Rapid Free-Breathing Self-Gated Spiral Pulse Sequences for Simultaneous Cine and T1 mapping

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7. Project Summary Heart failure (HF) is a major public health concern with an estimated 6.2 million Americans suffering from HF and greater than 1 million new cases per year. Patients with HF have significantly reduced quality of life and are at high risk for hospitalization and adverse cardiovascular outcomes. There is a growing recognition of the clinical utility of cardiac magnetic resonance imaging (CMR) for assessing patients with HF. While there is growing utilization of CMR for evaluation of HF, there remain a number of barriers to widespread acceptance and utilization of CMR for this application. Current clinical studies take 40 min to an hour and require the patient to complete about 40 separate breath-holds of 10-15 second duration. There is strong potential to improve the clinical utility of CMR in HF by creating simplified and robust free-breathing, non-ECG gated techniques, which are straightforward to perform. This would also improve the patient experience by shortening the study and eliminating the need for breath-holding, which is particularly difficult for HF patients. To address these limitations of current clinical techniques, we propose to develop and validate a technique, Cine And T1 mapping SPiral Acquisition with Respiratory and Cardiac Self-gating (CAT-SPARCS), which will simultaneously perform cine and T1 mapping in a <5 minute FB non-ECG gated acquisition. Application of this technique pre and post contrast will enable a comprehensive assessment of cardiac function, Native T1, LGE and ECV in under 15-minutes. The specific aims of this proposal are (1) to develop a 2D CAT- SPARCS technique to simultaneously acquire cine, T1 maps and LGE images during a free-breathing cardiac self-gated acquisition, (2) to extend the 2D CAT-SPARCS to provide whole heart simultaneous acquisition of cine, T1 mapping and LGE images using simultaneous multi-slice (SMS) and 3D spiral acquisition techniques, and (3) to validate the CAT-SPARCS technique against the clinical gold standard breath-held ECG-gated clinical techniques in normal subjects and patients being evaluated for HF. Successful completion of this grant will result in the development and validation of a highly efficient technique for simultaneous T1 mapping and cine imaging which will demonstrate high accuracy and repeatability significantly shortening the CMR examination.