Novel Cardiac MRI techniques for the diagnosis of coronary artery disease compared to PET imaging and Invasive Coronary Angiography.

与 PET 成像和侵入性冠状动脉造影相比，用于诊断冠状动脉疾病的新型心脏 MRI 技术。

• 批准号: MR/P01979X/1
• 负责人: Muhummad Sohaib Nazir
• 金额: $ 27.44万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2017
• 资助国家: 英国
• 起止时间: 2017 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FP01979X%2F1
• 关键词: Novel; Cardiac; MRI; techniques; diagnosis

Coronary artery disease (CAD) is the second most common cause of death in the UK and it is very important to identify patients who have CAD early so that prevention can be started before a heart attack occurs. A wide range of tests are used to detect CAD. Coronary angiography is routinely used in the NHS, and without extra flow measurements, we do not know how important CAD is. Heart scans can be used to detect important CAD including a scan that uses radioactive dye, ultrasound or cardiac MRI (CMR) which are interpreted by simply looking at images on a computer console. This visual interpretation is generally accurate but even with well trained individuals, scan reporters can differ in their interpretation especially in cases where there is such widespread CAD that the test may be appear normal. We can measure the heart's blood flow with heart scans and the best method to do this is with Positron Emission Tomography (PET). This is better than visual inspection in identifying heart disease, can help with predicting the risk of a heart attack and other health hazards and help doctors decide which patients to treat with heart surgery. Unfortunately PET scanning is expensive (over £2,000 per scan), not available widely and uses potential harmful ionising radiation.CMR can be used to measure the heart's blood flow. It has a major advantage over PET because it is much cheaper (around £500), more widely available and is safer as no harmful radiation is used. In previous research studies (the largest one performed at King's College London), blood flow measurements with PET and CMR were compared and found to be similar but not to agree perfectly. This study had some important limitations, as patients were scanned using separate CMR and PET scanners, on different days and separate analysis. Therefore, there has yet to be a conclusive comparison of PET and CMR blood flow measurements.ADVANCES IN TECHNOLOGY- We are privileged to have a 'hybrid PET-MR scanner', only the second one in the UK, which is able to perform PET and CMR scans at the same time. This scanner allows us to perform heart blood flow measurements at exactly the same time with PET and CMR and therefore allows a true head on comparison of the tests. This will help us to determine with more certainty if CMR is as good as PET for measuring the heart's blood flow. - We have developed a new method to measure the heart's blood flow which is very accurate in animal and flow model studies but we need to test this in humans.- Measuring blood flow is cumbersome and time-consuming with CMR and can take several hours even for an expert. We have developed an automated software to perform this which may be used for routine clinical diagnosis at point of care in the NHS.AIMI aim to test if CMR can be a cheaper, more widely available and safer alternative to PET. If proven to be comparable, automated CMR tools can be readily translated to clinical practice across the UK to enhance diagnosis of CAD. I will compare blood flow measured with PET and CMR using a novel hybrid PET-MR scanner and novel CMR techniques in patients with heart disease. We will compare blood flow measurements with novel CMR with findings with coronary angiography. METHODS-10 healthy volunteers without heart disease will undergo a PET-MR scan to measure blood flow with PET and CMR at the same time. This will allow us to test the method in humans.-77 patients who are scheduled for an angiogram will have a PET-MR scan of their heart . We will compare blood flow measurements with CMR, PET and presence of CAD with coronary angiography.We hope to get a better understanding of the heart's blood flow and test if this CMR tool is as good as PET and angiography. This will be helpful to patients as CMR is safe, non-invasive and does not use radiation. This tool may help doctors treat patients better by guiding doctors on which patients needs medications, stents or heart surgery.

冠状动脉疾病（CAD）是英国第二大常见的死亡原因，早期识别患有CAD的患者非常重要，以便在心脏病发作之前开始预防。广泛的测试用于检测CAD。冠状动脉造影是NHS的常规检查，如果没有额外的流量测量，我们就不知道CAD的重要性。心脏扫描可用于检测重要的CAD，包括使用放射性染料，超声或心脏MRI（CMR）的扫描，只需在计算机控制台上查看图像即可进行解释。这种目视判读通常是准确的，但即使是训练有素的人员，扫描报告员的判读也可能不同，特别是在CAD如此广泛以至于测试可能看起来正常的情况下。我们可以通过心脏扫描来测量心脏的血流量，最好的方法是使用正电子发射断层扫描（PET）。这在识别心脏病方面比目视检查更好，可以帮助预测心脏病发作和其他健康危害的风险，并帮助医生决定哪些患者接受心脏手术治疗。不幸的是，PET扫描价格昂贵（每次扫描超过2，000英镑），无法广泛使用，并且使用潜在的有害电离辐射。CMR可用于测量心脏的血流量。它比PET有一个主要的优势，因为它便宜得多（约500英镑），更广泛地使用，并且更安全，因为没有使用有害的辐射。在以前的研究中（伦敦国王学院进行的最大规模的研究），比较了PET和CMR的血流测量结果，发现两者相似，但并不完全一致。这项研究有一些重要的局限性，因为患者在不同的日期和单独的分析中使用单独的CMR和PET扫描仪进行扫描。因此，PET和CMR血流测量结果的比较尚无定论。技术进步-我们有幸拥有一台“混合PET-MR扫描仪”，这是英国第二台能够同时进行PET和CMR扫描的扫描仪。该扫描仪使我们能够在与PET和CMR完全相同的时间进行心脏血流测量，因此可以在测试比较中获得真实的头部。这将帮助我们更确定CMR是否与PET一样好地测量心脏的血流量。- 我们已经开发出一种新的方法来测量心脏的血流量，这在动物和流动模型研究中非常准确，但我们需要在人类中进行测试。使用CMR测量血流量既麻烦又耗时，即使是专家也可能需要几个小时。我们已经开发了一个自动化软件来执行这一点，可用于在护理点的NHS常规临床诊断。AIMI旨在测试CMR是否可以成为PET的更便宜，更广泛和更安全的替代品。如果被证明是可比的，自动化CMR工具可以很容易地转化为英国各地的临床实践，以提高CAD的诊断。我将比较使用新型混合PET-MR扫描仪和新型CMR技术在心脏病患者中使用PET和CMR测量的血流量。我们将比较新CMR的血流测量结果与冠状动脉造影结果。方法：10名无心脏病的健康志愿者将接受PET-MR扫描，同时用PET和CMR测量血流量。这将使我们能够在人类身上测试这种方法。安排进行血管造影的77名患者将对其心脏进行PET-MR扫描。我们将比较CMR、PET和冠状动脉造影术对血流测量的影响，我们希望更好地了解心脏的血流，并测试CMR工具是否与PET和血管造影术一样好。这将有助于患者，因为CMR是安全的，非侵入性的，不使用辐射。这个工具可以帮助医生更好地治疗病人，指导医生哪些病人需要药物，支架或心脏手术。

项目成果

Cardiovascular CT: the role of cardiologists.

• DOI: 10.1136/heartjnl-2018-314557
• 发表时间: 2019-09
• 期刊: Heart (British Cardiac Society)
• 作者: Nazir MS;Nicol ED
• 通讯作者: Nicol ED

Impact of Temporal Resolution and Methods for Correction on Cardiac Magnetic Resonance Perfusion Quantification.

时间分辨率和校正方法对心脏磁共振灌注定量的影响。

• DOI: 10.1002/jmri.28180
• 发表时间: 2022-12
• 期刊: JOURNAL OF MAGNETIC RESONANCE IMAGING
• 影响因子: 4.4
• 作者: Milidonis, Xenios;Nazir, Muhummad Sohaib;Chiribiri, Amedeo
• 通讯作者: Chiribiri, Amedeo

The SCOT-HEART trial: cardiac CT to guide patient management and improve outcomes.

SCOT-HEART 试验：心脏 CT 指导患者管理并改善结果。

• DOI: 10.1093/cvr/cvz173
• 发表时间: 2019
• 期刊: Cardiovascular research
• 影响因子: 10.8
• 作者: Nazir MS

Pixel-wise assessment of cardiovascular magnetic resonance first-pass perfusion using a cardiac phantom mimicking transmural myocardial perfusion gradients.

• DOI: 10.1002/mrm.28296
• 发表时间: 2020-11
• 期刊: Magnetic resonance in medicine
• 影响因子: 3.3
• 作者: Milidonis X;Nazir MS;Schneider T;Capstick M;Drost S;Kok G;Pelevic N;Poelma C;Schaeffter T;Chiribiri A
• 通讯作者: Chiribiri A

Pulmonary arteriovenous malformations and embolic myocardial infarction identified with cardiovascular magnetic resonance.

心血管磁共振识别肺动静脉畸形和栓塞性心肌梗死。

• DOI: 10.1093/ehjci/jez169
• 发表时间: 2019
• 期刊: European heart journal. Cardiovascular Imaging
• 作者: Nazir MS