Accurate Intramyocardial Hemorrhage Assessment with Fast, Free-running, Cardiac Quantitative Susceptibility Mapping
Yuheng Huang1, Xingmin Guan1, Xinheng Zhang1
1From the Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 116 N Robertson Blvd, Pacific Theatres Bldg, Ste 400, Los Angeles, CA 90048 (Y.H., L.T.H., H.L.L., D.L., H. Han, A.G.C., H.J.Y.); Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, Ind (Y.H., X.G., X.Z., G.Y., G.A., S.F.C., K.P.V., B.S., D.P.S., K.Y., R.D.); Departments of Bioengineering (Y.H., X.Z., A.G.C.) and Statistics (H. Ho), University of California Los Angeles, Los Angeles, Calif; Academia Sinica, Institute of Statistical Science, Nankang, Taipei, Taiwan (H. Ho); Department of Surgery, Division of Neurosurgery, Mackay Memorial Hospital, Taipei, Taiwan (L.T.H.); Department of Medical Imaging, National Cheng Kung University Hospital, Tainan, Taiwan (H.Y.L.); Siemens Medical Solutions USA, Malvern, Pa (X.B., F.H.); and Department of Radiological Sciences, University of California Los Angeles David Geffen School of Medicine, Los Angeles, Calif (A.G.C.).
High-dynamic-range quantitative susceptibility mapping (HDR-QSM) accurately detects intramyocardial hemorrhage (IMH) and quantifies iron in canine models. This fast cardiac MRI technique offers improved image quality and performance over conventional methods for IMH assessment.
Area of Science:
- Cardiovascular Magnetic Resonance Imaging
- Quantitative Susceptibility Mapping
- Biomarker Quantification
Background:
- Intramyocardial hemorrhage (IMH) is a critical complication following myocardial infarction.
- Accurate detection and quantification of IMH and its iron content are essential for patient management.
- Conventional MRI techniques for IMH assessment face limitations in image quality and quantification accuracy.
Purpose of the Study:
- To evaluate the performance of a novel high-dynamic-range quantitative susceptibility mapping (HDR-QSM) cardiac MRI technique.
- To assess HDR-QSM's ability to detect IMH and quantify intramyocardial iron content.
- To compare HDR-QSM with conventional R2* mapping in phantom and canine models.
Main Methods:
- Development and application of a free-running whole-heart HDR-QSM technique for IMH assessment.
- Evaluation in calibrated iron phantoms and 14 female canine models with induced IMH.
- Comparison of HDR-QSM with R2* maps, using ex vivo imaging as the reference standard.
Main Results:
- Phantom studies showed a strong linear correlation (R 2=0.98) between iron concentration and QSM values, confirming accurate quantification and artifact mitigation.
- In vivo HDR-QSM demonstrated superior image quality and susceptibility homogeneity compared to R2* (P < .001).
- HDR-QSM outperformed R2* in IMH detection (AUC, 0.96 vs 0.75; P < .001) and iron quantification (R 2, 0.71 vs 0.14).
Conclusions:
- The fast, free-running cardiac HDR-QSM technique accurately detects IMH and quantifies intramyocardial iron.
- This method provides whole-heart coverage within 5 minutes without breath-holding requirements.
- HDR-QSM represents a promising advancement for IMH assessment in clinical practice.
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