PMID- 26520782 OWN - NLM STAT- MEDLINE DCOM- 20160707 LR - 20240117 IS - 1532-429X (Electronic) IS - 1097-6647 (Print) IS - 1097-6647 (Linking) VI - 17 DP - 2015 Oct 29 TI - Gadolinium free cardiovascular magnetic resonance with 2-point Cine balanced steady state free precession. PG - 90 LID - 10.1186/s12968-015-0194-1 [doi] LID - 90 AB - BACKGROUND: Cardiovascular magnetic resonance (CMR) of ventricular structure and function is widely performed using cine balanced steady state free precession (bSSFP) MRI. The bSSFP signal of myocardium is weighted by magnetization transfer (MT) and T1/T2-relaxation times. In edematous and fibrotic tissues, increased T2 and reduced MT lead to increased signal intensity on images acquired with high excitation flip angles. We hypothesized that acquisition of two differentially MT-weighted bSSFP images (termed 2-point bSSFP) can identify tissue that would enhance with gadolinium similar to standard of care late gadolinium enhancement (LGE). METHODS: Cine bSSFP images (flip angles of 5 degrees and 45 degrees ) and native-T1 and T2 maps were acquired in one mid-ventricular slice in 47 patients referred for CMR and 10 healthy controls. Afterwards, LGE images and post-contrast T1 maps were acquired and gadolinium partition coefficient (GPC) was calculated. Maps of DeltaS/So were calculated as (S45-S5)/S5*100 (%), where Sflip_angle is the voxel signal intensity. RESULTS: Twenty three patients demonstrated areas of myocardial hyper-enhancement with LGE. In enhanced regions, DeltaS/So, native-T1, T2, and GPC were heightened (p < 0.05 vs. non-enhanced tissues). DeltaS/So, native-T1, and T2 all demonstrated association with GPC, however the association was strongest for DeltaS/So. Bland-Altman analysis revealed a slight bias towards larger volume of enhancement with DeltaS/So compared to LGE, and similar transmurality. Subjective analysis with 2-blinded expert readers revealed agreement between DeltaS/So and LGE of 73.4 %, with false positive detection of 16.7 % and false negative detection of 15.2 %. CONCLUSIONS: Gadolinium free 2-point bSSFP identified tissue that enhances at LGE with strong association to GPC. Our results suggest that with further development, MT-weighted CMR could be used similar to LGE for diagnostic imaging. FAU - Stromp, Tori A AU - Stromp TA AD - Department of Physiology, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. tori.stromp@uky.edu. FAU - Leung, Steve W AU - Leung SW AD - Gill Heart Institute, University of Kentucky Healthcare, Lexington, KY, USA. steve.leung@uky.edu. AD - Saha Cardiovascular Research Center, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. steve.leung@uky.edu. FAU - Andres, Kristin N AU - Andres KN AD - Saha Cardiovascular Research Center, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. Kristin.andres@uky.edu. FAU - Jing, Linyuan AU - Jing L AD - Saha Cardiovascular Research Center, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. jinglinyuan2008@gmail.com. AD - Department of Pediatrics, University of Kentucky Healthcare, Lexington, KY, USA. jinglinyuan2008@gmail.com. FAU - Fornwalt, Brandon K AU - Fornwalt BK AD - Department of Physiology, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. bkfornwalt@geisinger.edu. AD - Saha Cardiovascular Research Center, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. bkfornwalt@geisinger.edu. AD - Department of Pediatrics, University of Kentucky Healthcare, Lexington, KY, USA. bkfornwalt@geisinger.edu. AD - Department of Biomedical Engineering, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. bkfornwalt@geisinger.edu. FAU - Charnigo, Richard J AU - Charnigo RJ AD - Departments of Statistics and Biostatistics, University of Kentucky, Lexington, KY, USA. rjcharn2@aol.com. FAU - Sorrell, Vincent L AU - Sorrell VL AD - Gill Heart Institute, University of Kentucky Healthcare, Lexington, KY, USA. v.sorrell@uky.edu. AD - Saha Cardiovascular Research Center, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. v.sorrell@uky.edu. FAU - Vandsburger, Moriel H AU - Vandsburger MH AD - Department of Physiology, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. m.v@uky.edu. AD - Saha Cardiovascular Research Center, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. m.v@uky.edu. AD - Department of Biomedical Engineering, University of Kentucky, 741 South Limestone Street, BBSRB room 355, Lexington, 40536, KY, USA. m.v@uky.edu. LA - eng GR - UL1 TR000117/TR/NCATS NIH HHS/United States GR - KL2TR000116/TR/NCATS NIH HHS/United States GR - TL1 TR000115/TR/NCATS NIH HHS/United States GR - UL1TR000117/TR/NCATS NIH HHS/United States GR - DP5 OD012132/OD/NIH HHS/United States GR - KL2 TR000116/TR/NCATS NIH HHS/United States GR - R01 HL128592/HL/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20151029 PL - England TA - J Cardiovasc Magn Reson JT - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance JID - 9815616 RN - 0 (Contrast Media) RN - K2I13DR72L (Gadolinium DTPA) SB - IM MH - Adult MH - Aged MH - Algorithms MH - Cardiomyopathies/*diagnosis/pathology/physiopathology MH - Case-Control Studies MH - *Contrast Media MH - False Negative Reactions MH - False Positive Reactions MH - Female MH - Fibrosis MH - *Gadolinium DTPA MH - Humans MH - Image Interpretation, Computer-Assisted MH - Magnetic Resonance Imaging, Cine/*methods MH - Male MH - Middle Aged MH - Myocardium/*pathology MH - Observer Variation MH - Predictive Value of Tests MH - Prospective Studies MH - Reproducibility of Results MH - Stroke Volume MH - *Ventricular Remodeling PMC - PMC4628395 EDAT- 2015/11/02 06:00 MHDA- 2016/07/09 06:00 PMCR- 2015/10/29 CRDT- 2015/11/02 06:00 PHST- 2015/07/28 00:00 [received] PHST- 2015/10/09 00:00 [accepted] PHST- 2015/11/02 06:00 [entrez] PHST- 2015/11/02 06:00 [pubmed] PHST- 2016/07/09 06:00 [medline] PHST- 2015/10/29 00:00 [pmc-release] AID - S1097-6647(23)00915-8 [pii] AID - 194 [pii] AID - 10.1186/s12968-015-0194-1 [doi] PST - epublish SO - J Cardiovasc Magn Reson. 2015 Oct 29;17:90. doi: 10.1186/s12968-015-0194-1.