Development and validation of cardiovascular MRI techniques on a low-field, ultra-wide bore system to assess patients with severe obesity

在低场、超宽口径系统上开发和验证心血管 MRI 技术，以评估严重肥胖患者

• 批准号: 10569549
• 负责人: Orlando Paul Simonetti
• 金额: $ 57.71万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-15 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10569549
• 关键词: Address; Adipose tissue; Adult; Affect; American Heart Association; Body mass index; Breathing; Cardiovascular Diagnostic Techniques; Cardiovascular Diseases; Cardiovascular system; Caring; Centers for Disease Control and Prevention (U.S.); Classification; Clinical; Clinical Management; Compensation; Development; Diagnostic; Diagnostic Imaging; Diameter; Dyslipidemias; Echocardiography; Epidemic; Equipment; Face; Goals; Healthcare; Heart Diseases; Heart failure; Hispanic; Hypertension; Image; Image Enhancement; Incidence; Individual; Institution; Link; Machine Learning; Magnetic Resonance Imaging; Methods; Modality; Morbid Obesity; Morphologic artifacts; Myocardial tissue; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obesity Epidemic; Outcome; Patients; Physiologic pulse; Physiological; Population; Prevalence; Prognosis; Protocols documentation; Radiation; Radiation Dose Unit; Radiology Specialty; Reference Standards; Reporting; Reproducibility; Risk; Risk Factors; Safety; Scanning; Severities; Signal Transduction; Stroke; Structure; Symptoms; System; Techniques; Testing; Validation; Walking; Weight; Work; X-Ray Computed Tomography; absorption; accurate diagnosis; attenuation; black women; cardiac magnetic resonance imaging; cardiovascular disorder risk; cardiovascular imaging; clinical care; data acquisition; denoising; design; diagnostic accuracy; diagnostic value; efficacy evaluation; experience; flexibility; functional disability; head-to-head comparison; healthy volunteer; image reconstruction; imaging modality; imaging system; implantable device; innovation; interest; lifetime risk; magnetic field; magnetic resonance imaging biomarker; men; mortality risk; non-invasive imaging; novel; obese patients; prognostic value; reconstruction; single photon emission computed tomography; statistics; tool; ultrasound

Project Summary/Abstract Obesity has reached epidemic proportions in the USA, with more than 40% of the population classified as obese (body mass index (BMI) > 30 kg/m2), and nearly 10% as severely obese (BMI > 40 kg/m2). Cardiovascular disease (CVD), especially heart failure, is highly associated with obesity. Reliable non-invasive cardiovascular imaging tests are needed to provide accurate diagnosis and prognosis in this patient group. Unfortunately, obese patients present a diagnostic challenge to current non-invasive cardiovascular imaging modalities. Computed tomography and single-photon emission computed tomography can require excessive radiation for successful imaging of obese patients, while echocardiography suffers from limited windows and signal attenuation leading to degraded image quality. Magnetic resonance imaging (MRI) of obese patients at conventional field strengths (1.5T and 3.0T) is primarily limited by narrow patient bore and table weight limits. As lower field strength allows greater flexibility in magnet design, a new low-field (0.55T) MRI with a unique, ultra-wide 80 cm bore and 700 lb. table weight limit that can accommodate severely obese patients was recently announced by Siemens. One of the first such systems in the USA will be installed at our institution this summer. In this project, we will develop cardiovascular MRI techniques for this system, and demonstrate their clinical value in severely obese patients. Our group and others have recently shown initial feasibility of cardiovascular imaging at low field. We believe that this new low-field MRI platform, when combined with the advanced pulse sequences and image reconstruction methods developed by our team, can unlock the potential of this novel system as a more reliable means to provide non-invasive cardiovascular imaging to patients with severe obesity. Furthermore, the reduced field strength will make MRI safer and more effective in the growing number of patients with implanted devices. We will prove low-field MRI utility for CVD assessment. Aim 1 will establish the feasibility of low-field cardiovascular MRI regardless of body habitus. We will develop image acquisition and reconstruction techniques specifically designed to compensate for the reduced MR signal at 0.55T compared to higher field. This will offer a comprehensive assessment of cardiovascular structure and function, and myocardial tissue. Aim 2 will validate these techniques in normal weight to severely obese healthy individuals and CVD patients, by head-to-head comparison with standard 70 cm bore 1.5T MRI in those able to safely fit in both machines. Aim 3 will apply the validated techniques to evaluate the efficacy of a low-field cardiovascular MRI exam in heart failure patients who are severely obese (BMI > 40 kg/m2) and cannot be safely imaged on standard MRI systems. We will compare the comprehensive diagnostic value of 0.55T MRI against echocardiography, and will correlate MRI markers to clinical symptoms of heart failure severity determined by a six minute walk test in these patients. The cardiovascular techniques that we develop for this imminent novel 0.55 T MRI system provides a timely solution for effective clinical care and management of the increasing population of severely obese CVD patients.

项目总结/摘要 肥胖症在美国已达到流行病的比例，超过40%的人口被归类为肥胖 (body体重指数（BMI）> 30 kg/m2），近10%为重度肥胖（BMI > 40 kg/m2）。心血管 心血管疾病（CVD），特别是心力衰竭，与肥胖高度相关。可靠的非侵入性心血管 需要进行影像学检查以提供准确的诊断和预后。不幸的是，肥胖 患者对当前的非侵入性心血管成像模式提出了诊断挑战。计算 断层扫描和单光子发射计算机断层扫描可能需要过量的辐射来成功地进行放射治疗。 肥胖患者的成像，而超声心动图患有有限的窗口和信号衰减导致 图像质量下降。常规场强下肥胖患者的磁共振成像（MRI） (1.5T和3.0T）主要受限于狭窄的患者孔和扫描床重量限制。当较低的磁场强度允许时 更大的灵活性，在磁铁设计，一个新的低场（0.55T）磁共振成像与独特的，超宽80厘米孔和700磅。 西门子公司最近宣布了一项可以容纳严重肥胖病人的桌子重量限制。之一 今年夏天，美国的第一个这样的系统将安装在我们的机构。在这个项目中，我们将开发 心血管MRI技术，并证明其在严重肥胖患者的临床价值。 我们的小组和其他人最近显示了低场心血管成像的初步可行性。我们认为 这种新的低场MRI平台，当与先进的脉冲序列和图像相结合时， 我们的团队开发的重建方法，可以释放这种新系统的潜力， 为严重肥胖患者提供非侵入性心血管成像。此外，减少 场强将使MRI在越来越多的植入设备的患者中更安全和更有效。 我们将证明低场MRI对CVD评估的实用性。目标1将建立低场的可行性 心血管MRI，无论体型如何。我们将开发图像采集和重建技术 专门设计用于补偿0.55T时与更高场相比降低的MR信号。这将提供 全面评估心血管结构和功能以及心肌组织。目标2将验证 这些技术在正常体重的严重肥胖健康个体和CVD患者中，通过头对头 与标准70 cm孔径1.5T MRI相比，能够安全安装在两台机器上。目标3将应用 经验证的技术，以评估低场心血管MRI检查在心力衰竭患者中的有效性， 严重肥胖（BMI > 40 kg/m2），无法在标准MRI系统上安全成像。我们将比较 0.55T MRI对超声心动图的综合诊断价值，并将MRI标记物与 在这些患者中通过六分钟步行试验确定心力衰竭严重程度的临床症状。 我们为即将到来的新型0.55 T MRI系统开发的心血管技术提供了及时的 为日益增多的严重肥胖CVD患者提供有效的临床护理和管理解决方案。