoh M, Hayashi H, Takashio S, Usuku H, Nagayama Y, Nakaura T, Tsujita K, Hirai T, Aoki T. Cardiac MRI T1 and T2 Mapping as a Quantitative Imaging Biomarker in Transthyretin Amyloid Cardiomyopathy. Acad Radiol 2024; 31:514-522. [PMID: 37775448 DOI: 10.1016/j.acra.2023.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 10/01/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to assess the utility of cardiac magnetic resonance imaging (MRI) T1 and T2 mapping as quantitative imaging biomarkers in transthyretin amyloid cardiomyopathy (ATTR-CM). MATERIALS AND METHODS This study retrospectively evaluated 74 patients with confirmed wild-type ATTR-CM who underwent cardiac MRI, 99mTc-labeled pyrophosphate (99mTc-PYP) scintigraphy, and echocardiography. We assessed the quantitative disease parameters, for example, left ventricular ejection fraction (LVEF), and global longitudinal strain (GLS) by echocardiography, native T1, extracellular volume fraction (ECV), and native T2 value by cardiac MRI, heart-to-contralateral ratio (H/CL) by 99mTc-PYP, and high-sensitive cardiac troponin T. Myocardial native T2 of ≥50 ms was defined as myocardial edema. Correlations between the disease's quantitative parameters were evaluated, and the ECV was compared to other parameters in ATTR-CM with/without myocardial edema. RESULTS ECV in all patients with ATTR-CM revealed a strong correlation with native T1 (r = 0.62), a moderate correlation with hs-TnT (r = 0.59), LVEF (r = -0.48), GLS (r = 0.58), and H/CL (r = 0.48). Correlations between ECV and other quantitative parameters decreased in ATTR-CM with myocardial edema except for H/CL. Meanwhile, the correlations increased in ATTR-CM without myocardial edema. CONCLUSION The presence of myocardial edema affected the interpretation of ECV assessment, although ECV can be a comprehensive imaging biomarker for ATTR-CM. ECV showed a significant correlation with various quantitative disease parameters and can be a reliable disease monitoring marker in patients with ATTR-CM when myocardial edema was excluded.
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Affiliation(s)
- Shinpei Yamaguchi
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan (S.Y., T.A.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.).
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Hidetaka Hayashi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan (S.T., H.U., K.T.)
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan (S.T., H.U., K.T.)
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan (S.T., H.U., K.T.)
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Takatoshi Aoki
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan (S.Y., T.A.)
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Lyu Z, Hua S, Xu J, Shen Y, Guo R, Hu P, Qi H. Free-breathing simultaneous native myocardial T1, T2 and T1ρ mapping with Cartesian acquisition and dictionary matching. J Cardiovasc Magn Reson 2023; 25:63. [PMID: 37946191 PMCID: PMC10636995 DOI: 10.1186/s12968-023-00973-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND T1, T2 and T1ρ are well-recognized parameters for quantitative cardiac MRI. Simultaneous estimation of these parameters allows for comprehensive myocardial tissue characterization, such as myocardial fibrosis and edema. However, conventional techniques either quantify the parameters individually with separate breath-hold acquisitions, which may result in unregistered parameter maps, or estimate multiple parameters in a prolonged breath-hold acquisition, which may be intolerable to patients. We propose a free-breathing multi-parametric mapping (FB-MultiMap) technique that provides co-registered myocardial T1, T2 and T1ρ maps in a single efficient acquisition. METHODS The proposed FB-MultiMap performs electrocardiogram-triggered single-shot Cartesian acquisition over 16 consecutive cardiac cycles, where inversion, T2 and T1ρ preparations are introduced for varying contrasts. A diaphragmatic navigator was used for prospective through-plane motion correction and the in-plane motion was corrected retrospectively with a group-wise image registration method. Quantitative mapping was conducted through dictionary matching of the motion corrected images, where the subject-specific dictionary was created using Bloch simulations for a range of T1, T2 and T1ρ values, as well as B1 factors to account for B1 inhomogeneities. The FB-MultiMap was optimized and validated in numerical simulations, phantom experiments, and in vivo imaging of 15 healthy subjects and six patients with suspected cardiac diseases. RESULTS The phantom T1, T2 and T1ρ values estimated with FB-MultiMap agreed well with reference measurements with no dependency on heart rate. In healthy subjects, FB-MultiMap T1 was higher than MOLLI T1 mapping (1218 ± 50 ms vs. 1166 ± 38 ms, p < 0.001). The myocardial T2 and T1ρ estimated with FB-MultiMap were lower compared to the mapping with T2- or T1ρ-prepared 2D balanced steady-state free precession (T2: 41.2 ± 2.8 ms vs. 42.5 ± 3.1 ms, p = 0.06; T1ρ: 45.3 ± 4.4 ms vs. 50.2 ± 4.0, p < 0.001). The pathological changes in myocardial parameters measured with FB-MultiMap were consistent with conventional techniques in all patients. CONCLUSION The proposed free-breathing multi-parametric mapping technique provides co-registered myocardial T1, T2 and T1ρ maps in 16 heartbeats, achieving similar mapping quality to conventional breath-hold mapping methods.
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Affiliation(s)
- Zhenfeng Lyu
- School of Biomedical Engineering, ShanghaiTech University, 4th Floor, BME Building, 393 Middle Huaxia Road, Pudong District, Shanghai, 201210, China
- Shanghai Clinical Research and Trial Center, Shanghai, China
| | - Sha Hua
- Department of Cardiovascular Medicine, Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Xu
- UIH America, Inc., Houston, TX, USA
| | - Yiwen Shen
- Department of Cardiovascular Medicine, Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rui Guo
- School of Medical Technology, Beijing Institute of Technology, Beijing, China
| | - Peng Hu
- School of Biomedical Engineering, ShanghaiTech University, 4th Floor, BME Building, 393 Middle Huaxia Road, Pudong District, Shanghai, 201210, China.
- Shanghai Clinical Research and Trial Center, Shanghai, China.
| | - Haikun Qi
- School of Biomedical Engineering, ShanghaiTech University, 4th Floor, BME Building, 393 Middle Huaxia Road, Pudong District, Shanghai, 201210, China.
- Shanghai Clinical Research and Trial Center, Shanghai, China.
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Li B, Lee NG, Cui SX, Nayak KS. Lung parenchyma transverse relaxation rates at 0.55 T. Magn Reson Med 2023; 89:1522-1530. [PMID: 36404674 PMCID: PMC10100111 DOI: 10.1002/mrm.29541] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 10/14/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine R2 and R 2 ' $$ {R}_2^{\prime } $$ transverse relaxation rates in healthy lung parenchyma at 0.55 T. This is important in that it informs the design and optimization of new imaging methods for 0.55T lung MRI. METHODS Experiments were performed in 3 healthy adult volunteers on a prototype whole-body 0.55T MRI, using a custom free-breathing electrocardiogram-triggered, single-slice echo-shifted multi-echo spin echo (ES-MCSE) pulse sequence with respiratory navigation. Transverse relaxation rates R2 and R 2 ' $$ {R}_2^{\prime } $$ and off-resonance ∆f were jointly estimated using nonlinear least-squares estimation. These measurements were compared against R2 estimates from T2 -prepared balanced SSFP (T2 -Prep bSSFP) and R 2 * $$ {R}_2^{\ast } $$ estimates from multi-echo gradient echo, which are used widely but prone to error due to different subvoxel weighting. RESULTS The mean R2 and R 2 ' $$ {R}_2^{\prime } $$ values of lung parenchyma obtained from ES-MCSE were 17.3 ± 0.7 Hz and 127.5 ± 16.4 Hz (T2 = 61.6 ± 1.7 ms; T 2 ' $$ {\mathrm{T}}_2^{\prime } $$ = 9.5 ms ± 1.6 ms), respectively. The off-resonance estimates ranged from -60 to 30 Hz. The R2 from T2 -Prep bSSFP was 15.7 ± 1.7 Hz (T2 = 68.6 ± 8.6 ms) and R 2 * $$ {R}_2^{\ast } $$ from multi-echo gradient echo was 131.2 ± 30.4 Hz ( T 2 * $$ {\mathrm{T}}_2^{\ast } $$ = 8.0 ± 2.5 ms). Paired t-test indicated that there is a significant difference between the proposed and reference methods (p < 0.05). The mean R2 estimate from T2 -Prep bSSFP was slightly smaller than that from ES-MCSE, whereas the mean R 2 ' $$ {R}_2^{\prime } $$ and R 2 * $$ {R}_2^{\ast } $$ estimates from ES-MCSE and multi-echo gradient echo were similar to each other across all subjects. CONCLUSIONS Joint estimation of transverse relaxation rates and off-resonance is feasible at 0.55 T with a free-breathing electrocardiogram-gated and navigator-gated ES-MCSE sequence. At 0.55 T, the mean R2 of 17.3 Hz is similar to the reported mean R2 of 16.7 Hz at 1.5 T, but the mean R 2 ' $$ {R}_2^{\prime } $$ of 127.5 Hz is about 5-10 times smaller than that reported at 1.5 T.
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Affiliation(s)
- Bochao Li
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, California, Los Angeles, USA
| | - Nam G Lee
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, California, Los Angeles, USA
| | - Sophia X Cui
- Siemens Medical Solutions USA, Los Angeles, California, USA
| | - Krishna S Nayak
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, California, Los Angeles, USA.,Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, California, Los Angeles, USA
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Chamadol N, Syms R, Laopaiboon V, Promsorn J, Eurboonyanun K. New Imaging Techniques. Recent Results Cancer Res 2023; 219:109-145. [PMID: 37660333 DOI: 10.1007/978-3-031-35166-2_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
The chapter discusses the advancement of new imaging techniques, the role of imaging in CCA diagnosis, anatomical and morphological classification, ultrasound screening of CCA, ultrasound findings of MF-CCA, PI-CCA, ID-CCA, the use of CT in CCA diagnosis, staging and treatment planning, CT volumetry and estimation of future liver remnant, post-treatment follow-up and surveillance, MRI imaging, Positron Emission Tomography (PET)/CT, limitations to contrast studies and resolution, internal receivers for CCA imaging, and in vitro imaging of CCA.
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Affiliation(s)
- Nittaya Chamadol
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Richard Syms
- Department of Electrical and Electronic Engineering, Imperial College London, Exhibition Road, London, SW7 2AZ, UK
| | - Vallop Laopaiboon
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Julaluck Promsorn
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Kulyada Eurboonyanun
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
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Normal Values of Magnetic Resonance T
1
ρ
Relaxation Times in the Adult Heart at 1.5 T
MRI. J Magn Reson Imaging 2022. [DOI: 10.1002/jmri.28506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/14/2022] [Accepted: 10/14/2022] [Indexed: 11/27/2022] Open
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Jarkman C, Carlhäll CJ, Henningsson M. Clinical evaluation of the Multimapping technique for simultaneous myocardial T1 and T2 mapping. Front Cardiovasc Med 2022; 9:960403. [PMID: 36148079 PMCID: PMC9485633 DOI: 10.3389/fcvm.2022.960403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
The Multimapping technique was recently proposed for simultaneous myocardial T1 and T2 mapping. In this study, we evaluate its correlation with clinical reference mapping techniques in patients with a range of cardiovascular diseases (CVDs) and compare image quality and inter- and intra-observer repeatability. Multimapping consists of an ECG-triggered, 2D single-shot bSSFP readout with inversion recovery and T2 preparation modules, acquired across 10 cardiac cycles. The sequence was implemented at 1.5T and compared to clinical reference mapping techniques, modified Look-Locker inversion recovery (MOLLI) and T2 prepared bSSFP with four echo times (T2bSSFP), and compared in 47 patients with CVD (of which 44 were analyzed). In diseased myocardial segments (defined as the presence of late gadolinium enhancement), there was a high correlation between Multimapping and MOLLI for native myocardium T1 (r2 = 0.73), ECV (r2 = 0.91), and blood T1 (r2 = 0.88), and Multimapping and T2bSSFP for native myocardial T2 (r2 = 0.80). In healthy myocardial segments, a bias for native T1 (Multimapping = 1,116 ± 21 ms, MOLLI = 1,002 ± 21, P < 0.001), post-contrast T1 (Multimapping = 479 ± 31 ms, MOLLI = 426 ± 27 ms, 0.001), ECV (Multimapping = 21.5 ± 1.9%, MOLLI = 23.7 ± 2.3%, P = 0.001), and native T2 (Multimapping = 48.0 ± 3.0 ms, T2bSSFP = 53.9 ± 3.5 ms, P < 0.001) was observed. The image quality for Multimapping was scored as higher for all mapping techniques (native T1, post-contrast T1, ECV, and T2bSSFP) compared to the clinical reference techniques. The inter- and intra-observer agreements were excellent (intraclass correlation coefficient, ICC > 0.9) for most measurements, except for inter-observer repeatability of Multimapping native T1 (ICC = 0.87), post-contrast T1 (ICC = 0.73), and T2bSSFP native T2 (ICC = 0.88). Multimapping shows high correlations with clinical reference mapping techniques for T1, T2, and ECV in a diverse cohort of patients with different cardiovascular diseases. Multimapping enables simultaneous T1 and T2 mapping and can be performed in a short breath-hold, with image quality superior to that of the clinical reference techniques.
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Affiliation(s)
- Charlotta Jarkman
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Carl-Johan Carlhäll
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Markus Henningsson
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
- *Correspondence: Markus Henningsson
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Topriceanu CC, Pierce I, Moon JC, Captur G. T 2 and T 2⁎ mapping and weighted imaging in cardiac MRI. Magn Reson Imaging 2022; 93:15-32. [PMID: 35914654 DOI: 10.1016/j.mri.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022]
Abstract
Cardiac imaging is progressing from simple imaging of heart structure and function to techniques visualizing and measuring underlying tissue biological changes that can potentially define disease and therapeutic options. These techniques exploit underlying tissue magnetic relaxation times: T1, T2 and T2*. Initial weighting methods showed myocardial heterogeneity, detecting regional disease. Current methods are now fully quantitative generating intuitive color maps that do not only expose regionality, but also diffuse changes - meaning that between-scan comparisons can be made to define disease (compared to normal) and to monitor interval change (compared to old scans). T1 is now familiar and used clinically in multiple scenarios, yet some technical challenges remain. T2 is elevated with increased tissue water - oedema. Should there also be blood troponin elevation, this oedema likely reflects inflammation, a key biological process. T2* falls in the presence of magnetic/paramagnetic materials - practically, this means it measures tissue iron, either after myocardial hemorrhage or in myocardial iron overload. This review discusses how T2 and T2⁎ imaging work (underlying physics, innovations, dependencies, performance), current and emerging use cases, quality assurance processes for global delivery and future research directions.
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Affiliation(s)
- Constantin-Cristian Topriceanu
- Cardiac MRI Unit, Barts Heart Centre, West Smithfield, London, UK; UCL Institute of Cardiovascular Science, University College London, London, UK; UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Iain Pierce
- Cardiac MRI Unit, Barts Heart Centre, West Smithfield, London, UK; UCL Institute of Cardiovascular Science, University College London, London, UK
| | - James C Moon
- Cardiac MRI Unit, Barts Heart Centre, West Smithfield, London, UK; UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Gabriella Captur
- Cardiac MRI Unit, Barts Heart Centre, West Smithfield, London, UK; UCL Institute of Cardiovascular Science, University College London, London, UK; UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK; The Royal Free Hospital, Centre for Inherited Heart Muscle Conditions, Cardiology Department, Pond Street, Hampstead, London, UK.
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Hamilton JI. A Self-Supervised Deep Learning Reconstruction for Shortening the Breathhold and Acquisition Window in Cardiac Magnetic Resonance Fingerprinting. Front Cardiovasc Med 2022; 9:928546. [PMID: 35811730 PMCID: PMC9260051 DOI: 10.3389/fcvm.2022.928546] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/06/2022] [Indexed: 01/14/2023] Open
Abstract
The aim of this study is to shorten the breathhold and diastolic acquisition window in cardiac magnetic resonance fingerprinting (MRF) for simultaneous T1, T2, and proton spin density (M0) mapping to improve scan efficiency and reduce motion artifacts. To this end, a novel reconstruction was developed that combines low-rank subspace modeling with a deep image prior, termed DIP-MRF. A system of neural networks is used to generate spatial basis images and quantitative tissue property maps, with training performed using only the undersampled k-space measurements from the current scan. This approach avoids difficulties with obtaining in vivo MRF training data, as training is performed de novo for each acquisition. Calculation of the forward model during training is accelerated by using GRAPPA operator gridding to shift spiral k-space data to Cartesian grid points, and by using a neural network to rapidly generate fingerprints in place of a Bloch equation simulation. DIP-MRF was evaluated in simulations and at 1.5 T in a standardized phantom, 18 healthy subjects, and 10 patients with suspected cardiomyopathy. In addition to conventional mapping, two cardiac MRF sequences were acquired, one with a 15-heartbeat(HB) breathhold and 254 ms acquisition window, and one with a 5HB breathhold and 150 ms acquisition window. In simulations, DIP-MRF yielded decreased nRMSE compared to dictionary matching and a sparse and locally low rank (SLLR-MRF) reconstruction. Strong correlation (R2 > 0.999) with T1 and T2 reference values was observed in the phantom using the 5HB/150 ms scan with DIP-MRF. DIP-MRF provided better suppression of noise and aliasing artifacts in vivo, especially for the 5HB/150 ms scan, and lower intersubject and intrasubject variability compared to dictionary matching and SLLR-MRF. Furthermore, it yielded a better agreement between myocardial T1 and T2 from 15HB/254 ms and 5HB/150 ms MRF scans, with a bias of −9 ms for T1 and 2 ms for T2. In summary, this study introduces an extension of the deep image prior framework for cardiac MRF tissue property mapping, which does not require pre-training with in vivo scans, and has the potential to reduce motion artifacts by enabling a shortened breathhold and acquisition window.
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Affiliation(s)
- Jesse I. Hamilton
- Department of Radiology, University of Michigan, Ann Arbor, MI, United States
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
- *Correspondence: Jesse I. Hamilton,
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11
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O'Brien AT, Gil KE, Varghese J, Simonetti OP, Zareba KM. T2 mapping in myocardial disease: a comprehensive review. J Cardiovasc Magn Reson 2022; 24:33. [PMID: 35659266 PMCID: PMC9167641 DOI: 10.1186/s12968-022-00866-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 04/27/2022] [Indexed: 12/20/2022] Open
Abstract
Cardiovascular magnetic resonance (CMR) is considered the gold standard imaging modality for myocardial tissue characterization. Elevated transverse relaxation time (T2) is specific for increased myocardial water content, increased free water, and is used as an index of myocardial edema. The strengths of quantitative T2 mapping lie in the accurate characterization of myocardial edema, and the early detection of reversible myocardial disease without the use of contrast agents or ionizing radiation. Quantitative T2 mapping overcomes the limitations of T2-weighted imaging for reliable assessment of diffuse myocardial edema and can be used to diagnose, stage, and monitor myocardial injury. Strong evidence supports the clinical use of T2 mapping in acute myocardial infarction, myocarditis, heart transplant rejection, and dilated cardiomyopathy. Accumulating data support the utility of T2 mapping for the assessment of other cardiomyopathies, rheumatologic conditions with cardiac involvement, and monitoring for cancer therapy-related cardiac injury. Importantly, elevated T2 relaxation time may be the first sign of myocardial injury in many diseases and oftentimes precedes symptoms, changes in ejection fraction, and irreversible myocardial remodeling. This comprehensive review discusses the technical considerations and clinical roles of myocardial T2 mapping with an emphasis on expanding the impact of this unique, noninvasive tissue parameter.
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Affiliation(s)
- Aaron T O'Brien
- Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, USA
| | - Katarzyna E Gil
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Juliet Varghese
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USA
| | - Orlando P Simonetti
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USA
- Department of Radiology, The Ohio State University, Columbus, Ohio, USA
| | - Karolina M Zareba
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USA.
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12
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Ogier AC, Bustin A, Cochet H, Schwitter J, van Heeswijk RB. The Road Toward Reproducibility of Parametric Mapping of the Heart: A Technical Review. Front Cardiovasc Med 2022; 9:876475. [PMID: 35600490 PMCID: PMC9120534 DOI: 10.3389/fcvm.2022.876475] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/11/2022] [Indexed: 01/02/2023] Open
Abstract
Parametric mapping of the heart has become an essential part of many cardiovascular magnetic resonance imaging exams, and is used for tissue characterization and diagnosis in a broad range of cardiovascular diseases. These pulse sequences are used to quantify the myocardial T1, T2, T2*, and T1ρ relaxation times, which are unique surrogate indices of fibrosis, edema and iron deposition that can be used to monitor a disease over time or to compare patients to one another. Parametric mapping is now well-accepted in the clinical setting, but its wider dissemination is hindered by limited inter-center reproducibility and relatively long acquisition times. Recently, several new parametric mapping techniques have appeared that address both of these problems, but substantial hurdles remain for widespread clinical adoption. This review serves both as a primer for newcomers to the field of parametric mapping and as a technical update for those already well at home in it. It aims to establish what is currently needed to improve the reproducibility of parametric mapping of the heart. To this end, we first give an overview of the metrics by which a mapping technique can be assessed, such as bias and variability, as well as the basic physics behind the relaxation times themselves and what their relevance is in the prospect of myocardial tissue characterization. This is followed by a summary of routine mapping techniques and their variations. The problems in reproducibility and the sources of bias and variability of these techniques are reviewed. Subsequently, novel fast, whole-heart, and multi-parametric techniques and their merits are treated in the light of their reproducibility. This includes state of the art segmentation techniques applied to parametric maps, and how artificial intelligence is being harnessed to solve this long-standing conundrum. We finish up by sketching an outlook on the road toward inter-center reproducibility, and what to expect in the future.
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Affiliation(s)
- Augustin C. Ogier
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Aurelien Bustin
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, France
| | - Hubert Cochet
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, France
| | - Juerg Schwitter
- Cardiac MR Center, Cardiology Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Ruud B. van Heeswijk
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- *Correspondence: Ruud B. van Heeswijk
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13
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Mao X, Lee HL, Hu Z, Cao T, Han F, Ma S, Serry FM, Fan Z, Xie Y, Li D, Christodoulou AG. Simultaneous Multi-Slice Cardiac MR Multitasking for Motion-Resolved, Non-ECG, Free-Breathing T1–T2 Mapping. Front Cardiovasc Med 2022; 9:833257. [PMID: 35310971 PMCID: PMC8930916 DOI: 10.3389/fcvm.2022.833257] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/27/2022] [Indexed: 02/05/2023] Open
Abstract
The aim of this study is to simultaneously quantify T1/T2 across three slices of the left-ventricular myocardium without breath-holds or ECG monitoring, all within a 3 min scan. Radial simultaneous multi-slice (SMS) encoding, self-gating, and image reconstruction was incorporated into the cardiovascular magnetic resonance (CMR) Multitasking framework to simultaneously image three short-axis slices. A T2prep-IR FLASH sequence with two flip angles was designed and implemented to allow B1+-robust T1 and T2 mapping. The proposed Multitasking-SMS method was validated in a standardized phantom and 10 healthy volunteers, comparing T1 and T2 measurements and scan-rescan repeatability against corresponding reference methods in one layer of phantom vials and in 16 American Heart Association (AHA) myocardial segments. In phantom, Multitasking-SMS T1/T2 measurements showed substantial correlation (R2 > 0.996) and excellent agreement [intraclass correlation coefficients (ICC) ≥ 0.999)] with reference measurements. In healthy volunteers, Multitasking-SMS T1/T2 maps reported similar myocardial T1/T2 values (1,215 ± 91.0/41.5 ± 6.3 ms) to the reference myocardial T1/T2 values (1,239 ± 67.5/42.7 ± 4.1 ms), with P = 0.347 and P = 0.296, respectively. Bland–Altman analyses also demonstrated good in vivo repeatability in both the multitasking and references, with segment-wise coefficients of variation of 4.7% (multitasking T1), 8.9% (multitasking T2), 2.4% [modified look-locker inversion recovery (MOLLI)], and 4.6% (T2-prep FLASH), respectively. In summary, multitasking-SMS is feasible for free-breathing, non-ECG, myocardial T1/T2 quantification in 16 AHA segments over 3 short-axis slices in 3 min. The method shows the great potential for reducing exam time for quantitative CMR without ECG or breath-holds.
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Affiliation(s)
- Xianglun Mao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Hsu-Lei Lee
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Zhehao Hu
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Radiology, University of Southern California, Los Angeles, CA, United States
| | - Tianle Cao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Fei Han
- Siemens Medical Solutions, Inc., Los Angeles, CA, United States
| | - Sen Ma
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Fardad M. Serry
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Zhaoyang Fan
- Department of Radiology, University of Southern California, Los Angeles, CA, United States
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anthony G. Christodoulou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
- *Correspondence: Anthony G. Christodoulou
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14
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Henningsson M. Cartesian dictionary-based native T 1 and T 2 mapping of the myocardium. Magn Reson Med 2022; 87:2347-2362. [PMID: 34985143 DOI: 10.1002/mrm.29143] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE To implement and evaluate a new dictionary-based technique for native myocardial T1 and T2 mapping using Cartesian sampling. METHODS The proposed technique (Multimapping) consisted of single-shot Cartesian image acquisitions in 10 consecutive cardiac cycles, with inversion pulses in cycle 1 and 5, and T2 preparation (TE: 30 ms, 50 ms, and 70 ms) in cycles 8-10. Multimapping was simulated for different T1 and T2 , where entries corresponding to the k-space centers were matched to acquired data. Experiments were performed in a phantom, 16 healthy subjects, and 3 patients with cardiovascular disease. RESULTS Multimapping phantom measurements showed good agreement with reference values for both T1 and T2 , with no discernable heart-rate dependency for T1 and T2 within the range of myocardium. In vivo mean T1 in healthy subjects was significantly higher using Multimapping (T1 = 1114 ± 14 ms) compared to the reference (T1 = 991 ± 26 ms) (p < 0.01). Mean Multimapping T2 (47.1 ± 1.3 ms) and T2 spatial variability (5.8 ± 1.0 ms) was significantly lower compared to the reference (T2 = 54.7 ± 2.2 ms, p < 0.001; spatial variability = 8.4 ± 2.0 ms, p < 0.01). Increased T1 and T2 was detected in all patients using Multimapping. CONCLUSIONS Multimapping allows for simultaneous native myocardial T1 and T2 mapping with a conventional Cartesian trajectory, demonstrating promising in vivo image quality and parameter quantification results.
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Affiliation(s)
- Markus Henningsson
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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15
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Henningsson M, Malik S, Botnar R, Castellanos D, Hussain T, Leiner T. Black-Blood Contrast in Cardiovascular MRI. J Magn Reson Imaging 2020; 55:61-80. [PMID: 33078512 PMCID: PMC9292502 DOI: 10.1002/jmri.27399] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/14/2022] Open
Abstract
MRI is a versatile technique that offers many different options for tissue contrast, including suppressing the blood signal, so‐called black‐blood contrast. This contrast mechanism is extremely useful to visualize the vessel wall with high conspicuity or for characterization of tissue adjacent to the blood pool. In this review we cover the physics of black‐blood contrast and different techniques to achieve blood suppression, from methods intrinsic to the imaging readout to magnetization preparation pulses that can be combined with arbitrary readouts, including flow‐dependent and flow‐independent techniques. We emphasize the technical challenges of black‐blood contrast that can depend on flow and motion conditions, additional contrast weighting mechanisms (T1, T2, etc.), magnetic properties of the tissue, and spatial coverage. Finally, we describe specific implementations of black‐blood contrast for different vascular beds.
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Affiliation(s)
- Markus Henningsson
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Shaihan Malik
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Rene Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Daniel Castellanos
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tarique Hussain
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Division of Pediatric Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tim Leiner
- Department of Radiology, Utrecht University Medical Center, Utrecht, The Netherlands
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16
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Role of CMR Mapping Techniques in Cardiac Hypertrophic Phenotype. Diagnostics (Basel) 2020; 10:diagnostics10100770. [PMID: 33003571 PMCID: PMC7601617 DOI: 10.3390/diagnostics10100770] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/28/2022] Open
Abstract
Non-ischemic cardiomyopathies represent a heterogeneous group of myocardial diseases potentially leading to heart failure, life-threatening arrhythmias, and eventually death. Myocardial dysfunction is associated with different underlying pathological processes, ultimately inducing changes in morphological appearance. Thus, classification based on presenting morphological phenotypes has been proposed, i.e., dilated, hypertrophic, restrictive, and right ventricular cardiomyopathies. In light of the key diagnostic and prognostic role of morphological and functional features, cardiovascular imaging has emerged as key element in the clinical workflow of suspected cardiomyopathies, and above all, cardiovascular magnetic resonance (CMR) represents the ideal technique to be used: thanks to its physical principles, besides optimal spatial and temporal resolutions, incomparable contrast resolution allows to assess myocardial tissue abnormalities in detail. Traditionally, weighted images and late enhancement images after gadolinium-based contrast agent administration have been used to perform tissue characterization, but in the last decade quantitative assessment of pre-contrast longitudinal relaxation time (native T1), post-contrast longitudinal relaxation time (post-contrast T1) and transversal relaxation time (T2), all displayed with dedicated pixel-wise color-coded maps (mapping), has contributed to give precious knowledge insight, with positive influence of diagnostic accuracy and prognosis assessment, mostly in the setting of the hypertrophic phenotype. This review aims to describe the available evidence of the role of mapping techniques in the assessment of hypertrophic phenotype, and to suggest their integration in the routine CMR evaluation of newly diagnosed cardiomyopathies with increased wall thickness.
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17
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Khuntikeo N, Titapun A, Chamadol N, Boonphongsathien W, Sa-Ngiamwibool P, Taylor-Robinson SD, Wadsworth CA, Zhang S, Kardoulaki EM, Young IR, Syms RRA. Improving the Detection of Cholangiocarcinoma: In vitro MRI-Based Study Using Local Coils and T2 Mapping. Hepat Med 2020; 12:29-39. [PMID: 32280284 PMCID: PMC7127873 DOI: 10.2147/hmer.s232392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 02/20/2020] [Indexed: 12/15/2022] Open
Abstract
Aim Cholangiocarcinoma is endemic in southeast Asia, generally developing from liver fluke infestation. However, diagnostic imaging of early-stage disease is challenging. The aim of this work is to investigate relaxometry (specifically, T2 mapping) as a method of exploiting the higher signal-to-noise ratio (SNR) of internal coils for improved reception of magnetic resonance signals, despite their non-uniform sensitivity. Methods Ex vivo T2 mapping was carried out at 3T on fixed resection specimens from Thai cholangiocarcinoma patients using an mGRASE sequence and an endoscope coil based on a thin-film magneto-inductive waveguide and designed ultimately for internal use. Results Disease-induced changes including granulomatous inflammation, intraepithelial neoplasia and intraductal tumours were correlated with histopathology, and relaxation data were compared with mono- and bi-exponential models of T2 relaxation. An approximately 10-fold local advantage in SNR compared to a 16-element torso coil was demonstrated using the endoscope coil, and improved tissue differentiation was obtained without contrast agents. Conclusion The performance advantage above follows directly from the inverse relation between the component of the standard deviation of T2 due to thermal noise and the SNR, and offers an effective method of exploiting the SNR advantage of internal coils. No correction is required, avoiding the need for tracking, relaxing constraints on coil and slice orientation and providing rapid visualization.
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Affiliation(s)
- Narong Khuntikeo
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Attapol Titapun
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Nittaya Chamadol
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | | | - Prakasit Sa-Ngiamwibool
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Simon D Taylor-Robinson
- Division of Surgery and Cancer, Imperial College London, Liver Unit, St. Mary's Hospital, London W2 1NY, UK
| | - Christopher A Wadsworth
- Division of Surgery and Cancer, Imperial College London, Liver Unit, St. Mary's Hospital, London W2 1NY, UK
| | - Shuo Zhang
- Philips Healthcare Germany, Health Systems, Clinical Science, Hamburg 22335, Germany
| | | | - Ian R Young
- EEE Department, Imperial College, London SW7 2AZ, UK
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18
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Krumm P, Martirosian P, Rath D, Gawaz M, Nikolaou K, Klumpp BD, Hornung A, Kramer U, Schick F, Geisler T, Zitzelsberger T. Performance of two Methods for Cardiac MRI Edema Mapping: Dual-Contrast Fast Spin-Echo and T2 Prepared Balanced Steady State Free Precession. ROFO-FORTSCHR RONTG 2020; 192:669-677. [PMID: 32018303 DOI: 10.1055/a-1088-3478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE To compare true positive and false negative results of myocardial edema mapping in two methods. Myocardial edema may be difficult to detect on cardiac MRI. MATERIALS AND METHODS 76 patients (age 59 ± 11 years, 15 female) with acute myocardial infarction (MI) and 10 healthy volunteers were prospectively included in this single-center study. 1.5 T cardiac MRI was performed in patients 2.5 days after revascularization (median) for edema mapping: Steady State Free Precession (SSFP) mapping sequence with T2-preparation pulses (T2prep); and dual-contrast Fast Spin-Echo (dcFSE) signal decay edema mapping. Late gadolinium enhancement (LGE) was used as the reference for expected edema in acute MI. RESULTS 311 myocardial segments in patients were acutely infarcted with mean T2 73 ms for T2prep SSFP vs. 87 ms for dcFSE edema mapping. In healthy volunteers the mean T2 was 56 ms for T2prep SSFP vs. 50 ms for dcFSE edema mapping. Receiver operating characteristic (ROC) curve for T2prep SSFP show area under the curve (AUC) 0.962, p < 0.0001, Youden index J 0.8266, associated criterion > 60 ms, sensitivity 94 %, specificity 89 %. dcFSE ROC AUC 0.979, p < 0.0001, J 0.9219, associated criterion > 64 ms, sensitivity 93 %, specificity 99 %. CONCLUSION Both edema mapping methods indicate high-grade edema with high sensitivity. Nevertheless, edema in acute infarction may be focally underestimated in both mapping methods. KEY POINTS · Sensitivity for edema detection is high for both methods.. · Edema may be focally underestimated by T2prep SSFP edema mapping and dcFSE mapping.. CITATION FORMAT · Krumm P, Martirosian P, Rath D et al. Performance of two Methods for Cardiac MRI Edema Mapping: Dual-Contrast Fast Spin-Echo and T2 Prepared Balanced Steady State Free Precession. Fortschr Röntgenstr 2020; 192: 669 - 677.
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Affiliation(s)
- Patrick Krumm
- Diagnostic and Interventional Radiology, University of Tübingen, Germany
| | | | - Dominik Rath
- Cardiology and Cardiovascular Medicine, University of Tübingen, Germany
| | - Meinrad Gawaz
- Cardiology and Cardiovascular Medicine, University of Tübingen, Germany
| | | | | | | | - Ulrich Kramer
- Diagnostic and Interventional Radiology, University of Tübingen, Germany
| | - Fritz Schick
- Section on Experimental Radiology, University of Tübingen, Germany
| | - Tobias Geisler
- Cardiology and Cardiovascular Medicine, University of Tübingen, Germany
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19
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Dekkers IA, de Boer A, Sharma K, Cox EF, Lamb HJ, Buckley DL, Bane O, Morris DM, Prasad PV, Semple SIK, Gillis KA, Hockings P, Buchanan C, Wolf M, Laustsen C, Leiner T, Haddock B, Hoogduin JM, Pullens P, Sourbron S, Francis S. Consensus-based technical recommendations for clinical translation of renal T1 and T2 mapping MRI. MAGMA (NEW YORK, N.Y.) 2020; 33:163-176. [PMID: 31758418 PMCID: PMC7021750 DOI: 10.1007/s10334-019-00797-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/31/2019] [Accepted: 11/04/2019] [Indexed: 02/07/2023]
Abstract
To develop technical recommendations on the acquisition and post-processing of renal longitudinal (T1) and transverse (T2) relaxation time mapping. A multidisciplinary panel consisting of 18 experts in the field of renal T1 and T2 mapping participated in a consensus project, which was initiated by the European Cooperation in Science and Technology Action PARENCHIMA CA16103. Consensus recommendations were formulated using a two-step modified Delphi method. The first survey consisted of 56 items on T1 mapping, of which 4 reached the pre-defined consensus threshold of 75% or higher. The second survey was expanded to include both T1 and T2 mapping, and consisted of 54 items of which 32 reached consensus. Recommendations based were formulated on hardware, patient preparation, acquisition, analysis and reporting. Consensus-based technical recommendations for renal T1 and T2 mapping were formulated. However, there was considerable lack of consensus for renal T1 and particularly renal T2 mapping, to some extent surprising considering the long history of relaxometry in MRI, highlighting key knowledge gaps that require further work. This paper should be regarded as a first step in a long-term evidence-based iterative process towards ever increasing harmonization of scan protocols across sites, to ultimately facilitate clinical implementation.
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Affiliation(s)
- Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anneloes de Boer
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kaniska Sharma
- Department of Biomedical Imaging Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Eleanor F Cox
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - David L Buckley
- Department of Biomedical Imaging Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Octavia Bane
- Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David M Morris
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - Pottumarthi V Prasad
- Department of Radiology, Center for Advanced Imaging, NorthShore University Health System, Evanston, IL, USA
| | - Scott I K Semple
- Centre for Cardiovascular Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - Keith A Gillis
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Paul Hockings
- Antaros Medical, Mölndal, Sweden
- MedTech West, Chalmers University of Technology, Gothenburg, Sweden
| | - Charlotte Buchanan
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Marcos Wolf
- Center for Medical Physics and Biomedical Engineering, MR-Centre of Excellence, Medical University of Vienna, Vienna, Austria
| | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Bryan Haddock
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark
| | - Johannes M Hoogduin
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Pim Pullens
- Department of Radiology, University Hospital Ghent, Ghent, Belgium
- Ghent Institute of Functional and Metabolic Imaging, Ghent University, Ghent, Belgium
| | - Steven Sourbron
- Department of Biomedical Imaging Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Susan Francis
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
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Dekkers IA, de Boer A, Sharma K, Cox EF, Lamb HJ, Buckley DL, Bane O, Morris DM, Prasad PV, Semple SIK, Gillis KA, Hockings P, Buchanan C, Wolf M, Laustsen C, Leiner T, Haddock B, Hoogduin JM, Pullens P, Sourbron S, Francis S. Consensus-based technical recommendations for clinical translation of renal T1 and T2 mapping MRI. MAGMA (NEW YORK, N.Y.) 2019. [PMID: 31758418 DOI: 10.1007/s10334‐019‐00797‐5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
To develop technical recommendations on the acquisition and post-processing of renal longitudinal (T1) and transverse (T2) relaxation time mapping. A multidisciplinary panel consisting of 18 experts in the field of renal T1 and T2 mapping participated in a consensus project, which was initiated by the European Cooperation in Science and Technology Action PARENCHIMA CA16103. Consensus recommendations were formulated using a two-step modified Delphi method. The first survey consisted of 56 items on T1 mapping, of which 4 reached the pre-defined consensus threshold of 75% or higher. The second survey was expanded to include both T1 and T2 mapping, and consisted of 54 items of which 32 reached consensus. Recommendations based were formulated on hardware, patient preparation, acquisition, analysis and reporting. Consensus-based technical recommendations for renal T1 and T2 mapping were formulated. However, there was considerable lack of consensus for renal T1 and particularly renal T2 mapping, to some extent surprising considering the long history of relaxometry in MRI, highlighting key knowledge gaps that require further work. This paper should be regarded as a first step in a long-term evidence-based iterative process towards ever increasing harmonization of scan protocols across sites, to ultimately facilitate clinical implementation.
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Affiliation(s)
- Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anneloes de Boer
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kaniska Sharma
- Department of Biomedical Imaging Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Eleanor F Cox
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - David L Buckley
- Department of Biomedical Imaging Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Octavia Bane
- Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David M Morris
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - Pottumarthi V Prasad
- Department of Radiology, Center for Advanced Imaging, NorthShore University Health System, Evanston, IL, USA
| | - Scott I K Semple
- Centre for Cardiovascular Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - Keith A Gillis
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Paul Hockings
- Antaros Medical, Mölndal, Sweden.,MedTech West, Chalmers University of Technology, Gothenburg, Sweden
| | - Charlotte Buchanan
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Marcos Wolf
- Center for Medical Physics and Biomedical Engineering, MR-Centre of Excellence, Medical University of Vienna, Vienna, Austria
| | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Bryan Haddock
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark
| | - Johannes M Hoogduin
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Pim Pullens
- Department of Radiology, University Hospital Ghent, Ghent, Belgium.,Ghent Institute of Functional and Metabolic Imaging, Ghent University, Ghent, Belgium
| | - Steven Sourbron
- Department of Biomedical Imaging Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Susan Francis
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
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21
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Zhu Y, Yang D, Zou L, Chen Y, Liu X, Chung YC. T 2STIR preparation for single-shot cardiovascular magnetic resonance myocardial edema imaging. J Cardiovasc Magn Reson 2019; 21:72. [PMID: 31752919 PMCID: PMC6873416 DOI: 10.1186/s12968-019-0583-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 10/22/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Myocardial edema in acute myocardial infarction (AMI) is commonly imaged using dark-blood short tau inversion recovery turbo spin echo (STIR-TSE) cardiovascular magnetic resonance (CMR). The technique is sensitive to cardiac motion and coil sensitivity variation, leading to myocardial signal nonuniformity and impeding reliable depiction of edematous tissues. T2-prepared balanced steady state free precession (T2p-bSSFP) imaging has been proposed, but its contrast is low, and averaging is commonly needed. T2 mapping is useful but requires a long scan time and breathholding. We propose here a single-shot magnetization prepared sequence that increases the contrast between edema and normal myocardium and apply it to myocardial edema imaging. METHODS A magnetization preparation module (T2STIR) is designed to exploit the simultaneous elevation of T1 and T2 in edema to improve the depiction of edematous myocardium. The module tips magnetization down to the -z axis after T2 preparation. Transverse magnetization is sampled at the fat null point using bSSFP readout and allows for single-shot myocardial edema imaging. The sequence (T2STIR-bSSFP) was studied for its contrast behavior using simulation and phantoms. It was then evaluated on 7 healthy subjects and 7 AMI patients by comparing it to T2p-bSSFP and T2 mapping using the contrast-to-noise ratio (CNR) and the contrast ratio as performance indices. RESULTS In simulation and phantom studies, T2STIR-bSSFP had improved contrast between edema and normal myocardium compared with the other two edema imaging techniques. In patients, the CNR of T2STIR-bSSFP was higher than T2p-bSSFP (5.9 ± 2.6 vs. 2.8 ± 2.0, P < 0.05) but had no significant difference compared with that of the T2 map (T2 map: 6.6 ± 3.3 vs. 5.9 ± 2.6, P = 0.62). The contrast ratio of T2STIR-bSSFP (2.4 ± 0.8) was higher than that of the T2 map (1.3 ± 0.1, P < 0.01) and T2p-bSSFP (1.4 ± 0.5, P < 0.05). CONCLUSION T2STIR-bSSFP has improved contrast between edematous and normal myocardium compared with commonly used bSSFP-based edema imaging techniques. T2STIR-bSSFP also differentiates between fat that was robustly suppressed and fluids around the heart. The technique is useful for single-shot edema imaging in AMI patients.
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Affiliation(s)
- Yanjie Zhu
- Paul C. Lauterbur Research Centre for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Guangdong, 518055 China
| | - Dan Yang
- Department of Cardiology, West China Hospital, Chengdu, 610041 China
| | - Lixian Zou
- Paul C. Lauterbur Research Centre for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Guangdong, 518055 China
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Chengdu, 610041 China
| | - Xin Liu
- Paul C. Lauterbur Research Centre for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Guangdong, 518055 China
| | - Yiu-Cho Chung
- Siemens Healthcare Pte Ltd., 60 MacPherson Road, Singapore, 348615 Singapore
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22
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CMR Tissue Characterization in Patients with HFmrEF. J Clin Med 2019; 8:jcm8111877. [PMID: 31694263 PMCID: PMC6912482 DOI: 10.3390/jcm8111877] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/19/2019] [Accepted: 10/30/2019] [Indexed: 12/28/2022] Open
Abstract
The characteristics and optimal management of heart failure with a moderately reduced ejection fraction (HFmrEF, LV-EF 40–50%) are still unclear. Advanced cardiac MRI offers information about function, fibrosis and inflammation of the myocardium, and might help to characterize HFmrEF in terms of adverse cardiac remodeling. We, therefore, examined 17 patients with HFpEF, 18 with HFmrEF, 17 with HFrEF and 17 healthy, age-matched controls with cardiac MRI (Phillips 1.5 T). T1 and T2 relaxation time mapping was performed and the extracellular volume (ECV) was calculated. Global circumferential (GCS) and longitudinal strain (GLS) were derived from cine images. GLS (−15.7 ± 2.1) and GCS (−19.9 ± 4.1) were moderately reduced in HFmrEF, resembling systolic dysfunction. Native T1 relaxation times were elevated in HFmrEF (1027 ± 40 ms) and HFrEF (1033 ± 54 ms) compared to healthy controls (972 ± 31 ms) and HFpEF (985 ± 32 ms). T2 relaxation times were elevated in HFmrEF (55.4 ± 3.4 ms) and HFrEF (56.0 ± 6.0 ms) compared to healthy controls (50.6 ± 2.1 ms). Differences in ECV did not reach statistical significance. HFmrEF differs from healthy controls and shares similarities with HFrEF in cardiac MRI parameters of fibrosis and inflammation.
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23
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Cruz G, Jaubert O, Botnar RM, Prieto C. Cardiac Magnetic Resonance Fingerprinting: Technical Developments and Initial Clinical Validation. Curr Cardiol Rep 2019; 21:91. [PMID: 31352620 PMCID: PMC6661029 DOI: 10.1007/s11886-019-1181-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Magnetic resonance imaging (MRI) has enabled non-invasive myocardial tissue characterization in a wide range of cardiovascular diseases by quantifying several tissue specific parameters such as T1, T2, and T2* relaxation times. Simultaneous assessment of these parameters has recently gained interest to potentially improve diagnostic accuracy and enable further understanding of the underlying disease. However, these quantitative maps are usually acquired sequentially and are not necessarily co-registered, making multi-parametric analysis challenging. Magnetic resonance fingerprinting (MRF) has been recently introduced to unify and streamline parametric mapping into a single simultaneous, multi-parametric, fully co-registered, and efficient scan. Feasibility of cardiac MRF has been demonstrated and initial clinical validation studies are ongoing. Provide an overview of the cardiac MRF framework, recent technical developments and initial undergoing clinical validation. RECENT FINDINGS Cardiac MRF has enabled the acquisition of co-registered T1 and T2 maps in a single, efficient scan. Initial results demonstrate feasibility of cardiac MRF in healthy subjects and small patient cohorts. Current in vivo results show a small bias and comparable precision in T1 and T2 with respect to conventional clinical parametric mapping approaches. This bias may be explained by several confounding factors such as magnetization transfer and field inhomogeneities, which are currently not included in the cardiac MRF model. Initial clinical validation for cardiac MRF has demonstrated good reproducibility in healthy subjects and heart transplant patients, reduced artifacts in inflammatory cardiomyopathy patients and good differentiation between hypertrophic cardiomyopathy and healthy controls. Cardiac MRF has emerged as a novel technique for simultaneous, multi-parametric, and co-registered mapping of different tissue parameters. Initial efforts have focused on enabling T1, T2, and fat quantification; however this approach has the potential of enabling quantification of several other parameters (such as T2*, diffusion, perfusion, and flow) from a single scan. Initial results in healthy subjects and patients are promising, thus further clinical validation is now warranted.
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Affiliation(s)
- G. Cruz
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 3rd Floor, Lambeth Wing, St Thomas’ Hospital, London, SE1 7EH UK
| | - O. Jaubert
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 3rd Floor, Lambeth Wing, St Thomas’ Hospital, London, SE1 7EH UK
| | - R. M. Botnar
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 3rd Floor, Lambeth Wing, St Thomas’ Hospital, London, SE1 7EH UK
- Pontificia Universidad Católica de Chile Escuela de Ingeniería, Santiago, Chile
| | - C. Prieto
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 3rd Floor, Lambeth Wing, St Thomas’ Hospital, London, SE1 7EH UK
- Pontificia Universidad Católica de Chile Escuela de Ingeniería, Santiago, Chile
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24
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He M, Xu J, Sun Z, Wang S, Zhu L, Wang X, Wang J, Feng F, Xue H, Jin Z. Comparison and evaluation of the efficacy of compressed SENSE (CS) and gradient- and spin-echo (GRASE) in breath-hold (BH) magnetic resonance cholangiopancreatography (MRCP). J Magn Reson Imaging 2019; 51:824-832. [PMID: 31313426 DOI: 10.1002/jmri.26863] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 06/22/2019] [Accepted: 06/25/2019] [Indexed: 12/14/2022] Open
Abstract
CONTRACT GRANT SPONSOR Chinese Academy of Medical Sciences (CAMS) Initiative for Innovative Medicine; Contract grant number: 2017-I2M-1-001; Contract grant sponsor: Outstanding Youth Fund of Peking Union Medical College Hospital; Contract grant number: JQ201704; Contract grant sponsor: National Natural Science Foundation of China; Contract grant number: 81871512; Contract grant sponsor: National Public Welfare Basic Scientific Research Program of Chinese Academy of Medical Sciences; Contract grant numbers: 2018PT32003 and 2017PT32004. BACKGROUND Both compressed-sensing (CS) and gradient- and spin-echo (GRASE) sequences can achieve 3D magnetic resonance cholangiopancreatography (MRCP) with a single breath-hold (BH). This work hypothesized that compared with conventional navigator-triggered (NT)-MRCP, the two BH-MRCP protocols, GRASE and CS, may provide better imaging quality, especially for patients with irregular breathing. PURPOSE To evaluate and compare the image quality and diagnostic performance of three MRCP protocols. STUDY TYPE Prospective. SUBJECTS Seventy-four patients suspected to have duct-related pathologies were enrolled. FIELD STRENGTH 3.0T. SEQUENCES NT-MRCP, BH-CS-MRCP, and BH-GRASE-MRCP. ASSESSMENT Breath regularity was evaluated subjectively according to the respiratory waves. The acquisition time was compared. The pancreaticobiliary system was divided into 12 segments and evaluated on a 5-point scale. The diagnostic performance of the three MRCPs was evaluated and compared. STATISTICAL TESTS The Friedman test with a post-hoc test, receiver operating characteristic (ROC) curve analysis, McNemar test, and Kendall's W test were used. RESULTS The BH-MRCP decreased the scan time significantly (P < 0.05). The overall imaging scores of GRASE-MRCP and CS-MRCP were significantly higher than that of NT-MRCP for patients with irregular breathing (4.283 and 4.283 vs. 3.000, both P < 0.05). Compared with NT-MRCP, the diagnostic performance of BH-CS and BH-GRASE MRCP was significantly improved for patients with irregular breathing (AUC = 0.860 and 0.863 vs. 0.572, both P < 0.001). DATA CONCLUSION Compared with conventional NT-MRCP, the overall imaging quality and diagnostic performance of BH-CS and BH-GRASE MRCP were not significantly different for patients with regular breathing and significantly superior for patients with irregular breathing. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:824-832.
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Affiliation(s)
- Ming He
- The Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medicine Beijing, China
| | - Jin Xu
- The Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medicine Beijing, China
| | - Zhaoyong Sun
- The Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medicine Beijing, China
| | - Shitian Wang
- The Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medicine Beijing, China
| | - Liang Zhu
- The Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medicine Beijing, China
| | | | | | - Feng Feng
- The Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medicine Beijing, China
| | - Huadan Xue
- The Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medicine Beijing, China
| | - Zhengyu Jin
- The Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medicine Beijing, China
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Adams LC, Bressem KK, Jurmeister P, Fahlenkamp UL, Ralla B, Engel G, Hamm B, Busch J, Makowski MR. Use of quantitative T2 mapping for the assessment of renal cell carcinomas: first results. Cancer Imaging 2019; 19:35. [PMID: 31174616 PMCID: PMC6555952 DOI: 10.1186/s40644-019-0222-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/27/2019] [Indexed: 12/19/2022] Open
Abstract
Background Correct staging and grading of patients with clear cell renal cell carcinoma (cRCC) is of clinical relevance for the prediction of operability and for individualized patient management. As partial or radial resection with postoperative tumor grading currently remain the methods of choice for the classification of cRCC, non-invasive preoperative alternatives to differentiate lower grade from higher grade cRCC would be beneficial. Methods This institutional-review-board approved cross-sectional study included twenty-seven patients (8 women, mean age ± SD, 61.3 ± 14.2) with histopathologically confirmed cRCC, graded according to the International Society of Urological Pathology (ISUP). A native, balanced steady-state free precession T2 mapping sequence (TrueFISP) was performed at 1.5 T. Quantitative T2 values were measured with circular 2D ROIs in the solid tumor portion and also in the normal renal parenchyma (cortex and medulla). To estimate the optimal cut-off T2 value for identifying lower grade cRCC, a Receiver Operating Characteristic Curve (ROC) analysis was performed and sensitivity and specificity were calculated. Students’ t-tests were used to evaluate the differences in mean values for continuous variables, while intergroup differences were tested for significance with two-tailed Mann-Whitney-U tests. Results There were significant differences between the T2 values for lower grade (ISUP 1–2) and higher grade (ISUP 3–4) cRCC (p < 0.001), with higher T2 values for lower grade cRCC compared to higher grade cRCC. The sensitivity and specificity for the differentiation of lower grade from higher grade tumors were 83.3% (95% CI: 0.59–0.96) and 88.9% (95% CI: 0.52–1.00), respectively, using a threshold value of ≥110 ms. Intraobserver/interobserver agreement for T2 measurements was excellent/substantial. Conclusions Native T2 mapping based on a balanced steady-state free precession MR sequence might support an image-based distinction between lower and higher grade cRCC in a two-tier-system and could be a helpful addition to multiparametric imaging. Electronic supplementary material The online version of this article (10.1186/s40644-019-0222-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lisa C Adams
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany.
| | - Keno K Bressem
- Department of Radiology, Charité, Hindenburgdamm 30, 12203, Berlin, Germany
| | | | - Ute L Fahlenkamp
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Bernhard Ralla
- Department of Urology, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Guenther Engel
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Jonas Busch
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | - Marcus R Makowski
- Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany
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Abstract
OBJECTIVE. For many years, MRI of the musculoskeletal system has relied mostly on conventional sequences with qualitative analysis. More recently, using quantitative MRI applications to complement qualitative imaging has gained increasing interest in the MRI community, providing more detailed physiologic or anatomic information. CONCLUSION. In this article, we review the current state of quantitative MRI, technical and software advances, and the most relevant clinical and research musculoskeletal applications of quantitative MRI.
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Myocardial T1 and T2 mapping in severe aortic stenosis: Potential novel insights into the pathophysiology of myocardial remodelling. Eur J Radiol 2018; 107:76-83. [PMID: 30292277 DOI: 10.1016/j.ejrad.2018.08.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 08/06/2018] [Accepted: 08/20/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE Severe aortic stenosis (AS) is known to be associated with substantial myocardial remodelling, leading to diffuse myocardial fibrosis (DMF). Native myocardial T1 is emerging as a novel imaging biomarker for the non-invasive assessment of DMF. In contrast, no studies exist elucidating changes of myocardial T2 reflecting myocardial oedema in the presence of AS. The purpose of the present study was to combine native T1 and T2 mapping in order to characterize myocardial tissue changes in the setting of severe AS. METHODS After obtaining ethical approval and informed consent, a total of 26 prospectively selected patients with severe AS (13 women, mean age 81 ± 7 years) and 17 healthy controls (12 women, mean age 63 ± 6 years) underwent cardiac magnetic resonance (CMR) imaging on a clinical 3 T scanner. The CMR protocol included a native Modified Look-Locker (MOLLI) T1 mapping and a Gradient Spin Echo (GraSE) T2-mapping sequence in three short-axis slices and one long-axis view. After segmentation, myocardial T1 and T2 values were averaged over the entire myocardium. Statistical analysis was performed using Wilcoxon sum-rank test, Welch's independent t-test and Pearson's correlation coefficient. RESULTS Global native myocardial T1 was significantly increased in AS patients when compared to controls (1305 ± 39 vs. 1272 ± 21 ms, p = .005). Similarly, mean myocardial T2 was significantly elevated in AS patients (51 ± 4 vs. 46 ± 2 ms, p < .001) and showed a strong correlation with native T1 (r = .60, p < .001). An overlap was observed between T1 of both groups, whereas T2 discriminated nearly perfectly between the two groups (area under the curve in ROC analyses: 0.76 for T1, 0.87 for T2). CONCLUSIONS Patients with severe AS exhibit significantly elevated native myocardial T1, which has previously been shown to correlate with the amount of myocardial collagen. Adding to this evidence, the present study is the first to show that native T1 and T2 are both significantly elevated and correlated in AS patients, pointing towards a potential role of oedematous/inflammatory processes in the pathophysiology of myocardial remodelling associated with AS.
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Baessler B, Luecke C, Lurz J, Klingel K, von Roeder M, de Waha S, Besler C, Maintz D, Gutberlet M, Thiele H, Lurz P. Cardiac MRI Texture Analysis of T1 and T2 Maps in Patients with Infarctlike Acute Myocarditis. Radiology 2018; 289:357-365. [PMID: 30084736 DOI: 10.1148/radiol.2018180411] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Purpose To assess the diagnostic potential of texture analysis applied to T1 and T2 maps obtained with cardiac MRI for the diagnosis of acute infarctlike myocarditis. Materials and Methods This prospective study from August 2012 to May 2015 included 39 participants (overall mean age ± standard deviation, 34.7 years ± 12.2 [range, 18-63 years]; mean age of women, 46.1 years ± 10.8 [range, 24-63 years]; mean age of men, 29.8 years ± 9.2 [range, 18-56 years]) from the Magnetic Resonance Imaging in Myocarditis (MyoRacer) trial with clinical suspicion of acute myocarditis and infarctlike presentation. Participants underwent biventricular endomyocardial biopsy, cardiac catheterization, and cardiac MRI at 1.5 T, in which native T1 and T2 mapping as well as Lake Louise criteria (LLC) were assessed. Texture analysis was applied on T1 and T2 maps by using a freely available software package. Stepwise dimension reduction and texture feature selection was performed for selecting features enabling the diagnosis of myocarditis by using endomyocardial biopsy as the reference standard. Results Endomyocardial biopsy confirmed the diagnosis of acute myocarditis in 26 patients, whereas 13 participants had no signs of acute inflammation. Mean T1 and T2 values and LLC showed a low diagnostic performance, with area under the curve in receiver operating curve analyses as follows: 0.65 (95% confidence interval [CI]: 0.45, 0.85) for T1, 0.67 (95% CI: 0.49, 0.85) for T2, and 0.62 (95% CI: 0.42, 0.79) for LLC. Combining the texture features T2 run-length nonuniformity and gray-level nonuniformity resulted in higher diagnostic performance with an area under the curve of 0.88 (95% CI: 0.73, 1.00) (P < .001) and a sensitivity and specificity of 89% [95% CI: 81%, 93%] and 92% [95% CI: 77%, 93%], respectively. Conclusion Texture analysis of T2 maps shows high sensitivity and specificity for the diagnosis of acute infarctlike myocarditis. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Bettina Baessler
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
| | - Christian Luecke
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
| | - Julia Lurz
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
| | - Karin Klingel
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
| | - Maximilian von Roeder
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
| | - Suzanne de Waha
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
| | - Christian Besler
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
| | - David Maintz
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
| | - Matthias Gutberlet
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
| | - Holger Thiele
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
| | - Philipp Lurz
- From the Department of Radiology, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany (B.B., D.M.); Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany (C.L., M.G.); Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany (J.L., M.v.R., C.B., H.T., P.L.); Department of Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany (K.K.); Department of Cardiology, Angiology, and Intensive Care Medicine, University Heart Center Luebeck, Luebeck, Germany (S.d.W.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany (S.d.W.); and Leipzig Heart Institute, Leipzig, Germany (M.G., H.T., P.L.)
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Darçot E, Yerly J, Colotti R, Masci PG, Chaptinel J, Feliciano H, Bianchi V, van Heeswijk RB. Accelerated and high-resolution cardiac T 2 mapping through peripheral k-space sharing. Magn Reson Med 2018; 81:220-233. [PMID: 30058085 DOI: 10.1002/mrm.27374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/26/2018] [Accepted: 05/01/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE To develop high-spatial-resolution cardiac T2 mapping that allows for a reduced acquisition time while maintaining its precision. We implemented and optimized a new golden-angle radial T2 mapping technique named SKRATCH (Shared k-space Radial T2 Characterization of the Heart) that shares k-space peripheries of T2 -weighted images while preserving their contrasts. METHODS Six SKRATCH variants (gradient-recalled echo and balanced SSFP, free-breathing and breath-held, with and without a saturation preparation) were implemented, and their precision was compared with a navigator-gated reference technique in phantoms and 22 healthy volunteers at 3 T. The optimal breath-held SKRATCH technique was applied in a small cohort of patients with subacute myocardial infarction. RESULTS The faster free-breathing SKRATCH technique reduced the acquisition time by 52.4%, while maintaining the precision and spatial resolution of the reference technique. Similarly, the most precise and robust breath-held SKRATCH technique demonstrated homogenous T2 values that did not significantly differ from the navigator-gated reference (T2 = 39.9 ± 3.4 ms versus 39.5 ± 3.4 ms, P > .20, respectively). All infarct patients demonstrated a large T2 elevation in the ischemic regions of the myocardium. CONCLUSION The optimized SKRATCH technique enabled the accelerated acquisition of high-spatial-resolution T2 maps, was validated in healthy adult volunteers, and was successfully applied to a small initial group of patients.
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Affiliation(s)
- Emeline Darçot
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland.,Center for Biomedical Imaging, Lausanne and Geneva, Switzerland
| | - Roberto Colotti
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pier Giorgio Masci
- Center for Cardiac Magnetic Resonance, Cardiology Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Jerome Chaptinel
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Helene Feliciano
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Veronica Bianchi
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ruud B van Heeswijk
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland.,Center for Biomedical Imaging, Lausanne and Geneva, Switzerland
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Bohnen S, Radunski UK, Lund GK, Ojeda F, Looft Y, Senel M, Radziwolek L, Avanesov M, Tahir E, Stehning C, Schnackenburg B, Adam G, Blankenberg S, Muellerleile K. Tissue characterization by T1 and T2 mapping cardiovascular magnetic resonance imaging to monitor myocardial inflammation in healing myocarditis. Eur Heart J Cardiovasc Imaging 2018; 18:744-751. [PMID: 28329275 DOI: 10.1093/ehjci/jex007] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 01/16/2017] [Indexed: 12/18/2022] Open
Abstract
Aims Monitoring disease activity in myocarditis is important for tailored therapeutic strategies. This study evaluated the ability of T1 and T2 mapping cardiovascular magnetic resonance (CMR) to monitor the course of myocardial inflammation in healing myocarditis. Methods and Results Forty-eight patients with strictly defined acute myocarditis underwent CMR at 1.5 T in the acute stage, at 3-months (n = 39), and at 12-months follow-up (FU) (n = 21). Normal values were obtained in a control group of 27 healthy subjects. The CMR protocol included standard ('Lake-Louise') sequences as well as T1 (modified Look-Locker inversion recovery sequence, MOLLI) and T2 (gradient- and spin-echo sequence, GraSE) mapping. T1, T2, and extracellular volume (ECV) maps were generated using an OsiriX plug-in. Native myocardial T1, T2, and ECV values were increased in the acute stage, but declined with healing of myocarditis. The performances of global native T1 and T2 to differentiate acute from healed myocarditis stages were significantly better compared with all other global CMR parameters with AUCs of 0.85 (95% CI, 0.76-0.94) and 0.83 (95% CI, 0.73-0.93). Furthermore, regional native T1 and T2 in myocarditis lesions provided AUCs of 0.97 (95% CI, 0.93-1.02) and 0.93 (95% CI, 0.85-1.01), which were significantly superior to any other global or regional CMR parameter. Conclusion Healing of myocarditis can be monitored by native myocardial T1 and T2 measurements without the need for contrast media. Both native myocardial T1 and T2 provide an excellent performance for assessing the stage of myocarditis by CMR.
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Affiliation(s)
- S Bohnen
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - U K Radunski
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - G K Lund
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - F Ojeda
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - Y Looft
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - M Senel
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - L Radziwolek
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - M Avanesov
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - E Tahir
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - C Stehning
- Philips GmbH Market DACH, Roentgenstr. 22, 22335 Hamburg
| | | | - G Adam
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - S Blankenberg
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - K Muellerleile
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
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Magnetic resonance cholangiopancreatography with GRASE sequence at 3.0T: does it improve image quality and acquisition time as compared with 3D TSE? Eur Radiol 2018; 28:2436-2443. [DOI: 10.1007/s00330-017-5240-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 11/24/2017] [Accepted: 12/05/2017] [Indexed: 12/16/2022]
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Manning WJ. Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston. J Cardiovasc Magn Reson 2017; 19:108. [PMID: 29284487 PMCID: PMC5747150 DOI: 10.1186/s12968-017-0423-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 02/06/2023] Open
Abstract
The Journal of Cardiovascular Magnetic Resonance (JCMR) is the official publication of the Society for Cardiovascular Magnetic Resonance (SCMR). In 2016, the JCMR published 93 manuscripts, including 80 research papers, 6 reviews, 5 technical notes, 1 protocol, and 1 case report. The number of manuscripts published was similar to 2015 though with a 12% increase in manuscript submissions to an all-time high of 369. This reflects a decrease in the overall acceptance rate to <25% (excluding solicited reviews). The quality of submissions to JCMR continues to be high. The 2016 JCMR Impact Factor (which is published in June 2016 by Thomson Reuters) was steady at 5.601 (vs. 5.71 for 2015; as published in June 2016), which is the second highest impact factor ever recorded for JCMR. The 2016 impact factor means that the JCMR papers that were published in 2014 and 2015 were on-average cited 5.71 times in 2016.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in the order that they are accepted with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful to annually summarize the publications into broad areas of interest or themes, so that readers can view areas of interest in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes with previously published JCMR papers to guide continuity of thought in the journal. In addition, I have elected to open this publication with information for the readership regarding the transition of the JCMR editorial office to the Beth Israel Deaconess Medical Center, Boston and the editorial process.Though there is an author publication charge (APC) associated with open-access to cover the publisher's expenses, this format provides a much wider distribution/availability of the author's work and greater manuscript citation. For SCMR members, there is a substantial discount in the APC. I hope that you will continue to send your high quality manuscripts to JCMR for consideration. Importantly, I also ask that you consider referencing recent JCMR publications in your submissions to the JCMR and elsewhere as these contribute to our impact factor. I also thank our dedicated Associate Editors, Guest Editors, and reviewers for their many efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the leading publication in our field.
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Affiliation(s)
- Warren J Manning
- From the Journal of Cardiovascular Magnetic Resonance Editorial Office and the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Franke M, Baeßler B, Vechtel J, Dafinger C, Höhne M, Borgal L, Göbel H, Koerber F, Maintz D, Benzing T, Schermer B, Persigehl T. Magnetic resonance T2 mapping and diffusion-weighted imaging for early detection of cystogenesis and response to therapy in a mouse model of polycystic kidney disease. Kidney Int 2017; 92:1544-1554. [DOI: 10.1016/j.kint.2017.05.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/03/2017] [Accepted: 05/25/2017] [Indexed: 12/19/2022]
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Baeßler B, Treutlein M, Schaarschmidt F, Stehning C, Schnackenburg B, Michels G, Maintz D, Bunck AC. A novel multiparametric imaging approach to acute myocarditis using T2-mapping and CMR feature tracking. J Cardiovasc Magn Reson 2017; 19:71. [PMID: 28931401 PMCID: PMC5607501 DOI: 10.1186/s12968-017-0387-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 09/12/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the diagnostic potential of a novel cardiovascular magnetic resonance (CMR) based multiparametric imaging approach in suspected myocarditis and to compare it to traditional Lake Louise criteria (LLC). METHODS CMR data from 67 patients with suspected acute myocarditis were retrospectively analyzed. Seventeen age- and gender-matched healthy subjects served as control. T2-mapping data were acquired using a Gradient-Spin-Echo T2-mapping sequence in short-axis orientation. T2-maps were segmented according to the 16-segments AHA-model and segmental T2 values and pixel-standard deviation (SD) were recorded. Afterwards, the parameters maxT2 (the highest segmental T2 value) and madSD (the mean absolute deviation (MAD) of the pixel-SDs) were calculated for each subject. Cine sequences in three long axes and a stack of short-axis views covering the left and right ventricle were analyzed using a dedicated feature tracking algorithm. RESULTS A multiparametric imaging model containing madSD and LV global circumferential strain (GCSLV) resulted in the highest diagnostic performance in receiver operating curve analyses (area under the curve [AUC] 0.84) when compared to any model containing a single imaging parameter or to LLC (AUC 0.79). Adding late gadolinium enhancement (LGE) to the model resulted in a further increased diagnostic performance (AUC 0.93) and yielded the highest diagnostic sensitivity of 97% and specificity of 77%. CONCLUSIONS A multiparametric CMR imaging model including the novel T2-mapping derived parameter madSD, the feature tracking derived strain parameter GCSLV and LGE yields superior diagnostic sensitivity in suspected acute myocarditis when compared to any imaging parameter alone and to LLC.
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Affiliation(s)
- Bettina Baeßler
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany
| | - Melanie Treutlein
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany
| | - Frank Schaarschmidt
- Institute of Biostatistics, Faculty of Natural Sciences, Leibniz Universität Hannover, Hannover, Germany
| | | | | | - Guido Michels
- Department III of Internal Medicine, Heart Centre, University Hospital of Cologne, Cologne, Germany
| | - David Maintz
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany
| | - Alexander C. Bunck
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany
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Re-evaluation of a novel approach for quantitative myocardial oedema detection by analysing tissue inhomogeneity in acute myocarditis using T2-mapping. Eur Radiol 2017; 27:5169-5178. [DOI: 10.1007/s00330-017-4894-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 03/10/2017] [Accepted: 05/12/2017] [Indexed: 02/06/2023]
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Radunski UK, Bohnen S, Lund GK, Lindner D, Westermann D, Adam G, Blankenberg S, Muellerleile K. Advances in Quantitative Tissue Characterization in Myocarditis. CURRENT CARDIOVASCULAR IMAGING REPORTS 2017. [DOI: 10.1007/s12410-017-9398-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Pennell DJ, Baksi AJ, Prasad SK, Mohiaddin RH, Alpendurada F, Babu-Narayan SV, Schneider JE, Firmin DN. Review of Journal of Cardiovascular Magnetic Resonance 2015. J Cardiovasc Magn Reson 2016; 18:86. [PMID: 27846914 PMCID: PMC5111217 DOI: 10.1186/s12968-016-0305-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 11/02/2016] [Indexed: 12/14/2022] Open
Abstract
There were 116 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2015, which is a 14 % increase on the 102 articles published in 2014. The quality of the submissions continues to increase. The 2015 JCMR Impact Factor (which is published in June 2016) rose to 5.75 from 4.72 for 2014 (as published in June 2015), which is the highest impact factor ever recorded for JCMR. The 2015 impact factor means that the JCMR papers that were published in 2013 and 2014 were cited on average 5.75 times in 2015. 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 papers to JCMR for publication.
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Affiliation(s)
- D. J. Pennell
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - A. J. Baksi
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - S. K. Prasad
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - R. H. Mohiaddin
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - F. Alpendurada
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - S. V. Babu-Narayan
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - J. E. Schneider
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - D. N. Firmin
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
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Comparison of Image Processing Techniques for Nonviable Tissue Quantification in Late Gadolinium Enhancement Cardiac Magnetic Resonance Images. J Thorac Imaging 2016; 31:168-76. [DOI: 10.1097/rti.0000000000000206] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Baeßler B, Schaarschmidt F, Stehning C, Schnackenburg B, Giolda A, Maintz D, Bunck AC. Reproducibility of three different cardiac T 2 -mapping sequences at 1.5T. J Magn Reson Imaging 2016; 44:1168-1178. [PMID: 27043352 DOI: 10.1002/jmri.25258] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/15/2016] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To elucidate the impact of technical and intraindividual reproducibility on the overall variability of myocardial T2 relaxation times. MATERIALS AND METHODS Thirty healthy volunteers were examined three times (day 1 morning/evening, evening after 2-3 weeks) at 1.5T. During each examination three different T2 -mapping sequences were acquired twice at three slices in short axis view: multi-echo-spin-echo (MESE), T2 -prepared balanced steady-state free precession (SSFP) (T2 prep), and gradient-spin-echo with and without fat saturation (GraSE/GraSEFS ). Repeated measurements were performed for T2 prep and GraSE. Segmented T2 -maps were generated for each slice according to the American Heart Association (AHA) 16-segment model. RESULTS The coefficients of variation and intraclass correlation coefficients for intraobserver variability were: 1.3% and 0.89 for T2 prep, 1.5% and 0.93 for GraSE, 3.1% and 0.83 for MESE; and for interobserver variability: 3.3% and 0.66 for T2 prep, 2.0% and 0.83 for GraSE, 3.6% and 0.77 for MESE. No systematic difference of T2 times was observed due to diurnal effects and on long-term analysis using one-way analysis of variance (ANOVA) with Tukey-type multiple comparisons (morning vs. evening scan for T2 prep: 52.5 ± 2.4 vs. 51.7 ± 2.7 msec, P = 0.119; for GraSE: 58.6 ± 4.0 vs. 58.5 ± 3.8 msec, P = 0.984; for GraSEFS 57.1 ± 3.2 vs. 57.2 ± 3.9 msec, P = 0.998, and for MESE: 53.8 ± 2.7 vs. 53.3 ± 3.3 msec, P = 0.541; scans between weeks for T2 prep: 51.7 ± 2.7 vs. 51.4 ± 2.4 msec, P = 0.873; for GraSE: 58.5 ± 3.8 vs. 58.1 ± 3.4 msec, P = 0.736; for GraSEFS : 57.2 ± 3.9 vs. 57.0 ± 4.6 msec, P = 0.964, and for MESE: 53.3 ± 3.3 vs. 53.4 ± 2.4 msec, P = 0.970). ANOVA components, however, demonstrated a greater variance of T2 times over multiple timepoints than for repeated measurements within the same scan (variance components of the model fit for intraday variance vs. repeated measurements: T2 prep 2.22 vs. 1.36, GraSE 3.76 vs. 2.09, GraSEFS 3.96 vs. 1.58, MESE 1.86; and for interweeks variance vs. repeated measurements: T2 prep 2.21 vs. 0.80, GraSE 3.20 vs. 2.10, GraSEFS 8.82 vs. 1.18, and MESE 4.49). CONCLUSION Technical reproducibility and intra- and interobserver agreement of myocardial T2 relaxation times are excellent and intraindividual variation over time is small. Therefore, we consider subject-related factors to explain most of the interindividual variability of myocardial T2 times reported in previous studies. The acknowledgment of this subject-related, biological variability may be important for the future diagnostic value of T2 -mapping. J. Magn. Reson. Imaging 2016;44:1168-1178.
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Affiliation(s)
- Bettina Baeßler
- Department of Radiology, University Hospital of Cologne, Germany.
| | - Frank Schaarschmidt
- Institute of Biostatistics, Faculty of Natural Sciences, Leibniz Universität Hannover, Germany
| | | | | | - Agathe Giolda
- Department of Radiology, University Hospital of Cologne, Germany
| | - David Maintz
- Department of Radiology, University Hospital of Cologne, Germany
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Krumm P, Martirosian P, Rath D, Zitzelsberger T, Ruff CA, Klumpp BD, Nikolaou K, Gawaz M, Geisler T, Schick F, Kramer U. Signal decay mapping of myocardial edema using dual-contrast fast spin-echo MRI. J Magn Reson Imaging 2015; 44:186-93. [PMID: 26717865 DOI: 10.1002/jmri.25142] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 12/10/2015] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To introduce a dual-contrast fast spin-echo (dcFSE) sequence for signal decay mapping of myocardial edema. MATERIALS AND METHODS After consultation with the Institutional Review Board, 22 acute myocardial infarction (MI) patients were examined with magnetic resonance imaging (MRI) at 1.5T 2 days after revascularization. Edema was evaluated in 16 myocardial segments with an exponential fit for signal decay time (SDT) in dcFSE mapping and T2 signal intensity ratio for single-contrast FSE. Myocardial viability was evaluated in late gadolinium enhancement (LGE). A control group of 10 volunteers was examined for edema imaging. SDT was compared in segment groups: 1) with LGE in MI, 2) penumbra, 3) remote from LGE, 4) controls. Groups 1/3 and 3/4 were tested on difference. Three phantoms providing similar T2 but different T1 relaxation times (low, intermediate, high) were examined with dcFSE and multicontrast spin echo sequence as a reference. RESULTS The SDT/T2 ratio for segment groups was 1) 82msec/1.7 in segments with LGE; 2) 65msec/1.6 for penumbra, 3) 62msec/1.7 for remote segments, and 4) 50msec/1.6 in controls. In dcFSE group 1/3 (P < 0.0001) and in group 3/4 (P = 0.0002) SDT was significantly different. In single-contrast FSE the T2 ratio was not significantly different for both tests: 1/3 P = 0.1889; 3/4 P = 0.8879. T2 -overestimation of dcFSE was 23% in low, 29% in intermediate, and 35% in highly T1 contaminated phantoms. CONCLUSION dcFSE signal decay edema mapping is feasible in volunteers and patients. DcFSE SDT is superior to T2 ratio for detection of high-grade and diffuse myocardial edema. J. Magn. Reson. Imaging 2016;44:186-193.
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Affiliation(s)
- Patrick Krumm
- Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tübingen, Germany
| | - Petros Martirosian
- Department of Diagnostic and Interventional Radiology, Section on Experimental Radiology, Eberhard Karls University, Tübingen, Germany
| | - Dominik Rath
- Department of Cardiology and Cardiovascular Medicine, Eberhard Karls University, Tübingen, Germany
| | - Tanja Zitzelsberger
- Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tübingen, Germany
| | - Christer Andreas Ruff
- Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tübingen, Germany
| | - Bernhard Daniel Klumpp
- Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tübingen, Germany
| | - Meinrad Gawaz
- Department of Cardiology and Cardiovascular Medicine, Eberhard Karls University, Tübingen, Germany
| | - Tobias Geisler
- Department of Cardiology and Cardiovascular Medicine, Eberhard Karls University, Tübingen, Germany
| | - Fritz Schick
- Department of Diagnostic and Interventional Radiology, Section on Experimental Radiology, Eberhard Karls University, Tübingen, Germany
| | - Ulrich Kramer
- Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tübingen, Germany
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Baeßler B, Schaarschmidt F, Dick A, Stehning C, Schnackenburg B, Michels G, Maintz D, Bunck AC. Mapping tissue inhomogeneity in acute myocarditis: a novel analytical approach to quantitative myocardial edema imaging by T2-mapping. J Cardiovasc Magn Reson 2015; 17:115. [PMID: 26700020 PMCID: PMC4690253 DOI: 10.1186/s12968-015-0217-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/09/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The purpose of the present study was to investigate the diagnostic value of T2-mapping in acute myocarditis (ACM) and to define cut-off values for edema detection. METHODS Cardiovascular magnetic resonance (CMR) data of 31 patients with ACM were retrospectively analyzed. 30 healthy volunteers (HV) served as a control. Additionally to the routine CMR protocol, T2-mapping data were acquired at 1.5 T using a breathhold Gradient-Spin-Echo T2-mapping sequence in six short axis slices. T2-maps were segmented according to the 16-segments AHA-model and segmental T2 values as well as the segmental pixel-standard deviation (SD) were analyzed. RESULTS Mean differences of global myocardial T2 or pixel-SD between HV and ACM patients were only small, lying in the normal range of HV. In contrast, variation of segmental T2 values and pixel-SD was much larger in ACM patients compared to HV. In random forests and multiple logistic regression analyses, the combination of the highest segmental T2 value within each patient (maxT2) and the mean absolute deviation (MAD) of log-transformed pixel-SD (madSD) over all 16 segments within each patient proved to be the best discriminators between HV and ACM patients with an AUC of 0.85 in ROC-analysis. In classification trees, a combined cut-off of 0.22 for madSD and of 68 ms for maxT2 resulted in 83% specificity and 81% sensitivity for detection of ACM. CONCLUSIONS The proposed cut-off values for maxT2 and madSD in the setting of ACM allow edema detection with high sensitivity and specificity and therefore have the potential to overcome the hurdles of T2-mapping for its integration into clinical routine.
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Affiliation(s)
- Bettina Baeßler
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne, Germany.
| | - Frank Schaarschmidt
- Institute of Biostatistics, Faculty of Natural Sciences, Leibniz Universität Hannover, Hannover, Germany.
| | - Anastasia Dick
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne, Germany.
| | | | | | - Guido Michels
- Department III of Internal Medicine, Heart Centre, University Hospital of Cologne, Cologne, Germany.
| | - David Maintz
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne, Germany.
| | - Alexander C Bunck
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne, Germany.
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