PMID- 29603482
OWN - NLM
STAT- MEDLINE
DCOM- 20190930
LR  - 20190930
IS  - 1522-2586 (Electronic)
IS  - 1053-1807 (Linking)
VI  - 48
IP  - 4
DP  - 2018 Oct
TI  - 3D image fusion of whole-heart dynamic cardiac MR perfusion and late gadolinium 
      enhancement: Intuitive delineation of myocardial hypoperfusion and scar.
PG  - 1129-1138
LID - 10.1002/jmri.26020 [doi]
AB  - BACKGROUND: Since patients with myocardial hypoperfusion due to coronary artery 
      disease (CAD) with preserved viability are known to benefit from 
      revascularization, accurate differentiation of hypoperfusion from scar is 
      desirable. PURPOSE: To develop a framework for 3D fusion of whole-heart dynamic 
      cardiac MR perfusion and late gadolinium enhancement (LGE) to delineate 
      stress-induced myocardial hypoperfusion and scar. STUDY TYPE: Prospective 
      feasibility study. SUBJECTS: Sixteen patients (61 +/- 14 years, two females) with 
      known/suspected CAD. FIELD STRENGTH/SEQUENCE: 1.5T (nine patients); 3.0T (seven 
      patients); whole-heart dynamic 3D cardiac MR perfusion (3D-PERF, under adenosine 
      stress); 3D LGE inversion recovery sequences (3D-SCAR). ASSESSMENT: A software 
      framework was developed for 3D fusion of 3D-PERF and 3D-SCAR. Computation steps 
      included: 1) segmentation of the left ventricle in 3D-PERF and 3D-SCAR; 2) 
      semiautomatic thresholding of perfusion/scar data; 3) automatic calculation of 
      ischemic/scar burden (ie, pathologic relative to total myocardium); 4) projection 
      of perfusion/scar values onto artificial template of the left ventricle; 5) 
      semiautomatic coregistration to an exemplary heart contour easing 3D orientation; 
      and 6) 3D rendering of the combined datasets using automatically defined color 
      tables. All tasks were performed by two independent, blinded readers (J.S. and 
      R.M.). STATISTICAL TESTS: Intraclass correlation coefficients (ICC) for 
      determining interreader agreement. RESULTS: Image acquisition, postprocessing, 
      and 3D fusion were feasible in all cases. In all, 10/16 patients showed 
      stress-induced hypoperfusion in 3D-PERF; 8/16 patients showed LGE in 3D-SCAR. For 
      3D-PERF, semiautomatic thresholding was possible in all patients. For 3D-SCAR, 
      automatic thresholding was feasible where applicable. Average ischemic burden was 
      11 +/- 7% (J.S.) and 12 +/- 7% (R.M.). Average scar burden was 8 +/- 5% (J.S.) and 
      7 +/- 4% (R.M.). Interreader agreement was excellent (ICC for 3D-PERF = 0.993, for 
      3D-SCAR = 0.99). DATA CONCLUSION: 3D fusion of 3D-PERF and 3D-SCAR facilitates 
      intuitive delineation of stress-induced myocardial hypoperfusion and scar. LEVEL 
      OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 
      2018;48:1129-1138.
CI  - (c) 2018 International Society for Magnetic Resonance in Medicine.
FAU - von Spiczak, Jochen
AU  - von Spiczak J
AUID- ORCID: 0000-0002-1978-1535
AD  - Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 
      Zurich, Switzerland.
FAU - Mannil, Manoj
AU  - Mannil M
AD  - Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 
      Zurich, Switzerland.
FAU - Kozerke, Sebastian
AU  - Kozerke S
AD  - Institute for Biomedical Engineering, University and ETH Zurich, Zurich, 
      Switzerland.
FAU - Alkadhi, Hatem
AU  - Alkadhi H
AD  - Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 
      Zurich, Switzerland.
FAU - Manka, Robert
AU  - Manka R
AD  - Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 
      Zurich, Switzerland.
AD  - Institute for Biomedical Engineering, University and ETH Zurich, Zurich, 
      Switzerland.
AD  - Department of Cardiology, University Heart Center, University Hospital Zurich, 
      Zurich, Switzerland.
LA  - eng
GR  - CR3213_132671/1/Swiss National Science Foundation/Switzerland
GR  - Bayer Healthcare/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180330
PL  - United States
TA  - J Magn Reson Imaging
JT  - Journal of magnetic resonance imaging : JMRI
JID - 9105850
RN  - 0 (Contrast Media)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cicatrix/diagnostic imaging
MH  - Contrast Media/chemistry
MH  - *Coronary Angiography
MH  - Coronary Artery Disease/*diagnostic imaging
MH  - Feasibility Studies
MH  - Female
MH  - Heart/*diagnostic imaging
MH  - Heart Ventricles/diagnostic imaging
MH  - Humans
MH  - Image Processing, Computer-Assisted
MH  - *Imaging, Three-Dimensional
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/pathology
MH  - Myocardium/*pathology
MH  - Observer Variation
MH  - Perfusion
MH  - Prospective Studies
MH  - Software
OTO - NOTNLM
OT  - coronary artery disease
OT  - image fusion
OT  - late gadolinium enhancement
OT  - magnetic resonance imaging
OT  - myocardial perfusion
EDAT- 2018/04/01 06:00
MHDA- 2019/10/01 06:00
CRDT- 2018/04/01 06:00
PHST- 2017/11/24 00:00 [received]
PHST- 2018/03/01 00:00 [accepted]
PHST- 2018/04/01 06:00 [pubmed]
PHST- 2019/10/01 06:00 [medline]
PHST- 2018/04/01 06:00 [entrez]
AID - 10.1002/jmri.26020 [doi]
PST - ppublish
SO  - J Magn Reson Imaging. 2018 Oct;48(4):1129-1138. doi: 10.1002/jmri.26020. Epub 
      2018 Mar 30.