PMID- 28556294
OWN - NLM
STAT- MEDLINE
DCOM- 20190613
LR  - 20190613
IS  - 1522-2586 (Electronic)
IS  - 1053-1807 (Print)
IS  - 1053-1807 (Linking)
VI  - 47
IP  - 2
DP  - 2018 Feb
TI  - Combined Angiography and Late Gadolinium Enhancement Acquisition to Improve 
      Assessment of Pulmonary Vein Isolation for Atrial Fibrillation.
PG  - 477-486
LID - 10.1002/jmri.25771 [doi]
AB  - PURPOSE: To develop a Shared K-space (SharK) magnetic resonance imaging (MRI) 
      sequence that combines angiographic and late gadolinium enhancement (LGE) 
      acquisitions to improve atrial wall segmentation and scar identification, and to 
      develop a novel visualization method that quantifies scar encirclement of 
      pulmonary veins postablation treatment for atrial fibrillation. MATERIALS AND 
      METHODS: A SharK sequence was developed and used at 3T to image the left atrium 
      in 11 patients postcryoballoon ablation. The effects of sharing k-space between 
      the angiographic and LGE acquisitions on the accuracy of scar were assessed. The 
      left atrial wall was segmented and points about each pulmonary vein (PV) ostia 
      were projected onto a bullseye to quantitatively compare PV encirclement. The 
      parameters used to quantify encirclement were varied to perform a sensitivity 
      analysis. RESULTS: Compared to using a complete set of k-space, total atrial scar 
      differences were significant only when sharing >75% k-space (P = 0.014), and 90% 
      sensitivity and specificity for identifying scar was achieved when sharing 50% 
      k-space. In patients, the right PVs showed more intersubject variance in 
      encirclement compared to the left PVs. A 100 degrees  anteroinferior portion of the left 
      PVs was always encircled, while the superior segments of both right PVs was 
      ablated in only 6/11 patients. CONCLUSION: A SharK sequence was developed to 
      combine angiographic and LGE imaging for atrial wall segmentation and scar 
      identification. The PV bullseye quantifies and localizes encirclement about the 
      PVs. The left PVs showed a higher amount of scar encirclement and less 
      variability compared to the right PVs. LEVEL OF EVIDENCE: 2 Technical Efficacy: 
      Stage 1 J. Magn. Reson. Imaging 2018;47:477-486.
CI  - (c) 2017 International Society for Magnetic Resonance in Medicine.
FAU - Lam, Adrian
AU  - Lam A
AD  - Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of 
      Technology, Atlanta, Georgia, USA.
FAU - Okene, Erica
AU  - Okene E
AD  - Department of Medicine, Division of Cardiology, Emory University, Atlanta, 
      Georgia, USA.
FAU - Parikh, Ankit
AU  - Parikh A
AD  - Department of Medicine, Division of Cardiology, Emory University, Atlanta, 
      Georgia, USA.
FAU - Zhong, Xiaodong
AU  - Zhong X
AD  - MR R&D Collaborations, Siemens Healthcare, Atlanta, Georgia, USA.
AD  - Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, 
      USA.
FAU - Tejada, Thor
AU  - Tejada T
AD  - Department of Medicine, Division of Cardiology, Emory University, Atlanta, 
      Georgia, USA.
FAU - Hoskins, Michael
AU  - Hoskins M
AD  - Department of Medicine, Division of Cardiology, Emory University, Atlanta, 
      Georgia, USA.
FAU - Lloyd, Michael
AU  - Lloyd M
AD  - Department of Medicine, Division of Cardiology, Emory University, Atlanta, 
      Georgia, USA.
FAU - Oshinski, John N
AU  - Oshinski JN
AD  - Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of 
      Technology, Atlanta, Georgia, USA.
AD  - Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, 
      USA.
LA  - eng
GR  - R21 HL109979/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20170528
PL  - United States
TA  - J Magn Reson Imaging
JT  - Journal of magnetic resonance imaging : JMRI
JID - 9105850
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Atrial Fibrillation/*diagnostic imaging/pathology
MH  - *Contrast Media
MH  - Female
MH  - *Gadolinium
MH  - Heart Atria/diagnostic imaging
MH  - Humans
MH  - Image Enhancement/*methods
MH  - Imaging, Three-Dimensional
MH  - Magnetic Resonance Angiography/*methods
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Veins/*diagnostic imaging
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
PMC - PMC5705582
MID - NIHMS876065
OTO - NOTNLM
OT  - atrial fibrillation
OT  - cardiovascular MRI
OT  - cryoballoon ablation
OT  - late gadolinium enhancement
OT  - pulmonary vein isolation
EDAT- 2017/05/31 06:00
MHDA- 2019/06/14 06:00
PMCR- 2019/02/01
CRDT- 2017/05/31 06:00
PHST- 2017/02/28 00:00 [received]
PHST- 2017/05/09 00:00 [accepted]
PHST- 2017/05/31 06:00 [pubmed]
PHST- 2019/06/14 06:00 [medline]
PHST- 2017/05/31 06:00 [entrez]
PHST- 2019/02/01 00:00 [pmc-release]
AID - 10.1002/jmri.25771 [doi]
PST - ppublish
SO  - J Magn Reson Imaging. 2018 Feb;47(2):477-486. doi: 10.1002/jmri.25771. Epub 2017 
      May 28.