Browsing by Author "Masci, Pier Giorgio"

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    3D whole-heart grey-blood late gadolinium enhancement cardiovascular magnetic resonance imaging
    (2021) Milotta, Giorgia; Munoz, Camila; Kunze, Karl P.; Neji, Radhouene; Figliozzi, Stefano; Chiribiri, Amedeo; Hajhosseiny, R.; Masci, Pier Giorgio; Prieto Vásquez, Claudia; Botnar, René Michael
    Abstract Purpose To develop a free-breathing whole-heart isotropic-resolution 3D late gadolinium enhancement (LGE) sequence with Dixon-encoding, which provides co-registered 3D grey-blood phase-sensitive inversion-recovery (PSIR) and complementary 3D fat volumes in a single scan of < 7 min. Methods A free-breathing 3D PSIR LGE sequence with dual-echo Dixon readout with a variable density Cartesian trajectory with acceleration factor of 3 is proposed. Image navigators are acquired to correct both inversion recovery (IR)-prepared and reference volumes for 2D translational respiratory motion, enabling motion compensated PSIR reconstruction with 100% respiratory scan efficiency. An intermediate PSIR reconstruction is performed between the in-phase echoes to estimate the signal polarity which is subsequently applied to the IR-prepared water volume to generate a water grey-blood PSIR image. The IR-prepared water volume is obtained using a water/fat separation algorithm from the corresponding dual-echo readout. The complementary fat-volume is obtained after water/fat separation of the reference volume. Ten patients (6 with myocardial scar) were scanned with the proposed water/fat grey-blood 3D PSIR LGE sequence at 1.5 T and compared to breath-held grey-blood 2D LGE sequence in terms of contrast ratio (CR), contrast-to-noise ratio (CNR), scar depiction, scar transmurality, scar mass and image quality. Results Comparable CRs (p = 0.98, 0.40 and 0.83) and CNRs (p = 0.29, 0.40 and 0.26) for blood-myocardium, scar-myocardium and scar-blood respectively were obtained with the proposed free-breathing 3D water/fat LGE and 2D clinical LGE scan. Excellent agreement for scar detection, scar transmurality, scar mass (bias = 0.29%) and image quality scores (from 1: non-diagnostic to 4: excellent) of 3.8 ± 0.42 and 3.6 ± 0.69 (p > 0.99) were obtained with the 2D and 3D PSIR LGE approaches with comparable total acquisition time (p = 0.29). Similar agreement in intra and inter-observer variability were obtained for the 2D and 3D acquisition respectively. Conclusion The proposed approach enabled the acquisition of free-breathing motion-compensated isotropic-resolution 3D grey-blood PSIR LGE and fat volumes. The proposed approach showed good agreement with conventional 2D LGE in terms of CR, scar depiction and scan time, while enabling free-breathing acquisition, whole-heart coverage, reformatting in arbitrary views and visualization of both water and fat information.
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    Efficient non-contrast enhanced 3D Cartesian cardiovascular magnetic resonance angiography of the thoracic aorta in 3 min
    (2022) Fotaki, Anastasia; Munoz, Camila; Emanuel, Yaso; Hua, Alina; Bosio, Filippo; Kunze, Karl P.; Neji, Radhouene; Masci, Pier Giorgio; Botnar, Rene M.; Prieto, Claudia
    Background: The application of cardiovascular magnetic resonance angiography (CMRA) for the assessment of thoracic aortic disease is often associated with prolonged and unpredictable acquisition times and residual motion artefacts. To overcome these limitations, we have integrated undersampled acquisition with image-based navigators and inline non-rigid motion correction to enable a free-breathing, contrast-free Cartesian CMRA framework for the visualization of the thoracic aorta in a short and predictable scan of 3 min.
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    Evaluation of accelerated motion-compensated 3d water/fat late gadolinium enhanced MR for atrial wall imaging
    (SPRINGER, 2021) Munoz, Camila; Sim, Iain; Neji, Radhouene; Kunze, Karl P.; Masci, Pier Giorgio; Schmidt, Michaela; O'Neill, Mark; Williams, Steven; Botnar, Rene M.; Prieto, Claudia
    Objective 3D late gadolinium enhancement (LGE) imaging is a promising non-invasive technique for the assessment of atrial fibrosis. However, current techniques result in prolonged and unpredictable scan times and high rates of non-diagnostic images. The purpose of this study was to compare the performance of a recently proposed accelerated respiratory motion-compensated 3D water/fat LGE technique with conventional 3D LGE for atrial wall imaging. Materials and methods 18 patients (age: 55.7 +/- 17.1 years) with atrial fibrillation underwent conventional diaphragmatic navigator gated inversion recovery (IR)-prepared 3D LGE (dNAV) and proposed image-navigator motion-corrected water/fat IR-prepared 3D LGE (iNAV) imaging. Images were assessed for image quality and presence of fibrosis by three expert observers. The scan time for both techniques was recorded. Results Image quality scores were improved with the proposed compared to the conventional method (iNAV: 3.1 +/- 1.0 vs. dNAV: 2.6 +/- 1.0, p = 0.0012, with 1: Non-diagnostic to 4: Full diagnostic). Furthermore, scan time for the proposed method was significantly shorter with a 59% reduction is scan time (4.5 +/- 1.2 min vs. 10.9 +/- 3.9 min, p < 0.0001). The images acquired with the proposed method were deemed as inconclusive less frequently than the conventional images (expert 1/expert 2: 4/7 dNAV and 2/4 iNAV images inconclusive). Discussion The motion-compensated water/fat LGE method enables atrial wall imaging with diagnostic quality comparable to the current conventional approach with a significantly shorter scan of about 5 min.
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    Fully self-gated free-running 3D Cartesian cardiac CINE with isotropic whole-heart coverage in less than 2 min
    (2021) Küstner, Thomas; Bustin, Aurelien; Jaubert, Olivier; Hajhosseiny, Reza; Masci, Pier Giorgio; Neji, Radhouene; Botnar, René Michael; Prieto Vásquez, Claudia
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    High-resolution non-contrast free-breathing coronary cardiovascular magnetic resonance ngiography for detection of coronary artery disease: validation against invasive coronary angiography
    (2022) Nazir, Muhummad Sohaib; Bustin, Aurelien; Hajhosseiny, Reza; Yazdani, Momina; Ryan, Matthew; Vergani, Vittoria; Neji, Radhouene; Kunze, Karl P.; Nicol, Edward; Masci, Pier Giorgio; Perera, Divaka; Plein, Sven; Chiribiri, Amedeo; Botnar, Rene; Prieto, Claudia
    Background: Coronary artery disease (CAD) is the single most common cause of death worldwide. Recent technological developments with coronary cardiovascular magnetic resonance angiography (CCMRA) allow high-resolution free-breathing imaging of the coronary arteries at submillimeter resolution without contrast in a predictable scan time of similar to 10 min. The objective of this study was to determine the diagnostic accuracy of high-resolution CCMRA for CAD detection against the gold standard of invasive coronary angiography (ICA).
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    The future of MRI in thoracic aortopathy: blueprint for the paradigm shift to improve management
    (2025) Nadel, James; Rodríguez Palomares, José; Phinikaridou, Alkystis; Prieto Vásquez, Claudia Del Carmen; Masci, Pier Giorgio; Botnar, René Michael
    Thoracic aortopathies result in aneurysmal expansion of the aorta that can lead to rapidly fatal aortic dissection or rupture. Despite the availability of abundant non-invasive imaging tools, the greatest contemporary challenge in the management of thoracic aortic aneurysm (TAA) is the lack of reliable metrics for risk stratification, with absolute aortic diameter, growth rate and syndromic factors remaining the primary determinants by which prophylactic surgical intervention is adjudged. Advanced MRI techniques present as a potential key to unlocking insights into TAA that could guide disease surveillance and surgical intervention. MRI has the capacity to encapsulate the aorta as a complex biomechanical structure, permitting the determination of aortic volume, morphology, composition, distensibility and fluid dynamics in a time-efficient manner. Nevertheless, current standard-of-care imaging protocols do not harness its full capacity. This state-of-the-art review explores the emerging role of MRI in the assessment of TAA and presents a blueprint for the required paradigm shift away from aortic size as the sole metric for risk stratifying TAA.