Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - Comparison of an intravascular and extravascular contrast agent

Marcus R. Makowski, Andrea J. Wiethoff, Christian H.P. Jansen, Sergio Uribe, Victoria Parish, Andreas Schuster, Rene M. Botnar, Aaron Bell, Christoph Kiesewetter, Reza Razavi, Tobias Schaeffter, Gerald F. Greil

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Cardiovascular magnetic resonance (CMR) is the current gold standard for the assessment of left ventricular (LV) function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP). Accelerated single breath-hold techniques suffer from low contrast between blood pool and myocardium. In this study an intravascular contrast agent was prospectively compared to an extravascular contrast agent for the assessment of LV function using a single-breath-hold 3D-whole-heart cine SSFP sequence (3D-SSFP). Methods: LV function was assessed in fourteen patients on a 1.5 T MR-scanner (Philips Healthcare) using 32-channel coil technology. Patients were investigated twice using a 3D-SSFP sequence (acquisition time 1825 s) after Gadopentetate dimeglumine (GdD, day 1) and Gadofosveset trisodium (GdT, day 2) administration. Image acquisition was accelerated using sensitivity encoding in both phase encoding directions (4xSENSE). CNR and BMC were both measured between blood and myocardium. The CNR incorporated noise measurements, while the BMC represented the coeffiancy between the signal from blood and myocardium [1]. Contrast to noise ratio (CNR), blood to myocardium contrast (BMC), image quality, LV functional parameters and intra-/interobserver variability were compared. A M2D-SSFP sequence was used as a reference standard on both days. Results: All 3D-SSFP sequences were successfully acquired within one breath-hold after GdD and GdT administration. CNR and BMC were significantly (p < 0.05) higher using GdT compared to GdD, resulting in an improved endocardial definition. Using 3D-SSFP with GdT, BlandAltman plots showed a smaller bias (95% confidence interval LVEF: 9.0 vs. 23.7) and regression analysis showed a stronger correlation to the reference standard (R2 = 0.92 vs. R2 = 0.71), compared to 3D-SSFP with GdD. Conclusions: A single-breath-hold 3D-whole-heart cine SSFP sequence in combination with 32-channel technology and an intravascular contrast agent allows for the accurate and fast assessment of LV function. Trial registration: The study was approved by the local research ethics committee (Study No. 07/Q0704/2) and was registered with the Medicines and Healthcare Products Regulatory Agency (MHRA Study No. 28482/0002/0010001, EudraCTnumber 2006007042).

Original languageEnglish (US)
Article number53
JournalJournal of Cardiovascular Magnetic Resonance
Volume14
Issue number1
DOIs
StatePublished - Aug 2 2012

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Endovascular Procedures
Contrast Media
Myocardium
Noise
Left Ventricular Function
Technology
Delivery of Health Care
Gadolinium DTPA
Observer Variation
Research Ethics Committees
Magnetic Resonance Spectroscopy
Regression Analysis
Confidence Intervals

Keywords

  • 32-channel coil
  • Balanced steady-state-free precession (SSFP)
  • Cardiac function
  • Cardiovascular magnetic resonance
  • Gadofosveset trisodium
  • Gadopentetate dimeglumine
  • Sensitivity encoding (SENSE)

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine
  • Family Practice

Cite this

Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - Comparison of an intravascular and extravascular contrast agent. / Makowski, Marcus R.; Wiethoff, Andrea J.; Jansen, Christian H.P.; Uribe, Sergio; Parish, Victoria; Schuster, Andreas; Botnar, Rene M.; Bell, Aaron; Kiesewetter, Christoph; Razavi, Reza; Schaeffter, Tobias; Greil, Gerald F.

In: Journal of Cardiovascular Magnetic Resonance, Vol. 14, No. 1, 53, 02.08.2012.

Research output: Contribution to journalArticle

Makowski, Marcus R. ; Wiethoff, Andrea J. ; Jansen, Christian H.P. ; Uribe, Sergio ; Parish, Victoria ; Schuster, Andreas ; Botnar, Rene M. ; Bell, Aaron ; Kiesewetter, Christoph ; Razavi, Reza ; Schaeffter, Tobias ; Greil, Gerald F. / Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - Comparison of an intravascular and extravascular contrast agent. In: Journal of Cardiovascular Magnetic Resonance. 2012 ; Vol. 14, No. 1.
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abstract = "Background: Cardiovascular magnetic resonance (CMR) is the current gold standard for the assessment of left ventricular (LV) function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP). Accelerated single breath-hold techniques suffer from low contrast between blood pool and myocardium. In this study an intravascular contrast agent was prospectively compared to an extravascular contrast agent for the assessment of LV function using a single-breath-hold 3D-whole-heart cine SSFP sequence (3D-SSFP). Methods: LV function was assessed in fourteen patients on a 1.5 T MR-scanner (Philips Healthcare) using 32-channel coil technology. Patients were investigated twice using a 3D-SSFP sequence (acquisition time 1825 s) after Gadopentetate dimeglumine (GdD, day 1) and Gadofosveset trisodium (GdT, day 2) administration. Image acquisition was accelerated using sensitivity encoding in both phase encoding directions (4xSENSE). CNR and BMC were both measured between blood and myocardium. The CNR incorporated noise measurements, while the BMC represented the coeffiancy between the signal from blood and myocardium [1]. Contrast to noise ratio (CNR), blood to myocardium contrast (BMC), image quality, LV functional parameters and intra-/interobserver variability were compared. A M2D-SSFP sequence was used as a reference standard on both days. Results: All 3D-SSFP sequences were successfully acquired within one breath-hold after GdD and GdT administration. CNR and BMC were significantly (p < 0.05) higher using GdT compared to GdD, resulting in an improved endocardial definition. Using 3D-SSFP with GdT, BlandAltman plots showed a smaller bias (95{\%} confidence interval LVEF: 9.0 vs. 23.7) and regression analysis showed a stronger correlation to the reference standard (R2 = 0.92 vs. R2 = 0.71), compared to 3D-SSFP with GdD. Conclusions: A single-breath-hold 3D-whole-heart cine SSFP sequence in combination with 32-channel technology and an intravascular contrast agent allows for the accurate and fast assessment of LV function. Trial registration: The study was approved by the local research ethics committee (Study No. 07/Q0704/2) and was registered with the Medicines and Healthcare Products Regulatory Agency (MHRA Study No. 28482/0002/0010001, EudraCTnumber 2006007042).",
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T1 - Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - Comparison of an intravascular and extravascular contrast agent

AU - Makowski, Marcus R.

AU - Wiethoff, Andrea J.

AU - Jansen, Christian H.P.

AU - Uribe, Sergio

AU - Parish, Victoria

AU - Schuster, Andreas

AU - Botnar, Rene M.

AU - Bell, Aaron

AU - Kiesewetter, Christoph

AU - Razavi, Reza

AU - Schaeffter, Tobias

AU - Greil, Gerald F.

PY - 2012/8/2

Y1 - 2012/8/2

N2 - Background: Cardiovascular magnetic resonance (CMR) is the current gold standard for the assessment of left ventricular (LV) function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP). Accelerated single breath-hold techniques suffer from low contrast between blood pool and myocardium. In this study an intravascular contrast agent was prospectively compared to an extravascular contrast agent for the assessment of LV function using a single-breath-hold 3D-whole-heart cine SSFP sequence (3D-SSFP). Methods: LV function was assessed in fourteen patients on a 1.5 T MR-scanner (Philips Healthcare) using 32-channel coil technology. Patients were investigated twice using a 3D-SSFP sequence (acquisition time 1825 s) after Gadopentetate dimeglumine (GdD, day 1) and Gadofosveset trisodium (GdT, day 2) administration. Image acquisition was accelerated using sensitivity encoding in both phase encoding directions (4xSENSE). CNR and BMC were both measured between blood and myocardium. The CNR incorporated noise measurements, while the BMC represented the coeffiancy between the signal from blood and myocardium [1]. Contrast to noise ratio (CNR), blood to myocardium contrast (BMC), image quality, LV functional parameters and intra-/interobserver variability were compared. A M2D-SSFP sequence was used as a reference standard on both days. Results: All 3D-SSFP sequences were successfully acquired within one breath-hold after GdD and GdT administration. CNR and BMC were significantly (p < 0.05) higher using GdT compared to GdD, resulting in an improved endocardial definition. Using 3D-SSFP with GdT, BlandAltman plots showed a smaller bias (95% confidence interval LVEF: 9.0 vs. 23.7) and regression analysis showed a stronger correlation to the reference standard (R2 = 0.92 vs. R2 = 0.71), compared to 3D-SSFP with GdD. Conclusions: A single-breath-hold 3D-whole-heart cine SSFP sequence in combination with 32-channel technology and an intravascular contrast agent allows for the accurate and fast assessment of LV function. Trial registration: The study was approved by the local research ethics committee (Study No. 07/Q0704/2) and was registered with the Medicines and Healthcare Products Regulatory Agency (MHRA Study No. 28482/0002/0010001, EudraCTnumber 2006007042).

AB - Background: Cardiovascular magnetic resonance (CMR) is the current gold standard for the assessment of left ventricular (LV) function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP). Accelerated single breath-hold techniques suffer from low contrast between blood pool and myocardium. In this study an intravascular contrast agent was prospectively compared to an extravascular contrast agent for the assessment of LV function using a single-breath-hold 3D-whole-heart cine SSFP sequence (3D-SSFP). Methods: LV function was assessed in fourteen patients on a 1.5 T MR-scanner (Philips Healthcare) using 32-channel coil technology. Patients were investigated twice using a 3D-SSFP sequence (acquisition time 1825 s) after Gadopentetate dimeglumine (GdD, day 1) and Gadofosveset trisodium (GdT, day 2) administration. Image acquisition was accelerated using sensitivity encoding in both phase encoding directions (4xSENSE). CNR and BMC were both measured between blood and myocardium. The CNR incorporated noise measurements, while the BMC represented the coeffiancy between the signal from blood and myocardium [1]. Contrast to noise ratio (CNR), blood to myocardium contrast (BMC), image quality, LV functional parameters and intra-/interobserver variability were compared. A M2D-SSFP sequence was used as a reference standard on both days. Results: All 3D-SSFP sequences were successfully acquired within one breath-hold after GdD and GdT administration. CNR and BMC were significantly (p < 0.05) higher using GdT compared to GdD, resulting in an improved endocardial definition. Using 3D-SSFP with GdT, BlandAltman plots showed a smaller bias (95% confidence interval LVEF: 9.0 vs. 23.7) and regression analysis showed a stronger correlation to the reference standard (R2 = 0.92 vs. R2 = 0.71), compared to 3D-SSFP with GdD. Conclusions: A single-breath-hold 3D-whole-heart cine SSFP sequence in combination with 32-channel technology and an intravascular contrast agent allows for the accurate and fast assessment of LV function. Trial registration: The study was approved by the local research ethics committee (Study No. 07/Q0704/2) and was registered with the Medicines and Healthcare Products Regulatory Agency (MHRA Study No. 28482/0002/0010001, EudraCTnumber 2006007042).

KW - 32-channel coil

KW - Balanced steady-state-free precession (SSFP)

KW - Cardiac function

KW - Cardiovascular magnetic resonance

KW - Gadofosveset trisodium

KW - Gadopentetate dimeglumine

KW - Sensitivity encoding (SENSE)

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