ISMRM 24th Annual Meeting & Exhibition 07-13 May 2016 Singapore

Scientific Session: CMR Perfusion & Function

Thursday, May 12, 2016
Room 300-302
16:00 - 18:00
Moderators: Vincent Ho, Behzad Sharif

Harmonic-Phase versus Sine-Wave Modeling for Measuring Regional Cardiac Function from Tagged MRI Images
El-Sayed H. Ibrahim1, Scott Swanson1, Jadranka Stojanovska1, Claire Duvernoy1, and Rodica Pop-Busui1
1University of Michigan, Ann Arbor, MI, United States
MRI tagging is a valuable method for evaluating regional heart function. This study compares the harmonic-phase (HARP) and sine-wave modeling (SinMod) tagging analysis techniques for evaluating myocardial strain and torsion in healthy controls and type-1-diabetes patients. All SinMod measurements were significantly larger than those by HARP. Nevertheless, there existed consistency in the measurements by each technique, as seen by the good correlation between the HARP and SinMod measurements in both normals and patients, except for apical strain (patients and controls) and mid-ventricular strain in patients. The inter-observer agreement was better in SinMod than in HARP for both torsion and strain. 

Regional cardiac mechanical activation times using cine DENSE strain imaging strongly predict electrical activation times in cardiac resynchronization therapy
Daniel A Auger1, Kenneth C Bilchick2, and Frederick H Epstein1,3
1Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States, 2Department of Medicine, Cardiovascular Medicine, University of Virginia, Charlottesville, VA, United States,3Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, United States
A widely held goal in cardiac resynchronization therapy (CRT) is to implant the left-ventricular (LV) pacing lead in a late-activating region. Time to peak shortening (TPS) has been used to image mechanical activation; however electrical activation time is directly related to the time of onset of contraction rather than TPS. Using cine DENSE in heart failure patients, we show that the time of onset of shortening (TOS) shows a strong correlation with electrical activation time, whereas a lower correlation was found using TPS. Cine DENSE of TOS is a promising method for the detection of late-activating segments in CRT patients

Left ventricular (LV) volume and rate of volume change (dV/dt) during the early and late filling periods evaluated from respiratory triggered, high frame rate cine SSFP as markers of LV diastolic function: Direct correlation with Echocardiography
Jiming Zhang1, Benjamin Y Cheong1, Jie Chen1, Amol Pednekar2, Claudio Arena1, Melissa L Andrews1, and Raja Muthupillai1
1Diagnostic and Interventional Radiology, CHI St Luke's Health, Houston, TX, United States, 2Phillips Healthcare, Cleveland, OH, United States
LV chamber volumes measured using MR cine SSFP imaging and trans-mitral flow velocities measured with echo are considered de facto standards for evaluating LV systolic and diastolic function respectively. Our results show that the relative change in LV volume as well as peak LV volume-rate between the early and late filling periods of the cardiac cycle as measured from high-frame rate cine SSFP imaging, correlate well with conventional echo-based diastolic function index (E/A ratio).  The results from the study suggest that a free-breathing, high frame rate MR cine SSFP imaging approach can evaluate both systolic and diastolic function from a single LV volume data-set. 

An extended 3D whole-heart myocardial first-pass perfusion sequence: Alternate-cycles interchanging high-resolution and isotropic imaging
Merlin J Fair1,2, Peter D Gatehouse1,2, Liyong Chen3,4, Ricardo Wage2, Edward VR DiBella5, and David N Firmin1,2
1NHLI, Imperial College London, London, United Kingdom, 2NIHR Cardiovascular BRU, Royal Brompton Hospital, London, United Kingdom, 3UC Berkeley, Berkeley, CA, United States, 4Advanced MRI Technologies, Sebastopol, CA, United States, 5UCAIR, University of Utah, Salt Lake City, UT, United States
An alternate-cycle acquisition strategy is proposed for 3D whole-heart first-pass perfusion, capturing two separate datasets from the same first-pass, each pushing separate boundaries of currently achievable parameters whilst maintaining clinically feasible acquisition times. It is postulated this approach may also confer an advantage with regard to artefact detection.

Reduced field-of-view 3D stack-of-spirals perfusion imaging with high spatiotemporal resolution
Yang Yang1, Li Zhao2, Xiao Chen3, Kelvin Chow4, Peter W. Shaw4, Jorge A. Gonzalez4, Frederick H. Epstein1,5, Craig H. Meyer1,5, Christopher M. Kramer4,5, and Michael Salerno1,4,5
1Biomedical Engineering, University of Virginia, Charlottesville, VA, United States, 2Radiology, Beth Israel Deaconess Medical Center & Harvard Medical, Boston, MA, United States, 3Medical Imaging Technologies, Siemens Healthcare, Princeton, NJ, United States, 4Medicine, University of Virginia, Charlottesville, VA, United States, 5Radiology, University of Virginia, Charlottesville, VA, United States
3D CMR perfusion imaging enables whole ventricular coverage at the same cardiac cycle permitting quantification of ischemic burden of patients being evaluated for coronary artery disease.  Current 3D techniques have limited spatial-temporal resolution. We developed an efficient outer-volume suppressed 3D Stack-of-Spiral perfusion sequence with motion-guided compressed sensing reconstruction which can acquire 20 partitions with 2 mm in-plane and 4 mm through-plane resolution with a temporal foot print of 180 ms.  A pilot study of 10 subjects using this technique demonstrates clinically acceptable image quality.

Multi-center study of whole-heart dynamic 3-dimensional cardiac magnetic resonance perfusion imaging for the detection of coronary artery disease analysis of diagnostic performance in women
Sandra Hamada1, Alexander Gotschy2,3, Lukas Wissmann3, Sebastian Kozerke3, Cosima Jahnke4, Ingo Paetsch4, Rolf Gebker5, Nikolaus Marx6, Hatem Alkadhi1, and Manka Robert1,7
1Institue of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland, 2Department and Policlinic of Internal Medicine, University Hospital Zurich, Zurich, Switzerland, 3Institue for Biomecical Engineering, University and ETH Zurich, Zurich, Switzerland, 4University Heart Center Leipzig, Leipzig, Germany, 5German Heart Institute Berlin, Berlin, Germany, 6Department of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany, 7Department of Cardiology, University Heart Center, Universitiy Hospital Zurich, Zurich, Switzerland
Coronary heart disease accounts for a large amount of morbidity and mortality in women. To contribute to evidence for non-invasive testing in women, this study compares diagnostic performance of whole heart dynamic 3D myocardial first-pass perfusion stress imaging in female and male with findings in coronary angiography. 61 female and 139 male with suspected and known coronary artery disease were enrolled and a whole heart dynamic 3D-CMR first-pass perfusion imaging was performed at rest and at stress. Whole heart dynamic 3D-CMR perfusion imaging shows high sensitivity, specificity and diagnostic accuracy in women and men and therefore seems to be a suitable testing tool for myocardial ischemia in women and men.  

Towards Reliable Non-Contrast Enhanced MR-based Myocardial Perfusion Imaging: Myocardial BOLD MRI Using Late Effects of Regadenoson with Simultaneous 13N-ammonia PET Validation in a Whole-body Hybrid PET/MR System
Hsin-Jung Yang1, Damini Dey1, Jane Sykes2, John Butler2, Xiaoming Bi3, Behzad Sharif1, Sotirios Tsaftaris4, Debiao Li1, Piotr Slomka1, Frank Prato2, and Rohan Dharmakumar1
1Cedars Sinai Medical Center, Los Angeles, CA, United States, 2Lawson Health Research Institute, london, ON, Canada, 3Siemens Healthcare, Los Angeles, CA, United States, 4IMT Institute for Advanced Studies Lucca, Lucca, Italy
Over the past two decades myocardial BOLD MRI has seen major technical advancements and a number of clinical validation studies. However, the reliability of BOLD MRI still remains a key weakness for its widespread adoption for routine clinical use due to the unpredictable motions during stress tests. We investigated whether the unique pharmocokinetics of regadenoson, a new coronary vasodilator that is rapidly becoming the agent of choice for cardiac stress testing, can be used to markedly improve the reliability of myocardial BOLD MRI. Studies were performed in a canine model and validated in a clinical PET/MR system.

Comprehensive assessments of myocardial tissue kinetic parameters of K1, k2, MBF, lambda and ECV by using a synergistic quantitative analysis of first-pass myocardial perfusion MRI and pre-and post-contrast T1 mapping in patients with myocardial infarction.
Akimasa Yamada1, Masaki Ishida1, Takashi Ichihara2, Takahiro Natsume2, Yoshitaka Goto1, Mio Uno1, Motonori Nagata1, Yasutaka Ichikawa1, Kakuya Kitagawa1, and Hajime Sakuma1
1Radiology, Mie University Hospital, Tsu-Mie, Japan, 2Faculty of Radiological Technology, Fujita Health University School of Health Science, Toyoake-Aichi, Japan
In this study, we proposed a new method that synergistically analyzes quantitative perfusion MRI and T1-mapping for quantifying k2, as well as K1, myocardial blood flow, lambda and extracellular volume fraction. Nineteen patients with previous myocardial infarction (MI) were studied. Myocardial segments were categorized into 3 groups by presence or absence as well as severity of MI in each segment. Quantitative measurement was successful in all segments with significant difference among the 3 groups of myocardial segments for all tissue kinetic parameters including k2. Synergistic assessment of quantitative perfusion MRI and T1-mapping is promising for more detailed myocardial tissue characterization. 

Bayesian Intravoxel Incoherent Motion Imaging to Map Perfusion in the Human Heart
Georg Spinner1, Constantin von Deuster1,2, Christian Torben Stoeck1, and Sebastian Kozerke1
1Institute for Biomedical Engineering, ETH Zurich, Zurich, Switzerland, 2Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
In vivo cardiac Intravoxel Incoherent Motion Imaging (IVIM) is particularly challenging due to low signal-to-noise ratio, cardiac and respiratory motion. To address the limitation, a spin-echo (SE) based sequence employing motion-compensated diffusion gradients during cardiac contraction was used in combination with Bayesian Shrinkage Prior (BSP) inference. In this work, parameter maps of four volunteers (two slices) are compared to standard segmented least squares (LSQ) regression. Bayesian inferred IVIM parameter maps showed reduced intra-subject variation relative to LSQ. It is concluded that the proposed method is a promising alternative to map myocardial perfusion without the need for contrast agent administration.

Non-contrast Vasodilatory Response Assessment in a porcine model of Acute Myocardial Infarction using Arterial Spin Labeled CMR
Hung Phi Do1, Venkat Ramanan2, Graham A Wright2,3, Nilesh R Ghugre2,3, and Krishna S Nayak4
1Department of Physics and Astronomy, University of Southern California, Los Angeles, CA, United States, 2Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada, 3Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada, 4Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, CA, United States
Myocardial vasodilatory response is an important indicator of microvascular function and viability. Arterial spin labeled (ASL) CMR is a non-contrast method that can quantify myocardial blood flow making it attractive to study vasodilatory response. In this work, we demonstrate the feasibility of ASL in the assessment of regional vasodilatory response in a porcine model of acute myocardial infarction (AMI) using a pharmacological stress agent. Quantitative monitoring of microvascular function in the infarcted, salvageable and remote myocardial territories may potentially help identify patients who are prone to adverse long-term remodeling post-AMI.

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