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Cardiac DTI using short-axis PROPELLER: A feasibility study.

Mehdi Sadighi1, Danielle Kara1, Dingheng Mai1,2

  • 1Cardiovascular Innovation Research Center (CIRC), Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.

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|February 20, 2024
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Summary

A new free-breathing cardiac diffusion tensor imaging (cDTI) method using SAP-M2-EPI significantly reduces geometric distortion and aliasing in the left ventricle. This technique ensures accurate myocardial microstructure quantification, even in patients with higher body mass index.

Keywords:
PROPELLER MRIcardiac magnetic resonancediffusion tensor MRIdistortion correctionfree‐breathingmyocardium

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Area of Science:

  • Cardiovascular MRI
  • Diffusion Tensor Imaging
  • Medical Imaging Techniques

Background:

  • Cardiac diffusion tensor imaging (cDTI) is crucial for assessing myocardial microstructure.
  • Traditional methods often suffer from geometric distortion and aliasing, especially in free-breathing scans and individuals with higher body mass index (BMI).
  • Mitigating these artifacts is essential for accurate quantitative analysis of the myocardium.

Purpose of the Study:

  • To develop and evaluate a novel free-breathing (FB) cDTI method, termed SAP-M2-EPI.
  • This method utilizes short-axis PROPELLER (SAP) and M2 motion-compensated spin-echo EPI (SAP-M2-EPI) to address geometric distortion and aliasing.
  • The goal is to improve image quality and quantitative accuracy in cDTI, particularly for patients with higher BMI.

Main Methods:

  • The study included 10 healthy volunteers with varying BMIs (<25, 25-28, >30).
  • Cardiac DTI parameters (FA, MD, HAT) were compared between the novel SAP-M2-EPI and a standard M2-ssEPI sequence.
  • Geometric distortion was quantified using the DICE similarity coefficient (DSC) and misregistration area, comparing SAP-M2-EPI to CINE and M2-ssEPI.

Main Results:

  • SAP-M2-EPI successfully produced high-quality, aliasing-free LV DWIs in all volunteers.
  • Significantly reduced geometric distortion was observed with SAP-M2-EPI (average DSC 0.92, average misregistration 90 mm²), outperforming M2-ssEPI.
  • Reduced signal loss due to bulk motion and consistent DTI parameter maps without motion artifacts were noted.

Conclusions:

  • SAP-M2-EPI enables high-fidelity, free-breathing cDTI of the entire left ventricle.
  • The method effectively eliminates aliasing and minimizes geometric distortion compared to M2-ssEPI.
  • Accurate quantification of myocardial microstructure is preserved, offering a significant advancement in cardiac MRI.