Value CMR: Towards a Comprehensive, Rapid, Cost-Effective Cardiovascular Magnetic Resonance Imaging.

Area of Science:

• Cardiovascular Imaging
• Medical Physics
• Radiology

Background:

• Cardiac magnetic resonance imaging (CMR) is the gold standard for cardiac function assessment but is underutilized due to long scan times, multiple breath-holds, contrast agents, and cost.
• Conventional CMR sequences are time-consuming and require significant patient cooperation, limiting widespread clinical application.

Purpose of the Study:

• To develop and validate a rapid, comprehensive, and contrast-free CMR exam using advanced imaging sequences.
• To reduce CMR scan time, eliminate the need for repeated breath-holds, and improve patient tolerability and cost-effectiveness.

Main Methods:

• Replaced conventional 2D cine and phase-contrast (PC) sequences with optimized 3D-cine and 4D-flow sequences.
• Integrated fast strain-encoding (SENC) imaging for myocardial tagging and T1/T2 mapping for tissue characterization.
• Tested the proposed rapid CMR exam in vivo, comparing results with conventional methods.

Main Results:

• Reduced total scan time from over 1 hour to under 20 minutes.
• Achieved good agreement between rapid CMR measurements and conventional sequences, differentiating healthy volunteers from patients.
• 3D-cine imaging required only 1-2 breath-holds for whole-heart coverage; 4D-flow covered the chest in <10 minutes; SENC imaging acquired one slice per heartbeat.

Conclusions:

• The proposed rapid, contrast-free CMR exam is comprehensive, requires minimal breath-holds, and does not need constant supervision.
• These advancements enhance patient tolerance, improve cost-effectiveness, and are expected to increase the clinical adoption of CMR.