Value CMR: Towards a Comprehensive, Rapid, Cost-Effective Cardiovascular Magnetic Resonance Imaging. Int J Biomed Imaging 2021;2021:8851958
Date
06/01/2021Pubmed ID
34054936Pubmed Central ID
PMC8147553DOI
10.1155/2021/8851958Scopus ID
2-s2.0-85107219799 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
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 Time-consuming conventional sequences have been replaced by advanced sequences in the proposed CMR exam. Specifically, conventional 2D cine and phase-contrast (PC) sequences have been replaced by optimized 3D-cine and 4D-flow sequences, respectively. Furthermore, conventional myocardial tagging has been replaced by fast strain-encoding (SENC) imaging.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.
Author List
Ibrahim EH, Frank L, Baruah D, Arpinar VE, Nencka AS, Koch KM, Muftuler LT, Unal O, Stojanovska J, Rubenstein JC, Brown SA, Charlson J, Gore EM, Bergom CAuthors
John A. Charlson MD Associate Professor in the Medicine department at Medical College of WisconsinElizabeth M. Gore MD Professor in the Radiation Oncology department at Medical College of Wisconsin
Kevin M. Koch PhD Adjunct Professor in the Radiology department at Medical College of Wisconsin
Lutfi Tugan Muftuler PhD Professor in the Neurosurgery department at Medical College of Wisconsin
Andrew S. Nencka PhD Center Director, Professor in the Radiology department at Medical College of Wisconsin
Jason C. Rubenstein MD Associate Professor in the Medicine department at Medical College of Wisconsin
