Qian Tao¹, Esra Gucuk Ipek², Rahil Shahzad¹, Floris F. Berendsen¹, Saman Nazarian², and Rob J. van der Geest^1
1Department of Radiology, Leiden University Medical Center, Leiden, Netherlands, ²Department of Cardiology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States

The extent and distribution of left atrial (LA) scar, visualized by LGE MR, can provide important information for treatment of atrial fibrillation (AF) patients. However, in current practice, to extract such information requires substantial manual effort and expertise. In this study, a fully automatic method was developed to segment LA and PV’s in LGE-MRI, combining robust multi-atlas segmentation and flexible level-set based segmentation optimization. The method demonstrated comparable accuracy to manual segmentation, with improved 3D continuity. The method enables automated generation of patient-specific LA and PV geometry models, and potentially objective LA scar assessment for individual AF patients.

Gregory J Wilson¹, Niranjan Balu¹, Jinnan Wang^1,2, Chun Yuan¹, and Jeffrey H Maki^1
1University of Washington, Seattle, WA, United States, ²Bayer Healthcare, Whippany, NJ, United States

A novel black-blood pre-pulse is described that darkens intraventricular blood pool signal in late gadolinium enhanced (LGE) imaging of myocardial scar. The pre-pulse is m₁-nulled motion-sensitized driven equilibrium (m2MSDE) with user-specified motion-sensitizing direction. The pre-pulse nulls blood signal while maintaining good myocardial image quality. Preliminary results are described.

Charlene Liew^1,2, Tamer Basha¹, Mehmet Akcakaya¹, Connie Tsao¹, Francesca Delling¹, Kraig Kissinger¹, Beth Goddu¹, Sophie Berg¹, Warren Manning^1,3, and Reza Nezafat^1
1Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States, ²Department of Radiology, Changi General Hospital, Singapore, Singapore, ³Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, United States

Compressed sensing can be used to reduce 3D LGE scan time by factor of 5 with isotropic spatial resolution. However, clinical feasibility and overall image quality of 3D LGE with compressed sensing is still unknown. In this study, we sought to assess the image quality of 3D LGE with isotropic spatial resolution of 1-1.5 mm³ in 268 consecutive patients with known or suspected cardiovascular disease and investigate the impact of patient characteristics on overall image quality. 

Joep van Oorschot¹, Martijn Froeling¹, Thijs van den Broek², Frebus van Slochteren², Steven Chamuleau², Peter Luijten¹, Tim Leiner¹, and Jaco Zwanenburg^1
1Radiology, University Medical Center Utrecht, Utrecht, Netherlands, ²Cardiology, University Medical Center Utrecht, Utrecht, Netherlands

Two promising techniques for endogenous myocardial infarct detection are Magnetization Transfer  and T1ρ-MRI. Goal of the study was to compare the ability to detect and quantify myocardial scar tissue in a chronic infarct model using MT and T1ρ mapping. In vivo MRI was performed on a clinical 1.5 MR scanner in 3 anesthetized pigs, 4 weeks after 90 minutes occlusion of the LAD. The MTR was significantly lower in the infarcted region (0.27±0.01 ms), compared to remote myocardium (0.38±0.01 ms).The T1ρ relaxation time was significantly higher in the infarcted region (87.0±1 ms), compared to healthy remote myocardium (56.4± 1 ms).

Rajiv G Menon¹, G Wilson Miller², Jean Jeudy¹, Sanjay Rajagopalan³, and Taehoon Shin^1
1Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, Baltimore, MD, United States, ²Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, United States, ³Division of Cardiovascular Medicine, University of Maryland, Baltimore, Baltimore, MD, United States

We developed a free-breathing, 3D late gadolinium enhancement (FB 3D-LGE) cardiovascular magnetic resonance  technique based on outer volume suppressed 1D-projection navigators and a stack-of-spirals acquisition. The free-breathing 3D-LGE and conventional breath-hold 2D-LGE scans were performed on 29 cardiac patients. 2D and 3D techniques showed no significant differences in overall image quality scores and image artifact scores (P  >  0.1). There was a significant correlation in the average difference in fractional scar volume (r=0.96). The FB 3D-LGE is a viable option for patients, particularly in acute settings or in patients who are unable to comply with breath-hold instructions.

Gillian Macnaught^1,2, Christopher Rodgers³, Martin Denvir⁴, Olga Oikonomidou^5,6, Annette Cooper¹, William Clarke³, Heather McVicars⁶, Larry Hayward⁶, Saeed Mirsadraee¹, and Scott Semple^1,4
1Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, United Kingdom, ²the MRC Centre for inflammation Research, University of Edinburgh, Edinburgh, United Kingdom, ³RDM Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom, ⁴BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom, ⁵Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, United Kingdom, ⁶Edinburgh Cancer Centre, NHS Lothian, Edinburgh, United Kingdom

Anthracyclines are chemotherapy agents widely used to treat cancer but that can also induce cardiotoxicity. Techniques are required to provide an earlier warning of cardiotoxicity before irreversible myocardial damage. 9 subjects were recruited to this on-going 31P MRS study to detect changes in cardiac energetics of breast cancer patients undergoing chemotherapy. Between pre- and mid-chemotherapy four subjects experienced a greater than 20% decrease in their cardiac PCr/ATP ratio, 1 subject experienced a 13.8% decrease in left ventricular ejection fraction (LVEF) and all had increased troponin levels. Ultimately this study aims to determine whether changes in PCr/ATP precede changes in LVEF.

Antonella Meloni¹, Caterina Borgna-Pignatti², Giovanni Carlo Del Vecchio³, Maria Antonietta Romeo⁴, Maria Rita Gamberini⁵, Federico Bonetti⁶, Maria Giovanna Neri¹, Elisabetta Chiodi⁷, Vincenzo Positano¹, and Alessia Pepe^1
1Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy, ²Università di Ferrara, Ferrara, Italy, ³Uiversity of Bari, Bari, Italy, ⁴University of Catania, Catania, Italy, ⁵Arcispedale "S.Anna", Ferrara, Italy,⁶Policlinic Foundation San Matteo IRCCS, Pavia, Italy, ⁷Arcispedale “S. Anna”, Ferrara, Italy

The introduction of T2* CMR for the reproducible and non-invasive assessment of myocardial iron overload reduced the likelihood of developing decompensated cardiac failure, allowing the reduction of cardiac mortality in chronically transfused TM patients

Huilin Zhao¹, Beibei Sun¹, Xiaosheng Liu¹, Xihai Zhao², Yongming Dai³, Chun Yuan⁴, and Jianrong Xu^1
1Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, People's Republic of, ²Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China, People's Republic of, ³Philips Healthcare, Shanghai, China, People's Republic of, ⁴Radiology, University of Washington, Seattle, WA, United States

Further understanding of the association of hemoglobin A_1c(HbA_1c) levels with symptomatic carotid plaque characteristics will be helpful for stroke risk stratification and treatment strategy modification. This study sought to investigate the associations of HbA_1c levels with MR-identified carotid plaque characteristics in hypertensive patients with acute stroke. Our key findings are that elevated HbA_1c was associated with carotid plaque presence, higher HbA_1c level tended to exhibit an increased plaque burden and larger lipid-rich necrotic core, independent of other cardiovascular risk factors. Our findings indicate that elevated HbA_1c may contribute to the development of advanced carotid plaques in stroke patients with hypertension.

Rami Homsi¹, Alois Martin Sprinkart¹, Jürgen Gieseke^1,2, Julian Luetkens¹, Michael Meier-Schroers¹, Darius Dabir¹, Daniel Kuetting¹, Christian Marx¹, Hans Schild¹, and Daniel Thomas^1
1Radiology, University Hospital Bonn, Bonn, Germany, ²Philips Healthcare, Hamburg, Germany

In a Cardiac Magnetic Resonance based approach the study reveals a relationship between epicardial fat and aortic stiffness which are both associated with cardiovascular risk and disease.

Charlotte E Buchanan^1,2, Azharuddin Mohammed², Eleanor F Cox¹, Maarten W Taal², Nicholas M Selby², Susan T Francis¹, and Christopher W McIntyre^3
1Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom, ²Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, United Kingdom, ³Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada

We perform the first study of intradialytic MRI to assess cardiovascular stress during dialysis. A significant reduction in cardiac output (CO), stroke volume (SV) and IVC flux was seen during dialysis. Myocardial strain measures revealed significant stunned segments in the long axis in all individuals. No significant change in coronary artery flow was evident, and both myocardial perfusion and T₁ measures in a single short axis slice showed no significant change. The change in CO and SV was negatively correlated with dialysis ultrafiltration volume. This work demonstrates MRI can be used to assess cardiac stress during dialysis.