El-Sayed H Ibrahim, Luba Frank, Dhiraj Baruah, V Emre Arpinar, Andrew S Nencka, Kevin M Koch, L Tugan Muftuler, Orhan Unal, Jadranka Stojanovska, Jason C Rubenstein, Sherry-Ann Brown, John Charlson, Elizabeth M Gore, Carmen Bergom
{"title":"Value CMR: Towards a Comprehensive, Rapid, Cost-Effective Cardiovascular Magnetic Resonance Imaging.","authors":"El-Sayed H Ibrahim, Luba Frank, Dhiraj Baruah, V Emre Arpinar, Andrew S Nencka, Kevin M Koch, L Tugan Muftuler, Orhan Unal, Jadranka Stojanovska, Jason C Rubenstein, Sherry-Ann Brown, John Charlson, Elizabeth M Gore, Carmen Bergom","doi":"10.1155/2021/8851958","DOIUrl":null,"url":null,"abstract":"<p><p>Cardiac magnetic resonance imaging (CMR) is considered the gold standard for measuring cardiac function. Further, in a single CMR exam, information about cardiac structure, tissue composition, and blood flow could be obtained. Nevertheless, CMR is underutilized due to long scanning times, the need for multiple breath-holds, use of a contrast agent, and relatively high cost. In this work, we propose a rapid, comprehensive, contrast-free CMR exam that does not require repeated breath-holds, based on recent developments in imaging sequences. Time-consuming conventional sequences have been replaced by advanced sequences in the proposed CMR exam. Specifically, conventional 2D cine and phase-contrast (PC) sequences have been replaced by optimized 3D-cine and 4D-flow sequences, respectively. Furthermore, conventional myocardial tagging has been replaced by fast strain-encoding (SENC) imaging. Finally, T1 and T2 mapping sequences are included in the proposed exam, which allows for myocardial tissue characterization. The proposed rapid exam has been tested in vivo. The proposed exam reduced the scan time from >1 hour with conventional sequences to <20 minutes. Corresponding cardiovascular measurements from the proposed rapid CMR exam showed good agreement with those from conventional sequences and showed that they can differentiate between healthy volunteers and patients. Compared to 2D cine imaging that requires 12-16 separate breath-holds, the implemented 3D-cine sequence allows for whole heart coverage in 1-2 breath-holds. The 4D-flow sequence allows for whole-chest coverage in less than 10 minutes. Finally, SENC imaging reduces scan time to only one slice per heartbeat. In conclusion, the proposed rapid, contrast-free, and comprehensive cardiovascular exam does not require repeated breath-holds or to be supervised by a cardiac imager. These improvements make it tolerable by patients and would help improve cost effectiveness of CMR and increase its adoption in clinical practice.</p>","PeriodicalId":47063,"journal":{"name":"International Journal of Biomedical Imaging","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8147553/pdf/","citationCount":"5","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Biomedical Imaging","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2021/8851958","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 5
Abstract
Cardiac magnetic resonance imaging (CMR) is considered the gold standard for measuring cardiac function. Further, in a single CMR exam, information about cardiac structure, tissue composition, and blood flow could be obtained. Nevertheless, CMR is underutilized due to long scanning times, the need for multiple breath-holds, use of a contrast agent, and relatively high cost. In this work, we propose a rapid, comprehensive, contrast-free CMR exam that does not require repeated breath-holds, based on recent developments in imaging sequences. Time-consuming conventional sequences have been replaced by advanced sequences in the proposed CMR exam. Specifically, conventional 2D cine and phase-contrast (PC) sequences have been replaced by optimized 3D-cine and 4D-flow sequences, respectively. Furthermore, conventional myocardial tagging has been replaced by fast strain-encoding (SENC) imaging. Finally, T1 and T2 mapping sequences are included in the proposed exam, which allows for myocardial tissue characterization. The proposed rapid exam has been tested in vivo. The proposed exam reduced the scan time from >1 hour with conventional sequences to <20 minutes. Corresponding cardiovascular measurements from the proposed rapid CMR exam showed good agreement with those from conventional sequences and showed that they can differentiate between healthy volunteers and patients. Compared to 2D cine imaging that requires 12-16 separate breath-holds, the implemented 3D-cine sequence allows for whole heart coverage in 1-2 breath-holds. The 4D-flow sequence allows for whole-chest coverage in less than 10 minutes. Finally, SENC imaging reduces scan time to only one slice per heartbeat. In conclusion, the proposed rapid, contrast-free, and comprehensive cardiovascular exam does not require repeated breath-holds or to be supervised by a cardiac imager. These improvements make it tolerable by patients and would help improve cost effectiveness of CMR and increase its adoption in clinical practice.
期刊介绍：
The International Journal of Biomedical Imaging is managed by a board of editors comprising internationally renowned active researchers. The journal is freely accessible online and also offered for purchase in print format. It employs a web-based review system to ensure swift turnaround times while maintaining high standards. In addition to regular issues, special issues are organized by guest editors. The subject areas covered include (but are not limited to):
Digital radiography and tomosynthesis
X-ray computed tomography (CT)
Magnetic resonance imaging (MRI)
Single photon emission computed tomography (SPECT)
Positron emission tomography (PET)
Ultrasound imaging
Diffuse optical tomography, coherence, fluorescence, bioluminescence tomography, impedance tomography
Neutron imaging for biomedical applications
Magnetic and optical spectroscopy, and optical biopsy
Optical, electron, scanning tunneling/atomic force microscopy
Small animal imaging
Functional, cellular, and molecular imaging
Imaging assays for screening and molecular analysis
Microarray image analysis and bioinformatics
Emerging biomedical imaging techniques
Imaging modality fusion
Biomedical imaging instrumentation
Biomedical image processing, pattern recognition, and analysis
Biomedical image visualization, compression, transmission, and storage
Imaging and modeling related to systems biology and systems biomedicine
Applied mathematics, applied physics, and chemistry related to biomedical imaging
Grid-enabling technology for biomedical imaging and informatics
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