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Clinical Validation of a 3-Dimensional Ultrafast Cardiac Magnetic Resonance Protocol Including Single Breath-Hold
Sandra Gómez-Talavera1, Rodrigo Fernandez-Jimenez2, Valentín Fuster3
1Clinical Research Department, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Cardiology, IIS-Hospital Fundacion Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
A novel ultrafast 3D cardiac MRI protocol accurately assesses heart anatomy and function. This rapid cardiac magnetic resonance imaging (CMR) method, combining ESSOS cine and 3D LGE, enables a complete exam in under a minute.
Area of Science:
- Cardiovascular Imaging
- Magnetic Resonance Imaging
- Cardiac Physiology
Background:
- Cardiac magnetic resonance (CMR) is the gold standard for cardiac imaging but is often time-consuming.
- Developing faster CMR protocols is crucial for improving patient throughput and comfort.
- Ultrafast imaging techniques aim to reduce scan times without compromising diagnostic quality.
Purpose of the Study:
- To clinically validate a novel 3-dimensional (3D) ultrafast cardiac magnetic resonance (CMR) protocol.
- The protocol integrates cine imaging (anatomy and function) and late gadolinium enhancement (LGE) within a single breath-hold.
- To compare the accuracy and agreement of the novel 3D protocol against standard 2D CMR techniques.
Main Methods:
- A prospective study involving 107 patients compared a novel isotropic 3D cine (ESSOS) and 3D LGE protocol with a standard cine + LGE protocol.
- Left ventricular (LV) mass, volumes, and LV and right ventricular (RV) ejection fractions (LVEF, RVEF) were assessed.
- Late gadolinium enhancement (LGE) extent (% LV) was quantified using both 3D and 2D sequences.
Main Results:
- The 3D ESSOS and 3D LGE acquisitions were rapid, lasting 24s and 22s respectively, with good image quality for quantification.
- Mean LVEF showed excellent agreement between 3D ESSOS and 2D CMR (ICC: 0.96), with insignificant bias.
- Mean RVEF demonstrated acceptable agreement between 3D and 2D CMR (ICC: 0.73), also with insignificant bias. Both 2D and 3D LGE showed excellent agreement, with excellent intra- and inter-observer reproducibility for 3D LGE.
Conclusions:
- The ESSOS single breath-hold 3D CMR protocol enables accurate assessment of cardiac anatomy and function.
- Integrating ESSOS with 3D LGE allows for a comprehensive cardiac examination in less than one minute of acquisition time.
- This advanced CMR protocol has the potential to expand indications for CMR, reduce healthcare costs, and enhance patient experience.
