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Single breath-hold 3D measurement of left atrial volume using compressed sensing cardiovascular magnetic resonance and a non-model-based reconstruction approach.

Vardoulis O, Monney P, Bermano A, Vaxman A, Gotsman C, Schwitter J, Stuber M, Stergiopulos N, Schwitter J - J Cardiovasc Magn Reson (2015)

Bottom Line: For the new method the calculated volumes were not significantly different when different orientations of the CS-cineCMR slices were applied to cover the LA phantoms.Patient study: The CS-cineCMR LA volumes of the mid-diastolic frame matched closely with the reference LA volume (measured by 3D-HR-CMR) with a difference of -2.66 ± 6.5 ml (3.0% underestimation; true LA volumes: 63 ml, 62 ml, and 395 ml).Finally, a high intra- and inter-observer agreement for maximal and minimal LA volume measurement is also shown.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Hemodynamics and Cardiovascular Technology, Institute of Bioengineering, Swiss Federal Institute of Technology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland. orestis.vardoulis@epfl.ch.

ABSTRACT

Background: Left atrial (LA) dilatation is associated with a large variety of cardiac diseases. Current cardiovascular magnetic resonance (CMR) strategies to measure LA volumes are based on multi-breath-hold multi-slice acquisitions, which are time-consuming and susceptible to misregistration.

Aim: To develop a time-efficient single breath-hold 3D CMR acquisition and reconstruction method to precisely measure LA volumes and function.

Methods: A highly accelerated compressed-sensing multi-slice cine sequence (CS-cineCMR) was combined with a non-model-based 3D reconstruction method to measure LA volumes with high temporal and spatial resolution during a single breath-hold. This approach was validated in LA phantoms of different shapes and applied in 3 patients. In addition, the influence of slice orientations on accuracy was evaluated in the LA phantoms for the new approach in comparison with a conventional model-based biplane area-length reconstruction. As a reference in patients, a self-navigated high-resolution whole-heart 3D dataset (3D-HR-CMR) was acquired during mid-diastole to yield accurate LA volumes.

Results: Phantom studies. LA volumes were accurately measured by CS-cineCMR with a mean difference of -4.73 ± 1.75 ml (-8.67 ± 3.54%, r2 = 0.94). For the new method the calculated volumes were not significantly different when different orientations of the CS-cineCMR slices were applied to cover the LA phantoms. Long-axis "aligned" vs "not aligned" with the phantom long-axis yielded similar differences vs the reference volume (-4.87 ± 1.73 ml vs. -4.45 ± 1.97 ml, p = 0.67) and short-axis "perpendicular" vs. "not-perpendicular" with the LA long-axis (-4.72 ± 1.66 ml vs. -4.75 ± 2.13 ml; p = 0.98). The conventional bi-plane area-length method was susceptible for slice orientations (p = 0.0085 for the interaction of "slice orientation" and "reconstruction technique", 2-way ANOVA for repeated measures). To use the 3D-HR-CMR as the reference for LA volumes in patients, it was validated in the LA phantoms (mean difference: -1.37 ± 1.35 ml, -2.38 ± 2.44%, r2 = 0.97). Patient study: The CS-cineCMR LA volumes of the mid-diastolic frame matched closely with the reference LA volume (measured by 3D-HR-CMR) with a difference of -2.66 ± 6.5 ml (3.0% underestimation; true LA volumes: 63 ml, 62 ml, and 395 ml). Finally, a high intra- and inter-observer agreement for maximal and minimal LA volume measurement is also shown.

Conclusions: The proposed method combines a highly accelerated single-breathhold compressed-sensing multi-slice CMR technique with a non-model-based 3D reconstruction to accurately and reproducibly measure LA volumes and function.

No MeSH data available.


Related in: MedlinePlus

Presents the LA phantom shapes and the corresponding acquisition strategies that were utilized for the assessment of the CS-cineCMR sequence and reconstruction methods. The mitral valve is represented by the fading gray shape on the right. The large and small volumes of shapes a and b correspond to systolic and diastolic phases, respectively. Shape c represents a LA with oblique connection to the LV, which is occasionally found in patients with a hypertrophied LV and/or obesity. Phantom shape e (=curved) mimics impression of an enlarged LA by the aortic root. To complete the spectrum of LA shapes a spherical phantom (d) was also analyzed. a) Oval Big (= LA at end-systole), b) Oval small (=LA at end-diastole), c) Oval oblique, d) Spherical and e) Curved (=LA compression by aortic root). Row 1 corresponds to long-axis acquisitions aligned with the long-axis of the atrium (and with short-axis planes perpendicular to acquisition long-axis). Row 2 corresponds to long-axis acquisitions aligned with the long-axis of the atrium, but with short-axis planes non-perpendicular to the atrium long-axis. Row 3 corresponds to long-axis acquisitions not-aligned with the long-axis of the atrium and with short-axis planes perpendicular to the acquired long-axis
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Fig1: Presents the LA phantom shapes and the corresponding acquisition strategies that were utilized for the assessment of the CS-cineCMR sequence and reconstruction methods. The mitral valve is represented by the fading gray shape on the right. The large and small volumes of shapes a and b correspond to systolic and diastolic phases, respectively. Shape c represents a LA with oblique connection to the LV, which is occasionally found in patients with a hypertrophied LV and/or obesity. Phantom shape e (=curved) mimics impression of an enlarged LA by the aortic root. To complete the spectrum of LA shapes a spherical phantom (d) was also analyzed. a) Oval Big (= LA at end-systole), b) Oval small (=LA at end-diastole), c) Oval oblique, d) Spherical and e) Curved (=LA compression by aortic root). Row 1 corresponds to long-axis acquisitions aligned with the long-axis of the atrium (and with short-axis planes perpendicular to acquisition long-axis). Row 2 corresponds to long-axis acquisitions aligned with the long-axis of the atrium, but with short-axis planes non-perpendicular to the atrium long-axis. Row 3 corresponds to long-axis acquisitions not-aligned with the long-axis of the atrium and with short-axis planes perpendicular to the acquired long-axis

Mentions: Five LA phantoms were created to resemble a set of typical LA morphologies and volumes (oval small (diastolic), oval large (systolic), oblique, spherical, curved) as shown in Fig. 1. The phantoms were made of manually carved Solanum Tuberosum L. These phantom volumes were measured with the water displacement method to yield the reference volumes required to validate the CS-cineCMR and the 3D-HR-CMR techniques. With these phantoms it was also evaluated whether various slice orientations of the CS-cineCMR technique influence the accuracy of LA volume measurements when using the novel 3D non-model-based reconstruction or a conventional model-based bi-plane area-length reconstruction.Fig. 1


Single breath-hold 3D measurement of left atrial volume using compressed sensing cardiovascular magnetic resonance and a non-model-based reconstruction approach.

Vardoulis O, Monney P, Bermano A, Vaxman A, Gotsman C, Schwitter J, Stuber M, Stergiopulos N, Schwitter J - J Cardiovasc Magn Reson (2015)

Presents the LA phantom shapes and the corresponding acquisition strategies that were utilized for the assessment of the CS-cineCMR sequence and reconstruction methods. The mitral valve is represented by the fading gray shape on the right. The large and small volumes of shapes a and b correspond to systolic and diastolic phases, respectively. Shape c represents a LA with oblique connection to the LV, which is occasionally found in patients with a hypertrophied LV and/or obesity. Phantom shape e (=curved) mimics impression of an enlarged LA by the aortic root. To complete the spectrum of LA shapes a spherical phantom (d) was also analyzed. a) Oval Big (= LA at end-systole), b) Oval small (=LA at end-diastole), c) Oval oblique, d) Spherical and e) Curved (=LA compression by aortic root). Row 1 corresponds to long-axis acquisitions aligned with the long-axis of the atrium (and with short-axis planes perpendicular to acquisition long-axis). Row 2 corresponds to long-axis acquisitions aligned with the long-axis of the atrium, but with short-axis planes non-perpendicular to the atrium long-axis. Row 3 corresponds to long-axis acquisitions not-aligned with the long-axis of the atrium and with short-axis planes perpendicular to the acquired long-axis
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4464709&req=5

Fig1: Presents the LA phantom shapes and the corresponding acquisition strategies that were utilized for the assessment of the CS-cineCMR sequence and reconstruction methods. The mitral valve is represented by the fading gray shape on the right. The large and small volumes of shapes a and b correspond to systolic and diastolic phases, respectively. Shape c represents a LA with oblique connection to the LV, which is occasionally found in patients with a hypertrophied LV and/or obesity. Phantom shape e (=curved) mimics impression of an enlarged LA by the aortic root. To complete the spectrum of LA shapes a spherical phantom (d) was also analyzed. a) Oval Big (= LA at end-systole), b) Oval small (=LA at end-diastole), c) Oval oblique, d) Spherical and e) Curved (=LA compression by aortic root). Row 1 corresponds to long-axis acquisitions aligned with the long-axis of the atrium (and with short-axis planes perpendicular to acquisition long-axis). Row 2 corresponds to long-axis acquisitions aligned with the long-axis of the atrium, but with short-axis planes non-perpendicular to the atrium long-axis. Row 3 corresponds to long-axis acquisitions not-aligned with the long-axis of the atrium and with short-axis planes perpendicular to the acquired long-axis
Mentions: Five LA phantoms were created to resemble a set of typical LA morphologies and volumes (oval small (diastolic), oval large (systolic), oblique, spherical, curved) as shown in Fig. 1. The phantoms were made of manually carved Solanum Tuberosum L. These phantom volumes were measured with the water displacement method to yield the reference volumes required to validate the CS-cineCMR and the 3D-HR-CMR techniques. With these phantoms it was also evaluated whether various slice orientations of the CS-cineCMR technique influence the accuracy of LA volume measurements when using the novel 3D non-model-based reconstruction or a conventional model-based bi-plane area-length reconstruction.Fig. 1

Bottom Line: For the new method the calculated volumes were not significantly different when different orientations of the CS-cineCMR slices were applied to cover the LA phantoms.Patient study: The CS-cineCMR LA volumes of the mid-diastolic frame matched closely with the reference LA volume (measured by 3D-HR-CMR) with a difference of -2.66 ± 6.5 ml (3.0% underestimation; true LA volumes: 63 ml, 62 ml, and 395 ml).Finally, a high intra- and inter-observer agreement for maximal and minimal LA volume measurement is also shown.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Hemodynamics and Cardiovascular Technology, Institute of Bioengineering, Swiss Federal Institute of Technology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland. orestis.vardoulis@epfl.ch.

ABSTRACT

Background: Left atrial (LA) dilatation is associated with a large variety of cardiac diseases. Current cardiovascular magnetic resonance (CMR) strategies to measure LA volumes are based on multi-breath-hold multi-slice acquisitions, which are time-consuming and susceptible to misregistration.

Aim: To develop a time-efficient single breath-hold 3D CMR acquisition and reconstruction method to precisely measure LA volumes and function.

Methods: A highly accelerated compressed-sensing multi-slice cine sequence (CS-cineCMR) was combined with a non-model-based 3D reconstruction method to measure LA volumes with high temporal and spatial resolution during a single breath-hold. This approach was validated in LA phantoms of different shapes and applied in 3 patients. In addition, the influence of slice orientations on accuracy was evaluated in the LA phantoms for the new approach in comparison with a conventional model-based biplane area-length reconstruction. As a reference in patients, a self-navigated high-resolution whole-heart 3D dataset (3D-HR-CMR) was acquired during mid-diastole to yield accurate LA volumes.

Results: Phantom studies. LA volumes were accurately measured by CS-cineCMR with a mean difference of -4.73 ± 1.75 ml (-8.67 ± 3.54%, r2 = 0.94). For the new method the calculated volumes were not significantly different when different orientations of the CS-cineCMR slices were applied to cover the LA phantoms. Long-axis "aligned" vs "not aligned" with the phantom long-axis yielded similar differences vs the reference volume (-4.87 ± 1.73 ml vs. -4.45 ± 1.97 ml, p = 0.67) and short-axis "perpendicular" vs. "not-perpendicular" with the LA long-axis (-4.72 ± 1.66 ml vs. -4.75 ± 2.13 ml; p = 0.98). The conventional bi-plane area-length method was susceptible for slice orientations (p = 0.0085 for the interaction of "slice orientation" and "reconstruction technique", 2-way ANOVA for repeated measures). To use the 3D-HR-CMR as the reference for LA volumes in patients, it was validated in the LA phantoms (mean difference: -1.37 ± 1.35 ml, -2.38 ± 2.44%, r2 = 0.97). Patient study: The CS-cineCMR LA volumes of the mid-diastolic frame matched closely with the reference LA volume (measured by 3D-HR-CMR) with a difference of -2.66 ± 6.5 ml (3.0% underestimation; true LA volumes: 63 ml, 62 ml, and 395 ml). Finally, a high intra- and inter-observer agreement for maximal and minimal LA volume measurement is also shown.

Conclusions: The proposed method combines a highly accelerated single-breathhold compressed-sensing multi-slice CMR technique with a non-model-based 3D reconstruction to accurately and reproducibly measure LA volumes and function.

No MeSH data available.


Related in: MedlinePlus