scholarly journals Recent Advances in Fibrosis and Scar Segmentation From Cardiac MRI: A State-of-the-Art Review and Future Perspectives

2021 ◽  
Vol 12 ◽  
Author(s):  
Yinzhe Wu ◽  
Zeyu Tang ◽  
Binghuan Li ◽  
David Firmin ◽  
Guang Yang
Keyword(s):  
Magnetic Resonance ◽  
Clinical Diagnosis ◽  
Cardiac Fibrosis ◽  
State Of The Art ◽  
Automated Segmentation ◽  
Free Precession ◽  
Gadolinium Enhancement ◽  
Current State ◽  
Magnetic Resonance Imaging Mri ◽  
Lge Cmr

Segmentation of cardiac fibrosis and scars is essential for clinical diagnosis and can provide invaluable guidance for the treatment of cardiac diseases. Late Gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) has been successful in guiding the clinical diagnosis and treatment reliably. For LGE CMR, many methods have demonstrated success in accurately segmenting scarring regions. Co-registration with other non-contrast-agent (non-CA) modalities [e.g., balanced steady-state free precession (bSSFP) cine magnetic resonance imaging (MRI)] can further enhance the efficacy of automated segmentation of cardiac anatomies. Many conventional methods have been proposed to provide automated or semi-automated segmentation of scars. With the development of deep learning in recent years, we can also see more advanced methods that are more efficient in providing more accurate segmentations. This paper conducts a state-of-the-art review of conventional and current state-of-the-art approaches utilizing different modalities for accurate cardiac fibrosis and scar segmentation.

scholarly journals Risk stratification of cardiac metastases using late gadolinium enhancement cardiovascular magnetic resonance: prognostic impact of hypo-enhancement evidenced tumor avascularity

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Angel T. Chan ◽  
William Dinsfriend ◽  
Jiwon Kim ◽  
Brian Yum ◽  
Razia Sultana ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Magnetic Resonance ◽  
Contrast Enhancement ◽  
Cancer Etiology ◽  
Enhancement Pattern ◽  
Gadolinium Enhancement ◽  
Lesion Location ◽  
Heterogeneous Enhancement ◽  
Lge Cmr

Abstract Background Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is widely used to identify cardiac neoplasms, for which diagnosis is predicated on enhancement stemming from lesion vascularity: Impact of contrast-enhancement pattern on clinical outcomes is unknown. The objective of this study was to determine whether cardiac metastasis (CMET) enhancement pattern on LGE-CMR impacts prognosis, with focus on heterogeneous lesion enhancement as a marker of tumor avascularity. Methods Advanced (stage IV) systemic cancer patients with and without CMET matched (1:1) by cancer etiology underwent a standardized CMR protocol. CMET was identified via established LGE-CMR criteria based on lesion enhancement; enhancement pattern was further classified as heterogeneous (enhancing and non-enhancing components) or diffuse and assessed via quantitative (contrast-to-noise ratio (CNR); signal-to-noise ratio (SNR)) analyses. Embolic events and mortality were tested in relation to lesion location and contrast-enhancement pattern. Results 224 patients were studied, including 112 patients with CMET and unaffected (CMET -) controls matched for systemic cancer etiology/stage. CMET enhancement pattern varied (53% heterogeneous, 47% diffuse). Quantitative analyses were consistent with lesion classification; CNR was higher and SNR lower in heterogeneously enhancing CMET (p < 0.001)—paralleled by larger size based on linear dimensions (p < 0.05). Contrast-enhancement pattern did not vary based on lesion location (p = NS). Embolic events were similar between patients with diffuse and heterogeneous lesions (p = NS) but varied by location: Patients with right-sided lesions had threefold more pulmonary emboli (20% vs. 6%, p = 0.02); those with left-sided lesions had lower rates equivalent to controls (4% vs. 5%, p = 1.00). Mortality was higher among patients with CMET (hazard ratio [HR] = 1.64 [CI 1.17–2.29], p = 0.004) compared to controls, but varied by contrast-enhancement pattern: Diffusely enhancing CMET had equivalent mortality to controls (p = 0.21) whereas prognosis was worse with heterogeneous CMET (p = 0.005) and more strongly predicted by heterogeneous enhancement (HR = 1.97 [CI 1.23–3.15], p = 0.005) than lesion size (HR = 1.11 per 10 cm [CI 0.53–2.33], p = 0.79). Conclusions Contrast-enhancement pattern and location of CMET on CMR impacts prognosis. Embolic events vary by CMET location, with likelihood of PE greatest with right-sided lesions. Heterogeneous enhancement—a marker of tumor avascularity on LGE-CMR—is a novel marker of increased mortality risk.

Agreement between gadolinium-enhanced cardiac magnetic resonance and electro-anatomical maps in patients with non-ischaemic dilated cardiomyopathy and ventricular arrhythmias

EP Europace ◽  
2019 ◽  
Vol 21 (9) ◽  
pp. 1392-1399
Author(s):  
Federica Torri ◽  
Csilla Czimbalmos ◽  
Livio Bertagnolli ◽  
Sabrina Oebel ◽  
Andreas Bollmann ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Cardiac Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Magnetic Resonance ◽  
Dilated Cardiomyopathy ◽  
Ventricular Arrhythmias ◽  
Low Voltage ◽  
Gadolinium Enhancement ◽  
Lge Cmr ◽  
Good Agreement

Abstract Aims We sought to investigate the overlap between late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) and electro-anatomical maps (EAM) of patients with non-ischaemic dilated cardiomyopathy (NIDCM) and how it relates with the outcomes after catheter ablation of ventricular arrhythmias (VA). Methods and results We identified 50 patients with NIDCM who received CMR and ablation for VA. Late gadolinium enhancement was detected in 16 (32%) patients, mostly in those presenting with sustained ventricular tachycardia (VT): 15 patients. Low-voltage areas (<1.5 mV) were observed in 23 (46%) cases; in 7 (14%) cases without evidence of LGE. Using a threshold of 1.5 mV, a good and partially good agreement between the bipolar EAM and LGE-CMR was observed in only 4 (8%) and 9 (18%) patients, respectively. With further adjustments of EAM to match the LGE, we defined new cut-off limits of median 1.5 and 5 mV for bipolar and unipolar maps, respectively. Most VT exits (12 out of 16 patients) were found in areas with LGE. VT exits were found in segments without LGE in two patients with VT recurrence as well as in two patients without recurrence, P = 0.77. In patients with VT recurrence, the LGE volume was significantly larger than in those without recurrence: 12% ± 5.8% vs. 6.9% ± 3.4%; P = 0.049. Conclusions In NIDCM, the agreement between LGE and bipolar EAM was fairly poor but can be improved with adjustment of the thresholds for EAM according to the amount of LGE. The outcomes were related to the volume of LGE.

P1016Correlation between cardiac magnetic resonance-late gadolinium enhancement and electro-anatomical map for right atrium

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
C Gunturiz Beltran ◽  
R Borras-Amoraga ◽  
F Alarcon ◽  
P Garre ◽  
R Figueras ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Magnetic Resonance ◽  
Right Atrium ◽  
Healthy Tissue ◽  
Gadolinium Enhancement ◽  
Fibrotic Tissue ◽  
Bipolar Voltage ◽  
The Right ◽  
Lge Cmr

Abstract Funding Acknowledgements none Background  Electroanatomical map (EAM) detects areas of low voltage as a surrogated marker of fibrosis areas, being the reference technique for its detection. Cardiac magnetic resonance with Late Gadolinium enhancement (CMR-LGE) allows non-invasive detection of atrial fibrotic areas. CMR-LGE studies have focused on the left atrium since now. Purpose We need to validate this test to extend its use to the right atrium (RA), since it is involved in the arrhythmogenic substrate of several arrhythmias, and probably also in atrial fibrillation (AF). Methods  Prospective observational study. Fifteen patients undergoing a first AF ablation procedure were included. All patients had a pre-procedural LGE-CMR performed. The blood pool-normalized intensity signal (image intensity ratio-IIR) was calculated for the right atrial wall, and values projected in a shell. IIR values validated for the left atrium were used to identify dense and intermediate fibrosis, and healthy tissue (&gt;1.32, 1.2-1.32, &lt;1.2, respectively). During the procedure but before ablation, a point-by-point high density EA bipolar voltage map of RA was obtained with a multipolar catheter. Standard voltage thresholds of 0,1 mV and 0,5 mV were used to characterize fibrotic and healthy tissue in EAM. For each RA, the EAM was projected into the IIR shell, and the correlation between bipolar voltage and normalized IIR values for each shell point was quantified. Then, we also obtained its concordance (categorical variables) according to the label automatically assigned by EAM/CMR with the pre-set thresholds: healthy tissue/ intermediate fibrosis/dense fibrosis. Results  A total of 8,830 points were obtained, mean per patient 588 (± 509) points. A global weak negative correlation was found between the EA bipolar voltage map (EAM) and IIR (CMR) (r= -0.16, p &lt; 0.0001)(figure). LGE-CMR identified more healthy tissue than EAM (81.0% vs 60.6% respectively), then CMR underestimated the fibrotic tissue in RA. Finally, we analyzed the concordance and we obtained that the degree of accuracy between both measurements was 55.7%. Conclusion  There was an inverse correlation between the bipolar voltage EAM and IIR (CMR) of low grade but with statistical significance. CMR underestimated fibrotic tissue in RA with respect to its identification by EAM. Abstract Figure. Correlation between bipolar voltage-IIR

Magnetic resonance imaging of catalytically relevant processes

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Alexandra I. Svyatova ◽  
Kirill V. Kovtunov ◽  
Igor V. Koptyug
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
State Of The Art ◽  
Chemical Processes ◽  
Resonance Imaging ◽  
Heterogeneous Catalytic ◽  
Heterogeneous Catalytic Processes ◽  
Hyperpolarized Mri ◽  
Magnetic Resonance Imaging Mri ◽  
Low Sensitivity

Abstract The main aim of this article is to provide a state-of-the-art review of the magnetic resonance imaging (MRI) utilization in heterogeneous catalysis. MRI is capable to provide very useful information about both living and nonliving objects in a noninvasive way. The studies of an internal heterogeneous reactor structure by MRI help to understand the mass transport and chemical processes inside the working catalytic reactor that can significantly improve its efficiency. However, one of the serious disadvantages of MRI is low sensitivity, and this obstacle dramatically limits possible MRI application. Fortunately, there are hyperpolarization methods that eliminate this problem. Parahydrogen-induced polarization approach, for instance, can increase the nuclear magnetic resonance signal intensity by four to five orders of magnitude; moreover, the obtained polarization can be stored in long-lived spin states and then transferred into an observable signal in MRI. An in-depth account of the studies on both thermal and hyperpolarized MRI for the investigation of heterogeneous catalytic processes is provided in this review as part of the special issue emphasizing the research performed to date in Russia/USSR.

New Magnetic Resonance Imaging Biomarkers Advance the Characterization of Parkinson Disease

US Neurology ◽  
2013 ◽  
Vol 09 (01) ◽  
pp. 8
Author(s):  
David A Ziegler ◽  
Suzanne Corkin ◽  
◽  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Substantia Nigra ◽  
Parkinson Disease ◽  
Structural Mri ◽  
Careful Examination ◽  
Imaging Biomarkers ◽  
Resonance Imaging ◽  
Current State ◽  
Magnetic Resonance Imaging Mri

The pathophysiology of idiopathic Parkinson disease (PD) is traditionally characterized as substantia nigra degeneration, but careful examination of the widespread neuropathologic changes suggests individual differences in neuronal vulnerability. A major limitation to studies of disease progression in PD has been that conventional magnetic resonance imaging (MRI) techniques provide relatively poor contrast for the structures that are affected by the disease, and thus are not typically used in experimental or clinical studies. Here, we review the current state of structural MRI as applied to the analysis of the PD brain. We also describe a new multispectral MRI method that provides improved contrast for the substantia nigra and basal forebrain, which we recently used to show that these structures display different trajectories of volume loss early in the disease.

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