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Qin C, Murali S, Lee E, Supramaniam V, Hausenloy DJ, Obungoloch J, Brecher J, Lin R, Ding H, Akudjedu TN, Anazodo UC, Jagannathan NR, Ntusi NAB, Simonetti OP, Campbell-Washburn AE, Niendorf T, Mammen R, Adeleke S. Sustainable low-field cardiovascular magnetic resonance in changing healthcare systems. Eur Heart J Cardiovasc Imaging 2022; 23:e246-e260. [PMID: 35157038 PMCID: PMC9159744 DOI: 10.1093/ehjci/jeab286] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022] Open
Abstract
Cardiovascular disease continues to be a major burden facing healthcare systems worldwide. In the developed world, cardiovascular magnetic resonance (CMR) is a well-established non-invasive imaging modality in the diagnosis of cardiovascular disease. However, there is significant global inequality in availability and access to CMR due to its high cost, technical demands as well as existing disparities in healthcare and technical infrastructures across high-income and low-income countries. Recent renewed interest in low-field CMR has been spurred by the clinical need to provide sustainable imaging technology capable of yielding diagnosticquality images whilst also being tailored to the local populations and healthcare ecosystems. This review aims to evaluate the technical, practical and cost considerations of low field CMR whilst also exploring the key barriers to implementing sustainable MRI in both the developing and developed world.
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Affiliation(s)
- Cathy Qin
- Department of Imaging, Imperial College Healthcare NHS Trust, London, UK
| | - Sanjana Murali
- Department of Imaging, Imperial College Healthcare NHS Trust, London, UK
| | - Elsa Lee
- School of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | | | - Derek J Hausenloy
- Division of Medicine, University College London, London, UK
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore, Singapore
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Hatter Cardiovascular Institue, UCL Institute of Cardiovascular Sciences, University College London, London, UK
- Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Johnes Obungoloch
- Department of Biomedical Engineering, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Rongyu Lin
- School of Medicine, University College London, London, UK
| | - Hao Ding
- Department of Imaging, Imperial College Healthcare NHS Trust, London, UK
| | - Theophilus N Akudjedu
- Institute of Medical Imaging and Visualisation, Faculty of Health and Social Science, Bournemouth University, Poole, UK
| | | | - Naranamangalam R Jagannathan
- Department of Electrical Engineering, Indian Institute of Technology, Chennai, India
- Department of Radiology, Sri Ramachandra University Medical College, Chennai, India
- Department of Radiology, Chettinad Hospital and Research Institute, Kelambakkam, India
| | - Ntobeko A B Ntusi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Orlando P Simonetti
- Division of Cardiovascular Medicine, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Department of Radiology, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Adrienne E Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrück Centre for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Regina Mammen
- Department of Cardiology, The Essex Cardiothoracic Centre, Basildon, UK
| | - Sola Adeleke
- School of Cancer & Pharmaceutical Sciences, King’s College London, Queen Square, London WC1N 3BG, UK
- High Dimensional Neurology, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
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Varghese J, Craft J, Crabtree CD, Liu Y, Jin N, Chow K, Ahmad R, Simonetti OP. Assessment of cardiac function, blood flow and myocardial tissue relaxation parameters at 0.35 T. NMR IN BIOMEDICINE 2020; 33:e4317. [PMID: 32363644 DOI: 10.1002/nbm.4317] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/27/2020] [Accepted: 04/05/2020] [Indexed: 06/11/2023]
Abstract
A low field strength (B0) system could increase cardiac MRI availability for patients otherwise contraindicated at higher field. Lower equipment costs could also broaden cardiac MR accessibility. The current study investigated the feasibility of cardiac function with steady-state free precession and flow assessment with phase contrast (PC) cine images at 0.35 T, and evaluated differences in myocardial relaxation times using quantitative T1, T2 and T2* maps by comparison with 1.5 and 3 T results in a small cohort of six healthy volunteers. Signal-to-noise ratio (SNR) differences across systems were characterized with proton density-weighted spin echo phantom data. SNR at 0.35 T was lower by factors of 5.5 and 15.0 compared with the 1.5 and 3 T systems used in this study. All cine images at 0.35 T scored 3 or greater on a five-point image quality scale. Normalized blood-myocardium contrast in cine images, left ventricular volumes (end diastolic volume, end systolic volume) and function (ejection fraction and stroke volume) measures at 0.35 T matched 1.5 and 3 T results. Phase-to-noise ratio in 0.35 T PC images (11.7 ± 1.9) was lower than 1.5 T (18.7 ± 5.2) and 3 T (44.9 ± 16.5). Peak velocity and stroke volume determined from PC images were similar across systems. Myocardial T1 increased (564 ± 13 ms at 0.35 T, 955 ± 19 ms at 1.5 T and 1200 ± 35 ms at 3 T) while T2 (59 ± 4 ms at 0.35 T, 49 ± 3 ms at 1.5 T and 40 ± 2 ms at 3 T) and T2* (42 ± 8 ms at 0.35 T, 33 ± 6 ms at 1.5 T and 24 ± 3 ms at 3 T) decreased with increasing B0. Despite SNR deficits, cardiovascular function, flow assessment and myocardial relaxation parameter mapping is feasible at 0.35 T using standard cardiovascular imaging sequences.
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Affiliation(s)
- Juliet Varghese
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jason Craft
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
- St. Francis Hospital, Roslyn, New York, USA
| | - Christopher D Crabtree
- Kinesiology, Health and Exercise Sciences, Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | - Yingmin Liu
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Ning Jin
- Cardiovascular MR R&D, Siemens Medical Solutions, Columbus, Ohio
| | - Kelvin Chow
- Cardiovascular MR R&D, Siemens Medical Solutions, Chicago, Illinois
| | - Rizwan Ahmad
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio
- Department of Electrical and Computer Engineering, The Ohio State University, Columbus, Ohio
| | - Orlando P Simonetti
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
- Department of Radiology, The Ohio State University, Columbus, Ohio
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First-Step PPG Signal Analysis for Evaluation of Stress Induced during Scanning in the Open-Air MRI Device. SENSORS 2020; 20:s20123532. [PMID: 32580364 PMCID: PMC7349840 DOI: 10.3390/s20123532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 12/22/2022]
Abstract
The paper describes first-step experiments with parallel measurement of cardiovascular parameters using a photoplethysmographic optical sensor and standard portable blood pressure monitors in different situations of body relaxation and stimulation. Changes in the human cardiovascular system are mainly manifested by differences in the Oliva–Roztocil index, the instantaneous heart rate, and variations in blood pressure. In the auxiliary experiments, different physiological and psychological stimuli were applied to test whether relaxation and activation phases produce different measured parameters suitable for further statistical analysis and processing. The principal investigation is aimed at analysis of vibration and acoustic noise impact on a physiological and psychological state of a person lying inside the low-field open-air magnetic resonance imager (MRI). The obtained results will be used to analyze, quantify, and suppress a possible stress factor that has an impact on the speech signal recorded during scanning in the MRI device in the research aimed at 3D modeling of the human vocal tract.
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Přibil J, Přibilová A, Frollo I. Analysis of the Influence of Different Settings of Scan Sequence Parameters on Vibration and Noise Generated in the Open-Air MRI Scanning Area. SENSORS 2019; 19:s19194198. [PMID: 31569713 PMCID: PMC6806082 DOI: 10.3390/s19194198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 11/16/2022]
Abstract
A system of gradient coils of the magnetic resonance imaging (MRI) device produces significant vibration and noise. Energetic relations of these phenomena are analyzed depending on MRI scan parameters (sequence type, repetition time (TR), echo time (TE), slice orientation, body weight). This issue should be investigated because of negative physiological and psychological effects on a person exposed to vibration and acoustic noise. We also measured the sound pressure level in the MRI scanning area and its vicinity in order to minimize these negative impacts, depending on intensity and time duration of exposition. From the recorded vibration and noise signals, the energy parameters were determined and statistically analyzed, and the obtained results were visually and numerically compared. Finally, subjective evaluation by a listening test method was used to analyze the influence of the generated MRI noise on the human psyche.
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Affiliation(s)
- Jiří Přibil
- Institute of Measurement Science, Slovak Academy of Sciences, 841 04 Bratislava, Slovakia.
| | - Anna Přibilová
- Institute of Measurement Science, Slovak Academy of Sciences, 841 04 Bratislava, Slovakia.
| | - Ivan Frollo
- Institute of Measurement Science, Slovak Academy of Sciences, 841 04 Bratislava, Slovakia.
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