Democratizing cardiac imaging with an automated magnetic resonance exam

Advanced imaging of the heart, including cardiovascular magnetic resonance imaging (CMR), has revolutionized the diagnosis and prognosis for cardiovascular disease^1-3. For the past 40 years, CMR has primarily relied on the acquisition of numerous breath-held 2D images resulting in complex scanner operation, patient discomfort, long scan durations, and cumbersome image interpretation^4,5. These limitations constrain CMR use to major academic hospital systems and severely limit patient access to CMR, which makes up < 1% of total cardiovascular imaging despite being represented in two thirds of all AHA/ACC guidelines^6,7. By leveraging advanced multidimensional physics and artificial intelligence, we overcome these challenges by developing a 30-minute end-to-end automated CMR exam (AutoCMR) that delivers 4D anatomical, functional, and tissue characterization of the whole heart in a single click without breath-holds. AutoCMR was rigorously validated in three cohorts: preclinical large animals, patients scanned in an academic hospital setting with over 40 years of CMR experience, and patients scanned in a community health center with no prior CMR experience. While providing simplified CMR acquisition and automated analysis, we demonstrated that AutoCMR was not significantly different than conventional CMR in imaging biomarkers and human interpretation. With its 4D whole thoracic coverage, we further showcased that AutoCMR can enable next generation patient analytics including personalized digital twins, 3D printing, virtual reality, and automated clinical structured summaries. Due to its inherent scalability, we anticipate AutoCMR will promote the democratization of CMR, increasing patient access for all including underserved health communities, while enabling powerful downstream cutting-edge technologies aimed at personalized medicine.