Right ventricular assessment at cardiac MRI: initial clinical experience utilizing an IS-SENSE reconstruction

Abstract

Cardiac MR is considered the gold standard in assessing RV function. The purpose of this study is to evaluate the clinical utility of an investigational iterative reconstruction algorithm in the quantitative assessment of RV function. This technique has the potential to improve the clinical utility of CMR in the evaluation of RV pathologies, particularly in patients with dyspnea, by shortening acquisition times without adversely influencing imaging performance. Segmented cine images were acquired on 9 healthy volunteers and 29 patients without documented RV pathologies using conventional GRAPPA acquisition with factor 2 acceleration (GRAPPA 2), a spatio-temporal TSENSE acquisition with factor 4 acceleration (TSENSE 4), and iteratively reconstructed Sparse SENSE acquisition with factor 4 acceleration (IS-SENSE 4). 14 subjects were re-analyzed and intraclass correlation coefficients (ICC) were calculated and Bland-Altman plots generated to assess agreement. Two independent reviewers qualitatively scored images. Comparison of acquisition techniques was performed using univariate analysis of variance (ANOVA). Differences in RV EF, BSA-indexed ESV (ESVi), BSA-indexed EDV (EDVi), and BSA-indexed SV (SVi) were shown to be statistically insignificant via ANOVA testing. R(2) values for linear regression of TSENSE 4 and IS-SENSE 4 versus GRAPPA 2 were 0.34 and 0.72 for RV-EF, and 0.61 and 0.76 for RV-EDVi. ICC values for intraobserver and interobserver quantification yielded excellent agreement, and Bland-Altman plots assessing agreement were generated as well. Qualitative review yielded small, but statistically significant differences in image quality and noise between TSENSE 4 and IS-SENSE 4. All three techniques were rated nearly artifact free. Segmented imaging acquisitions with IS-SENSE reconstruction and an acceleration factor of 4 accurately and reliably quantitates RV systolic function parameters, while maintaining image quality. TSENSE-4 accelerated acquisitions showed poorer correlation to standard imaging, and inferior interobserver and intraobserver agreement. IS-SENSE has the potential to shorten cine acquisition times by 50 %, improving imaging options in patients with intermittent arrhythmias or difficulties with breath holding.

A Deep Learning Network for Right Ventricle Segmentation in Short:Axis MRI

“…However, most of researches focus on the left ventricle (LV) segmentation because the LV is the biggest chamber of heart [3][4][5]. Compared to the LV, the segmentation problems of RV get more and more attentions in recent years, along with the increasing cognition about the function of RV [6][7][8]. For instance, some cardiac diseases such as pulmonary hypertension, cardiomyopathy and dysplasia, are all related to the RV.…”

Right Ventricular Volume and Function Assessment in Congenital Heart Disease Using CMR Compressed-Sensing Real-Time Cine Imaging

“…The segmented steady-state free precession cine is currently considered the gold-standard technique for the measure-ment of ventricular volumes, including in CHD patients [2,[15][16][17]. However, these trends must be balanced with the clinically relevant LOA demonstrated in the Bland-Altman plots, mainly regarding the relative bias of RVEF (−13.7; +9.3%), which was also the case in other studies evaluating CS cine for RV assessment in non-CHD populations, where the LOA was reported to be from −10.5 to +11.6% [5,10,18,19]. A more recent study also found a similar performance of a novel real-time steady-state free precession spiral sequence reconstructed using CS in a pediatric-only CHD population, but did not evaluate the regional wall-motion abnormalities or the depiction of tricuspid-regurgitation-related flow artifacts [19].…”

Cardiovascular imaging 2016 in the International Journal of Cardiovascular Imaging

“…In related work, Bogachkov et al [37] used this technique for right ventricular assessment. A 3D-Dixon based method was developed for measuring epicardial and pericardial fat volumes [38].…”