PMID- 29458430 OWN - NLM STAT- MEDLINE DCOM- 20190314 LR - 20240117 IS - 1532-429X (Electronic) IS - 1097-6647 (Print) IS - 1097-6647 (Linking) VI - 20 IP - 1 DP - 2018 Feb 19 TI - Comparison of fast multi-slice and standard segmented techniques for detection of late gadolinium enhancement in ischemic and non-ischemic cardiomyopathy - a prospective clinical cardiovascular magnetic resonance trial. PG - 13 LID - 10.1186/s12968-018-0434-2 [doi] LID - 13 AB - BACKGROUND: Segmented phase-sensitive inversion recovery (PSIR) cardiovascular magnetic resonance (CMR) sequences are reference standard for non-invasive evaluation of myocardial fibrosis using late gadolinium enhancement (LGE). Several multi-slice LGE sequences have been introduced for faster acquisition in patients with arrhythmia and insufficient breathhold capability. The aim of this study was to assess the accuracy of several multi-slice LGE sequences to detect and quantify myocardial fibrosis in patients with ischemic and non-ischemic myocardial disease. METHODS: Patients with known or suspected LGE due to chronic infarction, inflammatory myocardial disease and hypertrophic cardiomyopathy (HCM) were prospectively recruited. LGE images were acquired 10-20 min after administration of 0.2 mmol/kg gadolinium-based contrast agent. Three different LGE sequences were acquired: a segmented, single-slice/single-breath-hold fast low angle shot PSIR sequence (FLASH-PSIR), a multi-slice balanced steady-state free precession inversion recovery sequence (bSSFP-IR) and a multi-slice bSSFP-PSIR sequence during breathhold and free breathing. Image quality was evaluated with a 4-point scoring system. Contrast-to-noise ratios (CNR) and acquisition time were evaluated. LGE was quantitatively assessed using a semi-automated threshold method. Differences in size of fibrosis were analyzed using Bland-Altman analysis. RESULTS: Three hundred twelve patients were enrolled (n = 212 chronic infarction, n = 47 inflammatory myocardial disease, n = 53 HCM) Of which 201 patients (67,4%) had detectable LGE (n = 143 with chronic infarction, n = 27 with inflammatory heart disease and n = 31 with HCM). Image quality and CNR were best on multi-slice bSSFP-PSIR. Acquisition times were significantly shorter for all multi-slice sequences (bSSFP-IR: 23.4 +/- 7.2 s; bSSFP-PSIR: 21.9 +/- 6.4 s) as compared to FLASH-PSIR (361.5 +/- 95.33 s). There was no significant difference of mean LGE size for all sequences in all study groups (FLASH-PSIR: 8.96 +/- 10.64 g; bSSFP-IR: 8.69 +/- 10.75 g; bSSFP-PSIR: 9.05 +/- 10.84 g; bSSFP-PSIR free breathing: 8.85 +/- 10.71 g, p > 0.05). LGE size was not affected by arrhythmia or absence of breathhold on multi-slice LGE sequences. CONCLUSIONS: Fast multi-slice and standard segmented LGE sequences are equivalent techniques for the assessment of myocardial fibrosis, independent of an ischemic or non-ischemic etiology. Even in patients with arrhythmia and insufficient breathhold capability, multi-slice sequences yield excellent image quality at significantly reduced scan time and may be used as standard LGE approach. TRIAL REGISTRATION: ISRCTN48802295 (retrospectively registered). FAU - Muehlberg, Fabian AU - Muehlberg F AUID- ORCID: 0000-0002-7981-5178 AD - Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center - a joint cooperation between the Charite Medical Faculty and the Max-Delbruck Center for Molecular Medicine and HELIOS Hospital Berlin-Buch, Department of Cardiology and Nephrology, Lindenberger Weg 80, 13125, Berlin, Germany. fabian.muehlberg@gmail.com. FAU - Arnhold, Kristin AU - Arnhold K AD - Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center - a joint cooperation between the Charite Medical Faculty and the Max-Delbruck Center for Molecular Medicine and HELIOS Hospital Berlin-Buch, Department of Cardiology and Nephrology, Lindenberger Weg 80, 13125, Berlin, Germany. FAU - Fritschi, Simone AU - Fritschi S AD - Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center - a joint cooperation between the Charite Medical Faculty and the Max-Delbruck Center for Molecular Medicine and HELIOS Hospital Berlin-Buch, Department of Cardiology and Nephrology, Lindenberger Weg 80, 13125, Berlin, Germany. FAU - Funk, Stephanie AU - Funk S AD - Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center - a joint cooperation between the Charite Medical Faculty and the Max-Delbruck Center for Molecular Medicine and HELIOS Hospital Berlin-Buch, Department of Cardiology and Nephrology, Lindenberger Weg 80, 13125, Berlin, Germany. FAU - Prothmann, Marcel AU - Prothmann M AD - Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center - a joint cooperation between the Charite Medical Faculty and the Max-Delbruck Center for Molecular Medicine and HELIOS Hospital Berlin-Buch, Department of Cardiology and Nephrology, Lindenberger Weg 80, 13125, Berlin, Germany. FAU - Kermer, Josephine AU - Kermer J AD - Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center - a joint cooperation between the Charite Medical Faculty and the Max-Delbruck Center for Molecular Medicine and HELIOS Hospital Berlin-Buch, Department of Cardiology and Nephrology, Lindenberger Weg 80, 13125, Berlin, Germany. FAU - Zange, Leonora AU - Zange L AD - Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center - a joint cooperation between the Charite Medical Faculty and the Max-Delbruck Center for Molecular Medicine and HELIOS Hospital Berlin-Buch, Department of Cardiology and Nephrology, Lindenberger Weg 80, 13125, Berlin, Germany. FAU - von Knobelsdorff-Brenkenhoff, Florian AU - von Knobelsdorff-Brenkenhoff F AD - Clinic Agatharied, Department of Cardiology, Ludwig-Maximilians-University Munich, Norbert-Kerkel-Platz, 83734, Hausham, Germany. FAU - Schulz-Menger, Jeanette AU - Schulz-Menger J AD - Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center - a joint cooperation between the Charite Medical Faculty and the Max-Delbruck Center for Molecular Medicine and HELIOS Hospital Berlin-Buch, Department of Cardiology and Nephrology, Lindenberger Weg 80, 13125, Berlin, Germany. LA - eng SI - ISRCTN/ISRCTN48802295 PT - Comparative Study PT - Journal Article DEP - 20180219 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 - 0 (Heterocyclic Compounds) RN - 0 (Organometallic Compounds) RN - 0199MV609F (gadoteridol) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Adult MH - Aged MH - Cardiomyopathies/*diagnostic imaging/pathology/physiopathology MH - Contrast Media/*administration & dosage MH - Female MH - Fibrosis MH - Gadolinium/administration & dosage MH - Heterocyclic Compounds/*administration & dosage MH - Humans MH - Image Interpretation, Computer-Assisted/*methods MH - Magnetic Resonance Imaging, Cine/*methods MH - Male MH - Middle Aged MH - Myocardial Infarction/*diagnostic imaging/pathology/physiopathology MH - Myocarditis/*diagnostic imaging/pathology/physiopathology MH - Myocardium/pathology MH - Organometallic Compounds/*administration & dosage MH - Predictive Value of Tests MH - Prospective Studies MH - Reproducibility of Results PMC - PMC5819178 OTO - NOTNLM OT - CMR OT - Cardiac MR OT - Hypertrophic cardiomyopathy OT - Inflammatory heart disease OT - Late gadolinium enhancement OT - Myocardial infarction OT - Myocarditis OT - Single-shot COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The study was approved by Charite University Medicine ethics board at Charite Campus Mitte, Berlin, Germany. CONSENT FOR PUBLICATION: Individuals have given their written consent for anonymous publication. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/02/21 06:00 MHDA- 2019/03/15 06:00 PMCR- 2018/02/19 CRDT- 2018/02/21 06:00 PHST- 2017/07/10 00:00 [received] PHST- 2018/02/05 00:00 [accepted] PHST- 2018/02/21 06:00 [entrez] PHST- 2018/02/21 06:00 [pubmed] PHST- 2019/03/15 06:00 [medline] PHST- 2018/02/19 00:00 [pmc-release] AID - S1097-6647(23)00550-1 [pii] AID - 434 [pii] AID - 10.1186/s12968-018-0434-2 [doi] PST - epublish SO - J Cardiovasc Magn Reson. 2018 Feb 19;20(1):13. doi: 10.1186/s12968-018-0434-2.