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Native contrast visualization and tissue characterization of myocardial radiofrequency ablation and acetic acid chemoablation lesions at 0.55 T

PURPOSE: Low-field (0.55 T) high-performance cardiovascular magnetic resonance (CMR) is an attractive platform for CMR-guided intervention as device heating is reduced around 7.5-fold compared to 1.5 T. This work determines the feasibility of visualizing cardiac radiofrequency (RF) ablation lesions...

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Autores principales: Kolandaivelu, Aravindan, Bruce, Chris G., Ramasawmy, Rajiv, Yildirim, Dursun Korel, O’Brien, Kendall J., Schenke, William H., Rogers, Toby, Campbell-Washburn, Adrienne E., Lederman, Robert J., Herzka, Daniel A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101152/
https://www.ncbi.nlm.nih.gov/pubmed/33952312
http://dx.doi.org/10.1186/s12968-020-00693-1
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author Kolandaivelu, Aravindan
Bruce, Chris G.
Ramasawmy, Rajiv
Yildirim, Dursun Korel
O’Brien, Kendall J.
Schenke, William H.
Rogers, Toby
Campbell-Washburn, Adrienne E.
Lederman, Robert J.
Herzka, Daniel A.
author_facet Kolandaivelu, Aravindan
Bruce, Chris G.
Ramasawmy, Rajiv
Yildirim, Dursun Korel
O’Brien, Kendall J.
Schenke, William H.
Rogers, Toby
Campbell-Washburn, Adrienne E.
Lederman, Robert J.
Herzka, Daniel A.
author_sort Kolandaivelu, Aravindan
collection PubMed
description PURPOSE: Low-field (0.55 T) high-performance cardiovascular magnetic resonance (CMR) is an attractive platform for CMR-guided intervention as device heating is reduced around 7.5-fold compared to 1.5 T. This work determines the feasibility of visualizing cardiac radiofrequency (RF) ablation lesions at low field CMR and explores a novel alternative method for targeted tissue destruction: acetic acid chemoablation. METHODS: N = 10 swine underwent X-ray fluoroscopy-guided RF ablation (6–7 lesions) and acetic acid chemoablation (2–3 lesions) of the left ventricle. Animals were imaged at 0.55 T with native contrast 3D-navigator gated T1-weighted T1w) CMR for lesion visualization, gated single-shot imaging to determine potential for real-time visualization of lesion formation, and T1 mapping to measure change in T1 in response to ablation. Seven animals were euthanized on ablation day and hearts imaged ex vivo. The remaining animals were imaged again in vivo at 21 days post ablation to observe lesion evolution. RESULTS: Chemoablation lesions could be visualized and displayed much higher contrast than necrotic RF ablation lesions with T1w imaging. On the day of ablation, in vivo myocardial T1 dropped by 19 ± 7% in RF ablation lesion cores, and by 40 ± 7% in chemoablation lesion cores (p < 4e−5). In high resolution ex vivo imaging, with reduced partial volume effects, lesion core T1 dropped by 18 ± 3% and 42 ± 6% for RF and chemoablation, respectively. Mean, median, and peak lesion signal-to-noise ratio (SNR) were all at least 75% higher with chemoablation. Lesion core to myocardium contrast-to-noise (CNR) was 3.8 × higher for chemoablation. Correlation between in vivo and ex vivo CMR and histology indicated that the periphery of RF ablation lesions do not exhibit changes in T1 while the entire extent of chemoablation exhibits T1 changes. Correlation of T1w enhancing lesion volumes indicated in vivo estimates of lesion volume are accurate for chemoablation but underestimate extent of necrosis for RF ablation. CONCLUSION: The visualization of coagulation necrosis from cardiac ablation is feasible using low-field high-performance CMR. Chemoablation produced a more pronounced change in lesion T1 than RF ablation, increasing SNR and CNR and thereby making it easier to visualize in both 3D navigator-gated and real-time CMR and more suitable for low-field imaging. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12968-020-00693-1.
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spelling pubmed-81011522021-05-06 Native contrast visualization and tissue characterization of myocardial radiofrequency ablation and acetic acid chemoablation lesions at 0.55 T Kolandaivelu, Aravindan Bruce, Chris G. Ramasawmy, Rajiv Yildirim, Dursun Korel O’Brien, Kendall J. Schenke, William H. Rogers, Toby Campbell-Washburn, Adrienne E. Lederman, Robert J. Herzka, Daniel A. J Cardiovasc Magn Reson Research PURPOSE: Low-field (0.55 T) high-performance cardiovascular magnetic resonance (CMR) is an attractive platform for CMR-guided intervention as device heating is reduced around 7.5-fold compared to 1.5 T. This work determines the feasibility of visualizing cardiac radiofrequency (RF) ablation lesions at low field CMR and explores a novel alternative method for targeted tissue destruction: acetic acid chemoablation. METHODS: N = 10 swine underwent X-ray fluoroscopy-guided RF ablation (6–7 lesions) and acetic acid chemoablation (2–3 lesions) of the left ventricle. Animals were imaged at 0.55 T with native contrast 3D-navigator gated T1-weighted T1w) CMR for lesion visualization, gated single-shot imaging to determine potential for real-time visualization of lesion formation, and T1 mapping to measure change in T1 in response to ablation. Seven animals were euthanized on ablation day and hearts imaged ex vivo. The remaining animals were imaged again in vivo at 21 days post ablation to observe lesion evolution. RESULTS: Chemoablation lesions could be visualized and displayed much higher contrast than necrotic RF ablation lesions with T1w imaging. On the day of ablation, in vivo myocardial T1 dropped by 19 ± 7% in RF ablation lesion cores, and by 40 ± 7% in chemoablation lesion cores (p < 4e−5). In high resolution ex vivo imaging, with reduced partial volume effects, lesion core T1 dropped by 18 ± 3% and 42 ± 6% for RF and chemoablation, respectively. Mean, median, and peak lesion signal-to-noise ratio (SNR) were all at least 75% higher with chemoablation. Lesion core to myocardium contrast-to-noise (CNR) was 3.8 × higher for chemoablation. Correlation between in vivo and ex vivo CMR and histology indicated that the periphery of RF ablation lesions do not exhibit changes in T1 while the entire extent of chemoablation exhibits T1 changes. Correlation of T1w enhancing lesion volumes indicated in vivo estimates of lesion volume are accurate for chemoablation but underestimate extent of necrosis for RF ablation. CONCLUSION: The visualization of coagulation necrosis from cardiac ablation is feasible using low-field high-performance CMR. Chemoablation produced a more pronounced change in lesion T1 than RF ablation, increasing SNR and CNR and thereby making it easier to visualize in both 3D navigator-gated and real-time CMR and more suitable for low-field imaging. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12968-020-00693-1. BioMed Central 2021-05-06 /pmc/articles/PMC8101152/ /pubmed/33952312 http://dx.doi.org/10.1186/s12968-020-00693-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Kolandaivelu, Aravindan
Bruce, Chris G.
Ramasawmy, Rajiv
Yildirim, Dursun Korel
O’Brien, Kendall J.
Schenke, William H.
Rogers, Toby
Campbell-Washburn, Adrienne E.
Lederman, Robert J.
Herzka, Daniel A.
Native contrast visualization and tissue characterization of myocardial radiofrequency ablation and acetic acid chemoablation lesions at 0.55 T
title Native contrast visualization and tissue characterization of myocardial radiofrequency ablation and acetic acid chemoablation lesions at 0.55 T
title_full Native contrast visualization and tissue characterization of myocardial radiofrequency ablation and acetic acid chemoablation lesions at 0.55 T
title_fullStr Native contrast visualization and tissue characterization of myocardial radiofrequency ablation and acetic acid chemoablation lesions at 0.55 T
title_full_unstemmed Native contrast visualization and tissue characterization of myocardial radiofrequency ablation and acetic acid chemoablation lesions at 0.55 T
title_short Native contrast visualization and tissue characterization of myocardial radiofrequency ablation and acetic acid chemoablation lesions at 0.55 T
title_sort native contrast visualization and tissue characterization of myocardial radiofrequency ablation and acetic acid chemoablation lesions at 0.55 t
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101152/
https://www.ncbi.nlm.nih.gov/pubmed/33952312
http://dx.doi.org/10.1186/s12968-020-00693-1
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