TY - JOUR
T1 - Accelerated 3d left atrial late gadolinium enhancement in patients with atrial fibrillation at 1.5 t
T2 - Technical development
AU - Gunasekaran, Suvai
AU - Haji-Valizadeh, Hassan
AU - Lee, Daniel C.
AU - Avery, Ryan J.
AU - Wilson, Brent D.
AU - Ibrahim, Mark
AU - Markl, Michael
AU - Passman, Rod S.
AU - Kholmovski, Eugene G.
AU - Kim, Daniel
N1 - Funding Information:
Supported in part by the National Institutes of Health (grants R01HL116895, R01HL138578, R21EB024315, R21AG055954, and R01HL151079) and American Heart Association (grants 14SFRN20480260 and 19IPLOI34760317).
Publisher Copyright:
© RSNA, 2020.
PY - 2020/10
Y1 - 2020/10
N2 - Purpose: To develop an accelerated three-dimensional (3D) late gadolinium enhancement (LGE) pulse sequence using balanced steady-state free precession readout with stack-of-stars k-space sampling and extra motion-state golden-angle radial sparse parallel (XD-GRASP) reconstruction and test the performance for detecting atrial scar and fibrosis in patients with atrial fibrillation (AF). Materials and Methods: Twenty-five patients with AF (20 paroxysmal and five persistent; 65 years 6 7 [standard deviation]; 18 men) were imaged at 1.5 T using the proposed LGE sequence with 1.3 mm 3 1.3 mm 3 2-mm spatial resolution and predictable imaging time. The resulting images were compared with historic images of 25 patients with AF (18 paroxysmal and seven persistent; 67 years 6 10; 14 men) obtained using a reference 3D left atrial (LA) LGE sequence with 1.3 mm 3 1.3 mm 3 2.5-mm spatial resolution. Two readers visually graded the 3D LGE images (conspicuity, artifact, noise) on a five-point Likert scale (1 = worst, 3 = acceptable, 5 = best), in which the summed visual score (SVS) of 9 or greater was defined as clinically acceptable. Appropriate statistical analyses (Cohen k coef-ficient, Mann-Whitney U test, t tests, and intraclass correlation) were performed, where a P value, .05 was considered significant. Results: Mean imaging time was significantly shorter (P, .01) for the proposed pulse sequence (5.9 minutes 6 1.3) than for the reference pulse sequence (10.6 minutes 6 2). Median SVS was significantly higher (P, .01) for the proposed (SVS = 11) than reference (SVS = 9.5) 3D LA LGE images. Interrater reproducibility in visual scores was higher for the proposed (k = 0.78–1) than reference 3D LA LGE (k = 0.44–0.75). Intrareader repeatability in fibrosis quantification was higher for the reference cohort (intraclass correlation coefficient [ICC] = 0.94) than the prospective cohort (ICC = 0.79). Conclusion: The proposed 3D LA LGE method produced clinically acceptable image quality with 1.5 mm 3 1.5 mm 3 2-mm nomi-nal spatial resolution and 6-minute predictable imaging time for quantification of LA scar and fibrosis in patients with AF.
AB - Purpose: To develop an accelerated three-dimensional (3D) late gadolinium enhancement (LGE) pulse sequence using balanced steady-state free precession readout with stack-of-stars k-space sampling and extra motion-state golden-angle radial sparse parallel (XD-GRASP) reconstruction and test the performance for detecting atrial scar and fibrosis in patients with atrial fibrillation (AF). Materials and Methods: Twenty-five patients with AF (20 paroxysmal and five persistent; 65 years 6 7 [standard deviation]; 18 men) were imaged at 1.5 T using the proposed LGE sequence with 1.3 mm 3 1.3 mm 3 2-mm spatial resolution and predictable imaging time. The resulting images were compared with historic images of 25 patients with AF (18 paroxysmal and seven persistent; 67 years 6 10; 14 men) obtained using a reference 3D left atrial (LA) LGE sequence with 1.3 mm 3 1.3 mm 3 2.5-mm spatial resolution. Two readers visually graded the 3D LGE images (conspicuity, artifact, noise) on a five-point Likert scale (1 = worst, 3 = acceptable, 5 = best), in which the summed visual score (SVS) of 9 or greater was defined as clinically acceptable. Appropriate statistical analyses (Cohen k coef-ficient, Mann-Whitney U test, t tests, and intraclass correlation) were performed, where a P value, .05 was considered significant. Results: Mean imaging time was significantly shorter (P, .01) for the proposed pulse sequence (5.9 minutes 6 1.3) than for the reference pulse sequence (10.6 minutes 6 2). Median SVS was significantly higher (P, .01) for the proposed (SVS = 11) than reference (SVS = 9.5) 3D LA LGE images. Interrater reproducibility in visual scores was higher for the proposed (k = 0.78–1) than reference 3D LA LGE (k = 0.44–0.75). Intrareader repeatability in fibrosis quantification was higher for the reference cohort (intraclass correlation coefficient [ICC] = 0.94) than the prospective cohort (ICC = 0.79). Conclusion: The proposed 3D LA LGE method produced clinically acceptable image quality with 1.5 mm 3 1.5 mm 3 2-mm nomi-nal spatial resolution and 6-minute predictable imaging time for quantification of LA scar and fibrosis in patients with AF.
UR - http://www.scopus.com/inward/record.url?scp=85108653082&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85108653082&partnerID=8YFLogxK
U2 - 10.1148/ryct.2020200134
DO - 10.1148/ryct.2020200134
M3 - Article
C2 - 33154994
AN - SCOPUS:85108653082
SN - 2638-6135
VL - 2
JO - Radiology: Cardiothoracic Imaging
JF - Radiology: Cardiothoracic Imaging
IS - 5
M1 - e200134
ER -