DrPeterGatehouse

Vassiliou V, Wassilew K, Cameron D, Heng EL, Nyktari E, Asimakopoulos G, de Souza A, Giri S, Pearce I, Jabbour A, Firmin D, Frenneaux M, Gatehouse P, pennell D, Prasad Set al., 2017, Identification of myocardial diffuse fibrosis by 11 heartbeat MOLLI T1 mapping: Averaging to improve precision and correlation with collagen volume fraction, Magnetic Resonance Materials in Physics Biology and Medicine, Vol: 31, Pages: 101-113, ISSN: 0968-5243

ObjectivesOur objectives involved identifying whether repeated averaging in basal and mid left ventricular myocardial levels improves precision and correlation with collagen volume fraction for 11 heartbeat MOLLI T1 mapping versus assessment at a single ventricular level.Materials and methodsFor assessment of T1 mapping precision, a cohort of 15 healthy volunteers underwent two CMR scans on separate days using an 11 heartbeat MOLLI with a 5(3)3 beat scheme to measure native T1 and a 4(1)3(1)2 beat post-contrast scheme to measure post-contrast T1, allowing calculation of partition coefficient and ECV. To assess correlation of T1 mapping with collagen volume fraction, a separate cohort of ten aortic stenosis patients scheduled to undergo surgery underwent one CMR scan with this 11 heartbeat MOLLI scheme, followed by intraoperative tru-cut myocardial biopsy. Six models of myocardial diffuse fibrosis assessment were established with incremental inclusion of imaging by averaging of the basal and mid-myocardial left ventricular levels, and each model was assessed for precision and correlation with collagen volume fraction.ResultsA model using 11 heart beat MOLLI imaging of two basal and two mid ventricular level averaged T1 maps provided improved precision (Intraclass correlation 0.93 vs 0.84) and correlation with histology (R2 = 0.83 vs 0.36) for diffuse fibrosis compared to a single mid-ventricular level alone. ECV was more precise and correlated better than native T1 mapping.ConclusionT1 mapping sequences with repeated averaging could be considered for applications of 11 heartbeat MOLLI, especially when small changes in native T1/ECV might affect clinical management.

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Ghonim S, Voges I, Gatehouse PD, Keegan J, Gatzoulis MA, Kilner PJ, Babu-Narayan SVet al., 2017, Myocardial Architecture, Mechanics, and Fibrosis in Congenital Heart Disease, Frontiers in Cardiovascular Medicine, Vol: 4, ISSN: 2297-055X

Congenital heart disease (CHD) is the most common category of birth defect, affecting1% of the population and requiring cardiovascular surgery in the first months of lifein many patients. Due to advances in congenital cardiovascular surgery and patientmanagement, most children with CHD now survive into adulthood. However, residualand postoperative defects are common resulting in abnormal hemodynamics, whichmay interact further with scar formation related to surgical procedures. Cardiovascularmagnetic resonance (CMR) has become an important diagnostic imaging modality inthe long-term management of CHD patients. It is the gold standard technique to assessventricular volumes and systolic function. Besides this, advanced CMR techniques allowthe acquisition of more detailed information about myocardial architecture, ventricularmechanics, and fibrosis. The left ventricle (LV) and right ventricle have unique myocardialarchitecture that underpins their mechanics; however, this becomes disorganized underconditions of volume and pressure overload. CMR diffusion tensor imaging is able tointerrogate non-invasively the principal alignments of microstructures in the left ventricularwall. Myocardial tissue tagging (displacement encoding using stimulated echoes) andfeature tracking are CMR techniques that can be used to examine the deformation andstrain of the myocardium in CHD, whereas 3D feature tracking can assess the twistingmotion of the LV chamber. Late gadolinium enhancement imaging and more recently T1mapping can help in detecting fibrotic myocardial changes and evolve our understandingof the pathophysiology of CHD patients. This review not only gives an overview aboutavailable or emerging CMR techniques for assessing myocardial mechanics and fibrosisbut it also describes their clinical value and how they can be used to detect abnormalitiesin myocardial architecture and mechanics in CHD patients.

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Khan TZ, Hsu LY, Arai AE, Rhodes S, Pottle A, Wage R, Banya W, Gatehouse PD, Giri S, Collins P, Pennell DJ, Barbir Met al., 2017, Apheresis as novel treatment for refractory angina with raised lipoprotein(a): a randomised controlled trial, European Heart Journal, Vol: 38, Pages: 1561-1569, ISSN: 1522-9645

AimsTo determine the clinical impact of lipoprotein apheresis in patients with refractory angina and raised lipoprotein(a) > 500 mg/L on the primary end point of quantitative myocardial perfusion, as well as secondary end points including atheroma burden, exercise capacity, symptoms, and quality of life.MethodsWe conducted a single-blinded randomized controlled trial in 20 patients with refractory angina and raised lipoprotein(a) > 500 mg/L, with 3 months of blinded weekly lipoprotein apheresis or sham, followed by crossover. The primary endpoint was change in quantitative myocardial perfusion reserve (MPR) assessed by cardiovascular magnetic resonance. Secondary endpoints included measures of atheroma burden, exercise capacity, symptoms and quality of life.ResultsThe primary endpoint, namely MPR, increased following apheresis (0.47; 95% CI 0.31–0.63) compared with sham (−0.16; 95% CI − 0.33–0.02) yielding a net treatment increase of 0.63 (95% CI 0.37–0.89; P < 0.001 between groups). Improvements with apheresis compared with sham also occurred in atherosclerotic burden as assessed by total carotid wall volume (P < 0.001), exercise capacity by the 6 min walk test (P = 0.001), 4 of 5 domains of the Seattle angina questionnaire (all P < 0.02) and quality of life physical component summary by the short form 36 survey (P = 0.001).ConclusionLipoprotein apheresis may represent an effective novel treatment for patients with refractory angina and raised lipoprotein(a) improving myocardial perfusion, atheroma burden, exercise capacity and symptoms.

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Lota AS, Gatehouse PD, Mohiaddin RH, 2017, T2 mapping and T2*imaging in heart failure, Heart Failure Reviews, Vol: 22, Pages: 431-440, ISSN: 1382-4147

Cardiovascular magnetic resonance (CMR) is aversatile imaging modality that enables aetiological assessmentand provides additional information to that of standardechocardiography in a significant proportion of patients withheart failure. In addition to highly accurate and reproducibleassessment of ventricular volumes and replacement fibrosis,multiparametric mapping techniques have rapidly evolved tofurther expand the diagnostic and prognostic applications invarious conditions ranging from acute inflammatory and ischaemiccardiomyopathy, to cardiac involvement in systemicdiseases such as sarcoidosis and iron overload cardiomyopathy.In this review, we discuss the established role of T2*imaging and rapidly evolving clinical applications of myocardialT2 mapping as quantitative adjuncts to established qualitativeimaging techniques.

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Lota AS, Wassall R, Scott AD, Gatehouse PD, Wage R, Smith G, Tayal U, Halliday BP, Ware JS, Firmin D, Cook SA, Cleland JG, Pennell DJ, Prasad SKet al., 2017, T2 MAPPING IN ACUTE AND RECOVERED MYOCARDITIS: POTENTIAL ROLE IN CLINICAL SURVEILLANCE, 12th Annual Meeting of the British-Society-of-Cardiovascular-Magnetic-Resonance (BSCMR), Publisher: BMJ PUBLISHING GROUP, Pages: A22-A24, ISSN: 1355-6037

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Nielles-Vallespin S, Khalique Z, Ferreira PF, de Silva R, Scott AD, Kilner P, McGill L-A, Giannakidis A, Gatehouse PD, Ennis D, Aliotta E, Al-Khalil M, Kellman P, Mazilu D, Balaban RS, Firmin DN, Arai AE, Pennell DJet al., 2017, Assessment of myocardial microstructural dynamics by in vivo diffusion tensor cardiac magnetic resonance, Journal of the American College of Cardiology, Vol: 69, Pages: 661-676, ISSN: 0735-1097

BackgroundCardiomyocytes are organized in microstructures termed sheetlets that reorientate during left ventricular thickening. Diffusion tensor cardiac magnetic resonance (DT-CMR) may enable noninvasive interrogation of in vivo cardiac microstructural dynamics. Dilated cardiomyopathy (DCM) is a condition of abnormal myocardium with unknown sheetlet function.ObjectivesThis study sought to validate in vivo DT-CMR measures of cardiac microstructure against histology, characterize microstructural dynamics during left ventricular wall thickening, and apply the technique in hypertrophic cardiomyopathy (HCM) and DCM.MethodsIn vivo DT-CMR was acquired throughout the cardiac cycle in healthy swine, followed by in situ and ex vivo DT-CMR, then validated against histology. In vivo DT-CMR was performed in 19 control subjects, 19 DCM, and 13 HCM patients.ResultsIn swine, a DT-CMR index of sheetlet reorientation (E2A) changed substantially (E2A mobility ∼46°). E2A changes correlated with wall thickness changes (in vivo r2 = 0.75; in situ r2 = 0.89), were consistently observed under all experimental conditions, and accorded closely with histological analyses in both relaxed and contracted states. The potential contribution of cyclical strain effects to in vivo E2A was ∼17%. In healthy human control subjects, E2A increased from diastole (18°) to systole (65°; p < 0.001; E2A mobility = 45°). HCM patients showed significantly greater E2A in diastole than control subjects did (48°; p < 0.001) with impaired E2A mobility (23°; p < 0.001). In DCM, E2A was similar to control subjects in diastole, but systolic values were markedly lower (40°; p < 0.001) with impaired E2A mobility (20°; p < 0.001).ConclusionsMyocardial microstructure dynamics can be characterized by in vivo DT-CMR. Sheetlet function was abnormal in DCM with altered systolic conformation and reduced mobility, contrasting with HCM, which showed reduced mobility with alte

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Patel HC, Hayward C, Keegan J, Gatehouse PD, Rajani R, Khattar RS, Mohiaddin RH, Rosen SD, Lyon AR, Di Mario Cet al., 2017, Effects of renal denervation on vascular remodelling in patients with heart failure and preserved ejection fraction: A randomised control trial, JRSM Cardiovascular Disease, Vol: 6, ISSN: 2048-0040

Objective:To assess the effect of renal denervation (RDT) on micro- and macro-vascular function in patients with heartfailure with preserved ejection fraction (HFpEF).Design:A prospective, randomised, open-controlled trial with blinded end-point analysis.Setting:A single-centre London teaching hospital.Participants:Twenty-five patients with HFpEF who were recruited into the RDT-PEF trial.Main outcome measures:Macro-vascular: 24-h ambulatory pulse pressure, aorta distensibilty (from cardiac magneticresonance imaging (CMR), aorta pulse wave velocity (CMR), augmentation index (peripheral tonometry) and renal arteryblood flow indices (renal MR). Micro-vascular: endothelial function (peripheral tonometry) and urine microalbuminuria.Results:At baseline, 15 patients were normotensive, 9 were hypertensive and 1 was hypotensive. RDT did not lowerany of the blood pressure indices. Though there was evidence of abnormal vascular function at rest, RDT did not affectthese at 3 or 12 months follow-up.Conclusions:RDT did not improve markers of macro- and micro-vascular function.

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Vassiliou VS, Heng EL, Gatehouse PD, Donovan J, Raphael CE, Giri S, Babu-Narayan SV, Gatzoulis MA, Pennell DJ, Prasad SK, Firmin DNet al., 2016, Magnetic resonance imaging phantoms for quality-control of myocardial T1 and ECV mapping: specific formulation, long-term stability and variation with heart rate and temperature, Journal of Cardiovascular Magnetic Resonance, Vol: 18, ISSN: 1532-429X

BACKGROUND: Magnetic resonance imaging (MRI) phantoms are routinely used for quality assurance in MRI centres; however their long term stability for verification of myocardial T1/ extracellular volume fraction (ECV) mapping has never been investigated. METHODS: Nickel-chloride agarose gel phantoms were formulated in a reproducible laboratory procedure to mimic blood and myocardial T1 and T2 values, native and late after Gadolinium administration as used in T1/ECV mapping. The phantoms were imaged weekly with an 11 heart beat MOLLI sequence for T1 and long TR spin-echo sequences for T2, in a carefully controlled reproducible manner for 12 months. RESULTS: There were only small relative changes seen in all the native and post gadolinium T1 values (up to 9.0 % maximal relative change in T1 values) or phantom ECV (up to 8.3 % maximal relative change of ECV, up to 2.2 % maximal absolute change in ECV) during this period. All native and post gadolinium T2 values remained stable over time with <2 % change. Temperature sensitivity testing showed MOLLI T1 values in the long T1 phantoms increasing by 23.9 ms per degree increase and short T1 phantoms increasing by 0.3 ms per degree increase. There was a small absolute increase in ECV of 0.069 % (~0.22 % relative increase in ECV) per degree increase. Variation in heart rate testing showed a 0.13 % absolute increase in ECV (~0.45 % relative increase in ECV) per 10 heart rate increase. CONCLUSIONS: These are the first phantoms reported in the literature modeling T1 and T2 values for blood and myocardium specifically for the T1mapping/ECV mapping application, with stability tested rigorously over a 12 month period. This work has significant implications for the utility of such phantoms in improving the accuracy of serial scans for myocardial tissue characterisation by T1 mapping methods and in multicentre work.

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Captur G, Gatehouse P, Keenan KE, Heslinga FG, Bruehl R, Prothmann M, Graves MJ, Eames RJ, Torlasco C, Benedetti G, Donovan J, Ittermann B, Boubertakh R, Bathgate A, Royet C, Pang W, Nezafat R, Salerno M, Kellman P, Moon JCet al., 2016, A medical device-grade T1 and ECV phantom for global T1 mapping quality assurance-the T₁ Mapping and ECV Standardization in cardiovascular magnetic resonance (T1MES) program, JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE, Vol: 18, ISSN: 1097-6647

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• Citations: 125

Firmin D, 2016, Abstracts, 14th Annual Meeting of the European Association of Cardiovascular Imaging, a registered branch of the ESC, Pages: i1-i80, ISSN: 2047-2404

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Bucciarelli-Ducci C, Auger D, Di Mario C, Locca D, Petryka J, O'Hanlon R, Grasso A, Wright C, Symmonds K, Wage R, Asimacopoulos E, Del Furia F, Lyne JC, Gatehouse PD, Fox KM, Pennell DJet al., 2016, CMR guidance for recanalization of coronary chronic total occlusion, JACC: Cardiovascular Imaging, Vol: 9, Pages: 547-556, ISSN: 1876-7591

ObjectivesThis study explored whether cardiac magnetic resonance (CMR) could help select patients who could benefit from revascularization by identifying inducible myocardial ischemia and viability in the perfusion territory of the artery with chronic total occlusion (CTO).BackgroundThe benefit of revascularization using percutaneous coronary intervention (PCI) in CTO is controversial. CMR offers incomparable left ventricular (LV) systolic function assessment in addition to potent ischemic burden quantification and reliable myocardial viability analysis. Whether CMR guided CTO revascularization would be helpful to such patients has not yet been explored fully.MethodsA prospective study of 50 consecutive CTO patients was conducted. Of 50 patients undergoing baseline stress CMR, 32 (64%) were selected for recanalization based on the presence of significant inducible perfusion deficit and myocardial viability within the CTO arterial territory. Patients were rescanned 3 months after successful CTO recanalization.ResultsAt baseline, myocardial perfusion reserve (MPR) in the CTO territory was significantly reduced compared with the remote region (1.8 ± 0.72 vs. 2.2 ± 0.7; p = 0.01). MPR in the CTO region improved significantly after PCI (to 2.3 ± 0.9; p = 0.02 vs. baseline) with complete or near-complete resolution of CTO related perfusion defect in 90% of patients. Remote territory MPR was unchanged after PCI (2.5 ± 1.2; p = NS vs. baseline). The LV ejection fraction increased from 63 ± 13% to 67 ± 12% (p < 0.0001) and end-systolic volume decreased from 65 ± 38 to 56 ± 38 ml (p < 0.001) 3 months after CTO PCI. Importantly, despite minimal post-procedural infarction due to distal embolization and side branch occlusion in 8 of 32 patients (25%), the total Seattle Angina Questionnaire score improved from a median of 54 (range 45 to 74) at baseline to 89 (range 77 to 98) after CTO recanalization (p < 0.0001).Co

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Vassiliou V, Wassilew K, Malley T, Raphael CE, Schofield RS, Kirby K, Bowman AD, Symmonds K, Spottiswoode BS, Greiser A, Pierce I, Firmin D, Gatehouse P, Pennell DJ, Prasad Set al., 2016, Incremental benefit in correlation with histology of native T1 mapping, partition coefficient and extracellular volume fraction in patients with aortic stenosis, Journal of Cardiovascular Magnetic Resonance, Vol: 18, ISSN: 1097-6647

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Fair M, Gatehouse P, DiBella EVR, Chen L, Firmin DNet al., 2016, An extended 3D whole-heart myocardial first-pass perfusion sequence: alternate-cycle views with isotropic and high-resolution imaging, Society for Cardiovascular Magnetic Resonance, Publisher: BioMed Central, ISSN: 1532-429X

Simultaneously optimising parameters such as LV cover-age, image resolution and contrast sensitivity is difficultin first-pass perfusion (FPP). 3D FPP shows potential (1)to improve coverage, but“whole-heart”coveragedemands high acceleration forcing compromises such asloss of spatial resolution. 2D FPP shows high diagnosticability with more slices distributed over alternate-RRcycles (2), relaxing acceleration requirements. This workproposes that 3D FPP could interleave two strategieswith different 3D parameters in alternate cycles, in sumapproaching the full set of desired FPP properties. Thiswork also aims to improve specificity against artefactsby imaging the same myocardium with two differentinterleaved 3D scans (distinct from reformatting a single3D FPP scan). Similar confirmation strategies are oftenused in CMR, such as repetition with swapped phase-encode direction in late-enhancement imaging.

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Vassiliou V, Wassilew K, Asimakopoulos G, de Souza A, Quarto C, Heng EL, Raphael CE, Spottiswoode BS, Greiser A, Nyktari E, Alpendurada F, Firmin D, Jabbour A, Pepper J, Pennell DJ, Gatehouse P, Prasad Set al., 2016, Histological validation of a new CMR T1-mapping-based protocol to improve accuracy for fibrosis assessment in patients with aortic stenosis, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-3, ISSN: 1097-6647

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Vassiliou V, Anita S, Malley T, Raphael CE, Tayal U, Ali A, Sehmi J, Bilal H, Mathew GL, Smith GC, Symmonds K, Greiser A, Spottiswoode BS, Alpendurada F, Auger D, Pennell DJ, Gatehouse P, Prasad Set al., 2016, Systolic T1 mapping for estimation of myocardial diffuse fibrosis, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-2, ISSN: 1097-6647

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Captur G, Gatehouse P, Kellman P, Heslinga FG, Keenan K, Bruehl R, Prothmann M, Graves MJ, Chiribiri A, Ittermann B, Pang W, Nezafat R, Salerno M, Moon JCet al., 2016, A T1 and ECV phantom for global T1 mapping quality assurance: The T<inf>1</inf> mapping and ECV standardisation in CMR (T1MES) program, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-3, ISSN: 1097-6647

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• Citations: 27

Hofman MB, Rodenburg MJ, Bloch KM, Werner B, Westenberg JJ, Valsangiacomo-Buechel E, Nijveldt R, Spruijt OA, Kilner PJ, van Rossum AC, Gatehouse Pet al., 2016, In-vivo validation of interpolation-based phase offset correction in MR flow quantification: A multi-vendor, multi-center study, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-3, ISSN: 1097-6647

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• Citations: 3

Mathew GL, Vassiliou V, Heng EL, Smith GC, Anita S, Unnikrishnan N, Alpendurada F, Pennell DJ, Gatehouse P, Symmonds K, Prasad Set al., 2016, Streamlining trigger delay estimation for T1 mapping, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-2, ISSN: 1097-6647

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Heng EL, Kellman P, Gatzoulis MA, Moon J, Gatehouse P, Babu-Narayan SVet al., 2016, Quantifying right ventricular diffuse fibrosis in tetralogy of fallot-a novel customised approach for the challenges of the right ventricle, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-3, ISSN: 1097-6647

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• Citations: 2

Wage R, Gatehouse P, Jasmin NH, Pennell DJet al., 2016, Myocardial T1 and ECV mapping: How we optimise technical aspects of acquisition, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-2, ISSN: 1097-6647

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Hsu LY, Kellman P, Gatehouse P, Conn HM, Benovoy M, Jacobs M, Arai AEet al., 2016, Correlations and validations of dual-bolus and dual-sequence quantification of first-pass myocardial perfusion CMR in humans and canines, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-2, ISSN: 1097-6647

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• Citations: 1

Wage R, Gatehouse P, Jasmin NH, Pennell DJet al., 2016, Myocardial T1 and ECV mapping: how we optimise technical aspects of acquisition, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, Vol: 18, ISSN: 1097-6647

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Fair MJ, Gatehouse P, DiBella EV, Chen L, Wage R, Firmin Det al., 2016, An extended 3D whole-heart myocardial first-pass perfusion sequence: alternate-cycle views with isotropic and high-resolution imaging, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, Vol: 18, ISSN: 1097-6647

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McGill LA, Ferreira PF, Scott AD, Nielles-Vallespin S, Giannakidis A, Kilner PJ, Gatehouse PD, De Silva R, Firmin DN, Pennell DJet al., 2016, Relationship between cardiac diffusion tensor imaging parameters and anthropometrics in healthy volunteers, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 2-2

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Nayak KS, Nielsen J-F, Bernstein MA, Markl M, Gatehouse PD, Botnar RM, Saloner D, Lorenz C, Wen H, Hu BS, Epstein FH, Oshinski JN, Raman SVet al., 2015, Cardiovascular magnetic resonance phase contrast imaging, Journal of Cardiovascular Magnetic Resonance, Vol: 17, ISSN: 1532-429X

Cardiovascular magnetic resonance (CMR) phase contrast imaging has undergone a wide range of changes with the development and availability of improved calibration procedures, visualization tools, and analysis methods. This article provides a comprehensive review of the current state-of-the-art in CMR phase contrast imaging methodology, clinical applications including summaries of past clinical performance, and emerging research and clinical applications that utilize today’s latest technology.

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Fair MJ, Gatehouse PD, DiBella EVR, Firmin DNet al., 2015, A review of 3D first-pass, whole-heart, myocardial perfusion cardiovascular magnetic resonance, Journal of Cardiovascular Magnetic Resonance, Vol: 17, ISSN: 1532-429X

A comprehensive review is undertaken of the methods available for 3D whole-heart first-pass perfusion (FPP) andtheir application to date, with particular focus on possible acceleration techniques. Following a summary of theparameters typically desired of 3D FPP methods, the review explains the mechanisms of key accelerationtechniques and their potential use in FPP for attaining 3D acquisitions. The mechanisms include rapid sequences,non-Cartesian k-space trajectories, reduced k-space acquisitions, parallel imaging reconstructions and compressedsensing. An attempt is made to explain, rather than simply state, the varying methods with the hope that it willgive an appreciation of the different components making up a 3D FPP protocol. Basic estimates demonstrating therequired total acceleration factors in typical 3D FPP cases are included, providing context for the extent that eachacceleration method can contribute to the required imaging speed, as well as potential limitations in present 3DFPP literature. Although many 3D FPP methods are too early in development for the type of clinical trials requiredto show any clear benefit over current 2D FPP methods, the review includes the small but growing quantity ofclinical research work already using 3D FPP, alongside the more technical work. Broader challenges concerning FPPsuch as quantitative analysis are not covered, but challenges with particular impact on 3D FPP methods, particularlywith regards to motion effects, are discussed along with anticipated future work in the field.

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Fair MJ, Gatehouse PD, Drivas P, Firmin DNet al., 2015, Improved dynamic parallel imaging coil calibration method robust to respiratory motion with application to first-pass contrast-enhanced myocardial perfusion imaging, Magnetic Resonance in Medicine, Vol: 75, Pages: 2315-2323, ISSN: 0740-3194

PURPOSE: To develop an accurate method of performing free-breathing coil calibration for application to parallel imaging reconstructions of dynamic single-shot datasets. METHODS: Coil calibration data are produced through acquisition of multiple prescans before the accelerated scan, applied during free-breathing. These multiple free-breathing prescans (MFPs) provide the necessary coil information for accurate parallel imaging reconstruction of each accelerated frame of a dynamic series, under guidance of an appropriate respiratory position based matching algorithm. This is investigated in myocardial first-pass perfusion with retrospectively undersampled datasets for analysis with standard calibration techniques to guide prospectively undersampled experiments for specific demonstration of performance against a range of "temporal" calibration techniques. RESULTS: Reconstruction of the retrospectively subsampled datasets with MFP-calibrated parallel imaging showed significant improvements in relative root-mean-square error comparative to all other techniques (all P < 0.05; n = 6) for acceleration factors R > 3. Accelerated acquisitions, reconstructed by means of various temporal calibration techniques and analyzed by visual observer artifact scoring, also demonstrated a large improvement with use of MFPs. Artifact levels were reduced from an average of 2.5 ± 0.6 for the best performing implementation of TGRAPPA to 0.8 ± 0.4 for MFP-GRAPPA (P < 0.001; n = 20) (0 = none to 4 = strong, nondiagnostic). CONCLUSION: MFP as parallel imaging coil calibration data can give improved performance in free-breathing dynamic MR while maintaining maximal acceleration. Magn Reson Med 75:2315-2323, 2016. © 2015 Wiley Periodicals, Inc.

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Pierce IT, Keegan J, Drivas P, Gatehouse PD, Firmin DNet al., 2015, Free-Breathing 3D Late Gadolinium Enhancement Imaging of the Left Ventricle Using a Stack of Spirals at 3T, Journal of Magnetic Resonance Imaging, Vol: 41, Pages: 1030-1037, ISSN: 1522-2586

Purpose: To develop navigator-gated free-breathing 3Dspiral late gadolinium enhancement (LGE) imaging of theleft ventricle at 3T and compare it with conventionalbreath-hold 2D Cartesian imaging.Materials and Methods: Equivalent slices from 3D spiraland multislice 2D Cartesian acquisitions were comparedin 15 subjects in terms of image quality (1,nondiagnostic to 5, excellent), sharpness (1–3), and presenceof artifacts (0–2). Blood signal-to-noise ratio (SNR),blood/myocardium contrast-to-noise ratio (CNR), andquantitative sharpness were also compared.Results: All 3D spiral scans were completed faster thanan equivalent 2D Cartesian short-axis stack (85 vs. 230 sec,P < 0.001). Image quality was significantly higher for 2DCartesian images than 3D spiral images (3.7 6 0.87 vs.3.4 6 1.05, P ¼ 0.03) but not for mid or apical slices specifi-cally. There were no significant differences in qualitativeand quantitative sharpness (95% confidence interval [CI]:1.91 6 0.67 vs. 1.93 6 0.69, P ¼ 0.83 and 95% CI:0.41 6 0.07 vs. 0.40 6 0.09, P ¼ 0.25, respectively), artifactscores (95% CI: 0.16 6 0.37 vs. 0.40 6 0.58, P ¼ 0.16), SNR(95% CI: 121.5 6 55.3 vs. 136.4 6 77.9, P ¼ 0.13), and CNR(95% CI: 101.6 6 48.4 vs. 102.7 6 61.8, P ¼ 0.98). Similarenhancement ratios (0.65 vs. 0.62) and volumes (13.8 vs.14.1cm3) were measured from scar regions of three patients.Conclusio: Navigator-gated 3D spiral LGE imaging canbe performed in significantly and substantially shorteracquisition durations, although with some reduced imagequality, than multiple breath-hold 2D Cartesian imagingwhile providing higher resolution and contiguous coverage.

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Vassiliou V, Heng EL, Nyktari E, Greiser A, Firmin D, Pennell DJ, Gatehouse P, Prasad SKet al., 2015, Effect of temperature and heart rate variability on Phantom T1 maps, Journal of Cardiovascular Magnetic Resonance, Pages: 1-2, ISSN: 1097-6647

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McGill LA, Scott AD, Ferreira P, Nielles-Vallespin S, Ismail TF, Kilner PJ, Gatehouse P, Prasad SK, Giannakidis A, Firmin D, Pennell DJet al., 2015, Heterogeneity of diffusion tensor imaging measurements of fractional anisotropy and mean diffusivity in normal human hearts in vivo, Journal of Cardiovascular Magnetic Resonance, Vol: 17, ISSN: 1097-6647

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