Disclosure of Interests. No financial relationships to disclose concerning the content of this presentation or session.

Transcription

1 Comparison of Free Breathing Cardiac MRI Radial Technique to the Standard Multi Breath-Hold Cine SSFP CMR Technique For the Assessment of LV Volumes and Function Shimon Kolker, Giora Weisz, Naama Bogot, Irit Hadas Halpern, Arik Wolak Shaare-Tzedek Medical Center Cardiology, Radiology Departments, Jerusalem, Israel.

2 Disclosure of Interests No financial relationships to disclose concerning the content of this presentation or session.

3 Background Cardiac MRI (CMRI) is considered the gold standard for left ventricular (LV) and right ventricular (RV) volumes and function assessment. Standard cine SSFP sequences require prolonged, repeated breath holds. Radial cine (RC) k space acquisition technique can provide a good image quality without the need for breath holding.

4 Background Continued Cine radial exploits the potential of image compression during acquisition of raw data. For this to occur 3 principles are crucial: 1)Sparsity. 2)Incoherent sampling. 3)Non linear iterative reconstruction

5 Background Continued Cine Radial (SOA) Cine SSFP (SOA)

6 Background Continued Cine Radial (SOA) with artifact Cine Radial (SOA) without artifact

7 Aim The purpose of this study was to compare volume and function results for both LV and RV between the new free breathing cine radial technique and the standard multi breath-hold cine SSFP technique.

8 Methods 30 patients who underwent clinically indicated cardiac MRI (CMRI) were included.

9 Methods In all patients both cine SSFP and cine radial sequences were performed. The images were analyzed using CMR 42 semiautomatic tool of the CVI42 software, version end diastolic volume (EDV), end systolic volume (ESV) and ejection fraction (EF) were calculated for both LV and RV and myocardial mass was calculated for LV only in both techniques.

10 Methods Continued All tests were done on a 1.5T SIEMENS Aera scanner. Image quality: 49% of images were of excellent or good quality and 51% of images were of adequate quality. The volume and function measurements of the RC vs. the cine SSFP multi breath-hold techniques were compared using Pearson correlation and Bland-Altman analyses. All statistical calculations were done using Analyse-it version 2.26.

11 Methods Continued Radial cine (SOA) Cine SSFP (SOA) Radial cine (SOA) Cine SSFP (SOA)

12 Methods Continued Radial cine (SOA)

13 Baseline Characteristics The average age was 34 (4-75) 33% were female The indication for the test was assessment of iron overload in 7%, assessment for infiltrative disease in 17%, evaluation of congenital conditions in 7%, assessment for a cardiomyopathy in 23%, assessment for myocarditis in 30%, viability assessment in 10% and assessment due to arrhythmias in 6%.

14 Difference ( - ) Results: LV Volumes and Function EDV 20 LV EDV difference plot Identity 15 Bias (-0.15) 350 LV EDV Correlation % Limits of agreement ( to 10.55) EDV Mean of EDV r statistic tailed p < Range 37.40to EDV Mean LV EDV RADIAL LV EDV CINE

15 Difference ( - ) Results: LV Volumes and Function ESV 15 LV ESV difference plot Identity 10 Bias (-1.45) 250 LV ESV Correlation % Limits of agreement ( to 8.93) ESV Mean of ESV r statistic tailed p < Range 15.30to ESV Mean LV ESV RADIAL LV ESV CINE 73.00

16 Difference ( - ) Results: LV Volumes and Function EF 15 LV EF difference plot Identity 10 Bias (0.60) LV EF Correlation % Limits of agreement (-5.34 to 6.53) EF Mean of EF r statistic tailed p < Range 18.00to EF Mean LV EF RADIAL LV EF CINE 58.53

17 Difference ( - ) Results: LV Volumes and Function MyoMass_diast LV mass difference plot Identity 50 Bias (2.19) 200 LV Mass Correlation % Limits of agreement ( to 34.74) MyoMass_diast Mean of MyoMass_diast r statistic tailed p < Range 69.10to Mean LV MYOCARDIAL MASS RADIAL LV MYOCARDIAL MASS CINE

18 Difference (RV EDV cine - RV EDV radial) RV EDV cine Results: RV Volumes and Function 10 RV EDV difference plot Identity 5 Bias (-0.23) 240 RV EDV Correlation % Limits of agreement (-7.89 to 7.43) Mean of All RV EDV radial r statistic tailed p < Range 31.50to Mean RV EDV radial RV EDV cine

19 Difference (RV ESV cine - RV ESC radial) RV ESV cine Results: RV Volumes and Function 10 RV ESV difference plot Identity 8 6 Bias (-0.34) 180 RV ESV Correlation % Limits of agreement (-6.99 to 6.31) Mean of All RV ESV radial r statistic tailed p < Mean RV ESV radial RV ESV cine 83.56

20 Difference (RV EF cine - RV EF rdial) RV EF cine Results: RV Volumes and Function 5 RV EF difference plot Identity 4 3 Bias (0.31) 70 RV EF Correlation 2 95% Limits of agreement (-3.42 to 4.03) Mean of All RV EF rdial r statistic tailed p < Range 14.70to Mean RV EF rdial RV EF cine 49.00

21 Conclusions The results demonstrate the feasibility of applying the RC non breath-hold strategy to evaluate LV and RV volume and function with high accuracy in a variety of patients.