Motion-corrected cardiac MRI is associated with decreased anesthesia exposure in children

Christopher, Adam; Quinn, Rachel E.; Zoulfagharian, Sara; Matisoff, Andrew; Cross, Russell R.; Xue, Hui; Campbell-Washburn, Adrienne E; Olivieri, Laura

doi:10.1007/s00247-020-04766-2

Cited by 8 publications

(4 citation statements)

References 20 publications

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“…Traditionally, CMR protocols have required deep sedation or anesthesia for infants and young children who are unable to cooperate and breath-hold for image acquisition. Since the feed-and-sleep technique was initially described in 2012 for infants < 6 months of age, and subsequently with the introduction of newer free breathing scanning techniques that mitigate the need for breath-holding, there has been more variation in the use of sedation among different programs 31 , 32 . Sedation for CMR carries a number of challenges, including the need for magnetic resonance imaging (MRI)-compatible equipment, the risks of anesthesia, and the cost of extended room occupancy 33 .…”

Section: Discussionmentioning

confidence: 99%

Multicenter research priorities in pediatric CMR: results of a collaborative wiki survey

Beroukhim

Merlocco

Gerardin

et al. 2023

Sci Rep

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Multicenter studies in pediatric cardiovascular magnetic resonance (CMR) improve statistical power and generalizability. However, a structured process for identifying important research topics has not been developed. We aimed to (1) develop a list of high priority knowledge gaps, and (2) pilot the use of a wiki survey to collect a large group of responses. Knowledge gaps were defined as areas that have been either unexplored or under-explored in the research literature. High priority goals were: (1) feasible and answerable from a multicenter research study, and (2) had potential for high impact on the field of pediatric CMR. Seed ideas were contributed by a working group and imported into a pairwise wiki survey format which allows for new ideas to be uploaded and voted upon (https://allourideas.org). Knowledge gaps were classified into 2 categories: ‘Clinical CMR Practice’ (16 ideas) and ‘Disease Specific Research’ (22 ideas). Over a 2-month period, 3,658 votes were cast by 96 users, and 2 new ideas were introduced. The 3 highest scoring sub-topics were myocardial disorders (9 ideas), translating new technology & techniques into clinical practice (7 ideas), and normal reference values (5 ideas). The highest priority gaps reflected strengths of CMR (e.g., myocardial tissue characterization; implementation of technologic advances into clinical practice), and deficiencies in pediatrics (e.g., data on normal reference values). The wiki survey format was effective and easy to implement, and could be used for future surveys.

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Section: Discussionmentioning

confidence: 99%

Multicenter research priorities in pediatric CMR: results of a collaborative wiki survey

Beroukhim

Merlocco

Gerardin

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“… 13 Imaging was completed using a 1.5 T Aera (Siemens, Erlangen, German), including standard volumetry and flow measurements, with parameters tailored to patient size according to guidelines and lab standards. 13 , 18 , 19 Baseline interventional cardiac magnetic resonance imaging was followed by cardiac catheterisation in the interventional cardiac magnetic resonance suite using standard real-time imaging guidance to collect oximetry and pressure data. 13 Heart rates at the time of pulmonary artery sampling (which served as the mixed venous saturation) were used to find the assumed oxygen consumption.…”

Section: Methodsmentioning

confidence: 99%

Cardiac magnetic resonance haemodynamics in paediatric heart transplant patients: fick oximetry versus cardiac magnetic resonance phase contrast

et al. 2023

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Background: Lifetime radiation exposure for paediatric orthotopic heart transplant (OHT) patients is significant with cardiac catheterisation as the dominant source. Interventional cardiac magnetic resonance is utilised to obtain simultaneous, radiation-free haemodynamics and flow/function measurements. We sought to compare invasive haemodynamic measurements and radiation exposure in traditional cardiac catheterisation, to comprehensive interventional cardiac magnetic resonance. Methods: Twenty-eight OHT patients who underwent 67 interventional cardiac magnetic resonance procedures at Children’s National Hospital were identified. Both invasive oximetry with peripheral oxygen saturation (Fick) and cardiac magnetic resonance phase contrast measurements of pulmonary and systemic blood flow were performed. Systemic and pulmonary blood flow from the two modalities was compared using Bland–Altman, concordance analysis, and inter-reader correlation. A mixed model was implemented to account for confounding variables and repeat encounters. Radiation dosage data were collected for a contemporaneous cohort of orthotopic heart transplant patients undergoing standard, X-ray-guided catheterisation. Results: Simultaneous cardiac magnetic resonance and Fick have poor agreement in our study based on Lin’s correlation coefficient of 0.68 and 0.73 for pulmonary and systemic blood flow, respectively. Bland–Altman analysis demonstrated a consistent over estimation of cardiac magnetic resonance cardiac output by Fick. The average indexed dose area product for patients undergoing haemodynamics with endomyocardial biopsy was 0.73 (SD ±0.6) Gy*m2/kg. With coronary angiography added, the indexed dose area product was 14.6 (SD ± 7.8) Gy*m2/kg. Conclusions: Cardiac magnetic resonancemeasurements of cardiac output/index in paediatric orthotopic heart transplant patients have poor concordance with Fick estimates; however, cardiac magnetic resonance has good internal validity and inter-reader reliability. Radiation doses are small for haemodynamics with biopsy and increase exponentially with angiography, identifying a new target for cardiac magnetic resonance imaging.

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“…This concern is based on preclinical models, as well as retrospective clinical data [6][7][8][9]. Additional mechanical ventilation is necessary for image acquisition using breath hold techniques [10]. This entails potential complications during the intubation process itself, such as tooth or airway injury or aspiration [11].…”

Section: Introductionmentioning

confidence: 99%

Free-Breathing and Single-Breath Hold Compressed Sensing Real-Time MRI of Right Ventricular Function in Children with Congenital Heart Disease

et al. 2023

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(1) Purpose: to compare right ventricular (RV) functional parameters in children with surgically repaired congenital heart disease (CHD) using single/double breath hold (BH) and free-breathing (FB) real-time compressed sensing (CS) cine cardiac magnetic resonance (cMRI) with standard retrospective segmented multi breath hold (RMB) cine cMRI. (2) Methods: Twenty patients with CHD underwent BH and FB, as well as RMB cine cMRI, at 3T to obtain a stack of continuous axial images of the RV. Two radiologists independently performed qualitative analysis of the image quality (rated on a 5-point scale; 1 = non-diagnostic to 5 = excellent) and quantitative analysis of the RV volume measurements. (3) Results: The best image quality was provided by RMB (4.5; range 2–5) compared to BH (3.9; range 3–5; p = 0.04) and FB (3.6; range 3–5; p < 0.01). The RV functional parameters were comparable among BH, FB, and RMB with a difference of less than 5%. The scan times for BH (44 ± 38 s, p < 0.01) and FB (24 ± 7 s, p < 0.01) were significantly reduced compared to for RMB (261 ± 68 s). (4) Conclusions: CS-FB and CS-BH real-time cine cMRI in children with CHD provides diagnostic image quality with excellent accuracy for measuring RV function with a significantly reduced scan time compared to RMB.

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Motion-corrected cardiac MRI is associated with decreased anesthesia exposure in children

Cited by 8 publications

References 20 publications

Multicenter research priorities in pediatric CMR: results of a collaborative wiki survey

Multicenter research priorities in pediatric CMR: results of a collaborative wiki survey

Cardiac magnetic resonance haemodynamics in paediatric heart transplant patients: fick oximetry versus cardiac magnetic resonance phase contrast

Free-Breathing and Single-Breath Hold Compressed Sensing Real-Time MRI of Right Ventricular Function in Children with Congenital Heart Disease

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