|
1
|
Borodzicz-Jazdzyk S, de Mooij GW, den Hartog A, Hofman MBM, Götte MJW. Advanced Cardiac Magnetic Resonance Imaging for Assessment of Obstructive Coronary Artery Disease - ADVOCATE-CMR Study Rationale and Design. J Cardiovasc Magn Reson 2025:101900. [PMID: 40288685 DOI: 10.1016/j.jocmr.2025.101900] [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: 12/09/2024] [Revised: 04/02/2025] [Accepted: 04/22/2025] [Indexed: 04/29/2025] Open
Abstract
BACKGROUND First-pass stress perfusion cardiovascular magnetic resonance (CMR) imaging is the guidelines-recommended non-invasive test for the detection of obstructive coronary artery disease (CAD). Recently developed quantitative perfusion CMR (QP CMR) allows quantification of myocardial blood flow. Moreover, the latest developments established several methods of CAD assessment without the need for a contrast agent, including stress T1 mapping reactivity (∆T1) and oxygenation-sensitive CMR (OS-CMR). These methods might eliminate the need for contrast administration in clinical practice, reducing time, invasiveness, and costs, thereby simplifying the evaluation of patients with suspected obstructive CAD. The ADVOCATE-CMR study aims to validate QP CMR, ∆T1 and OS-CMR imaging against invasive fractional flow reserve (FFR) for the detection of obstructive CAD. The study also aims to head-to-head compare the diagnostic accuracy of these CMR techniques with the conventional visual assessment of stress perfusion CMR and to correlate them to short- and long-term clinical outcomes. STUDY DESIGN ADVOCATE-CMR is a single-center, observational, prospective, cross-sectional cohort study. The study will enroll 182 symptomatic patients with suspected obstructive CAD scheduled for invasive coronary angiography (ICA). Before ICA, all participants will undergo CMR imaging including OS-CMR with breathing maneuvers, rest and adenosine stress T1 mapping and rest and adenosine stress first-pass perfusion. Subsequently, ICA will be performed including FFR, instantaneous wave-free ratio (iFR), resting Pd/Pa, coronary flow reserve (CFR) and index of microvascular resistance (IMR) measurements in all main coronary arteries. A follow-up CMR scan with the same protocol will be performed at 3 months after ICA. Clinical follow-up will be performed at 3, 6 months, 1 and 3 years after ICA. CONCLUSION The ADVOCATE-CMR will be the first study comprehensively evaluating and comparing head-to-head the diagnostic performance of a range of contrast- and non-contrast agent-based CMR imaging methods (including QP CMR, ∆T1 and OS-CMR) for the detection of FFR-defined obstructive CAD. We expect to establish a validated and time-efficient diagnostic workflow available to a wide range of general CMR services. Finally, these improvements may enable CMR to become an effective non-invasive, radiation-free gatekeeper for ICA in patients with suspected obstructive CAD, potentially without the need for a contrast agent.
Collapse
Affiliation(s)
- Sonia Borodzicz-Jazdzyk
- Dept. of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands; 1(st) Dept. of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Geoffrey W de Mooij
- Dept. of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
| | - Alexander den Hartog
- Dept. of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
| | - Mark B M Hofman
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1118, 1081 HV, Amsterdam, the Netherlands
| | - Marco J W Götte
- Dept. of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
| |
Collapse
|
|
2
|
Paudel B, Pan J, Singulane CC, Wang S, Thomas M, Ayers M, Philips S, Patel AR. Cardiac Magnetic Resonance Guidance for the Pathogenetic Definition of Cardiomyopathies. Curr Cardiol Rep 2025; 27:85. [PMID: 40238040 PMCID: PMC12003507 DOI: 10.1007/s11886-025-02233-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2025] [Indexed: 04/18/2025]
Abstract
PURPOSE OF REVIEW Pathogenetics is the study of genetics in disease pathogenesis. Many abnormal gene alleles have been identified in cardiomyopathies, but their clinical utility remains limited. This review aims to examine the integration of cardiac MRI (CMR) with genetic data to enhance early detection, prognostication, and treatment strategies for cardiomyopathies. RECENT FINDINGS CMR is the gold standard imaging modality for cardiomyopathy evaluation, capable of detecting subtle structural and functional changes throughout the disease course. When applied to patients with genetic mutations, with or without phenotypic expression, CMR aids in early diagnosis and risk stratification. Cardiomyopathies can be categorized into at least seven clinical groups based on morphology, function, and genetic associations: (1) Dilated cardiomyopathy (DCM), (2) Hypertrophic cardiomyopathy (HCM), (3) Restrictive cardiomyopathy, including transthyretin amyloidosis (ATTR-CM), iron overload, and Anderson-Fabry disease, (4) Arrhythmogenic cardiomyopathy (ACM), (5) Non-dilated left ventricular cardiomyopathy (NDLVC), (6) Peripartum cardiomyopathy, and (7) Muscular dystrophy-related cardiomyopathy. We have described left ventricular noncompaction (LVNC) as a morphological trait rather than a distinct cardiomyopathy. Emerging CMR and genetic data suggest an inflammatory component in DCM and ACM, with potential therapeutic implications for immunotherapy. Advanced CMR techniques, such as quantitative perfusion, can distinguish cardiomyopathies from ischemic heart disease and detect early microvascular dysfunction, particularly in ATTR-CM and HCM. Late gadolinium enhancement (LGE) and parametric mapping (T1 and extracellular volume [ECV]) further enhance early diagnosis, prognostication and treatment response by assessing fibrosis and myocardial composition. The integration of CMR and genetic insights improves our understanding of cardiomyopathy pathogenesis, aiding in early diagnosis and prognostic assessment. Future research should leverage artificial intelligence (AI) to analyze genetic and radiomic CMR features, including perfusion data, to establish a comprehensive pathogenetic framework. This approach could refine disease classification, identify novel therapeutic targets, and advance precision medicine in cardiomyopathy management.
Collapse
Affiliation(s)
- Bishow Paudel
- Department of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jonathan Pan
- Department of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Cristiane C Singulane
- Department of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Shuo Wang
- Department of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Matthew Thomas
- Department of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Michael Ayers
- Department of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Steven Philips
- Department of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Amit R Patel
- Department of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA.
| |
Collapse
|
|
3
|
Issahaku S, Hasford F, Sackey TA. Advancing sustainable magnetic resonance imaging access in Africa: review of clinical performance of MRI scanners using ACR MagPhan in Ghana. MAGMA (NEW YORK, N.Y.) 2025:10.1007/s10334-025-01240-8. [PMID: 40029546 DOI: 10.1007/s10334-025-01240-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2025] [Revised: 02/20/2025] [Accepted: 02/21/2025] [Indexed: 03/05/2025]
Affiliation(s)
- Shirazu Issahaku
- Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra, Ghana.
- Department of Medical Physics, University of Ghana, Legon-Accra, Ghana.
| | - Francis Hasford
- Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra, Ghana
- Department of Medical Physics, University of Ghana, Legon-Accra, Ghana
| | - Theophilus A Sackey
- Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra, Ghana
- Department of Medical Physics, University of Ghana, Legon-Accra, Ghana
| |
Collapse
|
|
4
|
Gao J, Gong Y, Emu Y, Chen Z, Chen H, Yang F, Ding Z, Hua S, Jin W, Hu C. High Spatial-Resolution and Acquisition-Efficiency Cardiac MR T1 Mapping Based on Radial bSSFP and a Low-Rank Tensor Constraint. J Magn Reson Imaging 2025; 61:1388-1401. [PMID: 39143028 DOI: 10.1002/jmri.29564] [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: 01/22/2024] [Revised: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Cardiac T1 mapping is valuable for evaluating myocardial fibrosis, yet its resolution and acquisition efficiency are limited, potentially obscuring visualization of small pathologies. PURPOSE To develop a technique for high-resolution cardiac T1 mapping with a less-than-100-millisecond acquisition window based on radial MOdified Look-Locker Inversion recovery (MOLLI) and a calibrationless space-contrast-coil locally low-rank tensor (SCC-LLRT) constrained reconstruction. STUDY TYPE Prospective. SUBJECTS/PHANTOM Sixteen healthy subjects (age 25 ± 3 years, 44% females) and 12 patients with suspected cardiomyopathy (age 57 ± 15 years, 42% females), NiCl2-agar phantom. FIELD STRENGTH/SEQUENCE 3-T, standard MOLLI, radial MOLLI, inversion-recovery spin-echo, late gadolinium enhancement. ASSESSMENT SCC-LLRT was compared to a conventional locally low-rank (LLR) method through simulations using Normalized Root-Mean-Square Error (NRMSE) and Structural Similarity Index Measure (SSIM). Radial MOLLI was compared to standard MOLLI across phantom, healthy subjects, and patients. Three independent readers subjectively evaluated the quality of T1 maps using a 5-point scale (5 = best). STATISTICAL TESTS Paired t-test, Wilcoxon signed-rank test, intraclass correlation coefficient analysis, linear regression, Bland-Altman analysis. P < 0.05 was considered statistically significant. RESULTS In simulations, SCC-LLRT demonstrated a significant improvement in NRMSE and SSIM compared to LLR. In phantom, both radial MOLLI and standard MOLLI provided consistent T1 estimates across different heart rates. In healthy subjects, radial MOLLI exhibited a significantly lower mean T1 (1115 ± 39 msec vs. 1155 ± 36 msec), similar T1 SD (74 ± 14 msec vs. 67 ± 23 msec, P = 0.20), and similar T1 reproducibility (28 ± 18 msec vs. 22 ± 15 msec, P = 0.34) compared to standard MOLLI. In patients, the proposed method significantly improved the sharpness of myocardial boundaries (4.50 ± 0.65 vs. 3.25 ± 0.43), the conspicuity of papillary muscles and fine structures (4.33 ± 0.74 vs. 3.33 ± 0.47), and artifacts (4.75 ± 0.43 vs. 3.83 ± 0.55). The reconstruction time for a single slice was 5.2 hours. DATA CONCLUSION The proposed method enables high-resolution cardiac T1 mapping with a short acquisition window and improved image quality. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
Collapse
Affiliation(s)
- Juan Gao
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yiwen Gong
- Department of Cardiovascular Medicine, Heart Failure Center, Ruijin Hospital and Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixin Emu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Zhuo Chen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Haiyang Chen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Fan Yang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Zekang Ding
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Sha Hua
- Department of Cardiovascular Medicine, Heart Failure Center, Ruijin Hospital and Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Jin
- Department of Cardiovascular Medicine, Heart Failure Center, Ruijin Hospital and Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenxi Hu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
|
5
|
Wang Y, Ma X, Zhang Y, Yang Y, Wang P, Chen T, Gao C, Dong C, Zheng J, Wu A. Insights into Non-Metallic Magnetic Resonance Imaging Contrast Agents: Advances and Perspectives. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2025; 21:e2411875. [PMID: 39901535 DOI: 10.1002/smll.202411875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2024] [Revised: 01/15/2025] [Indexed: 02/05/2025]
Abstract
Traditional metal-based magnetic resonance imaging contrast agents (MRI CAs), such as gadolinium, iron, and manganese, have made significant advancements in diagnosing major diseases. However, their potential toxicity due to long-term accumulation in the brain and bones raises safety concerns. In contrast, non-metallic MRI CAs, which can produce a nuclear magnetic resonance effect, show great promise in MRI applications due to their adaptable structure and function, good biocompatibility, and excellent biodegradability. Nevertheless, the development of non-metallic MRI CAs is slow due to the inherent low magnetic sensitivity of organic compounds, their rapid metabolism, and susceptibility to reduction. Designing effective multifunctional organic compounds for high-sensitivity MRI remains a challenge. In this discussion, the mechanisms of various non-metallic MRI CAs are explored and an overview of their current status, highlighting both their advantages and potential drawbacks, is provided. The key strategies for creating high-performance MRI CAs are summarized and how different synthetic approaches affect the performance of non-metallic MRI Cas is evaluated. Last, the challenges and future prospects for these promising non-metallic MRI CAs are addressed.
Collapse
Affiliation(s)
- Yanan Wang
- Cixi Biomedical Research Institute, Wenzhou Medical University, Cixi, 315300, China
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China
| | - Xuehua Ma
- Cixi Biomedical Research Institute, Wenzhou Medical University, Cixi, 315300, China
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yunhao Zhang
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China
| | - Yanqiang Yang
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China
| | - Pengyu Wang
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Tianxiang Chen
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China
| | - Changyong Gao
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China
| | - Chen Dong
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China
| | - Jianjun Zheng
- Department of Radiology, Ningbo No.2 Hospital, Ningbo, 3l5010, China
| | - Aiguo Wu
- Cixi Biomedical Research Institute, Wenzhou Medical University, Cixi, 315300, China
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China
| |
Collapse
|
|
6
|
Borodzicz-Jazdzyk S, de Mooij GW, Vink CEM, van de Wiel MA, Benovoy M, Götte MJW. Stress T1 Mapping and Quantitative Perfusion Cardiovascular Magnetic Resonance in Patients with Suspected Obstructive Coronary Artery Disease. Eur Heart J Cardiovasc Imaging 2025:jeaf059. [PMID: 39957254 DOI: 10.1093/ehjci/jeaf059] [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: 10/27/2024] [Revised: 01/08/2025] [Accepted: 02/07/2025] [Indexed: 02/18/2025] Open
Abstract
AIMS T1 mapping reactivity (ΔT1) has been proposed as a novel contrast-free technique to detect obstructive coronary artery disease (CAD). The aims of the study are: 1) to compare the cardiovascular magnetic resonance (CMR)-derived ΔT1 with quantitative perfusion (QP CMR) measures; 2) to assess the influence of sex and comorbidities on ΔT1; and 3) to assess the diagnostic accuracy of ΔT1 to detect obstructive CAD diagnosed with the invasive coronary angiography (ICA) and/or fractional flow reserve. METHODS AND RESULTS This study retrospectively analyzed 51 patients with suspected obstructive CAD who underwent CMR including rest and adenosine stress first-pass perfusion and native T1 mapping (MOLLI). A moderate correlation was found between pooled rest and stress native T1 mapping and MBF (Pearson's r=0.476; p<0.001). When stratified by MPR, ischemic myocardium had significantly lower stress T1 mapping values (p<0.001) and ΔT1 (p=0.005) vs. nonischemic myocardium. Male sex and history of diabetes were independently associated with lower ΔT1. The optimal cut-off value of Δ T1 to detect impaired MPR on a per-vessel basis was ≤5.4%, with an AUC of 0.662 (95% CI: 0.563-0.752, p=0.003), sensitivity of 84% (95% CI: 67-95) and specificity of 46% (95% CI: 34-58). When validated against ICA, stress T1 and Δ T1 did not reach statistical significance in detecting obstructive CAD. CONCLUSION ΔT1 is significantly influenced by sex and comorbidities and has poor diagnostic accuracy for detecting myocardial ischemia. Therefore, the clinical utility of ΔT1 in a real-world cohort of patients to detect obstructive CAD is limited.
Collapse
Affiliation(s)
- S Borodzicz-Jazdzyk
- Dept. of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
- 1st Dept. of Cardiology, Medical University of Warsaw, Banacha 1a Str., 02-097 Warsaw, Poland
| | - G W de Mooij
- Dept. of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
| | - C E M Vink
- Dept. of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
| | - M A van de Wiel
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - M Benovoy
- Area19 Medical Inc., Montreal, H2V2X5, Canada
| | - M J W Götte
- Dept. of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
| |
Collapse
|
|
7
|
Kim K, Kim KI, Lee JW, Jeong YJ. Unlocking the Potential of Chest MRI: Strategies for Establishing a Successful Practice. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2025; 86:83-104. [PMID: 39958489 PMCID: PMC11822286 DOI: 10.3348/jksr.2024.0056] [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: 04/18/2024] [Revised: 07/26/2024] [Accepted: 08/09/2024] [Indexed: 02/18/2025]
Abstract
Chest MRI is a valuable tool for assessing chest structures, particularly when CT produces inconclusive results. MRI provides exceptional soft-tissue resolution and enables the determination of lesion location, size, and invasion into neighboring structures. Its applications span various clinical scenarios, including the differentiation of non-tumorous and tumorous conditions in the mediastinum or pleura, planning of surgical interventions and treatments for such tumors, evaluation of post-treatment recurrence, staging of lung cancer, and diagnosis of progressive massive fibrosis. Despite the technical hurdles posed by cardiac and respiratory motion, advancements in sequence and scan techniques have enabled high-quality chest MRI examinations to be conducted across diverse clinical settings. This pictorial essay aims to offer comprehensive resources and strategies for radiologists to integrate chest MRI into clinical practice and to overcome its present challenges.
Collapse
|
|
8
|
Schultz JD, Yuly JL, Arsenault EA, Parker K, Chowdhury SN, Dani R, Kundu S, Nuomin H, Zhang Z, Valdiviezo J, Zhang P, Orcutt K, Jang SJ, Fleming GR, Makri N, Ogilvie JP, Therien MJ, Wasielewski MR, Beratan DN. Coherence in Chemistry: Foundations and Frontiers. Chem Rev 2024; 124:11641-11766. [PMID: 39441172 DOI: 10.1021/acs.chemrev.3c00643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2024]
Abstract
Coherence refers to correlations in waves. Because matter has a wave-particle nature, it is unsurprising that coherence has deep connections with the most contemporary issues in chemistry research (e.g., energy harvesting, femtosecond spectroscopy, molecular qubits and more). But what does the word "coherence" really mean in the context of molecules and other quantum systems? We provide a review of key concepts, definitions, and methodologies, surrounding coherence phenomena in chemistry, and we describe how the terms "coherence" and "quantum coherence" refer to many different phenomena in chemistry. Moreover, we show how these notions are related to the concept of an interference pattern. Coherence phenomena are indeed complex, and ambiguous definitions may spawn confusion. By describing the many definitions and contexts for coherence in the molecular sciences, we aim to enhance understanding and communication in this broad and active area of chemistry.
Collapse
Affiliation(s)
- Jonathan D Schultz
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
- Department of Chemistry, Northwestern University, Evanston, Illinois 60208, United States
| | - Jonathon L Yuly
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, New Jersey 08540, United States
- Department of Physics, Duke University, Durham, North Carolina 27708, United States
| | - Eric A Arsenault
- Department of Chemistry, University of California, Berkeley, Berkeley, California 94720, United States
- Department of Chemistry, Columbia University, New York, New York 10027, United States
| | - Kelsey Parker
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
| | - Sutirtha N Chowdhury
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
| | - Reshmi Dani
- Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States
| | - Sohang Kundu
- Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States
| | - Hanggai Nuomin
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
| | - Zhendian Zhang
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
| | - Jesús Valdiviezo
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, United States
- Sección Química, Departamento de Ciencias, Pontificia Universidad Católica del Perú, San Miguel, Lima 15088, Peru
| | - Peng Zhang
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
| | - Kaydren Orcutt
- Department of Chemistry, University of California, Berkeley, Berkeley, California 94720, United States
- Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
- Bioproducts Research Unit, Western Regional Research Center, Agricultural Research Service, United States Department of Agriculture, 800 Buchanan Street, Albany, California 94710, United States
| | - Seogjoo J Jang
- Department of Chemistry and Biochemistry, Queens College, City University of New York, Queens, New York 11367, United States
- Chemistry and Physics PhD programs, Graduate Center, City University of New York, New York, New York 10016, United States
| | - Graham R Fleming
- Department of Chemistry, University of California, Berkeley, Berkeley, California 94720, United States
| | - Nancy Makri
- Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States
- Department of Physics, University of Illinois, Urbana, Illinois 61801, United States
- Illinois Quantum Information Science and Technology Center, University of Illinois, Urbana, Illinois 61801, United States
| | - Jennifer P Ogilvie
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Michael J Therien
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
| | - Michael R Wasielewski
- Department of Chemistry, Northwestern University, Evanston, Illinois 60208, United States
| | - David N Beratan
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
- Department of Physics, Duke University, Durham, North Carolina 27708, United States
- Department of Biochemistry, Duke University, Durham, North Carolina 27710, United States
| |
Collapse
|
|
9
|
Rajah MR, Doubell AF, Herbst PG. Quantification of Replacement Fibrosis in Aortic Stenosis: A Narrative Review on the Utility of Cardiovascular Magnetic Resonance Imaging. Diagnostics (Basel) 2024; 14:2435. [PMID: 39518402 PMCID: PMC11544846 DOI: 10.3390/diagnostics14212435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2024] [Revised: 10/27/2024] [Accepted: 10/29/2024] [Indexed: 11/16/2024] Open
Abstract
Aortic stenosis (AS) is associated with the development of replacement myocardial fibrosis/scar. Given the dose-dependent relationship between scar and clinical outcomes after aortic valve replacement (AVR) surgery, scar quantity may serve as an important risk-stratification tool to aid decision-making on the optimal timing of AVR. Scar is non-invasively assessed and quantified by cardiovascular magnetic resonance (CMR) imaging. Several quantification techniques exist, and consensus on the optimal technique is lacking. These techniques range from a visual manual method to fully automated ones. This review describes the different scar quantification techniques used and highlights their strengths and shortfalls within the context of AS. The two most commonly used techniques in AS include the semi-automated signal threshold versus reference mean (STRM) and full-width half-maximum (FWHM) techniques. The accuracy and reproducibility of these techniques may be hindered in AS by the coexistence of diffuse interstitial fibrosis and the presence of relatively small, non-bright scars. The validation of these techniques against histology, which is the current gold standard for scar quantification in AS, is limited. Based on the best current evidence, the STRM method using a threshold of three standard deviations above the mean signal intensity of remote myocardium is recommended. The high reproducibility of the FWHM technique in non-AS cohorts has been shown and merits further evaluation within the context of AS. Future directions include the use of quantitative T1 mapping for the detection and quantification of scar, as well as the development of serum biomarkers that reflect the fibrotic status of the myocardium in AS.
Collapse
Affiliation(s)
- Megan R. Rajah
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town 7505, South Africa
| | | | | |
Collapse
|
|
10
|
Rafiee MJ, Eyre K, Leo M, Benovoy M, Friedrich MG, Chetrit M. Comprehensive review of artifacts in cardiac MRI and their mitigation. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024; 40:2021-2039. [PMID: 39292396 DOI: 10.1007/s10554-024-03234-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 08/27/2024] [Indexed: 09/19/2024]
Abstract
Cardiac magnetic resonance imaging (CMR) is an important clinical tool that obtains high-quality images for assessment of cardiac morphology, function, and tissue characteristics. However, the technique may be prone to artifacts that may limit the diagnostic interpretation of images. This article reviews common artifacts which may appear in CMR exams by describing their appearance, the challenges they mitigate true pathology, and offering possible solutions to reduce their impact. Additionally, this article acts as an update to previous CMR artifacts reports by including discussion about new CMR innovations.
Collapse
Affiliation(s)
| | - Katerina Eyre
- Research Institute, McGill University Health Centre, Montreal, Canada
| | - Margherita Leo
- Research Institute, McGill University Health Centre, Montreal, Canada
| | | | - Matthias G Friedrich
- Research Institute, McGill University Health Centre, Montreal, Canada
- Area19 Medical Inc, Montreal, Canada
- Department of Diagnostic Radiology, Division of Cardiology, McGill University Health Centre, Montreal, Canada
| | - Michael Chetrit
- Research Institute, McGill University Health Centre, Montreal, Canada
- Department of Diagnostic Radiology, Division of Cardiology, McGill University Health Centre, Montreal, Canada
| |
Collapse
|
|
11
|
Vanmali A, Alhumaid W, White JA. Cardiovascular Magnetic Resonance-Based Tissue Characterization in Patients With Hypertrophic Cardiomyopathy. Can J Cardiol 2024; 40:887-898. [PMID: 38490449 DOI: 10.1016/j.cjca.2024.02.029] [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: 12/04/2023] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 03/17/2024] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is a common hereditable cardiomyopathy that affects between 1:200 to 1:500 of the general population. The role of cardiovascular magnetic resonance (CMR) imaging in the management of HCM has expanded over the past 2 decades to become a key informant of risk in this patient population, delivering unique insights into tissue health and its influence on future outcomes. Numerous mature CMR-based techniques are clinically available for the interrogation of tissue health in patients with HCM, inclusive of contrast and noncontrast methods. Late gadolinium enhancement imaging remains a cornerstone technique for the identification and quantification of myocardial fibrosis with large cumulative evidence supporting value for the prediction of arrhythmic outcomes. T1 mapping delivers improved fidelity for fibrosis quantification through direct estimations of extracellular volume fraction but also offers potential for noncontrast surrogate assessments of tissue health. Water-sensitive imaging, inclusive of T2-weighted dark blood imaging and T2 mapping, have also shown preliminary potential for assisting in risk discrimination. Finally, emerging techniques, inclusive of innovative multiparametric methods, are expanding the utility of CMR to assist in the delivery of comprehensive tissue characterization toward the delivery of personalized HCM care. In this narrative review we summarize the contemporary landscape of CMR techniques aimed at characterizing tissue health in patients with HCM. The value of these respective techniques to identify patients at elevated risk of future cardiovascular outcomes are highlighted.
Collapse
Affiliation(s)
- Atish Vanmali
- Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Alberta, Canada; Department of Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada; Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada; Department of Cardiac Science, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Waleed Alhumaid
- Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Alberta, Canada; Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada; Department of Cardiac Science, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada
| | - James A White
- Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Alberta, Canada; Department of Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada; Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada; Department of Cardiac Science, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada.
| |
Collapse
|
|
12
|
Weihsbach C, Vogt N, Al-Haj Hemidi Z, Bigalke A, Hansen L, Oster J, Heinrich MP. AcquisitionFocus: Joint Optimization of Acquisition Orientation and Cardiac Volume Reconstruction Using Deep Learning. SENSORS (BASEL, SWITZERLAND) 2024; 24:2296. [PMID: 38610507 PMCID: PMC11014047 DOI: 10.3390/s24072296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024]
Abstract
In cardiac cine imaging, acquiring high-quality data is challenging and time-consuming due to the artifacts generated by the heart's continuous movement. Volumetric, fully isotropic data acquisition with high temporal resolution is, to date, intractable due to MR physics constraints. To assess whole-heart movement under minimal acquisition time, we propose a deep learning model that reconstructs the volumetric shape of multiple cardiac chambers from a limited number of input slices while simultaneously optimizing the slice acquisition orientation for this task. We mimic the current clinical protocols for cardiac imaging and compare the shape reconstruction quality of standard clinical views and optimized views. In our experiments, we show that the jointly trained model achieves accurate high-resolution multi-chamber shape reconstruction with errors of <13 mm HD95 and Dice scores of >80%, indicating its effectiveness in both simulated cardiac cine MRI and clinical cardiac MRI with a wide range of pathological shape variations.
Collapse
Affiliation(s)
- Christian Weihsbach
- Institute of Medical Informatics, University of Lübeck, 23562 Lübeck, Germany; (Z.A.-H.H.); (A.B.); (M.P.H.)
| | - Nora Vogt
- IADI U1254, Inserm, Université de Lorraine, 54511 Nancy, France
| | - Ziad Al-Haj Hemidi
- Institute of Medical Informatics, University of Lübeck, 23562 Lübeck, Germany; (Z.A.-H.H.); (A.B.); (M.P.H.)
| | - Alexander Bigalke
- Institute of Medical Informatics, University of Lübeck, 23562 Lübeck, Germany; (Z.A.-H.H.); (A.B.); (M.P.H.)
| | | | - Julien Oster
- IADI U1254, Inserm, Université de Lorraine, 54511 Nancy, France
- CHRU-Nancy, Inserm, Université de Lorraine, CIC 1433, Innovation Technologique, 54000 Nancy, France
| | - Mattias P. Heinrich
- Institute of Medical Informatics, University of Lübeck, 23562 Lübeck, Germany; (Z.A.-H.H.); (A.B.); (M.P.H.)
| |
Collapse
|
|
13
|
Wada DT, Wada LS, Machado CVB, Lourenço MR, de Nadai TR, Cipriano FEG, Fabro AT, Koenigkam-Santos M. Look-Locker T1 relaxometry and high-resolution T2 in the evaluation of lung lesions: a single-center prospective study. Radiol Bras 2024; 57:e20240033. [PMID: 39399790 PMCID: PMC11469640 DOI: 10.1590/0100-3984.2024.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/18/2024] [Accepted: 07/08/2024] [Indexed: 10/15/2024] Open
Abstract
Objective To explore the feasibility of two magnetic resonance imaging (MRI) sequences-high-resolution T2-weighted (HR T2) and Look-Locker T1 (LL T1) relaxometry-for the investigation focal lung lesions (FLLs). As a secondary objective, we analyzed the diagnostic accuracy of these sequences. Materials and Methods This was a prospective observational study involving 39 subjects with FLLs scanned in a 1.5-T MRI system with LL T1 relaxometry and HR T2 sequences focused on the FLL region, in addition to a conventional protocol. All images were evaluated by two radiologists, working independently, who were blinded to other findings. Results Most of the examinations (31 of the LL T1 relaxometry sequences and 36 of the HR T2 sequences) were of adequate diagnostic quality. Nondiagnostic examinations were considered so mainly because of limited coverage of the sequences. Of the FLLs studied, 19 were malignant, 17 were benign, and three were excluded from the accuracy analysis because there was no definitive diagnosis. Although LL T1 relaxometry could not distinguish between benign and malignant lesions, the signal intensity at its first inversion time (160 ms) differed between the two groups. The HR T2 sequence was considered the best sequence for assessing specific morphological characteristics, especially pseudocavities and pleural tags. We found that MRI showed better accuracy than did computed tomography (86% vs. 74%). Conclusion Both MRI sequences are feasible for the evaluation of FLLs. Images at 160 ms of the LL T1 relaxometry sequence helped distinguish between benign and malignant lesions, and the HR T2 sequence was considered the best sequence for evaluating specific morphological characteristics.
Collapse
Affiliation(s)
- Danilo Tadao Wada
- Faculdade de Medicina de Ribeirão Preto da Universidade de
São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Li Siyuan Wada
- Faculdade de Medicina de Ribeirão Preto da Universidade de
São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Camila Vilas Boas Machado
- Faculdade de Medicina de Ribeirão Preto da Universidade de
São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Mateus Repolês Lourenço
- Faculdade de Medicina de Ribeirão Preto da Universidade de
São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Tales Rubens de Nadai
- Faculdade de Medicina de Ribeirão Preto da Universidade de
São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | | | - Alexandre Todorovic Fabro
- Faculdade de Medicina de Ribeirão Preto da Universidade de
São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Marcel Koenigkam-Santos
- Faculdade de Medicina de Ribeirão Preto da Universidade de
São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
- Faculdade de Medicina de Bauru da Universidade de São Paulo
(FMBRU-USP), Bauru, SP, Brazil
| |
Collapse
|
|
14
|
Chen YC, Zheng G, Donner DG, Wright DK, Greenwood JP, Marwick TH, McMullen JR. Cardiovascular magnetic resonance imaging for sequential assessment of cardiac fibrosis in mice: technical advancements and reverse translation. Am J Physiol Heart Circ Physiol 2024; 326:H1-H24. [PMID: 37921664 PMCID: PMC11213480 DOI: 10.1152/ajpheart.00437.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Abstract
Cardiovascular magnetic resonance (CMR) imaging has become an essential technique for the assessment of cardiac function and morphology, and is now routinely used to monitor disease progression and intervention efficacy in the clinic. Cardiac fibrosis is a common characteristic of numerous cardiovascular diseases and often precedes cardiac dysfunction and heart failure. Hence, the detection of cardiac fibrosis is important for both early diagnosis and the provision of guidance for interventions/therapies. Experimental mouse models with genetically and/or surgically induced disease have been widely used to understand mechanisms underlying cardiac fibrosis and to assess new treatment strategies. Improving the appropriate applications of CMR to mouse studies of cardiac fibrosis has the potential to generate new knowledge, and more accurately examine the safety and efficacy of antifibrotic therapies. In this review, we provide 1) a brief overview of different types of cardiac fibrosis, 2) general background on magnetic resonance imaging (MRI), 3) a summary of different CMR techniques used in mice for the assessment of cardiac fibrosis including experimental and technical considerations (contrast agents and pulse sequences), and 4) provide an overview of mouse studies that have serially monitored cardiac fibrosis during disease progression and/or therapeutic interventions. Clinically established CMR protocols have advanced mouse CMR for the detection of cardiac fibrosis, and there is hope that discovery studies in mice will identify new antifibrotic therapies for patients, highlighting the value of both reverse translation and bench-to-bedside research.
Collapse
Affiliation(s)
- Yi Ching Chen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Gang Zheng
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Daniel G Donner
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - David K Wright
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - John P Greenwood
- Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Thomas H Marwick
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Melbourne, Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Department of Cardiology, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Julie R McMullen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| |
Collapse
|
|
15
|
Dattani A, Singh A, McCann GP, Gulsin GS. Myocardial Calcium Handling in Type 2 Diabetes: A Novel Therapeutic Target. J Cardiovasc Dev Dis 2023; 11:12. [PMID: 38248882 PMCID: PMC10817027 DOI: 10.3390/jcdd11010012] [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: 11/06/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Type 2 diabetes (T2D) is a multisystem disease with rapidly increasing global prevalence. Heart failure has emerged as a major complication of T2D. Dysregulated myocardial calcium handling is evident in the failing heart and this may be a key driver of cardiomyopathy in T2D, but until recently this has only been demonstrated in animal models. In this review, we describe the physiological concepts behind calcium handling within the cardiomyocyte and the application of novel imaging techniques for the quantification of myocardial calcium uptake. We take an in-depth look at the evidence for the impairment of calcium handling in T2D using pre-clinical models as well as in vivo studies, following which we discuss potential novel therapeutic approaches targeting dysregulated myocardial calcium handling in T2D.
Collapse
Affiliation(s)
- Abhishek Dattani
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Leicester LE3 9QP, UK; (A.S.); (G.P.M.); (G.S.G.)
| | | | | | | |
Collapse
|
|
16
|
Hopman LHGA, van Pouderoijen N, Mulder MJ, van der Laan AM, Bhagirath P, Nazarian S, Niessen HWM, Ferrari VA, Allaart CP, Götte MJW. Atrial Ablation Lesion Evaluation by Cardiac Magnetic Resonance: Review of Imaging Strategies and Histological Correlations. JACC Clin Electrophysiol 2023; 9:2665-2679. [PMID: 37737780 DOI: 10.1016/j.jacep.2023.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/09/2023] [Indexed: 09/23/2023]
Abstract
Cardiac magnetic resonance (CMR) imaging is a valuable noninvasive tool for evaluating tissue response following catheter ablation of atrial tissue. This review provides an overview of the contemporary CMR strategies to visualize atrial ablation lesions in both the acute and chronic postablation stages, focusing on their strengths and limitations. Moreover, the accuracy of CMR imaging in comparison to atrial lesion histology is discussed. T2-weighted CMR imaging is sensitive to edema and tends to overestimate lesion size in the acute stage after ablation. Noncontrast agent-enhanced T1-weighted CMR imaging has the potential to provide more accurate assessment of lesions in the acute stage but may not be as effective in the chronic stage. Late gadolinium enhancement imaging can be used to detect chronic atrial scarring, which may inform repeat ablation strategies. Moreover, novel imaging strategies are being developed, but their efficacy in characterizing atrial lesions is yet to be determined. Overall, CMR imaging has the potential to provide virtual histology that aids in evaluating the efficacy and safety of catheter ablation and monitoring of postprocedural myocardial changes. However, technical factors, scanning during arrhythmia, and transmurality assessment pose challenges. Therefore, further research is needed to develop CMR strategies to visualize the ablation lesion maturation process more effectively.
Collapse
Affiliation(s)
| | | | - Mark J Mulder
- Department of Cardiology, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Pranav Bhagirath
- Department of Cardiology, Amsterdam UMC, Amsterdam, the Netherlands
| | - Saman Nazarian
- Penn Cardiovascular Institute, Penn Heart and Vascular Center, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, USA
| | - Hans W M Niessen
- Department of Pathology, Amsterdam UMC, Amsterdam, the Netherlands
| | - Victor A Ferrari
- Penn Cardiovascular Institute, Penn Heart and Vascular Center, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, USA
| | | | - Marco J W Götte
- Department of Cardiology, Amsterdam UMC, Amsterdam, the Netherlands.
| |
Collapse
|
|
17
|
Nikolaidou C, Ormerod JO, Ziakas A, Neubauer S, Karamitsos TD. The Role of Cardiovascular Magnetic Resonance Imaging in Patients with Cardiac Arrhythmias. Rev Cardiovasc Med 2023; 24:252. [PMID: 39076394 PMCID: PMC11262447 DOI: 10.31083/j.rcm2409252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 07/31/2024] Open
Abstract
Cardiac arrhythmias are associated with significant morbidity, mortality and poor quality of life. Cardiovascular magnetic resonance (CMR) imaging, with its unsurpassed capability of non-invasive tissue characterisation, high accuracy, and reproducibility of measurements, plays an integral role in determining the underlying aetiology of cardiac arrhytmias. CMR can reliably diagnose previous myocardial infarction, non-ischemic cardiomyopathy, characterise congenital heart disease and valvular pathologies, and also detect the underlying substrate concealed on conventional investigations in a significant proportion of patients with arrhythmias. Determining the underlying substrate of arrhythmia is of paramount importance for treatment planning and prognosis. However, CMR imaging in patients with irregular heart rates can be problematic. Understanding the different ways to overcome the limitations of CMR in arrhythmia is essential for providing high-quality imaging, comprehensive information, and definitive answers in this diverse group of patients.
Collapse
Affiliation(s)
- Chrysovalantou Nikolaidou
- Oxford Centre for Clinical Magnetic Resonance Research, University of
Oxford, John Radcliffe Hospital, Headington, OX3 9DU Oxford, UK
| | - Julian O.M. Ormerod
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine,
University of Oxford, John Radcliffe Hospital, Headington, OX3 9DU
Oxford, UK
| | - Antonios Ziakas
- First Department of Cardiology, AHEPA Hospital, School of Medicine,
Faculty of Health Sciences, Aristotle University of Thessaloniki, 54636
Thessaloniki, Greece
| | - Stefan Neubauer
- Oxford Centre for Clinical Magnetic Resonance Research, University of
Oxford, John Radcliffe Hospital, Headington, OX3 9DU Oxford, UK
| | - Theodoros D. Karamitsos
- Oxford Centre for Clinical Magnetic Resonance Research, University of
Oxford, John Radcliffe Hospital, Headington, OX3 9DU Oxford, UK
- First Department of Cardiology, AHEPA Hospital, School of Medicine,
Faculty of Health Sciences, Aristotle University of Thessaloniki, 54636
Thessaloniki, Greece
| |
Collapse
|
|
18
|
Mamalakis M, Garg P, Nelson T, Lee J, Swift AJ, Wild JM, Clayton RH. Artificial Intelligence framework with traditional computer vision and deep learning approaches for optimal automatic segmentation of left ventricle with scar. Artif Intell Med 2023; 143:102610. [PMID: 37673578 DOI: 10.1016/j.artmed.2023.102610] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 05/17/2023] [Accepted: 06/06/2023] [Indexed: 09/08/2023]
Abstract
Automatic segmentation of the cardiac left ventricle with scars remains a challenging and clinically significant task, as it is essential for patient diagnosis and treatment pathways. This study aimed to develop a novel framework and cost function to achieve optimal automatic segmentation of the left ventricle with scars using LGE-MRI images. To ensure the generalization of the framework, an unbiased validation protocol was established using out-of-distribution (OOD) internal and external validation cohorts, and intra-observation and inter-observer variability ground truths. The framework employs a combination of traditional computer vision techniques and deep learning, to achieve optimal segmentation results. The traditional approach uses multi-atlas techniques, active contours, and k-means methods, while the deep learning approach utilizes various deep learning techniques and networks. The study found that the traditional computer vision technique delivered more accurate results than deep learning, except in cases where there was breath misalignment error. The optimal solution of the framework achieved robust and generalized results with Dice scores of 82.8 ± 6.4% and 72.1 ± 4.6% in the internal and external OOD cohorts, respectively. The developed framework offers a high-performance solution for automatic segmentation of the left ventricle with scars using LGE-MRI. Unlike existing state-of-the-art approaches, it achieves unbiased results across different hospitals and vendors without the need for training or tuning in hospital cohorts. This framework offers a valuable tool for experts to accomplish the task of fully automatic segmentation of the left ventricle with scars based on a single-modality cardiac scan.
Collapse
Affiliation(s)
- Michail Mamalakis
- Insigneo Institute for in-silico, Medicine, University of Sheffield, Sheffield, S1 4DP, UK; Department of Computer Science, University of Sheffield, Regent Court, Sheffield, S1 4DP, UK.
| | - Pankaj Garg
- Department of Cardiology, Sheffield Teaching Hospitals Sheffield S5 7AU, UK
| | - Tom Nelson
- Department of Cardiology, Sheffield Teaching Hospitals Sheffield S5 7AU, UK
| | - Justin Lee
- Department of Cardiology, Sheffield Teaching Hospitals Sheffield S5 7AU, UK
| | - Andrew J Swift
- Department of Computer Science, University of Sheffield, Regent Court, Sheffield, S1 4DP, UK; Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - James M Wild
- Insigneo Institute for in-silico, Medicine, University of Sheffield, Sheffield, S1 4DP, UK; Polaris, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Richard H Clayton
- Insigneo Institute for in-silico, Medicine, University of Sheffield, Sheffield, S1 4DP, UK; Department of Computer Science, University of Sheffield, Regent Court, Sheffield, S1 4DP, UK.
| |
Collapse
|
|
19
|
Lu J, Jin R, Wang M, Song E, Ma G. A bidirectional registration neural network for cardiac motion tracking using cine MRI images. Comput Biol Med 2023; 160:107001. [PMID: 37187138 DOI: 10.1016/j.compbiomed.2023.107001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 03/15/2023] [Accepted: 05/02/2023] [Indexed: 05/17/2023]
Abstract
Using cine magnetic resonance imaging (cine MRI) images to track cardiac motion helps users to analyze the myocardial strain, and is of great importance in clinical applications. At present, most of the automatic deep learning-based motion tracking methods compare two images without considering temporal information between MRI frames, which easily leads to the lack of consistency of the generated motion fields. Even though a small number of works take into account the temporal factor, they are usually computationally intensive or have limitations on image length. To solve this problem, we propose a bidirectional convolution neural network for motion tracking of cardiac cine MRI images. This network leverages convolutional blocks to extract spatial features from three-dimensional (3D) image registration pairs, and models the temporal relations through a bidirectional recurrent neural network to obtain the Lagrange motion field between the reference image and other images. Compared with previous pairwise registration methods, the proposed method can automatically learn spatiotemporal information from multiple images with fewer parameters. We evaluated our model on three public cardiac cine MRI datasets. The experimental results demonstrated that the proposed method can significantly improve the motion tracking accuracy. The average Dice coefficient between estimated segmentation and manual segmentation has reached almost 0.85 on the widely used Automatic Cardiac Diagnostic Challenge (ACDC) dataset.
Collapse
Affiliation(s)
- Jiayi Lu
- School of Computer Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| | - Renchao Jin
- School of Computer Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China.
| | - Manyang Wang
- School of Computer Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| | - Enmin Song
- School of Computer Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| | - Guangzhi Ma
- School of Computer Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| |
Collapse
|
|
20
|
Ferreira VM, Plein S, Wong TC, Tao Q, Raisi-Estabragh Z, Jain SS, Han Y, Ojha V, Bluemke DA, Hanneman K, Weinsaft J, Vidula MK, Ntusi NAB, Schulz-Menger J, Kim J. Cardiovascular magnetic resonance for evaluation of cardiac involvement in COVID-19: recommendations by the Society for Cardiovascular Magnetic Resonance. J Cardiovasc Magn Reson 2023; 25:21. [PMID: 36973744 PMCID: PMC10041524 DOI: 10.1186/s12968-023-00933-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic that has affected nearly 600 million people to date across the world. While COVID-19 is primarily a respiratory illness, cardiac injury is also known to occur. Cardiovascular magnetic resonance (CMR) imaging is uniquely capable of characterizing myocardial tissue properties in-vivo, enabling insights into the pattern and degree of cardiac injury. The reported prevalence of myocardial involvement identified by CMR in the context of COVID-19 infection among previously hospitalized patients ranges from 26 to 60%. Variations in the reported prevalence of myocardial involvement may result from differing patient populations (e.g. differences in severity of illness) and the varying intervals between acute infection and CMR evaluation. Standardized methodologies in image acquisition, analysis, interpretation, and reporting of CMR abnormalities across would likely improve concordance between studies. This consensus document by the Society for Cardiovascular Magnetic Resonance (SCMR) provides recommendations on CMR imaging and reporting metrics towards the goal of improved standardization and uniform data acquisition and analytic approaches when performing CMR in patients with COVID-19 infection.
Collapse
Affiliation(s)
- Vanessa M Ferreira
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford British Heart Foundation Centre of Research Excellence, The National Institute for Health Research Oxford Biomedical Research Centre at the Oxford University Hospitals NHS Foundation Trust, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Sven Plein
- Department of Biomedical Imaging Science, University of Leeds, Leeds, UK
| | - Timothy C Wong
- Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Qian Tao
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - Supriya S Jain
- Division of Pediatric Cardiology, Department of Pediatrics, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, New York, USA
| | - Yuchi Han
- Cardiovascular Medicine, Wexner Medical Center, The Ohio State University, Columbus, USA
| | - Vineeta Ojha
- Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - David A Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Kate Hanneman
- Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Jonathan Weinsaft
- Department of Medicine, Division of Cardiology, Weill Cornell Medicine/New York Presbyterian Hospital, Weill Cornell Medical College, New York, USA
| | - Mahesh K Vidula
- Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, USA
| | - Ntobeko A B Ntusi
- Division of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur Hospital; Cape Heart Institute, University of Cape Town, South African Medical Research Council Extramural Unit On Intersection of Noncommunicable Diseases and Infectious Diseases, Cape Town, South Africa
| | - Jeanette Schulz-Menger
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité and MDC, Charité University Medicine, Berlin, Germany
- Department of Cardiology and Nephrology, Helios Hospital Berlin-Buch, Berlin, Germany
| | - Jiwon Kim
- Department of Medicine, Division of Cardiology, Weill Cornell Medicine/New York Presbyterian Hospital, Weill Cornell Medical College, New York, USA.
| |
Collapse
|
|
21
|
Sun X, Cheng LH, Plein S, Garg P, Moghari MH, van der Geest RJ. Deep learning-based prediction of intra-cardiac blood flow in long-axis cine magnetic resonance imaging. Int J Cardiovasc Imaging 2023; 39:1045-1053. [PMID: 36763209 PMCID: PMC10160163 DOI: 10.1007/s10554-023-02804-2] [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: 12/14/2022] [Accepted: 01/22/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE We aimed to design and evaluate a deep learning-based method to automatically predict the time-varying in-plane blood flow velocity within the cardiac cavities in long-axis cine MRI, validated against 4D flow. METHODS A convolutional neural network (CNN) was implemented, taking cine MRI as the input and the in-plane velocity derived from the 4D flow acquisition as the ground truth. The method was evaluated using velocity vector end-point error (EPE) and angle error. Additionally, the E/A ratio and diastolic function classification derived from the predicted velocities were compared to those derived from 4D flow. RESULTS For intra-cardiac pixels with a velocity > 5 cm/s, our method achieved an EPE of 8.65 cm/s and angle error of 41.27°. For pixels with a velocity > 25 cm/s, the angle error significantly degraded to 19.26°. Although the averaged blood flow velocity prediction was under-estimated by 26.69%, the high correlation (PCC = 0.95) of global time-varying velocity and the visual evaluation demonstrate a good agreement between our prediction and 4D flow data. The E/A ratio was derived with minimal bias, but with considerable mean absolute error of 0.39 and wide limits of agreement. The diastolic function classification showed a high accuracy of 86.9%. CONCLUSION Using a deep learning-based algorithm, intra-cardiac blood flow velocities can be predicted from long-axis cine MRI with high correlation with 4D flow derived velocities. Visualization of the derived velocities provides adjunct functional information and may potentially be used to derive the E/A ratio from conventional CMR exams.
Collapse
Affiliation(s)
- Xiaowu Sun
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Li-Hsin Cheng
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sven Plein
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Pankaj Garg
- Norwich Medical School, University of East Anglia, Norwich, UK.,Norfolk and Norwich University Hospital Foundation Trust, Norwich, UK
| | - Mehdi H Moghari
- Department of Radiology, Children's Hospital Colorado, and School of Medicine, The University of Colorado, Boulder, CO, USA
| | - Rob J van der Geest
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
| |
Collapse
|
|
22
|
Abstract
Myocardial inflammation occurs following activation of the cardiac immune system, producing characteristic changes in the myocardial tissue. Cardiovascular magnetic resonance is the non-invasive imaging gold standard for myocardial tissue characterization, and is able to detect image signal changes that may occur resulting from inflammation, including edema, hyperemia, capillary leak, necrosis, and fibrosis. Conventional cardiovascular magnetic resonance for the detection of myocardial inflammation and its sequela include T2-weighted imaging, parametric T1- and T2-mapping, and gadolinium-based contrast-enhanced imaging. Emerging techniques seek to image several parameters simultaneously for myocardial tissue characterization, and to depict subtle immune-mediated changes, such as immune cell activity in the myocardium and cardiac cell metabolism. This review article outlines the underlying principles of current and emerging cardiovascular magnetic resonance methods for imaging myocardial inflammation.
Collapse
Affiliation(s)
- Katharine E Thomas
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (K.E.T., V.M.F.)
| | - Anastasia Fotaki
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, United Kingdom (A.F., R.M.B.)
| | - René M Botnar
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, United Kingdom (A.F., R.M.B.)
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile (R.M.B.)
- Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile (R.M.B.)
| | - Vanessa M Ferreira
- University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (K.E.T., V.M.F.)
| |
Collapse
|
|
23
|
Moscatelli S, Borrelli N, Sabatino J, Leo I, Avesani M, Montanaro C, Di Salvo G. Role of Cardiovascular Imaging in the Follow-Up of Patients with Fontan Circulation. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121875. [PMID: 36553321 PMCID: PMC9777137 DOI: 10.3390/children9121875] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
Since its first description in 1971, the Fontan procedure and its modifications have led to a substantial improvement in the survival rates of patients with a variety of types of complex Congenital Heart Disease (CHD) characterised by the presence of a single, dominant ventricle. However, despite the significant improvement of the prognosis over the years, Fontan patients are still exposed to several cardiovascular and systemic complications. It is, therefore, important to fully understand the pitfalls hidden behind a Fontan anatomy and the potential predictors of ventricular failure. Cardiovascular imaging plays a key role in this context, allowing for the early identification of complications with important prognostic implications. Echocardiography remains the first-line imaging modality for serial evaluation of Fontan patients. However, there is a growing role of cardiovascular magnetic resonance and cardiac computed tomography from pre-operative assessment to longitudinal follow-up. The aim of this paper will be to provide a comprehensive overview of the role, strengths, and weaknesses of each imaging modality in the assessment of congenital cardiac conditions palliated with the Fontan procedure.
Collapse
Affiliation(s)
- Sara Moscatelli
- Paediatric Cardiology Department, Royal Brompton Hospital Harefield NHS Foundation Trust, London SW3 5NP, UK
| | - Nunzia Borrelli
- Adult Congenital Heart Disease Unit, A.O. dei Colli, Monaldi Hospital, 80131 Naples, Italy
| | - Jolanda Sabatino
- Division of Paediatric Cardiology, Department of Women and Children’s Health, University Hospital Padua, 35128 Padua, Italy
- Paediatric Research Institute (IRP), Città Della Speranza, 35127 Padua, Italy
| | - Isabella Leo
- Department of Medical and Surgical Sciences, Magna Grecia University, 88100 Catanzaro, Italy
- Cardiac Magnetic Resonance Department, Royal Brompton Hospital Harefield NHS Foundation Trust, London SW3 5NP, UK
| | - Martina Avesani
- Division of Paediatric Cardiology, Department of Women and Children’s Health, University Hospital Padua, 35128 Padua, Italy
| | - Claudia Montanaro
- Adult Congenital Department, Royal Brompton Hospital & Harefield NHS Foundation Trust, London SW3 5NP, UK
| | - Giovanni Di Salvo
- Division of Paediatric Cardiology, Department of Women and Children’s Health, University Hospital Padua, 35128 Padua, Italy
- Paediatric Research Institute (IRP), Città Della Speranza, 35127 Padua, Italy
- Correspondence:
| |
Collapse
|
|
24
|
Oikonomou E, Theofilis P, Lampsas S, Katsarou O, Kalogeras K, Marinos G, Tsatsaragkou A, Anastasiou A, Lysandrou A, Gounaridi MI, Gialamas I, Vavuranakis MA, Tousoulis D, Vavuranakis M, Siasos G. Current Concepts and Future Applications of Non-Invasive Functional and Anatomical Evaluation of Coronary Artery Disease. Life (Basel) 2022; 12:1803. [PMID: 36362957 PMCID: PMC9696378 DOI: 10.3390/life12111803] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/31/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
Over the last decades, significant advances have been achieved in the treatment of coronary artery disease (CAD). Proper non-invasive diagnosis and appropriate management based on functional information and the extension of ischemia or viability remain the cornerstone in the fight against adverse CAD events. Stress echocardiography and single photon emission computed tomography are often used for the evaluation of ischemia. Advancements in non-invasive imaging modalities such as computed tomography (CT) coronary angiography and cardiac magnetic resonance imaging (MRI) have not only allowed non-invasive imaging of coronary artery lumen but also provide additional functional information. Other characteristics regarding the plaque morphology can be further evaluated with the latest modalities achieving a morpho-functional evaluation of CAD. Advances in the utilization of positron emission tomography (PET), as well as software advancements especially regarding cardiac CT, may provide additional prognostic information to a more evidence-based treatment decision. Since the armamentarium on non-invasive imaging modalities has evolved, the knowledge of the capabilities and limitations of each imaging modality should be evaluated in a case-by-case basis to achieve the best diagnosis and treatment decision. In this review article, we present the most recent advances in the noninvasive anatomical and functional evaluation of CAD.
Collapse
Affiliation(s)
- Evangelos Oikonomou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Panagiotis Theofilis
- 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece
| | - Stamatios Lampsas
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Ourania Katsarou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Georgios Marinos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aikaterini Tsatsaragkou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Antonios Lysandrou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Maria-Ioanna Gounaridi
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Ioannis Gialamas
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Michael-Andrew Vavuranakis
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
- Cardiovascular Division, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA 02115, USA
| |
Collapse
|
|
25
|
Gallo-Bernal S, Bedoya MA, Gee MS, Jaimes C. Pediatric magnetic resonance imaging: faster is better. Pediatr Radiol 2022:10.1007/s00247-022-05529-x. [PMID: 36261512 DOI: 10.1007/s00247-022-05529-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/29/2022] [Accepted: 10/03/2022] [Indexed: 10/24/2022]
Abstract
Magnetic resonance imaging (MRI) has emerged as the preferred imaging modality for evaluating a wide range of pediatric medical conditions. Nevertheless, the long acquisition times associated with this technique can limit its widespread use in young children, resulting in motion-degraded or non-diagnostic studies. As a result, sedation or general anesthesia is often necessary to obtain diagnostic images, which has implications for the safety profile of MRI, the cost of the exam and the radiology department's clinical workflow. Over the last decade, several techniques have been developed to increase the speed of MRI, including parallel imaging, single-shot acquisition, controlled aliasing techniques, compressed sensing and artificial-intelligence-based reconstructions. These are advantageous because shorter examinations decrease the need for sedation and the severity of motion artifacts, increase scanner throughput, and improve system efficiency. In this review we discuss a framework for image acceleration in children that includes the synergistic use of state-of-the-art MRI hardware and optimized pulse sequences. The discussion is framed within the context of pediatric radiology and incorporates the authors' experience in deploying these techniques in routine clinical practice.
Collapse
Affiliation(s)
- Sebastian Gallo-Bernal
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - M Alejandra Bedoya
- Department of Radiology, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., 2nd floor, Main Building, Boston, MA, 02115, USA
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Camilo Jaimes
- Department of Radiology, Harvard Medical School, Boston, MA, USA. .,Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., 2nd floor, Main Building, Boston, MA, 02115, USA.
| |
Collapse
|
|
26
|
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: 5] [Impact Index Per Article: 1.7] [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.
Collapse
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.
| |
Collapse
|
|
27
|
Krishnan RR, Chandran SR, Johnson E, Hariharan PK. Biomedical Applications of Dendrimer Functionalized Magnetic Nanoparticles. ChemistrySelect 2022. [DOI: 10.1002/slct.202201401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Raji Rama Krishnan
- Post Graduate Department of Chemistry and Research Centre Sanatana Dharma College University of Kerala Alappuzha Kerala India 688003
- Research Centre University of Kerala Thiruvananthapuram Kerala India 695034
| | - Shine Rama Chandran
- Post Graduate Department of Chemistry and Research Centre Sanatana Dharma College University of Kerala Alappuzha Kerala India 688003
- Research Centre University of Kerala Thiruvananthapuram Kerala India 695034
| | - Elizabath Johnson
- Post Graduate Department of Chemistry and Research Centre Sanatana Dharma College University of Kerala Alappuzha Kerala India 688003
- Research Centre University of Kerala Thiruvananthapuram Kerala India 695034
| | - Prema Kakkadath Hariharan
- Post Graduate Department of Chemistry and Research Centre Sanatana Dharma College University of Kerala Alappuzha Kerala India 688003
- Research Centre University of Kerala Thiruvananthapuram Kerala India 695034
| |
Collapse
|
|
28
|
Wang TKM, Ayoub C, Chetrit M, Kwon DH, Jellis CL, Cremer PC, Bolen MA, Flamm SD, Klein AL. Cardiac Magnetic Resonance Imaging Techniques and Applications for Pericardial Diseases. Circ Cardiovasc Imaging 2022; 15:e014283. [DOI: 10.1161/circimaging.122.014283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cardiac magnetic resonance imaging plays a central role among multimodality imaging modalities in the assessment, diagnosis, and surveillance of pericardial diseases. Clinicians and imagers should have a foundational understanding of the utilities, advantages, and limitations of cardiac magnetic resonance imaging and how they integrate with other diagnostic tools involved in the evaluation and management of pericardial diseases. This review aims to outline the contemporary magnetic resonance imaging sequences used to evaluate the pericardium, followed by exploring the main clinical applications of magnetic resonance imaging for identifying pericardial inflammation, constriction, and effusion.
Collapse
Affiliation(s)
- Tom Kai Ming Wang
- Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., M.C., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.‚ A.L.K.)
- Section of Cardiovascular Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.)
- Center for Diagnosis and Treatment of Pericardial Diseases, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A.‚ D.H.K., C.L.J., P.C.C., A.L.K.)
| | - Chadi Ayoub
- Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., M.C., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.‚ A.L.K.)
- Section of Cardiovascular Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.)
- Center for Diagnosis and Treatment of Pericardial Diseases, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A.‚ D.H.K., C.L.J., P.C.C., A.L.K.)
| | - Michael Chetrit
- Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., M.C., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.‚ A.L.K.)
- Department of Cardiovascular Medicine, McGill University Health Centre, Montreal, Quebec, Canada (M.C.)
| | - Deborah H. Kwon
- Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., M.C., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.‚ A.L.K.)
- Section of Cardiovascular Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.)
- Center for Diagnosis and Treatment of Pericardial Diseases, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A.‚ D.H.K., C.L.J., P.C.C., A.L.K.)
| | - Christine L. Jellis
- Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., M.C., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.‚ A.L.K.)
- Section of Cardiovascular Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.)
- Center for Diagnosis and Treatment of Pericardial Diseases, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A.‚ D.H.K., C.L.J., P.C.C., A.L.K.)
| | - Paul C. Cremer
- Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., M.C., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.‚ A.L.K.)
- Section of Cardiovascular Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.)
- Center for Diagnosis and Treatment of Pericardial Diseases, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A.‚ D.H.K., C.L.J., P.C.C., A.L.K.)
| | - Michael A. Bolen
- Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., M.C., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.‚ A.L.K.)
- Section of Cardiovascular Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.)
| | - Scott D. Flamm
- Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., M.C., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.‚ A.L.K.)
- Section of Cardiovascular Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.)
| | - Allan L. Klein
- Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A., M.C., D.H.K., C.L.J., P.C.C., M.A.B., S.D.F.‚ A.L.K.)
- Center for Diagnosis and Treatment of Pericardial Diseases, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH. (T.K.M.W., C.A.‚ D.H.K., C.L.J., P.C.C., A.L.K.)
| |
Collapse
|
|
29
|
Bogatu L, Hoppenbrouwers J, Van Den Bosch H, Turco S, Mischi M, Schmitt L, Woerlee P, Bouwman RA, Korsten HHM, Muehlsteff J. On the value of MRI for improved understanding of cuff-based oscillometric measurements. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:2898-2901. [PMID: 36085836 DOI: 10.1109/embc48229.2022.9871137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Blood pressure (BP) is a key parameter in critical care and in cardiovascular disease management. BP is typically measured via cuff-based oscillometry. This method is highly inaccurate in hypo- and hypertensive patients. Improvements are difficult to achieve because oscillometry is not yet fully understood; many assumptions and uncertainties exist in models describing the process by which arterial pulsations become expressed within the cuff signal. As a result, it is also difficult to estimate other parameters via the cuff such as arterial stiffness, cardiac output and pulse wave velocity (PWV)-BP calibration. Many research modalities have been employed to study oscillometry (ultrasound, computer simulations, ex-vivo studies, measurement of PWV, mechanical analysis). However, uncertainties remain; additional investigation modalities are needed. In this study, we explore the extent to which MRI can help investigate oscillometric assumptions. Four healthy volunteers underwent a number of MRI scans of the upper arm during cuff inflation. It is found that MRI provides a novel perspective over oscillometry; the artery, surrounding tissue, veins and the cuff can be simultaneously observed along the entire length of the upper arm. Several existing assumptions are challenged: tissue compression is not isotropic, arterial transmural pressure is not uniform along the length of the cuff and propagation of arterial pulsations through tissue is likely impacted by patient-specific characteristics (vasculature position and tissue composition). Clinical Relevance- The cuff interaction with the vasculature is extremely complex; existing models are oversimplified. MRI is a valuable tool for further development of cuff-based physiological measurements.
Collapse
|
|
30
|
Okune M, Yasuda M, Soejima N, Kagioka Y, Kakehi K, Kawamura T, Hanaoka K, Kaida H, Ishii K, Nakazawa G, Miyazaki S, Iwanaga Y. Diagnostic utility of fusion 18F-fluorodeoxyglucose positron emission tomography/cardiac magnetic resonance imaging in cardiac sarcoidosis. J Nucl Cardiol 2022; 29:753-764. [PMID: 33000410 DOI: 10.1007/s12350-020-02359-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/06/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Although each 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) has been used to diagnose cardiac sarcoidosis (CS), active CS is still misdiagnosed. METHODS Active CS, diagnosed by PET alone, was defined as focal or focal on diffuse FDG uptake pattern. In fusion PET/CMR imaging, using a regional analysis with AHA 17-segment model, the patients were categorized into four groups: (1) PET-/LGE-, (2) PET+/LGE-, (3) PET+/LGE+, and (4) PET-/LGE+. PET+/LGE+ was defined as active CS. RESULTS 74 Patients with suspected CS were enrolled. Between PET alone and fusion PET/CMR imaging, 20 cases had mismatch evaluations of active CS, and most had diffuse or focal on diffuse FDG uptake pattern on PET alone imaging. 40 Patients fulfilled the 2016 the Japanese Circulation Society diagnostic criteria for CS. The interobserver diagnostic agreement was excellent (κ statistics 0.89) and the overall accuracy for diagnosing CS was 87.8% in fusion PET/CMR imaging, which were superior to those in PET alone imaging (0.57 and 82.4%, respectively). In a sub-analysis of diffuse and focal on diffuse patterns, the agreement (κ statistics 0.86) and overall accuracy (81.8%) in fusion PET/CMR imaging were still better. CONCLUSIONS Fusion PET/CMR imaging with regional analysis offered reliable and accurate diagnosis of CS, covering low diagnostic area by FDG-PET alone.
Collapse
Affiliation(s)
- Mana Okune
- Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Masakazu Yasuda
- Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Naoko Soejima
- Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Yoshinori Kagioka
- Division of Cardiology, Osaka Pref. Saiseikai Tondabayashi Hospital, Tondabayashi, Japan
| | - Kazuyoshi Kakehi
- Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Takayuki Kawamura
- Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Kohei Hanaoka
- Division of Positron Emission Tomography, Institute of Advanced Clinical Medicine, Kindai University, Osakasayama, Japan
| | - Hayato Kaida
- Departments of Radiology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Kazunari Ishii
- Departments of Radiology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Gaku Nakazawa
- Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Shunichi Miyazaki
- Division of Cardiology, Osaka Pref. Saiseikai Tondabayashi Hospital, Tondabayashi, Japan
| | - Yoshitaka Iwanaga
- Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan.
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita, Japan.
| |
Collapse
|
|
31
|
Ismail TF, Strugnell W, Coletti C, Božić-Iven M, Weingärtner S, Hammernik K, Correia T, Küstner T. Cardiac MR: From Theory to Practice. Front Cardiovasc Med 2022; 9:826283. [PMID: 35310962 PMCID: PMC8927633 DOI: 10.3389/fcvm.2022.826283] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/17/2022] [Indexed: 01/10/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading single cause of morbidity and mortality, causing over 17. 9 million deaths worldwide per year with associated costs of over $800 billion. Improving prevention, diagnosis, and treatment of CVD is therefore a global priority. Cardiovascular magnetic resonance (CMR) has emerged as a clinically important technique for the assessment of cardiovascular anatomy, function, perfusion, and viability. However, diversity and complexity of imaging, reconstruction and analysis methods pose some limitations to the widespread use of CMR. Especially in view of recent developments in the field of machine learning that provide novel solutions to address existing problems, it is necessary to bridge the gap between the clinical and scientific communities. This review covers five essential aspects of CMR to provide a comprehensive overview ranging from CVDs to CMR pulse sequence design, acquisition protocols, motion handling, image reconstruction and quantitative analysis of the obtained data. (1) The basic MR physics of CMR is introduced. Basic pulse sequence building blocks that are commonly used in CMR imaging are presented. Sequences containing these building blocks are formed for parametric mapping and functional imaging techniques. Commonly perceived artifacts and potential countermeasures are discussed for these methods. (2) CMR methods for identifying CVDs are illustrated. Basic anatomy and functional processes are described to understand the cardiac pathologies and how they can be captured by CMR imaging. (3) The planning and conduct of a complete CMR exam which is targeted for the respective pathology is shown. Building blocks are illustrated to create an efficient and patient-centered workflow. Further strategies to cope with challenging patients are discussed. (4) Imaging acceleration and reconstruction techniques are presented that enable acquisition of spatial, temporal, and parametric dynamics of the cardiac cycle. The handling of respiratory and cardiac motion strategies as well as their integration into the reconstruction processes is showcased. (5) Recent advances on deep learning-based reconstructions for this purpose are summarized. Furthermore, an overview of novel deep learning image segmentation and analysis methods is provided with a focus on automatic, fast and reliable extraction of biomarkers and parameters of clinical relevance.
Collapse
Affiliation(s)
- Tevfik F. Ismail
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Cardiology Department, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Wendy Strugnell
- Queensland X-Ray, Mater Hospital Brisbane, Brisbane, QLD, Australia
| | - Chiara Coletti
- Magnetic Resonance Systems Lab, Delft University of Technology, Delft, Netherlands
| | - Maša Božić-Iven
- Magnetic Resonance Systems Lab, Delft University of Technology, Delft, Netherlands
- Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
| | | | - Kerstin Hammernik
- Lab for AI in Medicine, Technical University of Munich, Munich, Germany
- Department of Computing, Imperial College London, London, United Kingdom
| | - Teresa Correia
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Centre of Marine Sciences, Faro, Portugal
| | - Thomas Küstner
- Medical Image and Data Analysis (MIDAS.lab), Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany
| |
Collapse
|
|
32
|
Robbertse PPS, Doubell AF, Nachega JB, Herbst PG. The hidden continuum of HIV-associated cardiomyopathy: A focussed review with case reports. SA HEART JOURNAL 2021; 18:126-135. [PMID: 35529802 PMCID: PMC9073718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
HIV-associated cardiomyopathy (HIVAC) is a poorly understood group of diseases with a poor prognosis once ventricular dysfunction is present. Cardiovascular magnetic resonance has revealed a previously unappreciated burden of asymptomatic myocardial abnormalities in people living with HIV, including abnormalities already present at the time of HIV diagnosis. These abnormalities include thickened, inflamed ventricles that bear resemblance to cases of symptomatic HIVAC that are reported on in this article. Our understanding and the significance of asymptomatic HIV-associated myocardial pathology will be explored as early disease on a continuum towards more advanced cardiomyopathy. The need for prospective research in persons naïve to anti-retroviral therapy is emphasised as it may provide key findings to better understand this elusive disease process.
Collapse
Affiliation(s)
- Pieter-Paul S. Robbertse
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, South Africa
| | - Anton F. Doubell
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, South Africa
| | - Jean B. Nachega
- Department of Medicine and Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Epidemiology, Infectious Diseases and Microbiology, and Centre for Global Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Philip G. Herbst
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, South Africa
| |
Collapse
|
|
33
|
Steele JM, Moore RA, Lang SM. Use of advanced cardiac imaging in congenital heart disease: growth, indications and innovations. Curr Opin Pediatr 2021; 33:495-502. [PMID: 34374664 DOI: 10.1097/mop.0000000000001051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Significant improvements in the diagnosis and management of patients with congenital heart disease (CHD) have led to improved survival. These patients require life-long noninvasive evaluation. The use of advanced imaging such as cardiac magnetic resonance imaging (CMR) and cardiac computed tomography (CCT) has increased to support this need. The purpose of this review is to discuss the basics of advanced cardiac imaging, indications and review the recent innovations. RECENT FINDINGS Recent literature has demonstrated the increasing reliance of advanced imaging for CHD patients. In addition, research is focusing on CMR techniques to shorten scan time and address previous limitations that made imaging younger and sicker patients more challenging. CCT research has involved demonstrating high-quality images with low radiation exposure. Advances in digital technology have impacted the interactivity of 3D imaging through the use of virtual and augmented reality platforms. With the increased reliance of advanced imaging, appropriate use criteria have been developed to address possible under or over utilization. SUMMARY The utilization of advanced cardiac imaging continues to increase. As CMR and CCT continue to grow, increased knowledge of these modalities and their usage will be necessary for clinicians caring for CHD patients.
Collapse
Affiliation(s)
- Jeremy M Steele
- Department of Pediatrics, Section of Pediatric Cardiology, Yale University School of Medicine, New Haven, Connecticut
| | - Ryan A Moore
- Heart Institute, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Sean M Lang
- Heart Institute, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| |
Collapse
|
|
34
|
Gaspar AS, Maltês S, Marques H, Nunes RG, Ferreira A. Myocardial T1 mapping with magnetic resonance imaging – a useful tool to understand the diseased heart. Rev Port Cardiol 2021; 41:61-69. [DOI: 10.1016/j.repc.2021.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/17/2021] [Accepted: 04/05/2021] [Indexed: 01/19/2023] Open
|
|
35
|
Brito B, Price TW, Gallo J, Bañobre-López M, Stasiuk GJ. Smart magnetic resonance imaging-based theranostics for cancer. Theranostics 2021; 11:8706-8737. [PMID: 34522208 PMCID: PMC8419031 DOI: 10.7150/thno.57004] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/29/2021] [Indexed: 12/29/2022] Open
Abstract
Smart theranostics are dynamic platforms that integrate multiple functions, including at least imaging, therapy, and responsiveness, in a single agent. This review showcases a variety of responsive theranostic agents developed specifically for magnetic resonance imaging (MRI), due to the privileged position this non-invasive, non-ionising imaging modality continues to hold within the clinical imaging field. Different MRI smart theranostic designs have been devised in the search for more efficient cancer therapy, and improved diagnostic efficiency, through the increase of the local concentration of therapeutic effectors and MRI signal intensity in pathological tissues. This review explores novel small-molecule and nanosized MRI theranostic agents for cancer that exhibit responsiveness to endogenous (change in pH, redox environment, or enzymes) or exogenous (temperature, ultrasound, or light) stimuli. The challenges and obstacles in the design and in vivo application of responsive theranostics are also discussed to guide future research in this interdisciplinary field towards more controllable, efficient, and diagnostically relevant smart theranostics agents.
Collapse
Affiliation(s)
- Beatriz Brito
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King's College London, Strand, London, UK, SE1 7EH
- School of Life Sciences, Faculty of Health Sciences, University of Hull, Cottingham Road, Hull, UK, HU6 7RX
- Advanced Magnetic Theranostic Nanostructures Lab, International Iberian Nanotechnology Laboratory, Av. Mestre José Veiga, 4715-330 Braga
| | - Thomas W. Price
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King's College London, Strand, London, UK, SE1 7EH
| | - Juan Gallo
- Advanced Magnetic Theranostic Nanostructures Lab, International Iberian Nanotechnology Laboratory, Av. Mestre José Veiga, 4715-330 Braga
| | - Manuel Bañobre-López
- Advanced Magnetic Theranostic Nanostructures Lab, International Iberian Nanotechnology Laboratory, Av. Mestre José Veiga, 4715-330 Braga
| | - Graeme J. Stasiuk
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King's College London, Strand, London, UK, SE1 7EH
| |
Collapse
|
|
36
|
Baritussio A, Scatteia A, Dellegrottaglie S, Bucciarelli-Ducci C. Evidence and Applicability of Stress Cardiovascular Magnetic Resonance in Detecting Coronary Artery Disease: State of the Art. J Clin Med 2021; 10:3279. [PMID: 34362063 PMCID: PMC8347143 DOI: 10.3390/jcm10153279] [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] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 12/28/2022] Open
Abstract
Cardiovascular magnetic resonance is increasingly used in clinical practice, as it has emerged over the years as an invaluable imaging technique for diagnosis and prognosis, with clear-cut applications in managing patients with both ischemic and non-ischemic heart disease. In this review, we focus on the evidence and clinical application of stress CMR in coronary artery disease from diagnosis to prognosis.
Collapse
Affiliation(s)
- Anna Baritussio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Azienda Ospedale Università Padova, 35128 Padua, Italy;
| | - Alessandra Scatteia
- Division of Cardiology, Ospedale Medico-Chirurgico Accreditato “Villa dei Fiori”, 80011 Acerra, Italy; (A.S.); (S.D.)
| | - Santo Dellegrottaglie
- Division of Cardiology, Ospedale Medico-Chirurgico Accreditato “Villa dei Fiori”, 80011 Acerra, Italy; (A.S.); (S.D.)
- Zena and Michael A, Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029-5674, USA
| | - Chiara Bucciarelli-Ducci
- Royal Brompton and Harefield Hospitals, London SW3 6LR, UK
- Guys’s and St Thomas’ Foundation Trust and Kings College London, London SE5 9NU, UK
| |
Collapse
|
|
37
|
Liu J, Jin H, Chen Y, Fu C, Chen C, Zeng M. Free-breathing BLADE acquisition method improves T2-weighted cardiac MR image quality compared with conventional breath-hold turbo spin-echo cartesian acquisition. Acta Radiol 2021; 62:341-347. [PMID: 32443937 DOI: 10.1177/0284185120924567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiac magnetic resonance (MR) has become an essential diagnostic imaging modality in cardiovascular disease. However, the insufficient image quality of traditional breath-hold (BH) T2-weighted (T2W) imaging may compromise its diagnostic accuracy. PURPOSE To assess the efficacy of the BLADE technique to reduce motion artifacts and improve the image quality. MATERIAL AND METHODS Free-breathing TSE-T2W imaging sequence with cartesian and BLADE k-space trajectory were acquired in 20 patients. Thirty patients underwent conventional BH turbo spin-echo (TSE) T2W imaging and free-breathing BLADE T2W (FB BLADE-T2W) imaging. Twenty-one patients who had a signal loss of myocardium in BH short-axis T2W turbo inversion recovery (TSE-T2W-TIR) were scanned using free-breathing BLADE T2W turbo inversion recovery (BLADE TSE-T2W-TIR). The overall image quality, blood nulling, and visualization of the heart were scored on a 5-point Likert scale. The signal loss of myocardium, incomplete fat suppression near the myocardium, and the streaking or ghosting artifacts were noted in T2W-TIR sequences additionally. RESULTS The overall imaging quality, blood nulling, and the visualization of heart structure of FB BLADE-T2W imaging sequence were significantly better than those of FB T2W imaging with Cartesian k-space trajectory and BH TSE-T2W imaging sequence (P<0.01). The FB BLADE TSE-T2W-TIR reduces the myocardium signal dropout (P<0.05), incomplete fat suppression near myocardium (P<0.05), and the streaking and ghosting artifacts (P<0.05) in comparison with the BH TSE-T2W-TIR. CONCLUSIONS FB BLADE T2W imaging provides improved myocardial visibility, less motion sensitivity, and better image quality. It may be applied in patients who have poor breath-holding capability.
Collapse
Affiliation(s)
- Jingjing Liu
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, PR China
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, PR China
| | - Hang Jin
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, PR China
| | - Yinyin Chen
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, PR China
| | - Caixia Fu
- Siemens Shenzhen Magnetic Resonance, Shenzhen, PR China
| | - Caizhong Chen
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, PR China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, PR China
| |
Collapse
|
|
38
|
Muser D, Santangeli P, Nucifora G. Procainamide for the Rapid Suppression of Premature Ventricular Contractions: An (Almost) Forgotten Tool in the Cardiologist's Armamentarium. Diagnostics (Basel) 2021; 11:diagnostics11020357. [PMID: 33672729 PMCID: PMC7924344 DOI: 10.3390/diagnostics11020357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Daniele Muser
- Cardiac Electrophysiology, Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, PA 3400, USA; (D.M.); (P.S.)
| | - Pasquale Santangeli
- Cardiac Electrophysiology, Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, PA 3400, USA; (D.M.); (P.S.)
| | - Gaetano Nucifora
- Cardiac Imaging Unit, NorthWest Heart Centre, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
- Correspondence: or
| |
Collapse
|
|
39
|
Bolus Intravenous Procainamide in Patients with Frequent Ventricular Ectopics during Cardiac Magnetic Resonance Scanning: A Way to Ensure High Quality Imaging. Diagnostics (Basel) 2021; 11:diagnostics11020178. [PMID: 33513676 PMCID: PMC7911068 DOI: 10.3390/diagnostics11020178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 01/15/2023] Open
Abstract
Acquiring high-quality cardiac magnetic resonance (CMR) images in patients with frequent ventricular arrhythmias remains a challenge. We examined the safety and efficacy of procainamide when administered on the scanner table prior to CMR scanning to suppress ventricular ectopy and acquire high-quality images. Fifty consecutive patients (age 53.0 [42.0–58.0]; 52% female, left ventricular ejection fraction 55 ± 9%) were scanned in a 1.5 T scanner using a standard cardiac protocol. Procainamide was administered at intermittent intravenous bolus doses of 50 mg every minute until suppression of the ectopics or a maximum dose of 10 mg/kg. The average dose of procainamide was 567 ± 197 mg. Procainamide successfully suppressed premature ventricular contractions (PVCs) in 82% of patients, resulting in high-quality images. The baseline blood pressure (BP) was mildly reduced (mean change systolic BP −12 ± 9 mmHg; diastolic BP −4 ± 9 mmHg), while the baseline heart rate (HR) remained relatively unchanged (mean HR change −1 ± 6 bpm). None of the patients developed proarrhythmic changes. Bolus intravenous administration of procainamide prior to CMR scanning is a safe and effective alternative approach for suppressing PVCs and acquiring high-quality images in patients with frequent PVCs and normal or only mildly reduced systolic function.
Collapse
|
|
40
|
Deshpande S, Kella D, Padmanabhan D. MRI in patients with cardiac implantable electronic devices: A comprehensive review. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2021; 44:360-372. [DOI: 10.1111/pace.14141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/20/2020] [Accepted: 11/29/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Saurabh Deshpande
- Department of Cardiac Electrophysiology Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore India
| | - Danesh Kella
- Department of Cardiology Piedmont Heart Institute Atlanta Georgia USA
| | - Deepak Padmanabhan
- Department of Cardiac Electrophysiology Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore India
| |
Collapse
|
|
41
|
Curtis AD, Cheng HM. Primer and Historical Review on Rapid Cardiac
CINE MRI. J Magn Reson Imaging 2020; 55:373-388. [DOI: 10.1002/jmri.27436] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Aaron D. Curtis
- The Edward S. Rogers Sr. Department of Electrical and Computer Engineering University of Toronto Toronto Ontario Canada
- Ted Rogers Centre for Heart Research, Translational Biology & Engineering Program Toronto Ontario Canada
| | - Hai‐Ling M. Cheng
- The Edward S. Rogers Sr. Department of Electrical and Computer Engineering University of Toronto Toronto Ontario Canada
- Ted Rogers Centre for Heart Research, Translational Biology & Engineering Program Toronto Ontario Canada
- Institute of Biomedical Engineering, University of Toronto Toronto Ontario Canada
| |
Collapse
|
|
42
|
Concannon J, Hynes N, McMullen M, Smyth E, Moerman K, McHugh PE, Sultan S, Karmonik C, McGarry JP. A Dual-VENC Four-Dimensional Flow MRI Framework for Analysis of Subject-Specific Heterogeneous Nonlinear Vessel Deformation. J Biomech Eng 2020; 142:114502. [PMID: 33006370 DOI: 10.1115/1.4048649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Indexed: 07/25/2024]
Abstract
Advancement of subject-specific in silico medicine requires new imaging protocols tailored to specific anatomical features, paired with new constitutive model development based on structure/function relationships. In this study, we develop a new dual-velocity encoding coefficient (VENC) 4D flow MRI protocol that provides unprecedented spatial and temporal resolution of in vivo aortic deformation. All previous dual-VENC 4D flow MRI studies in the literature focus on an isolated segment of the aorta, which fail to capture the full spectrum of aortic heterogeneity that exists along the vessel length. The imaging protocol developed provides high sensitivity to all blood flow velocities throughout the entire cardiac cycle, overcoming the challenge of accurately measuring the highly unsteady nonuniform flow field in the aorta. Cross-sectional area change, volumetric flow rate, and compliance are observed to decrease with distance from the heart, while pulse wave velocity (PWV) is observed to increase. A nonlinear aortic lumen pressure-area relationship is observed throughout the aorta such that a high vessel compliance occurs during diastole, and a low vessel compliance occurs during systole. This suggests that a single value of compliance may not accurately represent vessel behavior during a cardiac cycle in vivo. This high-resolution MRI data provide key information on the spatial variation in nonlinear aortic compliance, which can significantly advance the state-of-the-art of in-silico diagnostic techniques for the human aorta.
Collapse
Affiliation(s)
- J Concannon
- Biomedical Engineering, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - N Hynes
- Department of Vascular and Endovascular Surgery, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - M McMullen
- Department of Radiology, Galway Clinic, Doughiska, Galway H91 HHT0, Ireland
| | - E Smyth
- Department of Radiology, Galway Clinic, Doughiska, Galway H91 HHT0, Ireland
| | - K Moerman
- Biomedical Engineering, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - P E McHugh
- Biomedical Engineering, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - S Sultan
- Department of Vascular and Endovascular Surgery, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - C Karmonik
- MRI Core, Houston Methodist Debakey Heart and Vascular Center, Houston, TX 77030
| | - J P McGarry
- Biomedical Engineering, National University of Ireland Galway, Galway H91 TK33, Ireland
| |
Collapse
|
|
43
|
Abstract
Classification of heart failure is based on the left ventricular ejection fraction (EF): preserved EF, midrange EF, and reduced EF. There remains an unmet need for further heart failure phenotyping of ventricular structure-function relationships. Because of high spatiotemporal resolution, cardiac magnetic resonance (CMR) remains the reference modality for quantification of ventricular contractile function. The authors aim to highlight novel frameworks, including theranostic use of ferumoxytol, to enable more efficient evaluation of ventricular function in heart failure patients who are also frequently anemic, and to discuss emerging quantitative CMR approaches for evaluation of ventricular structure-function relationships in heart failure.
Collapse
|
|
44
|
Demirkiran A, Everaars H, Amier RP, Beijnink C, Bom MJ, Götte MJW, van Loon RB, Selder JL, van Rossum AC, Nijveldt R. Cardiovascular magnetic resonance techniques for tissue characterization after acute myocardial injury. Eur Heart J Cardiovasc Imaging 2020; 20:723-734. [PMID: 31131401 DOI: 10.1093/ehjci/jez094] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/19/2019] [Accepted: 04/26/2019] [Indexed: 12/22/2022] Open
Abstract
The annual incidence of hospital admission for acute myocardial infarction lies between 90 and 312 per 100 000 inhabitants in Europe. Despite advances in patient care 1 year mortality after ST-segment elevation myocardial infarction (STEMI) remains around 10%. Cardiovascular magnetic resonance imaging (CMR) has emerged as a robust imaging modality for assessing patients after acute myocardial injury. In addition to accurate assessment of left ventricular ejection fraction and volumes, CMR offers the unique ability of visualization of myocardial injury through a variety of imaging techniques such as late gadolinium enhancement and T2-weighted imaging. Furthermore, new parametric mapping techniques allow accurate quantification of myocardial injury and are currently being exploited in large trials aiming to augment risk management and treatment of STEMI patients. Of interest, CMR enables the detection of microvascular injury (MVI) which occurs in approximately 40% of STEMI patients and is a major independent predictor of mortality and heart failure. In this article, we review traditional and novel CMR techniques used for myocardial tissue characterization after acute myocardial injury, including the detection and quantification of MVI. Moreover, we discuss clinical scenarios of acute myocardial injury in which the tissue characterization techniques can be applied and we provide proposed imaging protocols tailored to each scenario.
Collapse
Affiliation(s)
- Ahmet Demirkiran
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Henk Everaars
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Raquel P Amier
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Casper Beijnink
- Department of Cardiology, Radboudumc, Geert Grooteplein Zuid 10, GA, Nijmegen, the Netherlands
| | - Michiel J Bom
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Marco J W Götte
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Ramon B van Loon
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Jasper L Selder
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Albert C van Rossum
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands
| | - Robin Nijveldt
- Department of Cardiology, Amsterdam University Medical Center - Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, De Boelelaan 1117, HV, Amsterdam, the Netherlands.,Department of Cardiology, Radboudumc, Geert Grooteplein Zuid 10, GA, Nijmegen, the Netherlands
| |
Collapse
|
|
45
|
Kuhn J, Papanastasiou G, Tai CW, Moran CM, Jansen MA, Tavares AA, Lennen RJ, Corral CA, Wang C, Thomson AJ, Berry CC, Yiu HH. Tri-modal imaging of gold-dotted magnetic nanoparticles for magnetic resonance imaging, computed tomography and intravascular ultrasound: an in vitro study. Nanomedicine (Lond) 2020; 15:2433-2445. [PMID: 32914695 DOI: 10.2217/nnm-2020-0236] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Aim: To examine the multimodal contrasting ability of gold-dotted magnetic nanoparticles (Au*MNPs) for magnetic resonance (MR), computed tomography (CT) and intravascular ultrasound (IVUS) imaging. Materials & methods: Au*MNPs were prepared by adapting an impregnation method, without using surface capping reagents and characterized (transmission electron microscopy, x-ray diffraction and Fourier-transform infrared spectroscopy) with their in vitro cytotoxicity assessed, followed by imaging assessments. Results: The contrast-enhancing ability of Au*MNPs was shown to be concentration-dependent across MR, CT and IVUS imaging. The Au content of the Au*MNP led to evident increases of the IVUS signal. Conclusion: We demonstrated that Au*MNPs showed concentration-dependent contrast-enhancing ability in MRI and CT imaging, and for the first-time in IVUS imaging due to the Au content. These Au*MNPs are promising toward solidifying tri-modal imaging-based theragnostics.
Collapse
Affiliation(s)
- Joel Kuhn
- Chemical Engineering, School of Engineering & Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, UK
| | - Giorgos Papanastasiou
- School of Computer Science & Electronic Engineering, University of Essex, Colchester, CO4 3SQ, UK.,Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, U.K
| | - Cheuk-Wai Tai
- Department of Materials & Environmental Chemistry, Arrhenius Laboratory, Stockholm University, Stockholm, SE-106 91, Sweden
| | - Carmel M Moran
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, U.K.,Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Maurits A Jansen
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, U.K.,Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Adriana As Tavares
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, U.K.,Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Ross J Lennen
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, U.K.,Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Carlos Alcaide Corral
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, U.K.,Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Chengjia Wang
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, U.K
| | - Adrian Jw Thomson
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, U.K.,Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Catherine C Berry
- Centre for Cell Engineering, IMCSB, Joseph Black Building, University Avenue, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Humphrey Hp Yiu
- Chemical Engineering, School of Engineering & Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, UK
| |
Collapse
|
|
46
|
Cardiac magnetic resonance imaging and computed tomography for the pediatric cardiologist. PROGRESS IN PEDIATRIC CARDIOLOGY 2020. [DOI: 10.1016/j.ppedcard.2020.101273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
|
47
|
Jo Y, Kim J, Park CH, Lee JW, Hur JH, Yang DH, Lee BY, Im DJ, Hong SJ, Kim EY, Park EA, Kim PK, Yong HS. Guideline for Cardiovascular Magnetic Resonance Imaging from the Korean Society of Cardiovascular Imaging-Part 1: Standardized Protocol. Korean J Radiol 2020; 20:1313-1333. [PMID: 31464111 PMCID: PMC6715561 DOI: 10.3348/kjr.2019.0398] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 08/12/2019] [Indexed: 12/21/2022] Open
Abstract
Cardiac magnetic resonance (CMR) imaging is widely used in many areas of cardiovascular disease assessment. This is a practical, standard CMR protocol for beginners that is designed to be easy to follow and implement. This protocol guideline is based on previously reported CMR guidelines and includes sequence terminology used by vendors, essential MR physics, imaging planes, field strength considerations, MRI-conditional devices, drugs for stress tests, various CMR modules, and disease/symptom-based protocols based on a survey of cardiologists and various appropriate-use criteria. It will be of considerable help in planning and implementing tests. In addressing CMR usage and creating this protocol guideline, we particularly tried to include useful tips to overcome various practical issues and improve CMR imaging. We hope that this document will continue to standardize and simplify a patient-based approach to clinical CMR and contribute to the promotion of public health.
Collapse
Affiliation(s)
- Yeseul Jo
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - JeongJae Kim
- Department of Radiology, Jeju National University Hospital, Jeju, Korea
| | - Chul Hwan Park
- Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Jae Wook Lee
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jee Hye Hur
- Department of Radiology, Hanil General Hospital, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bae Young Lee
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Jin Im
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Su Jin Hong
- Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Eun Young Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Ah Park
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Pan Ki Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, Seoul, Korea.
| |
Collapse
|
|
48
|
Caspani S, Magalhães R, Araújo JP, Sousa CT. Magnetic Nanomaterials as Contrast Agents for MRI. MATERIALS 2020; 13:ma13112586. [PMID: 32517085 PMCID: PMC7321635 DOI: 10.3390/ma13112586] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/18/2020] [Accepted: 05/29/2020] [Indexed: 01/17/2023]
Abstract
Magnetic Resonance Imaging (MRI) is a powerful, noninvasive and nondestructive technique, capable of providing three-dimensional (3D) images of living organisms. The use of magnetic contrast agents has allowed clinical researchers and analysts to significantly increase the sensitivity and specificity of MRI, since these agents change the intrinsic properties of the tissues within a living organism, increasing the information present in the images. Advances in nanotechnology and materials science, as well as the research of new magnetic effects, have been the driving forces that are propelling forward the use of magnetic nanostructures as promising alternatives to commercial contrast agents used in MRI. This review discusses the principles associated with the use of contrast agents in MRI, as well as the most recent reports focused on nanostructured contrast agents. The potential applications of gadolinium- (Gd) and manganese- (Mn) based nanomaterials and iron oxide nanoparticles in this imaging technique are discussed as well, from their magnetic behavior to the commonly used materials and nanoarchitectures. Additionally, recent efforts to develop new types of contrast agents based on synthetic antiferromagnetic and high aspect ratio nanostructures are also addressed. Furthermore, the application of these materials in theragnosis, either as contrast agents and controlled drug release systems, contrast agents and thermal therapy materials or contrast agents and radiosensitizers, is also presented.
Collapse
|
|
49
|
Situ Y, Birch SCM, Moreyra C, Holloway CJ. Cardiovascular magnetic resonance imaging for structural heart disease. Cardiovasc Diagn Ther 2020; 10:361-375. [PMID: 32420118 DOI: 10.21037/cdt.2019.06.02] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Cardiovascular magnetic resonance (CMR) has increasingly become a powerful imaging technique over the past few decades due to increasing knowledge about clinical applications, operator experience and technological advances, including the introduction of high field strength magnets, leading to improved signal-to-noise ratio. Its success is attributed to the free choice of imaging planes, the wide variety of imaging techniques, and the lack of harmful radiation. Developments in CMR have led to the accurate evaluation of cardiac structure, function and tissues characterisation, so this non-invasive technique has become a powerful tool for a broad range of cardiac pathologies. This review will provide an introduction of magnetic resonance imaging (MRI) physics, an overview of the current techniques and clinical application of CMR in structural heart disease, and illustrated examples of its use in clinical practice.
Collapse
Affiliation(s)
- Yiling Situ
- St Vincent's Hospital Sydney, New South Wales, Australia.,St Vincent's Clinical School, University of New South Wales, Kensington, Australia.,Victor Chang Cardiac Research Institute, Darlinghurst, Australia
| | | | - Camila Moreyra
- St Vincent's Hospital Sydney, New South Wales, Australia
| | - Cameron J Holloway
- St Vincent's Hospital Sydney, New South Wales, Australia.,St Vincent's Clinical School, University of New South Wales, Kensington, Australia.,Victor Chang Cardiac Research Institute, Darlinghurst, Australia
| |
Collapse
|
|
50
|
Nanodiamond phantoms mimicking human liver: perspective to calibration of T1 relaxation time in magnetic resonance imaging. Sci Rep 2020; 10:6446. [PMID: 32296116 PMCID: PMC7160200 DOI: 10.1038/s41598-020-63581-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 03/30/2020] [Indexed: 11/21/2022] Open
Abstract
Phantoms of biological tissues are materials that mimic the properties of real tissues. This study shows the development of phantoms with nanodiamond particles for calibration of T1 relaxation time in magnetic resonance imaging. Magnetic resonance imaging (MRI) is a commonly used and non-invasive method of detecting pathological changes inside the human body. Nevertheless, before a new MRI device is approved for use, it is necessary to calibrate it properly and to check its technical parameters. In this article, we present phantoms of tissue with diamond nanoparticles dedicated to magnetic resonance calibration. The method of producing phantoms has been described. As a result of our research, we obtained phantoms that were characterized by the relaxation time T1 the same as the relaxation time of the human tissue T1 = 810.5 ms. Furthermore, the use of diamond nanoparticles in phantoms allowed us to tune the T1 value of the phantoms which open the way to elaborated phantoms of other tissues in the future.
Collapse
|