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Lopes V, Almeida PC, Moreira N, Ferreira LA, Teixeira R, Donato P, Gonçalves L. Computed tomography imaging in preprocedural planning of transcatheter valvular heart interventions. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024:10.1007/s10554-024-03140-9. [PMID: 38780710 DOI: 10.1007/s10554-024-03140-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
Cardiac Computed Tomography (CCT) has become a reliable imaging modality in cardiology providing robust information on the morphology and structure of the heart with high temporal and isotropic spatial resolution. For the past decade, there has been a paradigm shift in the management of valvular heart disease since previously unfavorable candidates for surgery are now provided with less-invasive interventions. Transcatheter heart valve interventions provide a real alternative to medical and surgical management and are often the only treatment option for valvular heart disease patients. Successful transcatheter valve interventions rely on comprehensive multimodality imaging assessment. CCT is the mainstay imaging technique for preprocedural planning of these interventions. CCT is critical in guiding patient selection, choice of procedural access, device selection, procedural guidance, as well as allowing postprocedural follow-up of complications. This article aims to review the current evidence of the role of CCT in the preprocedural planning of patients undergoing transcatheter valvular interventions.
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Affiliation(s)
- Vanessa Lopes
- Cardiology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
| | - Pedro Carvalho Almeida
- Medical Imaging Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
| | - Nádia Moreira
- Cardiology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
| | - Luís Amaral Ferreira
- Medical Imaging Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
| | - Rogério Teixeira
- Cardiology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
- Faculty of Medicine, Univ Coimbra, Coimbra, Portugal
| | - Paulo Donato
- Medical Imaging Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
- Faculty of Medicine, Univ Coimbra, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Biomedical Imaging and Translation Research (CIBIT), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Lino Gonçalves
- Cardiology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
- Faculty of Medicine, Univ Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, Univ Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), Univ Coimbra, Coimbra, Portugal
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2
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Goo HW. Pediatric three-dimensional quantitative cardiovascular computed tomography. Pediatr Radiol 2024:10.1007/s00247-024-05931-7. [PMID: 38755443 DOI: 10.1007/s00247-024-05931-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 05/18/2024]
Abstract
High-resolution, isotropic, 3-dimensional (D) data from pediatric cardiovascular computed tomography (CT) offer great potential for the accurate quantitative evaluation of pediatric cardiovascular and pulmonary vascular diseases. Recent pilot studies using pediatric 3-D cardiovascular CT have shown promising results in assessing cardiac function in conditions such as tetralogy of Fallot, cardiac defects with a hypoplastic ventricle, Ebstein anomaly, and in quantifying myocardial mass. In addition, the quantitative assessment of pulmonary vascularity is useful for evaluating differential right-to-left pulmonary vascular volume ratio, the effectiveness of pulmonary angioplasty, and predicting pulmonary hypertension. These initial experiences could broaden the role of pediatric cardiovascular CT in clinical practice. Furthermore, the current barriers to its widespread use, pertinent solutions to these problems, and new applications are discussed. In this review, the 3-D quantitative evaluations of cardiac function and pulmonary vascularity using high-resolution pediatric cardiovascular CT data are illustrated.
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Affiliation(s)
- Hyun Woo Goo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
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3
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Scott A, Chen Z, Kligerman S, Kim P, Tran H, Adler E, Narezkina A, Contijoch F. Regional Strain of Right Ventricle From Computed Tomography Improves Risk Stratification of Right Ventricle Failure. ASAIO J 2024; 70:358-364. [PMID: 38166039 PMCID: PMC11062830 DOI: 10.1097/mat.0000000000002123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024] Open
Abstract
Patients who undergo implantation of a left ventricular assist device (LVAD) are at a high risk for right ventricular failure (RVF), presumably due to poor right ventricular (RV) function before surgery. Cine computerized tomography (cineCT) can be used to evaluate RV size, function, and endocardial strain. However, CT-based strain measures in patients undergoing workup for LVAD implantation have not been evaluated. We quantified RV strain in the free wall (FW) and septal wall (SW) in patients with end-stage heart failure using cineCT. Compared to controls, both FW and SW strains were significantly impaired in heart failure patients. The difference between FW and SW strains predicted RV failure after LVAD implantation (area-under-the curve [AUC] = 0.82). Cine CT strain can be combined with RV volumetry to risk-stratify patients. In our study, patients with preserved RV volumes and poor strain had a higher rate of RV failure (57%), than those with preserved volume and preserved strain (0%). This suggests that CT could improve risk stratification of patients receiving LVADs and that strain metrics were particularly useful in risk-stratifying patients with preserved RV volumes.
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Affiliation(s)
- Anderson Scott
- Shu Chien-Gene Lay Department of Bioengineering, UC San Diego, La Jolla CA
| | - Zhennong Chen
- Shu Chien-Gene Lay Department of Bioengineering, UC San Diego, La Jolla CA
| | - Seth Kligerman
- Department of Radiology, National Jewish Health, Denver, CO
| | - Paul Kim
- Division of Cardiology, Department of Medicine, UC San Diego, La Jolla CA
| | - Hao Tran
- Division of Cardiology, Department of Medicine, UC San Diego, La Jolla CA
| | - Eric Adler
- Division of Cardiology, Department of Medicine, UC San Diego, La Jolla CA
| | - Anna Narezkina
- Division of Cardiology, Department of Medicine, UC San Diego, La Jolla CA
| | - Francisco Contijoch
- Shu Chien-Gene Lay Department of Bioengineering, UC San Diego, La Jolla CA
- Department of Radiology, UC San Diego, La Jolla CA
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4
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Cheong D, Alloah Q, Fishbein JS, Rajagopal HG. Comparison and Agreement between Cardiovascular Computed Tomography-Derived Mid-Diastolic and End-Diastolic Ventricular Volume in Patients with Congenital Heart Disease. Pediatr Cardiol 2024:10.1007/s00246-024-03504-x. [PMID: 38689021 DOI: 10.1007/s00246-024-03504-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/19/2024] [Indexed: 05/02/2024]
Abstract
Prospective electrocardiogram (ECG)-triggered cardiovascular computed tomography (CCT) is primarily utilized for anatomical information in congenital heart disease (CHD) and has not been utilized for calculation of the end-diastolic volume (EDV); however, the mid-diastolic volume (MDV) may be measured. The objective of this study was to evaluate the feasibility and agreement between ventricular EDV and MDV. 31 retrospectively ECG-gated CCT were analyzed for the study of the 450 consecutive CCT. CCT images were processed using syngo.via with automatic contouring followed by manual adjustment of the endocardial borders of the left ventricles (LV) and right ventricles (RV) at end-diastolic and mid-diastolic phase (measured at 70% of cardiac cycle). The correlation and agreements between EDV and MDV were demonstrated using Spearman rank coefficient and intraclass correlation coefficient (ICC), respectively. Mean age ± SD was 28.8 ± 12.5 years, 19 were male (61.3%) and tetralogy of Fallot (TOF) was the most common diagnosis (58.1%), 35% (11/31) patients with a pacemaker, ICD or other such contraindication for a CMRI, 23% (7/31) with claustrophobia, and 6.5% (2/31) with developmental delay with refusal for sedation did not have a previous CMRI. The mean ± SD indexed LV EDV and LV MDV were 91.1 ± 24.5 and 84.8 ± 22.3 ml/m2, respectively. The mean ± SD indexed RV EDV and RV MDV were 136.8 ± 41 and 130.2 ± 41.5 ml/m2, respectively. EDV and MDV had a strong positive correlation and good agreement (ICC 0.92 for LV and 0.95 for RV). This agreement was preserved in a subset of patients (21) with dilated RV (indexed RV EDV z-score > 2). Intra-observer reliability (0.97 and 0.98 for LV and RV MDV, respectively) and inter-observer reliability (0.96 and 0.90 for LV and RV MDV, respectively) were excellent. In a select group of patients with CHD, measuring MDV by CCT is feasible and these values have good agreements with EDV. This may be used to derive functional data from prospectively ECG-triggered CCT studies. Further large-scale analysis is needed to determine accuracy and clinical correlation.
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Affiliation(s)
- Daniel Cheong
- Pediatric Cardiology, Cohen Children's Medical Center, Northwell Health, 2000 Marcus Ave, Suite 300, New Hyde Park, NY, 11042-1069, USA.
| | - Qais Alloah
- Pediatric Cardiology, Cohen Children's Medical Center, Northwell Health, 2000 Marcus Ave, Suite 300, New Hyde Park, NY, 11042-1069, USA
| | - Joanna S Fishbein
- Biostatistics Unit, Office of Academic Affairs, Northwell Health, New Hyde Park, USA
| | - Hari G Rajagopal
- Pediatric Cardiology, Cohen Children's Medical Center, Northwell Health, 2000 Marcus Ave, Suite 300, New Hyde Park, NY, 11042-1069, USA
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Xiao H, Wang X, Yang P, Wang L, Xu J. Optimization of uniformity in coronary artery enhancement using a bolus tracking technique with a dual region of interest in coronary computed tomographic angiography. Acta Radiol 2024; 65:202-210. [PMID: 38059327 DOI: 10.1177/02841851231215421] [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] [Indexed: 12/08/2023]
Abstract
BACKGROUND Consistent coronary artery enhancement is essential to achieve accurate and reproducible quantification of coronary plaque composition. PURPOSE To optimize coronary artery uniformity of enhancement using a bolus tracking technique with a dual region of interest (ROI) in coronary computed tomography angiography (CCTA) on a 320-detector CT scanner. MATERIAL AND METHODS This prospective study recruited 100 consecutive patients who underwent CCTA and were randomly divided into two groups, namely, a manual trigger group (n = 50), in which a manual fast start technique was used to start the diagnostic scan with the visual evaluation of attenuation in the left atrium and left ventricle, and an automatic trigger group (n = 50), in which a bolus tracking technique was used to automatically start the breath-holding command and diagnostic scan with two ROIs placed in the right and left ventricles. Coronary artery image quality was assessed using quantitative and qualitative scores. The enhancement uniformity was characterized by attenuation variability of the ascending aorta (AAO) and coronary arteries. RESULTS No statistically significant differences in the image quality of the coronary arteries were observed between the two groups (all P > 0.05). The coefficients of variation (COVs) of arterial attenuation in the automatic trigger group were significantly smaller than in the manual trigger group (AAO: 9.89% vs. 17.93%; LMA: 10.35% vs. 18.98%; LAD proximal: 12.09% vs. 20.84%; LCX proximal: 11.85% vs. 20.95%; RCA proximal: 12.13% vs. 20.84%; all P < 0.05). CONCLUSION The automatic trigger technique accompanied with dual ROI provides consistent coronary artery enhancement and optimizes coronary artery enhancement uniformity in CCTA on a 320-detector CT scanner.
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Affiliation(s)
- Huawei Xiao
- Heart Center, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Xiangquan Wang
- Heart Center, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Panfeng Yang
- Heart Center, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Ling Wang
- Heart Center, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jian Xu
- Heart Center, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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6
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Han BK, Garcia S, Aboulhosn J, Blanke P, Martin MH, Zahn E, Crean A, Overman D, Craig CH, Hanneman K, Semple T, Armstrong A. Technical recommendations for computed tomography guidance of intervention in the right ventricular outflow tract: Native RVOT, conduits and bioprosthetic valves:: A white paper of the Society of Cardiovascular Computed Tomography (SCCT), Congenital Heart Surgeons' Society (CHSS), and Society for Cardiovascular Angiography & Interventions (SCAI). J Cardiovasc Comput Tomogr 2024; 18:75-99. [PMID: 37517984 DOI: 10.1016/j.jcct.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/03/2023] [Accepted: 06/20/2023] [Indexed: 08/01/2023]
Abstract
This consensus document for the performance of Cardiovascular Computed Tomography (CCT) to guide intervention in the right ventricular outflow tract (RVOT) in patients with congenital disease (CHD) was developed collaboratively by pediatric and adult interventionalists, surgeons and cardiac imagers with expertise specific to this patient subset. The document summarizes definitions of RVOT dysfunction as assessed by multi-modality imaging techniques and reviews existing consensus statements and guideline documents pertaining to indications for intervention. In the context of this background information, recommendations for CCT scan acquisition and a standardized approach for reporting prior to surgical or transcatheter pulmonary valve replacement are proposed and presented. It is the first Imaging for Intervention collaboration for CHD patients and encompasses imaging and reporting recommendations prior to both surgical and percutaneous pulmonary valve replacement.
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Affiliation(s)
- B Kelly Han
- University of Utah, Intermountain Primary Children's Hospital, Salt Lake City, Utah, USA.
| | - Santiago Garcia
- The Carl and Edyth Lindner Center for Research and Education and the Christ Hospital, Cincinnati, Ohio, USA
| | - Jamil Aboulhosn
- University of California Los Angeles (UCLA) Health, Los Angeles, California, USA
| | - Phillip Blanke
- St. Paul's Hospital & University of British Columbia, Vancouver, Canada
| | - Mary Hunt Martin
- University of Utah, Intermountain Primary Children's Hospital, Salt Lake City, Utah, USA
| | - Evan Zahn
- Cedars-Sinai, Smidt Heart Institute, Los Angeles, California, USA
| | - Andrew Crean
- University of Ottawa Heart Institute, Ottawa, Canada
| | - David Overman
- The Children's Heart Clinic, Children's Minnesota, Mayo Clinic-Children's Minnesota Cardiovascular Collaborative, Minneapolis, Minnesota, USA
| | - C Hamilton Craig
- University of Queensland and Griffith University, Queensland, New Zealand
| | | | - Thomas Semple
- The Royal Brompton Hospital, London, England, United Kingdom
| | - Aimee Armstrong
- Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
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7
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Truesdell W, Salavitabar A, Zampi JD, Agarwal P, Joshi A. An Imager's Overview to Transcatheter Pulmonic Valve Replacement. Semin Roentgenol 2024; 59:76-86. [PMID: 38388100 DOI: 10.1053/j.ro.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 02/24/2024]
Affiliation(s)
| | - Arash Salavitabar
- Department of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH
| | - Jeffrey D Zampi
- Department of Pediatric Cardiology, Michigan Medicine, Ann Arbor, MI
| | - Prachi Agarwal
- Department of Radiology, Michigan Medicine, Ann Arbor, MI
| | - Aparna Joshi
- Department of Radiology, Michigan Medicine, Ann Arbor, MI
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8
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Salgado R, Budde RP, Saba L. CT and MR imaging of patients with a dilated right ventricle due to congenital causes and their treatment. Br J Radiol 2023; 96:20230484. [PMID: 37807919 PMCID: PMC10646655 DOI: 10.1259/bjr.20230484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/10/2023] Open
Abstract
A variety of both acquired and congenital conditions can significantly affect the right ventricle, with a variety of potential origins that can have substantial clinical ramifications. These conditions can range from the impact of diseases like pulmonary arterial hypertension and ischaemic heart disease to valvular deficiencies resulting in heart failure. Moreover, the right ventricle response to factors like abnormal loading conditions, and its subsequent clinical effects, are influenced by factors such as age, disease progression, potential interventions, and their immediate and long-term clinical outcomes. Therefore, a readily available and reproducible non-invasive imaging assessment can aid in diagnosing the underlying condition of a dilated right ventricle, track its evolution, and help devising the most appropriate treatment strategy and optimal timing for its implementation throughout the patient's life.In this review, our primary focus will be on the non-invasive imaging with CT and MR of an enlarged right ventricle resulting from congenital causes and their treatment.
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Affiliation(s)
| | - Ricardo P.J. Budde
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
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9
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Han BK, Garcia S, Aboulhosn J, Blanke P, Martin MH, Zahn E, Crean A, Overman D, Hamilton Craig C, Hanneman K, Semple T, Armstrong A. Technical Recommendations for Computed Tomography Guidance of Intervention in the Right Ventricular Outflow Tract: Native RVOT, Conduits, and Bioprosthetic Valves. World J Pediatr Congenit Heart Surg 2023; 14:761-791. [PMID: 37647270 PMCID: PMC10685707 DOI: 10.1177/21501351231186898] [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] [Indexed: 09/01/2023]
Abstract
This consensus document for the performance of cardiovascular computed tomography (CCT) to guide intervention in the right ventricular outflow tract (RVOT) in patients with congenital heart disease (CHD) was developed collaboratively by pediatric and adult interventionalists, surgeons, and cardiac imagers with expertise specific to this patient subset. The document summarizes definitions of RVOT dysfunction as assessed by multimodality imaging techniques and reviews existing consensus statements and guideline documents pertaining to indications for intervention. In the context of this background information, recommendations for CCT scan acquisition and a standardized approach for reporting prior to surgical or transcatheter pulmonary valve replacement are proposed and presented. It is the first Imaging for Intervention collaboration for CHD patients and encompasses imaging and reporting recommendations prior to both surgical and percutaneous pulmonary valve replacement.
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Affiliation(s)
- B. Kelly Han
- University of Utah, Intermountain Primary Children’s Hospital, Salt Lake City, UT, USA
| | - Santiago Garcia
- The Carl and Edyth Lindner Center for Research and Education and The Christ Hospital, Cincinnati, OH, USA
| | - Jamil Aboulhosn
- University of California Los Angeles (UCLA) Health, Los Angeles, CA, USA
| | - Phillip Blanke
- St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Mary Hunt Martin
- University of Utah, Intermountain Primary Children’s Hospital, Salt Lake City, UT, USA
| | - Evan Zahn
- Cedars-Sinai, Smidt Heart Institute, Los Angeles, CA, USA
| | - Andrew Crean
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - David Overman
- The Children’s Heart Clinic, Children’s Minnesota, Mayo Clinic-Children’s Minnesota Cardiovascular Collaborative, Minneapolis, MN, USA
| | - C. Hamilton Craig
- University of Queensland and Griffith University, Queensland, Australia
| | | | | | - Aimee Armstrong
- Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
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10
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Addison D, Neilan TG, Barac A, Scherrer-Crosbie M, Okwuosa TM, Plana JC, Reding KW, Taqueti VR, Yang EH, Zaha VG. Cardiovascular Imaging in Contemporary Cardio-Oncology: A Scientific Statement From the American Heart Association. Circulation 2023; 148:1271-1286. [PMID: 37732422 DOI: 10.1161/cir.0000000000001174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Advances in cancer therapeutics have led to dramatic improvements in survival, now inclusive of nearly 20 million patients and rising. However, cardiovascular toxicities associated with specific cancer therapeutics adversely affect the outcomes of patients with cancer. Advances in cardiovascular imaging have solidified the critical role for robust methods for detecting, monitoring, and prognosticating cardiac risk among patients with cancer. However, decentralized evaluations have led to a lack of consensus on the optimal uses of imaging in contemporary cancer treatment (eg, immunotherapy, targeted, or biological therapy) settings. Similarly, available isolated preclinical and clinical studies have provided incomplete insights into the effectiveness of multiple modalities for cardiovascular imaging in cancer care. The aims of this scientific statement are to define the current state of evidence for cardiovascular imaging in the cancer treatment and survivorship settings and to propose novel methodological approaches to inform the optimal application of cardiovascular imaging in future clinical trials and registries. We also propose an evidence-based integrated approach to the use of cardiovascular imaging in routine clinical settings. This scientific statement summarizes and clarifies available evidence while providing guidance on the optimal uses of multimodality cardiovascular imaging in the era of emerging anticancer therapies.
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11
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Rajiah PS, Reddy P, Baliyan V, Hedgire SS, Foley TA, Williamson EE, Eleid MF. Utility of CT and MRI in Tricuspid Valve Interventions. Radiographics 2023; 43:e220153. [PMID: 37384544 DOI: 10.1148/rg.220153] [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: 07/01/2023]
Abstract
Transcatheter tricuspid valve interventions (TTVIs) comprise a variety of catheter-based interventional techniques for treatment of tricuspid regurgitation (TR) in patients at high surgical risk and those with failed previous surgeries. Several TTVI devices with different mechanisms of action are either currently used or in preclinical evaluation. Echocardiography is the first-line modality for evaluation of tricuspid valve disease that provides information on tricuspid valve morphology, mechanism of TR, and hemodynamics. Cardiac CT and MRI have several advantages for a comprehensive preprocedure evaluation. CT and MRI provide complementary information to that of echocardiography on the mechanism and cause of TR. MRI can quantify the severity of TR using indirect or direct techniques that involve two-dimensional or four-dimensional flow sequences. MRI and CT can also accurately quantify right ventricular volumes and function, which is crucial for timing of intervention. CT provides comprehensive three-dimensional information on the morphology of the valve, annulus, subvalvular apparatus, and adjacent structures. CT is the procedure of choice for evaluation of several device-specific measurements, including tricuspid annulus dimensions, annulus-to-right coronary artery distance, leaflet morphology, coaptation gaps, caval dimensions, and cavoatrial-to-hepatic vein distance. CT allows evaluation of the vascular access as well as optimal procedure fluoroscopic angles and catheter trajectory. Postprocedure CT and MRI are useful in detection of complications such as paravalvular leak, pseudoaneurysm, thrombus, pannus, infective endocarditis, and device migration. © RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Prabhakar Shantha Rajiah
- From the Departments of Radiology (P.S.R., T.A.F., E.E.W.) and Cardiology (P.R., M.F.E.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Radiology, Massachusetts General Hospital, Boston, Mass (V.B., S.S.H.)
| | - Prajwal Reddy
- From the Departments of Radiology (P.S.R., T.A.F., E.E.W.) and Cardiology (P.R., M.F.E.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Radiology, Massachusetts General Hospital, Boston, Mass (V.B., S.S.H.)
| | - Vinit Baliyan
- From the Departments of Radiology (P.S.R., T.A.F., E.E.W.) and Cardiology (P.R., M.F.E.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Radiology, Massachusetts General Hospital, Boston, Mass (V.B., S.S.H.)
| | - Sandeep S Hedgire
- From the Departments of Radiology (P.S.R., T.A.F., E.E.W.) and Cardiology (P.R., M.F.E.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Radiology, Massachusetts General Hospital, Boston, Mass (V.B., S.S.H.)
| | - Thomas A Foley
- From the Departments of Radiology (P.S.R., T.A.F., E.E.W.) and Cardiology (P.R., M.F.E.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Radiology, Massachusetts General Hospital, Boston, Mass (V.B., S.S.H.)
| | - Eric E Williamson
- From the Departments of Radiology (P.S.R., T.A.F., E.E.W.) and Cardiology (P.R., M.F.E.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Radiology, Massachusetts General Hospital, Boston, Mass (V.B., S.S.H.)
| | - Mackram F Eleid
- From the Departments of Radiology (P.S.R., T.A.F., E.E.W.) and Cardiology (P.R., M.F.E.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Radiology, Massachusetts General Hospital, Boston, Mass (V.B., S.S.H.)
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12
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Appadurai V, Safdur T, Narang A. Assessment of Right Ventricle Function and Tricuspid Regurgitation in Heart Failure: Current Advances in Diagnosis and Imaging. Heart Fail Clin 2023; 19:317-328. [PMID: 37230647 DOI: 10.1016/j.hfc.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Right ventricular (RV) systolic dysfunction increases mortality among heart failure patients, and therefore, accurate diagnosis and monitoring is paramount. RV anatomy and function are complex, usually requiring a combination of imaging modalities to completely quantitate volumes and function. Tricuspid regurgitation usually occurs with RV dysfunction, and quantifying this valvular lesion also may require multiple imaging modalities. Echocardiography is the first-line imaging tool for identifying RV dysfunction, with cardiac MRI and cardiac computed tomography adding valuable additional information.
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Affiliation(s)
- Vinesh Appadurai
- Bluhm Cardiovascular Institute, Northwestern University, 676 North St Clair Street Suite 19-100 Galter Pavilion, Chicago, IL 60611, USA; School of Medicine, The University of Queensland, St Lucia, QLD, 4067 Australia
| | - Taimur Safdur
- Bluhm Cardiovascular Institute, Northwestern University, 676 North St Clair Street Suite 19-100 Galter Pavilion, Chicago, IL 60611, USA
| | - Akhil Narang
- Bluhm Cardiovascular Institute, Northwestern University, 676 North St Clair Street Suite 19-100 Galter Pavilion, Chicago, IL 60611, USA.
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13
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Scott A, Kligerman S, Hernandez DH, Kim P, Tran H, Pretorius V, Adler E, Contijoch F. Preoperative Computed Tomography Assessment of Risk of Right Ventricle Failure After Left Ventricular Assist Device Placement. ASAIO J 2023; 69:69-75. [PMID: 36583772 PMCID: PMC10684273 DOI: 10.1097/mat.0000000000001710] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Identification of patients who are at a high risk for right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation is of critical importance. Conventional tools for predicting RVF, including two-dimensional echocardiography, right heart catheterization (RHC), and clinical parameters, generally have limited sensitivity and specificity. We retrospectively examined the ability of computed tomography (CT) ventricular volume measures to identify patients who experienced RVF after LVAD implantation. Between September 2017 and November 2021, 92 patients underwent LVAD surgery at our institution. Preoperative CT-derived ventricular volumes were obtained in 20 patients. Patients who underwent CT evaluation had a similar demographics and rate of RVF after LVAD as patients who did not undergo cardiac CT imaging. In the study cohort, seven of 20 (35%) patients experienced RVF (2 unplanned biventricular assist device, 5 prolonged inotropic support). Computed tomography-derived right ventricular end-diastolic and end-systolic volume indices were the strongest predictors of RVF compared with demographic, echocardiographic, and RHC data with areas under the receiver operating curve of 0.79 and 0.76, respectively. Computed tomography volumetric assessment of RV size can be performed in patients evaluated for LVAD treatment. RV measures of size provide a promising means of pre-LVAD assessment for postoperative RV failure.
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Affiliation(s)
- Anderson Scott
- Department of Bioengineering, UC San Diego, 9500 Gilman Drive, La Jolla CA, United States
| | - Seth Kligerman
- Department of Radiology, UC San Diego, 9500 Gilman Drive, La Jolla CA, United States
| | | | - Paul Kim
- Department of Medicine, UC San Diego, 9500 Gilman Drive, La Jolla CA, United States
| | - Hao Tran
- Department of Medicine, UC San Diego, 9500 Gilman Drive, La Jolla CA, United States
| | - Victor Pretorius
- Department of Surgery, UC San Diego, 9500 Gilman Drive, La Jolla CA, United States
| | - Eric Adler
- Department of Medicine, UC San Diego, 9500 Gilman Drive, La Jolla CA, United States
| | - Francisco Contijoch
- Department of Bioengineering, UC San Diego, 9500 Gilman Drive, La Jolla CA, United States
- Department of Radiology, UC San Diego, 9500 Gilman Drive, La Jolla CA, United States
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Canan A, Ocazionez-Trujillo D, Vargas D, Foley TA, Cabalka AK, Rajiah PS. Pre- and Postprocedure Imaging of Transcatheter Pulmonary Valve Implantation. Radiographics 2022; 42:991-1011. [PMID: 35687519 DOI: 10.1148/rg.210160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Transcatheter pulmonary valve replacement (TPVR) is a minimally invasive procedure for treatment of right ventricular outflow tract (RVOT) dysfunction in surgically repaired congenital heart diseases. TPVR is performed in these patients to avoid the high risk and complexity of repeat surgeries. Several TPVR devices are now available to be placed in the right ventricle (RV) to pulmonary artery (PA) conduit, native RVOT, or surgical bioprosthetic valves. Imaging is used before TPVR to determine patient eligibility and optimal timing, which is critical to avoid irreversible RV dilatation and failure. Imaging is also required for evaluation of contraindications, particularly proximity of the RVOT to the left main coronary artery and its branches. Cross-sectional imaging provides details of the complex anatomy in which the TPVR device will be positioned and measurements of the RVOT, RV-PA conduit, or PA. Echocardiography is the first-line imaging modality for evaluation of the RVOT or conduit to determine the need for intervention, although its utility is limited by the complex RVOT morphology and altered anatomy after surgery. CT and MRI provide complementary information for TPVR, including patient eligibility, assessment of contraindications, and key measurements of the RVOT and PA, which are necessary for procedure planning. TPVR, performed using a cardiac catheterization procedure, includes a sizing step in which a balloon is expanded in the RVOT, which also allows assessment of the risk for extrinsic coronary artery compression. Follow-up imaging with CT and MRI is used for evaluation of postprocedure remodeling and valve function and to monitor complications. ©RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Arzu Canan
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Radiology, UT Health Sciences Center, Houston, Tex (D.O.T.); Department of Radiology, University of Colorado, Aurora, Colo (D.V.); and Department of Radiology (T.A.F., P.S.R.) and Division of Cardiology (A.K.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Daniel Ocazionez-Trujillo
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Radiology, UT Health Sciences Center, Houston, Tex (D.O.T.); Department of Radiology, University of Colorado, Aurora, Colo (D.V.); and Department of Radiology (T.A.F., P.S.R.) and Division of Cardiology (A.K.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Daniel Vargas
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Radiology, UT Health Sciences Center, Houston, Tex (D.O.T.); Department of Radiology, University of Colorado, Aurora, Colo (D.V.); and Department of Radiology (T.A.F., P.S.R.) and Division of Cardiology (A.K.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Thomas A Foley
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Radiology, UT Health Sciences Center, Houston, Tex (D.O.T.); Department of Radiology, University of Colorado, Aurora, Colo (D.V.); and Department of Radiology (T.A.F., P.S.R.) and Division of Cardiology (A.K.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Allison K Cabalka
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Radiology, UT Health Sciences Center, Houston, Tex (D.O.T.); Department of Radiology, University of Colorado, Aurora, Colo (D.V.); and Department of Radiology (T.A.F., P.S.R.) and Division of Cardiology (A.K.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Prabhakar Shantha Rajiah
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Radiology, UT Health Sciences Center, Houston, Tex (D.O.T.); Department of Radiology, University of Colorado, Aurora, Colo (D.V.); and Department of Radiology (T.A.F., P.S.R.) and Division of Cardiology (A.K.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
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15
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Park HY, Suh CH, Woo S, Kim PH, Kim KW. Quality Reporting of Systematic Review and Meta-Analysis According to PRISMA 2020 Guidelines: Results from Recently Published Papers in the Korean Journal of Radiology. Korean J Radiol 2022; 23:355-369. [PMID: 35213097 PMCID: PMC8876652 DOI: 10.3348/kjr.2021.0808] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/26/2021] [Accepted: 12/21/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the completeness of the reporting of systematic reviews and meta-analyses published in a general radiology journal using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. MATERIALS AND METHODS Twenty-four articles (systematic review and meta-analysis, n = 18; systematic review only, n = 6) published between August 2009 and September 2021 in the Korean Journal of Radiology were analyzed. Completeness of the reporting of main texts and abstracts were evaluated using the PRISMA 2020 statement. For each item in the statement, the proportion of studies that met the guidelines' recommendation was calculated and items that were satisfied by fewer than 80% of the studies were identified. The review process was conducted by two independent reviewers. RESULTS Of the 42 items (including sub-items) in the PRISMA 2020 statement for main text, 24 were satisfied by fewer than 80% of the included articles. The 24 items were grouped into eight domains: 1) assessment of the eligibility of potential articles, 2) assessment of the risk of bias, 3) synthesis of results, 4) additional analysis of study heterogeneity, 5) assessment of non-reporting bias, 6) assessment of the certainty of evidence, 7) provision of limitations of the study, and 8) additional information, such as protocol registration. Of the 12 items in the abstract checklists, eight were incorporated in fewer than 80% of the included publications. CONCLUSION Several items included in the PRISMA 2020 checklist were overlooked in systematic review and meta-analysis articles published in the Korean Journal of Radiology. Based on these results, we suggest a double-check list for improving the quality of systematic reviews and meta-analyses. Authors and reviewers should familiarize themselves with the PRISMA 2020 statement and check whether the recommended items are fully satisfied prior to publication.
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Affiliation(s)
- Ho Young Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Sungmin Woo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pyeong Hwa Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Coronary Sinus Diameter as a Potential Marker of Right Ventricle Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042217. [PMID: 35206403 PMCID: PMC8871674 DOI: 10.3390/ijerph19042217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 11/28/2022]
Abstract
The aim of this study was to assess the influence of the parameters of the coronary sinus (CS) on the parameters that describe the function of the right ventricle (RV), which were calculated using cardiac computed tomography. Methods: A CT scan of the heart was performed on 150 patients due to suspicion of coronary artery disease using a Siemens Somatom Force (2 × 192 × 0.6) and a syngo.via workstation. The “CT coronary” and in some cases the generic presets were used to measure the CS ostium in millimeters (mm). The functional measurements of right heart ventricles were examined using the “CT cardiac function” automatic function on a 256 × 256 matrix. Results: The average diameter of the CS ostium was 16.29 ± 4.37 mm. In the group with RV impairment, it was 16.56 ± 4.76, whereas in the group with normal values of the RV, it was 15.98 ± 3.88 mm, p = 0.4199. The average angle of the entrance of the CS into the right atrium was 107.25° ± 9.68°. In the group with an RV impairment, it was 105.91° ± 9.22°, while in the patients with normal values of the RV, it was 108.82° ± 10.04°; p = 0.0682. A multiple regression showed that end systolic volume (p = 0.0017) and stroke volume (p = 0.0144) are important predictors of the CS ostium. Conclusions: Some relationships were found between the CS and the selected parameters that describe the function of the RV. This may suggest a role for the CS as a right ventricular buffer, which could potentially be treated as a marker of an RV impairment.
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17
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Toia P, Maffei E, Mantini C, Runza G, La Grutta L, Grassedonio E, Guaricci A, Punzo B, Cavaliere C, Cademartiri F. Cardiac Magnetic Resonance with Delayed Enhancement of the Right Ventricle in patients with Left Ventricle primary involvement: diagnosis and evaluation of functional parameters. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022023. [PMID: 35546038 PMCID: PMC9171872 DOI: 10.23750/abm.v93i2.10765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 11/04/2022]
Abstract
Cardiac Magnetic Resonance (CMR) allows an accurate Right Ventricle (RV) assessment that could be of great relevance in diseases causing inflammation or fibrosis. The aim of this study was to evaluate the concomitant involvement of the RV in patients with delayed enhancement (DE) of the Left Ventricle (LV-DE) using CMR. We retrospectively enrolled 95 (male n. 66; age 55±18years; BMI 26±5kg/m2) consecutive patients with LV-DE who underwent a CMR (Achieva 1.5 T, Philips) for different indications: post-ischemic dilated cardiopathy (PDM), hypertrophic cardiomyopathy (HCM), myocardial infarction (MI), myocarditis/pericarditis (MP) and congenital heart disease (CD). We assessed the presence and extension of DE and functional parameters such as ventricular end-diastolic (EDV), end-systolic volumes (ESV) and ejection fraction (EF) of both LV and RV. Prevalence of RV-DE was 30.5% (29/95): 75% (3/4) for CD, 44% (4/9) for PDM, 36% (17/47) for MI, 27.8% (5/18) for MP and 0% (0/17) for HCM. LV-EF and RV-EF were 53±15mL and 51±13mL, respectively, for patients without RV-DE (RV-DE-), and 40±19 mL and 42±15 mL, respectively, for patients with RV-DE (RV-DE+) (p<0.05), while LV-EDV and LV-ESV were 80±28 mL and 40±26 mL, respectively, for RV-DE- and 100±45 mL and 65±49 mL, respectively, for RV-DE+ (p<0.05). The prevalence of RV-DE in patients with LV primary involvement is not negligible and it is found mainly in patients with CD and PDM and then in patients with MI and MP. It is more often associated with LV-EF and RV-EF reduction and increase in LV volumes.
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Affiliation(s)
| | - Erica Maffei
- Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy
| | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti, Italy
| | - Giuseppe Runza
- Department of Radiology, P.O. Umberto I, ASP 8, Siracusa, Italy
| | | | | | - Andrea Guaricci
- Department of Cardiology, University Hospital of Bari, Bari, Italy
| | | | | | - Filippo Cademartiri
- Department of Radiology, Fondazione Toscana Gabriele Monasterio/CNR, Pisa, Italy
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18
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Omidi A, Weiss E, Wilson JS, Rosu-Bubulac M. Quantitative assessment of intra- and inter-modality deformable image registration of the heart, left ventricle, and thoracic aorta on longitudinal 4D-CT and MR images. J Appl Clin Med Phys 2021; 23:e13500. [PMID: 34962065 PMCID: PMC8833287 DOI: 10.1002/acm2.13500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/17/2021] [Accepted: 11/29/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose Magnetic resonance imaging (MRI)‐based investigations into radiotherapy (RT)‐induced cardiotoxicity require reliable registrations of magnetic resonance (MR) imaging to planning computed tomography (CT) for correlation to regional dose. In this study, the accuracy of intra‐ and inter‐modality deformable image registration (DIR) of longitudinal four‐dimensional CT (4D‐CT) and MR images were evaluated for heart, left ventricle (LV), and thoracic aorta (TA). Methods and materials Non‐cardiac‐gated 4D‐CT and T1 volumetric interpolated breath‐hold examination (T1‐VIBE) MRI datasets from five lung cancer patients were obtained at two breathing phases (inspiration/expiration) and two time points (before treatment and 5 weeks after initiating RT). Heart, LV, and TA were manually contoured. Each organ underwent three intramodal DIRs ((A) CT modality over time, (B) MR modality over time, and (C) MR contrast effect at the same time) and two intermodal DIRs ((D) CT/MR multimodality at same time and (E) CT/MR multimodality over time). Hausdorff distance (HD), mean distance to agreement (MDA), and Dice were evaluated and assessed for compliance with American Association of Physicists in Medicine (AAPM) Task Group (TG)‐132 recommendations. Results Mean values of HD, MDA, and Dice under all registration scenarios for each region of interest ranged between 8.7 and 16.8 mm, 1.0 and 2.6 mm, and 0.85 and 0.95, respectively, and were within the TG‐132 recommended range (MDA < 3 mm, Dice > 0.8). Intramodal DIR showed slightly better results compared to intermodal DIR. Heart and TA demonstrated higher registration accuracy compared to LV for all scenarios except for HD and Dice values in Group A. Significant differences for each metric and tissue of interest were noted between Groups B and D and between Groups B and E. MDA and Dice significantly differed between LV and heart in all registrations except for MDA in Group E. Conclusions DIR of the heart, LV, and TA between non‐cardiac‐gated longitudinal 4D‐CT and MRI across two modalities, breathing phases, and pre/post‐contrast is acceptably accurate per AAPM TG‐132 guidelines. This study paves the way for future evaluation of RT‐induced cardiotoxicity and its related factors using multimodality DIR.
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Affiliation(s)
- Alireza Omidi
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Elisabeth Weiss
- Department of Radiation Oncology, Virginia Commonwealth University Health, Richmond, Virginia, USA
| | - John S Wilson
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA.,Pauley Heart Center, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Mihaela Rosu-Bubulac
- Department of Radiation Oncology, Virginia Commonwealth University Health, Richmond, Virginia, USA
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Abstract
Introduction: Advancements in surgery and management have resulted in a growing population of aging adults with tetralogy of Fallot (TOF). As a result, there has been a parallel growth in late complications associated with the sequelae from the underlying cardiac anomalies as well as the surgical and other interventional treatments.Areas covered: Here, we review challenges related to an aging population of patients with TOF, particularly late complications, and highlight advances in management and key areas for future research. Pulmonary regurgitation, heart failure, arrhythmias, and aortic complications are some of these late complications. There is also a growing incidence of acquired cardiovascular disease, obesity, and diabetes associated with aging. Management of these late complications and acquired comorbidities continues to evolve as research provides insights into long-term outcomes from medical therapies and surgical interventions.Expert opinion: The management of an aging TOF population will continue to transform with advances in imaging technologies to identify subclinical disease and valve replacement technologies that will prevent and mitigate disease progression. In the coming years, we speculate that there will be more data to support the use of novel heart failure therapies in TOF and consensus guidelines on the management of refractory arrhythmias and aortic complications.
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Affiliation(s)
- Jennifer P Woo
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, California, USA
| | - Doff B McElhinney
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, California, USA
| | - George K Lui
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, California, USA
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20
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Siripornpitak S, Goo HW. CT and MRI for Repaired Complex Adult Congenital Heart Diseases. Korean J Radiol 2020; 22:308-323. [PMID: 33289363 PMCID: PMC7909854 DOI: 10.3348/kjr.2020.0895] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/21/2020] [Accepted: 09/01/2020] [Indexed: 12/30/2022] Open
Abstract
An increasing number of adult congenital heart disease (ACHD) patients continue to require life-long diagnostic imaging surveillance using cardiac CT and MRI. These patients typically exhibit a large spectrum of unique anatomical and functional changes resulting from either single- or multi-stage palliation and surgical correction. Radiologists involved in the diagnostic task of monitoring treatment effects and detecting potential complications should be familiar with common cardiac CT and MRI findings observed in patients with repaired complex ACHD. This review article highlights the contemporary role of CT and MRI in three commonly encountered repaired ACHD: repaired tetralogy of Fallot, transposition of the great arteries after arterial switch operation, and functional single ventricle after Fontan operation.
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Affiliation(s)
- Suvipaporn Siripornpitak
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Hyun Woo Goo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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