Improved dark blood late gadolinium enhancement (DB-LGE) imaging using an optimized joint inversion preparation and T2 magnetization preparation

2017 ◽  
Vol 79 (1) ◽  
pp. 351-360 ◽  
Author(s):  
Tamer A. Basha ◽  
Maxine C. Tang ◽  
Connie Tsao ◽  
Cory M. Tschabrunn ◽  
Elad Anter ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Joint Inversion ◽  
Gadolinium Enhancement ◽  
Dark Blood ◽  
Magnetization Preparation

scholarly journals Dark-blood late gadolinium enhancement cardiovascular magnetic resonance for improved detection of subendocardial scar: a review of current techniques

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Robert J. Holtackers ◽  
Caroline M. Van De Heyning ◽  
Amedeo Chiribiri ◽  
Joachim E. Wildberger ◽  
René M. Botnar ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Magnetic Resonance ◽  
Myocardial Viability ◽  
Current Evidence ◽  
Future Research ◽  
Gadolinium Enhancement ◽  
Dark Blood ◽  
Magnetization Preparation ◽  
Non Invasive

AbstractFor almost 20 years, late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) has been the reference standard for the non-invasive assessment of myocardial viability. Since the blood pool often appears equally bright as the enhanced scar regions, detection of subendocardial scar patterns can be challenging. Various novel LGE methods have been proposed that null or suppress the blood signal by employing additional magnetization preparation mechanisms. This review aims to provide a comprehensive overview of these dark-blood LGE methods, discussing the magnetization preparation schemes and findings in phantom, preclinical, and clinical studies. Finally, conclusions on the current evidence and limitations are drawn and new avenues for future research are discussed. Dark-blood LGE methods are a promising new tool for non-invasive assessment of myocardial viability. For a mainstream adoption of dark-blood LGE, however, clinical availability and ease of use are crucial.

scholarly journals Histopathological Validation of Dark‐Blood Late Gadolinium Enhancement MRI Without Additional Magnetization Preparation

2021 ◽  
Author(s):  
Robert J. Holtackers ◽  
Suzanne Gommers ◽  
Luuk I.B. Heckman ◽  
Caroline M. Van De Heyning ◽  
Amedeo Chiribiri ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Gadolinium Enhancement ◽  
Dark Blood ◽  
Magnetization Preparation

Histological validation of dark-blood late gadolinium enhancement MRI without additional magnetization preparation

2021 ◽  
Author(s):  
Robert J. Holtackers ◽  
Suzanne Gommers ◽  
Luuk I.B. Heckman ◽  
Caroline M. Van De Heyning ◽  
Amedeo Chiribiri ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Gadolinium Enhancement ◽  
Dark Blood ◽  
Magnetization Preparation ◽  
Histological Validation

scholarly journals Dark-blood late gadolinium enhancement without additional magnetization preparation

2017 ◽  
Vol 19 (1) ◽  
Author(s):  
Robert J. Holtackers ◽  
Amedeo Chiribiri ◽  
Torben Schneider ◽  
David M. Higgins ◽  
René M. Botnar
Keyword(s):  
Late Gadolinium Enhancement ◽  
Gadolinium Enhancement ◽  
Dark Blood ◽  
Magnetization Preparation

scholarly journals Novel dark-blood versus conventional bright-blood late gadolinium enhancement CMR: A pilot study comparing impact on myocardial ischaemic burden

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
R Franks ◽  
R Holtackers ◽  
M Nazir ◽  
S Plein ◽  
A Chiribiri
Keyword(s):  
Late Gadolinium Enhancement ◽  
Perfusion Imaging ◽  
Stress Perfusion ◽  
Strong Positive Correlation ◽  
Gadolinium Enhancement ◽  
Dark Blood ◽  
Scar Burden ◽  
Perfusion Defects ◽  
Bright Blood ◽  
Ischaemic Burden

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Background In patients with coronary artery disease (CAD), increasing myocardial ischaemic burden (MIB) is a strong predictor of adverse events. When measured by cardiovascular magnetic resonance (CMR), a MIB ≥12.5% is considered significant and often used as a threshold to guide revascularisation. Ischaemic scar can cause stress perfusion defects which do not represent ischaemia and should be excluded from the MIB calculation. Conventional bright-blood late gadolinium enhancement (LGE) is able to identify ischaemic scar but can suffer from poor scar-to-blood contrast, making accurate assessment of scar volume difficult. Dark-blood LGE methods increase scar-to-blood contrast and improve scar conspicuity which may impact the calculated scar burden and consequently the estimation of MIB when read in conjunction with perfusion images. Purpose To evaluate the impact of dark-blood LGE versus conventional bright-blood LGE on the estimation of MIB in patients with CAD. Methods 37 patients with suspected or known CAD who had evidence of CMR stress perfusion defects and ischaemic scar on LGE imaging were recruited. Patients underwent adenosine stress perfusion imaging followed by dark-blood LGE then conventional bright-blood LGE imaging at 3T. For dark-blood LGE, phase sensitive inversion recovery imaging with a shorter inversion time to null the LV blood-pool was used without any additional magnetization preparation. For each patient, three short-axis LGE slices were selected to match the three perfusion slice locations. Images were anonymised and analysed in random order. Ischaemic scar burden (ISB) was quantified for both LGE methods using a threshold >5 standard deviations above remote myocardium. Perfusion defect burden (PDB) was quantified by manual contouring of perfusion defects. MIB was calculated by subtracting the ISB from the PDB. Results MIB calculated using dark-blood LGE was 19% less compared to bright-blood LGE (15.7 ± 15.2% vs 19.4 ± 15.2%, p < 0.001). There was a strong positive correlation between the two LGE methods (rs = 0.960, p < 0.001, Figure 1A). Bland-Altman analysis revealed a significant fixed bias (mean bias = -3.6%, bias 95% CI: -2.6 to -4.7%, 95% limits of agreement: -9.8 to 2.5%) with no proportional bias (Figure 1B). MIB was calculated ≥12.5% and <12.5% by both LGE methods in 19 (51%) and 12 (32%) patients respectively. In 6 patients (16%), MIB was ≥12.5% using bright-blood LGE and <12.5% using dark-blood LGE (Figure 1A – orange data points). Overall, when used to classify MIB as <12.5% or ≥12.5%, there was only substantial agreement between the two LGE methods (κ=0.67, 95% CI: 0.45 to 0.90). Conclusions The use of dark-blood LGE in conjunction with perfusion imaging results in a lower estimate of MIB compared to conventional bright-blood LGE. This can cause disagreement around the threshold of clinically significant ischaemia which could impact clinical management in patients being considered for coronary revascularisation. Abstract Figure. Linear regression with corresponding B&A

scholarly journals The impact of dark-blood versus conventional bright-blood late gadolinium enhancement on the myocardial ischemic burden

2021 ◽  
pp. 109728
Author(s):  
Russell Franks ◽  
Robert J. Holtackers ◽  
Muhummad Sohaib Nazir ◽  
Brian Clapp ◽  
Joachim E. Wildberger ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Gadolinium Enhancement ◽  
Dark Blood ◽  
The Impact ◽  
Bright Blood

The impact of dark-blood versus conventional bright-blood late gadolinium enhancement the on myocardial ischemic burden

2021 ◽  
pp. 109947
Author(s):  
Russell Franks ◽  
Mr. Robert J. Holtackers ◽  
Ebraham Alskaf ◽  
Muhummad Sohaib Nazir ◽  
Brian Clapp ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Gadolinium Enhancement ◽  
Dark Blood ◽  
The Impact ◽  
Bright Blood

Steadily Increasing Inversion Time Improves Blood Suppression for Free-Breathing 3D Late Gadolinium Enhancement MRI With Optimized Dark-Blood Contrast

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Robert J. Holtackers ◽  
Suzanne Gommers ◽  
Caroline M. Van De Heyning ◽  
Casper Mihl ◽  
Jouke Smink ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Free Breathing ◽  
Gadolinium Enhancement ◽  
Dark Blood ◽  
Blood Suppression ◽  
Inversion Time
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