Alena Uus¹, Milou P.M. van Poppel^1,2, Johannes K. Steinweg¹, Irina Grigorescu¹, Alexia Egloff Collado³, Paula Ramirez Gilliland¹, Thomas A. Roberts¹, Joseph V. Hajnal^1,3, Mary Rutherford³, David F.A. Lloyd^1,2, Kuberan Pushparajah^1,2, and Maria Deprez^1
1Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²Department of Congenital Heart Disease, Evelina London Children’s Hospital, London, United Kingdom, ³Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom

This work introduces the first black blood 3D T2w MRI atlases of the normal fetal heart and congenital aortic arch anomalies. The atlases were generated from 87 subjects from normal, CoA, RAA and DAA cohorts and also include multi-label segmentations of the major cardiovascular structures. We further evaluated the feasibility of using deep learning for automated multi-label vessel segmentation in 3D T2w motion-corrected MRI images of the fetal heart.   

Aurelien Bustin^1,2,3, Soumaya Sridi², Aurelien Maillot¹, Xavier Pineau², Marta Nuñez-Garcia¹, Maxime Sermesant^1,4, Dounia El Hamrani¹, Julie Magat¹, Jérôme Naulin¹, Stéphanie Clément-Guinaudeau², Claire Bazin², Gäel Dournes², Michel Montaudon², François Laurent², Pierre Jaïs^1,5, Matthias Stuber^1,3,6, and Hubert Cochet^1,2
1IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux – INSERM U1045, Bordeaux, France, ²Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Bordeaux, France, ³Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ⁴INRIA, Université Côte d’Azur, Sophia Antipolis, France, ⁵Department of Cardiac Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Bordeaux, France, ⁶CIBM Center for Biomedical Imaging, Lausanne, Switzerland

Black-blood late gadolinium enhancement (LGE) techniques are increasingly being used to uncover myocardial scar patterns that may be otherwise confused with blood signal on conventional bright-blood LGE, especially when involving the subendocardium. With signal-attenuated blood and dark muscle representation, these techniques may however be hampered by a lack of anatomical information, making spatial localization of myocardial injuries a challenging task. Here we aim to assess the clinical performance of a novel LGE technique that combines both bright- and black-blood imaging in a single time-efficient free-breathing exam to obtain LGE images with unprecedented scar contrast and localization.

Calder David Sheagren^1,2, Terenz Escartin^1,2, Philippa Krahn^1,2, Jaykumar Patel^1,2, Fumin Guo², and Graham Wright^1,2
1Medical Biophysics, University of Toronto, Toronto, ON, Canada, ²Schulich Heart Centre, Sunnybrook Research Institute, Toronto, ON, Canada

High-resolution late gadolinium enhancement imaging is a powerful tool for arrhythmia risk assessment post-myocardial infarction, but requires  substantial operator time and expertise to analyze. To address this challenge, automated analysis is introduced to isolate and depict relevant image features corresponding to healthy myocardium, peri-infarct gray zone, and dense scar. Using two sets of manual epicardial and endocardial contours, weighted total variation denoising is used to correct for statistical noise, and persistent homology is used to stratify topological features of the image. K-means clustering was used to generate remote myocardium and dense scar signal intensities for automated FWHM thresholding.

Chiara Coletti¹, Joao Tourais¹, Telly Ploem¹, Mehmet Akçakaya², Christal van de Steeg-Henzen³, and Sebastian Weingärtner ^1
1Department of Imaging Physics, TU Delft, Delft, Netherlands, ²Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, United States, ³Medical Imaging and Radiation, Holland Proton Therapy Center, Delft, Netherlands

T_1ρ-mapping constitutes a promising contrast-free alternative to LGE MRI for assessment of myocardial viability. However its applicability is hindered by susceptibility to B₀ and B₁⁺ field imperfections. In this work we propose a single breath-hold ECG-triggered adiabatically-prepared single-shot bSSFP T_1ρ-mapping sequence. Bloch simulations are employed to identify optimal parameters for adiabatic pulses. The use of adiabatic preparations yields better resilience to system inhomogeneities and improved myocardium/blood contrast compared with conventional spin-lock modules, both in phantom and in-vivo. Thus, adiabatically-prepared sequences at 3T form a promising candidate for non-contrast evaluation of ischemic and non-ischemic cardiomyopathies.

Xianglun Mao¹, Hsu-Lei Lee¹, Alan C Kwan^1,2, Tianle Cao^1,3, Fei Han⁴, Yibin Xie¹, Debiao Li^1,3, and Anthony Christodoulou^1,3
1Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ²Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ³Department of Bioengineering, University of California in Los Angeles, Los Angeles, CA, United States, ⁴Siemens Medical Solutions USA, Los Angeles, CA, United States

Cardiovascular MR (CMR) is used to acquire function, morphology, and composition of the heart which aids in clinical diagnosis and management. While measures such as ejection fraction, ventricular dimensions, and presence/pattern of late gadolinium enhancement (LGE) have stood the test of time as diagnostic pillars, newer quantitative tissue property measurements such as T1, T2, and extracellular volume (ECV) can characterize diffuse fibrosis, inflammation, or infiltration. The purpose of this study was to integrate multiple quantitative measurements into a single 20-min free-breathing, non-ECG, motion-resolved whole ventricular 3D acquisition using CMR Multitasking, including cardiac function, pre-contrast T1/T2, ECV, and LGE images.

Imran Rashid^1,2, Varun Rajagopalan^1,2, Sadeer Al-Kindi^1,2, Sanjay Rajagopalan^1,2, Nicole Seiberlich^3,4, and Jesse Ian Hamilton^3,4
1Cardiology, University Hospitals Cleveland Medical Center, Cleveland, OH, United States, ²Medicine, Case Western Reserve University, Cleveland, OH, United States, ³Radiology, University of Michigan, Ann Arbor, MI, United States, ⁴Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States

A technique is introduced using post-contrast cardiac Magnetic Resonance Fingerprinting (MRF) T₁ and T₂ maps to calculate synthetic late gadolinium enhancement (LGE) images with multiple contrast weightings, including bright-blood magnitude inversion recovery images, dark-blood T₂-prepared inversion recovery images, and a novel contrast weighting (optimized  for each patient) designed to improve differentiation among viable myocardium, blood, and scar based on measured T₁ and T₂ values. Initial results are presented in fifteen patients with ischemic cardiomyopathy scanned at 1.5T using conventional LGE and MRF-derived multi-contrast LGE images.

Laurent Ruck¹, Tobias Wilferth¹, Lena V. Gast¹, Tanja Platt², Denise Lichthardt¹, Christian R. Meixner¹, Andreas K. Bitz³, Titus Lanz⁴, Simon Konstandin⁵, Christoph Kopp⁶, Michael Uder¹, and Armin M. Nagel^1,2
1Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany, ²Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany, ³Faculty of Electrical Engineering and Information Technology, University of Applied Sciences, Aachen, Germany, ⁴Rapid Biomedical GmbH, Rimpar, Germany, ⁵Fraunhofer MEVIS, Bremen, Germany, ⁶Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany

A dual-nuclear interleaved ²³Na/¹H MRI sequence for cardiac MRI was implemented and evaluated in phantom and in vivo measurements using a ²³Na body coil in combination with two 4 Tx/8 Rx ¹H arrays. The ¹H arrays were operated in 1Tx mode with fixed transmit magnitude/phase setting. Compared to single-nuclear sequences, the interleaved sequence led to almost identical SNR und image intensities in phantom measurements.  Furthermore, the feasibility of interleaved ²³Na/¹H in vivo MRI measurements at 7 T was demonstrated. The interleaved approach enables reduced acquisition times and further eliminates the need for image co-registration.

Matthias Anders¹, Carsten Warmuth¹, Heiko Tzschätzsch¹, Helge Herthum¹, Katja Degenhardt², Sebastian Schmitter², Jeanette Schulz-Menger^1,3,4, Jürgen Braun¹, and Ingolf Sack^1
1Charité Universitätsmedizin Berlin, Berlin, Germany, ²Physikalisch-Technische Bundesanstalt(PTB), Braunschweig and Berlin, Berlin, Germany, ³Experimentaland Clinical Research Center (ECRC), DZHK partner site Berlin, Berlin, Germany, ⁴HELIOS Klinikum Berlin Buch, Berlin, Germany

Cardiac MR elastography (MRE) has the potential to noninvasively characterize the underlying pathophysiology in heart failure with preserved ejection fraction based on abnormal stiffness values. However, the need for synchronizing MRE with cardiac motion, breathing and harmonic vibrations continues to be a challenge. We have developed a single-shot, spin-echo cardiac MRE sequence, which continuously acquires wave images at multiple frequencies with retrospective gating of wave phases relative to the cardiac phase to cover the propagation of shear waves over the full cardiac cycle. Our preliminary data show the dispersion of myocardial stiffness over frequency in systole and diastole.