3D Cine Magnetic Resonance Fingerprinting for Rapid Phenotyping of Cardiomyopathy

3D 电影磁共振指纹图谱用于心肌病的快速表型分析

• 批准号: 10626789
• 负责人: JESSE Ian HAMILTON
• 金额: $ 66.51万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10626789
• 关键词: 3-Dimensional; Acceleration; Adult; Agreement; Blood; Breathing; Cardiac; Cardiomyopathies; Caring; Cicatrix; Clinical; Collection; Complex; Cross-Sectional Studies; Darkness; Dependence; Detection; Development; Diagnosis; Diagnostic; Disease; EFRAC; Echocardiography; Electrocardiogram; Ensure; Evaluation; Evolution; Fibrosis; Fingerprint; Functional disorder; Gadolinium; Heart; Heart Diseases; Heart failure; Image; Image Enhancement; Imaging Techniques; Inflammation; Ischemia; Left; Logistic Regressions; Magnetic Resonance; Magnetic Resonance Imaging; Manuals; Maps; Measurement; Measures; Mechanics; Methods; Morphologic artifacts; Motion; Myocardial; Myocardial tissue; Outcome; Pathology; Patient Care; Patients; Phase; Phenotype; Physics; Property; Protocols documentation; Protons; Quantitative Evaluations; Reproducibility; Research; Resolution; Running; Scanning; Scientist; Services; Signal Transduction; Standardization; Structural defect; Structure; Techniques; Testing; Time; Tissues; Validation; Ventricular; Work; cardiac magnetic resonance imaging; cardiac muscle disease; clinical imaging; contrast imaging; deep learning; density; diagnostic accuracy; extracellular; heart dimension/size; heart function; imaging modality; improved; multidisciplinary; multiparametric imaging; novel; prospective; quantitative imaging; radiologist; reconstruction; recruit; respiratory; risk stratification; simulation; tool

PROJECT SUMMARY/ABSTRACT Cardiomyopathy (CM) encompasses a diverse group of diseases of the heart muscle that occur in 1 out of 500 adults and predispose to heart failure. Accurate determination of CM subtype (phenotyping) is essential to inform downstream tests, risk stratification, and targeted treatments. Cardiac MRI has emerged as the non-invasive standard for assessment of cardiac structure, function, and tissue properties in patients with suspected CM. However, cardiac MRI only comprises 1% of all MRI exams in the US, largely due to the need for (1) long and complex protocols where multiple images are collected with different contrast weightings, (2) unreliable and uncomfortable strategies to reduce motion, and (3) a lack of reproducibility of certain tissue property measurements. This multidisciplinary project between MRI scientists and cardiologists will validate 3D cine Magnetic Resonance Fingerprinting (MRF) as a comprehensive all-in-one imaging technique for CM detection and phenotyping. A streamlined and paradigm-changing cardiac MRI exam is proposed, consisting of a 5-minute free-breathing and ungated 3D cine MRF scan that will be collected before and after administration of gadolinium contrast. This technique will yield quantitative T1, T2, and spin density (M0) maps with 3D isotropic coverage over the left (LV) and right (RV) ventricles. Additionally, measured tissue properties and MRI simulations will be used to generate contrast-weighted cine and LGE images in an automated fashion, eliminating the need for multiple acquisitions and manual scan adjustments. A multicontrast LGE approach is also proposed where bright-blood, dark-blood, and novel “optimal-contrast” images will be generated to optimally highlight myocardial scar and fibrosis. The 3D cine MRF exam is expected to have advantages over routine clinical imaging and existing rapid imaging methods in terms of (1) improved accuracy/reproducibility of quantitative tissue properties, (2) shorter exam times, (3) reduced operator dependence, and (4) high diagnostic accuracy for specific CM phenotypes. Technical validation of 3D cine MRF in healthy subjects will be performed in Aim 1, including development of cardiac/respiratory self-gating methods tailored for MRF and development of a “physics-informed” deep learning reconstruction for artifact reduction and scan acceleration. Aim 2 will compare image quality and quantitative measurements from 3D cine MRF to standard MRI methods in patients with established CM. Additionally, quantitative thresholds for objective detection of specific CM phenotypes will be determined. In Aim 3, tissue properties and synthetic images derived from 3D cine MRF for will be tested in a prospective cross-sectional study to evaluate diagnostic accuracy for differentiating (1) ischemic vs nonischemic CM and (2) nonischemic CM phenotypes, using a standard cardiac MRI protocol as reference. The overall expected outcome of this work is an ultrafast all-in-one MRI exam for CM detection and phenotyping that will streamline cardiac MRI exams and assess cardiac structure, function, and tissue properties using reproducible quantitative imaging.

项目总结/摘要 心肌病（CM）包括一组不同的心肌疾病，发生在1/500 成年人和易患心力衰竭。CM亚型（表型）的准确测定对于告知 下游检测、风险分层和靶向治疗。心脏磁共振成像已成为非侵入性的 评估疑似CM患者心脏结构、功能和组织特性的标准。 然而，心脏MRI仅占美国所有MRI检查的1%，这主要是由于（1）需要长时间且 复杂的协议，其中使用不同的对比度权重收集多个图像，（2）不可靠并且 减少运动的不舒适策略，以及（3）缺乏某些组织特性的再现性 测量. MRI科学家和心脏病学家之间的这个多学科项目将验证3D电影 磁共振指纹（MRF）作为一种全面的一体化成像技术，用于CM检测 和表型分析。提出了一种精简和范式改变的心脏MRI检查，包括5分钟的 将在钆给药前后采集的自由呼吸和非门控3D电影MRF扫描 对比度该技术将产生定量的T1、T2和自旋密度（M0）图，具有3D各向同性覆盖， 左心室（LV）和右心室（RV）。此外，将使用测量的组织特性和MRI模拟 以自动方式生成对比加权电影和LGE图像，无需多个 采集和手动扫描调整。还提出了一种多对比度LGE方法， 将生成暗血和新的"最佳对比度"图像，以最佳地突出心肌瘢痕， 纤维化预计3D电影MRF检查优于常规临床成像和现有的快速 在以下方面的成像方法：（1）定量组织性质的提高的准确性/再现性，（2）更短的 检查次数，（3）减少操作者依赖性，和（4）对特定CM表型的高诊断准确性。 将在目标1中对健康受试者进行3D电影MRF的技术确认，包括开发 为MRF量身定制的心脏/呼吸自门控方法和开发"物理信息"深度学习 重建以减少伪影和扫描加速。目标2将比较图像质量和定量 从3D电影MRF到标准MRI方法的测量结果。此外，本发明还 将确定客观检测特定CM表型的定量阈值。在目标3中，组织 将在前瞻性横截面中测试来自3D电影MRF的特性和合成图像 评价区分（1）缺血性与非缺血性CM和（2）非缺血性CM的诊断准确性的研究 CM表型，使用标准心脏MRI方案作为参考。这项工作的总体预期成果 是一种用于CM检测和表型分析的超快一体化MRI检查，将简化心脏MRI检查， 使用可再现的定量成像评估心脏结构、功能和组织特性。