Synthetic late gadolinium enhancement cardiac magnetic resonance for diagnosing myocardial scar

Abdula, Goran; Nickander, Jannike; Sörensson, Peder; Lundin, Magnus; Kellman, Peter; Sigfridsson, Andreas

doi:10.1080/14017431.2018.1449960

Cited by 7 publications

(8 citation statements)

References 15 publications

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“…A synthetic fat‐suppressed LGE image can be generated from the postcontrast Dixon cardiac MRF maps for comparison with the PSIR LGE images using the following equation (Eq. ) 30 :

S_{LGE} = M_{0, normalw} ((), 1 - 2 e^{- \ln ((), 2) \frac{normalT 1 mPC}{normalT 1 PC}})

where M 0,w , T 1PC , and T 1mPC are the postcontrast Dixon cardiac MRF water proton density map, water T 1 map, and myocardial T 1 measurement, respectively.…”

Section: Methodsmentioning

confidence: 99%

T1, T2, and Fat Fraction Cardiac MR Fingerprinting: Preliminary Clinical Evaluation

Jaubert

Cruz

Bustin

et al. 2020

Magnetic Resonance Imaging

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Background Dixon cardiac magnetic resonance fingerprinting (MRF) has been recently introduced to simultaneously provide water T1, water T2, and fat fraction (FF) maps. Purpose To assess Dixon cardiac MRF repeatability in healthy subjects and its clinical feasibility in a cohort of patients with cardiovascular disease. Population T1MES phantom, water‐fat phantom, 11 healthy subjects and 19 patients with suspected cardiovascular disease. Study Type Prospective. Field Strength/Sequence 1.5T, inversion recovery spin echo (IRSE), multiecho spin echo (MESE), modified Look–Locker inversion recovery (MOLLI), T2 gradient spin echo (T2‐GRASE), 6‐echo gradient rewound echo (GRE), and Dixon cardiac MRF. Assessment Dixon cardiac MRF precision was assessed through repeated scans against conventional MOLLI, T2‐GRASE, and PDFF in phantom and 11 healthy subjects. Dixon cardiac MRF native T1, T2, FF, postcontrast T1 and synthetic extracellular volume (ECV) maps were assessed in 19 patients in comparison to conventional sequences. Measurements in patients were performed in the septum and in late gadolinium enhanced (LGE) areas and assessed using mean value distributions, correlation, and Bland–Altman plots. Image quality and diagnostic confidence were assessed by three experts using 5‐point scoring scales. Statistical Tests Paired Wilcoxon rank signed test and paired t‐tests were applied. Statistical significance was indicated by *(P < 0.05). Results Dixon cardiac MRF showed good overall precision in phantom and in vivo. Septal average repeatability was ~23 msec for T1, ~2.2 msec for T2, and ~1% for FF. Biases in healthy subjects/patients were measured at +37 msec*/+60 msec* and –8.8 msec*/–8 msec* when compared to MOLLI and T2‐GRASE, respectively. No statistically significant differences in postcontrast T1 (P = 0.17) and synthetic ECV (P = 0.19) measurements were observed in patients. Data Conclusion Dixon cardiac MRF attained good overall precision in phantom and healthy subjects, while providing coregistered T1, T2, and fat fraction maps in a single breath‐hold scan with similar or better image quality than conventional methods in patients. Level of Evidence 2. Technical Efficacy Stage 2.

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“…A synthetic fat‐suppressed LGE image can be generated from the postcontrast Dixon cardiac MRF maps for comparison with the PSIR LGE images using the following equation (Eq. ) 30 :

S_{LGE} = M_{0, normalw} ((), 1 - 2 e^{- \ln ((), 2) \frac{normalT 1 mPC}{normalT 1 PC}})

where M 0,w , T 1PC , and T 1mPC are the postcontrast Dixon cardiac MRF water proton density map, water T 1 map, and myocardial T 1 measurement, respectively.…”

Section: Methodsmentioning

confidence: 99%

T1, T2, and Fat Fraction Cardiac MR Fingerprinting: Preliminary Clinical Evaluation

Jaubert

Cruz

Bustin

et al. 2020

Magnetic Resonance Imaging

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“…However, there have been no studies systematically comparing the image quality between synthetic and conventional LGE images. Furthermore, the subjects in previous studies analyzing the diagnostic accuracy of synthetic LGE images were limited to patients with ischemic cardiomyopathy or animals [ 9 – 12 , 14 ]. Therefore, the novelty of this study is that it is the first study investigating and verifying better image quality of synthetic LGE images compared to conventional LGE images, with all patient groups suspected of myocardial disease.…”

Section: Discussionmentioning

confidence: 99%

“…In recent studies, the accuracy of synthetic LGE images has been evaluated in patients with myocardial infarction in comparison to that of conventional LGE images. They showed high sensitivity and specificity of the synthetic IR images for the detection of LGE and excellent agreement with conventional LGE imaging for assessing myocardial scars [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

The image quality and diagnostic accuracy of T1-mapping-based synthetic late gadolinium enhancement imaging: comparison with conventional late gadolinium enhancement imaging in real-life clinical situation

Lee

Kim

et al. 2022

Journal of Cardiovascular Magnetic Resonance

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Backgrounds Synthetic late gadolinium enhancement (LGE) images are less sensitive to inversion time (TI) and robust to motion artifact, because it is generated retrospectively by post-contrast T1-mapping images. To explore the clinical applicability of synthetic LGE, we investigated the image quality and diagnostic accuracy of synthetic LGE images, in comparison to that of conventional LGE for various disease groups. Method and materials From July to November 2019, a total of 98 patients who underwent cardiovascular magnetic resonance imaging (CMR), including LGE and T1-mapping sequences, with suspicion of myocardial abnormality were retrospectively included. Synthetic magnitude inversion-recovery (IR) and phase-sensitive IR (PSIR) images were generated through calculations based on the post-contrast T1-mapping sequence. Three cardiothoracic radiologists independently analyzed the image quality of conventional and synthetic LGE images on an ordinal scale with per-segment basis and the image qualities were compared with chi-square test. The agreement of LGE detection was analyzed on per-patient and per-segment basis with Cohen’s kappa test. In addition, the LGE area and percentage were semi-quantitatively analyzed for LGE positive ischemic (n = 14) and hypertrophic cardiomyopathy (n = 13) subgroups by two cardiothoracic radiologists. The difference of quantified LGE area and percentage between conventional and synthetic LGE images were assessed with Mann–Whitney U-test and the inter-reader agreement was assessed with Bland–Altman analysis. Results The image quality of synthetic images was significantly better than conventional images in both magnitude IR and PSIR through all three observers (P < 0.001, all). The agreements of per-patient and per-segment LGE detection rates were excellent (kappa = 0.815–0.864). The semi-quantitative analysis showed no significant difference in the LGE area and percentage between conventional and synthetic LGE images. In the inter-reader agreement showed only small systematic differences in both magnitude IR and PSIR and synthetic LGE images showed smaller systematic biases compared to conventional LGE images. Conclusion Compared to conventional LGE images, synthetic LGE images have better image quality in real-life clinical situation.

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“…LGE has been previously proposed to mitigate some of the short-comings of conventional LGE imaging, by generating LGE imaging contrast retrospectively [14], [15], [16] from quantitative or semi-quantitative T 1 relaxation information [17], [18]. This alleviates sensitivity to the correct choice of the pre-defined inversion time and allows visualization with varying contrasts [19].…”

Section: Syntheticmentioning

confidence: 99%

Functional LGE Imaging: Cardiac Phase-Resolved Assessment of Focal Fibrosis

Weingärtner

Demirel

Shenoy

et al. 2019

2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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Cardiac Magnetic Resonance Imaging (CMR) is a central tool for diagnosis of various ischemic and non-ischemic cardiomyopathies. CMR protocols commonly comprise assessment of functional properties using cardiac phase-resolved CINE MRI and characterization of myocardial viability using late gadolinium enhancement (LGE) imaging. Conventional LGE imaging requires inversion recovery preparation with a specific inversion time to null the healthy myocardium, which restricts the acquisition to a single cardiac phase. In turn, this necessitates separate scans for cardiac function and viability. In this work, we develop a new method for functional LGE imaging in a single breath-hold using a three-step approach: 1) ECG-triggered multi-contrast data is acquired for each cardiac phase, 2) semi-quantitative relaxation maps are generated, 3) LGE imaging contrast is synthesized based on the semi-quantitative maps. The proposed functional LGE method is evaluated in four healthy subject and 20 patients at 1.5T and 3T. Thorough suppression of the healthy myocardium, as well as 40-80ms temporal resolution are achieved, with no visually apparent temporal blurring at tissue interfaces. Functional LGE in patients with focal scar demonstrates robust hyperenhancement in the scar area throughout all cardiac phases, allowing for visual assessment of scar motility. The proposed technique bears the potential to simplify and speed-up common cardiac imaging protocols, while enabling improved data fusion of functional and viability information for improved evaluation of CMR.

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Synthetic late gadolinium enhancement cardiac magnetic resonance for diagnosing myocardial scar

Cited by 7 publications

References 15 publications

T1, T2, and Fat Fraction Cardiac MR Fingerprinting: Preliminary Clinical Evaluation

T1, T2, and Fat Fraction Cardiac MR Fingerprinting: Preliminary Clinical Evaluation

The image quality and diagnostic accuracy of T1-mapping-based synthetic late gadolinium enhancement imaging: comparison with conventional late gadolinium enhancement imaging in real-life clinical situation

Functional LGE Imaging: Cardiac Phase-Resolved Assessment of Focal Fibrosis

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