Improved Workflow for Quantification of Right Ventricular Volumes Using Free-Breathing Motion Corrected Cine Imaging
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Cardiac MR traditionally requires breath-holding for cine imaging. Younger or less stable patients benefit from free-breathing during cardiac MR but current free-breathing cine images can be spatially blurred. Motion corrected re-binning (MOC) is a novel approach that acquires and then reformats real-time images over multiple cardiac cycles with high spatial resolution. The technique was previously limited by reconstruction time but distributed computing has reduced these times. Using this technique, left ventricular volumetry has compared favorably to breath-held balanced steady-state free precession cine imaging (BH), the current gold-standard, however, right ventricular volumetry validation remains incomplete, limiting the applicability of MOC in clinical practice. Fifty subjects underwent cardiac MR for evaluation of right ventricular size and function by end-diastolic (EDV) and end-systolic (ESV) volumetry. Measurements using MOC were compared to those using BH. Pearson correlation coefficients and Bland–Altman plots tested agreement across techniques. Total scan plus reconstruction times were tested for significant differences using paired t-test. Volumes obtained by MOC compared favorably to BH (R = 0.9911 for EDV, 0.9690 for ESV). Combined acquisition and reconstruction time (previously reported) were reduced 37% for MOC, requiring a mean of 5.2 min compared to 8.2 min for BH (p < 0.0001). Right ventricular volumetry compares favorably to BH using MOC image reconstruction, but is obtained in a fraction of the time. Combined with previous validation of its use for the left ventricle, this novel method now offers an alternative imaging approach in appropriate clinical settings.
KeywordsRetrospective reconstruction Cardiac volume Motion correction Cardiovascular MR Free-breathing Reconstruction time
The authors wish to thank Michael Hansen PhD for his work through the National Institutes of Health/NHLBI. The combined contributions through development and implementation of the motion-corrected free-breathing re-binning technique made this work possible.
This study was funded by the Intramural Research Program of the National Institutes of Health (US), National Heart, Lung, and Blood Institute.
Compliance with Ethical Standards
Conflict of interest
Anthony Merlocco, Laura Olivieri, Peter Kellman, Hui Xue and Russell Cross declares that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board of Children’s National Health System and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Written informed consent, and assent when appropriate, was obtained from all study participants.
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