High-resolution late gadolinium enhancement imaging with compressed sensing: a single-center clinical study
Akcakaya et al. Journal of Cardiovascular Magnetic
Resonance
High-resolution late gadolinium enhancement imaging with compressed sensing: a single-center clinical study
Mehmet Akcakaya 1 2 3
Tamer Basha 0 3 5
Connie Tsao 0 3
Sophie Berg 0 3
Kraig V Kissinger 0 3
Beth Goddu 0 3
Warren J Manning 0 3 4
Reza Nezafat 0 3
0 Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center , Boston, MA , USA
1 Center for Magnetic Resonance Research, University of Minnesota , Minneapolis, MN , USA
2 Electrical and Computer Engineering, University of Minnesota , Minneapolis, MN , USA
3 Authors' details
4 Radiology, Beth Israel Deaconess Medical Center , Boston, MA , USA
5 Biomedical Engineering, Cairo University , Giza , Egypt
-
From 19th Annual SCMR Scientific Sessions
Los Angeles, CA, USA. 27-30 January 2016
Background
Late gadolinium enhancement (LGE) MRI is the clinical
standard for imaging of scar in the left ventricle (LV). It
has also been employed for assessing RF ablations in the
left atrium (LA). LV LGE imaging is typically performed
in 2D. When 3D is utilized, spatial resolution is limited
due to prolonged scan time. We have shown that an
accelerated imaging technique called LOST with
random undersampling can be used to achieve isotropic
resolution in 3D LGE. To benefit from this novel
technique and the resolution gains, reconstruction needs to
be automated and integrated into clinical workflow. In
this study, we sought to utilize random undersampling
and LOST reconstruction, with a novel software tool
that enables clinically feasible integration, in order to
enable LGE MRI with high isotropic spatial resolution
in the clinical setting in a large cohort of patients.
Methods
Patient Study
In a prospective study, 270 patients (181 men; 54.9 ±
14.1 yrs) were recruited. 190 were referred for LV LGE,
and 80 for LA LGE. LGE were acquired 10-to-20 minutes
after bolus infusion of 0.1-to-0.2 mmol/kg of Gd-BOPTA
or Gd-DTPA. Imaging was performed at 1.5T with an
ECG-triggered navigator-gated IR-GRE sequence. The
isotropic resolution varied from 1 × 1 × 1 mm3 to 1.5 × 1.5 ×
1.5 mm3. 3D random undersampling was used, with
acceleration rates of 3 (133 patients) or 5 (137 patients),
corresponding to acquisition durations of 4:00 or 2:30 minutes
(70 bpm, 100% navigator efficiency).
1Electrical and Computer Engineering, University of Minnesota, Minneapolis,
MN, USA
Full list of author information is available at the end of the article
Reconstruction
Randomly undersampled acquisitions were reconstructed
offline using B1-weighted LOST algorithm as in. The
automated reconstruction framework (Fig. 1) was implemented
based on. After an LGE scan the operator used the
framework to initiate LOST reconstruction on a remote CPU
cluster. The reconstruction progress was updated via
communication with the cluster, while the operator continued
scanning. After finishing, results were automatically
retrieved, sent to the scanner database and stored on
hospital PACS.
Analysis
Subjective image quality assessment was performed by an
experienced blinded cardiologist. Presence of LGE was
assessed as present with confidence/absent with
confidence/unconfident to decide. Datasets were also assessed
using a 4-point system: 1 (poor, LGE interpretable in
< 50% of LV myocardium/LA), 2 (fair, LGE interpretable
in 50-75% of LV/LA), 3 (good, LGE interpretable in
75-90% of LV/LA), 4 (excellent, LGE interpretable in
>90% of LV/LA).
Results
LGE imaging was completed in all cases. Enhancement
was visually present in 49 patients, absent in 214 patients,
and the reader was unconfident in 7 cases. Fig. 2a shows
an example LGE image in axial, sagittal and coronal views.
Fig. 2b shows the results of the qualitative assessment,
where >84% of the cases were scored good or excellent.
Conclusions
The proposed acquisition and automated reconstruction
framework enables the clinical use of accelerated high
isotropic resolution LGE imaging in a large number of
patients.
doi:10.1186/1532-429X-18-S1-O56
Cite this article as: Akcakaya et al.: High-resolution late gadolinium
enhancement imaging with compressed sensing: a single-center clinical
study. Journal of Cardiovascular Magnetic Resonance 2016 18(Suppl 1):O56. (...truncated)