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Quality assessment of cardiac magnetic resonance myocardial scar imaging prior to ventricular arrhythmia ablation

High-resolution scar characterization using late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR) is useful for guiding ventricular arrhythmia (VA) treatment. However, imaging study quality may be degraded by breath-holding difficulties, arrhythmias, and implantable cardioverter-d...

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Autores principales: Shah, Rushil, Sharma, Apurva, Assis, Fabrizio, De Vasconcellos, Henrique Doria, Alugubelli, Navya, Pandey, Pallavi, Akhtar, Tauseef, Gasperetti, Alessio, Zhou, Shijie, Halperin, Henry, Zimmerman, Stefan L., Tandri, Harikrishna, Kolandaivelu, Aravindan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870828/
https://www.ncbi.nlm.nih.gov/pubmed/36331683
http://dx.doi.org/10.1007/s10554-022-02734-5
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author Shah, Rushil
Sharma, Apurva
Assis, Fabrizio
De Vasconcellos, Henrique Doria
Alugubelli, Navya
Pandey, Pallavi
Akhtar, Tauseef
Gasperetti, Alessio
Zhou, Shijie
Halperin, Henry
Zimmerman, Stefan L.
Tandri, Harikrishna
Kolandaivelu, Aravindan
author_facet Shah, Rushil
Sharma, Apurva
Assis, Fabrizio
De Vasconcellos, Henrique Doria
Alugubelli, Navya
Pandey, Pallavi
Akhtar, Tauseef
Gasperetti, Alessio
Zhou, Shijie
Halperin, Henry
Zimmerman, Stefan L.
Tandri, Harikrishna
Kolandaivelu, Aravindan
author_sort Shah, Rushil
collection PubMed
description High-resolution scar characterization using late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR) is useful for guiding ventricular arrhythmia (VA) treatment. However, imaging study quality may be degraded by breath-holding difficulties, arrhythmias, and implantable cardioverter-defibrillators (ICDs). We evaluated the effect of image quality on left ventricle (LV) base to apex scar interpretation in pre-VA ablation LGE-CMR. 43 consecutive patients referred for VA ablation underwent gradient-recalled-echo LGE-CMR. In ICD patients (n = 24), wide-bandwidth inversion-recovery suppressed ICD artifacts. In non-ICD patients, single-shot steady-state free-precession LGE-CMR could also be performed to reduce respiratory motion/arrhythmia artifacts. Study quality was assessed for adequate/limited scar interpretation due to cardiac/respiratory motion artifacts, ICD-related artifacts, and image contrast. 28% of non-ICD patients had studies where image quality limited scar interpretation in at least one image compared to 71% of ICD patient studies (p = 0.012). A median of five image slices had limited quality per ICD patient study, compared to 0 images per non-ICD patient study. Poorer quality in ICD patients was largely due to motion-related artifacts (54% ICD vs 6% non-ICD studies, p = 0.001) as well as ICD-related image artifacts (25% of studies). In VA ablation patients with ICDs, conventional CMR protocols frequently have image slices with limited scar interpretation, which can limit whole-heart scar assessment. Motion artifacts contribute to suboptimal image quality, particularly in ICD patients. Improved methods for motion and ICD artifact suppression may better delineate high-resolution LGE scar features of interest for guiding VA ablation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10554-022-02734-5.
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spelling pubmed-98708282023-01-25 Quality assessment of cardiac magnetic resonance myocardial scar imaging prior to ventricular arrhythmia ablation Shah, Rushil Sharma, Apurva Assis, Fabrizio De Vasconcellos, Henrique Doria Alugubelli, Navya Pandey, Pallavi Akhtar, Tauseef Gasperetti, Alessio Zhou, Shijie Halperin, Henry Zimmerman, Stefan L. Tandri, Harikrishna Kolandaivelu, Aravindan Int J Cardiovasc Imaging OriginalPaper High-resolution scar characterization using late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR) is useful for guiding ventricular arrhythmia (VA) treatment. However, imaging study quality may be degraded by breath-holding difficulties, arrhythmias, and implantable cardioverter-defibrillators (ICDs). We evaluated the effect of image quality on left ventricle (LV) base to apex scar interpretation in pre-VA ablation LGE-CMR. 43 consecutive patients referred for VA ablation underwent gradient-recalled-echo LGE-CMR. In ICD patients (n = 24), wide-bandwidth inversion-recovery suppressed ICD artifacts. In non-ICD patients, single-shot steady-state free-precession LGE-CMR could also be performed to reduce respiratory motion/arrhythmia artifacts. Study quality was assessed for adequate/limited scar interpretation due to cardiac/respiratory motion artifacts, ICD-related artifacts, and image contrast. 28% of non-ICD patients had studies where image quality limited scar interpretation in at least one image compared to 71% of ICD patient studies (p = 0.012). A median of five image slices had limited quality per ICD patient study, compared to 0 images per non-ICD patient study. Poorer quality in ICD patients was largely due to motion-related artifacts (54% ICD vs 6% non-ICD studies, p = 0.001) as well as ICD-related image artifacts (25% of studies). In VA ablation patients with ICDs, conventional CMR protocols frequently have image slices with limited scar interpretation, which can limit whole-heart scar assessment. Motion artifacts contribute to suboptimal image quality, particularly in ICD patients. Improved methods for motion and ICD artifact suppression may better delineate high-resolution LGE scar features of interest for guiding VA ablation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10554-022-02734-5. Springer Netherlands 2022-11-04 2023 /pmc/articles/PMC9870828/ /pubmed/36331683 http://dx.doi.org/10.1007/s10554-022-02734-5 Text en © The Author(s) 2022 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/) .
spellingShingle OriginalPaper
Shah, Rushil
Sharma, Apurva
Assis, Fabrizio
De Vasconcellos, Henrique Doria
Alugubelli, Navya
Pandey, Pallavi
Akhtar, Tauseef
Gasperetti, Alessio
Zhou, Shijie
Halperin, Henry
Zimmerman, Stefan L.
Tandri, Harikrishna
Kolandaivelu, Aravindan
Quality assessment of cardiac magnetic resonance myocardial scar imaging prior to ventricular arrhythmia ablation
title Quality assessment of cardiac magnetic resonance myocardial scar imaging prior to ventricular arrhythmia ablation
title_full Quality assessment of cardiac magnetic resonance myocardial scar imaging prior to ventricular arrhythmia ablation
title_fullStr Quality assessment of cardiac magnetic resonance myocardial scar imaging prior to ventricular arrhythmia ablation
title_full_unstemmed Quality assessment of cardiac magnetic resonance myocardial scar imaging prior to ventricular arrhythmia ablation
title_short Quality assessment of cardiac magnetic resonance myocardial scar imaging prior to ventricular arrhythmia ablation
title_sort quality assessment of cardiac magnetic resonance myocardial scar imaging prior to ventricular arrhythmia ablation
topic OriginalPaper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870828/
https://www.ncbi.nlm.nih.gov/pubmed/36331683
http://dx.doi.org/10.1007/s10554-022-02734-5
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