Focus Session
SCMR 22nd Annual Scientific Sessions
Marco Guglielmo, MD
Cardiologist
Centro Cardiologico Monzino
Giuseppe Muscogiuri, MD
Consultant
Centro Cardiologico Monzino
Marco Gatti, MD
Medical Doctor
Department of surgical sciences, University of Turin
Serena Dell'Aversana, MD
Radiologist
Università degli Studi di Napoli "Federico II"
Silvia Pica, MD
Research Cardiologist
Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo
Daniele Andreini, MD, PhD
Director
Centro Cardiologico Monzino
Andrea Igoren Guaricci, MD
Cardiologist
Università degli Studi di Bari
Andrea Baggiano, MD
Cardiologist
Centro Cardiologico Monzino
Saima Mushtaq, MD
Cardiologist Assistant
Centro Cardiologico Monzino
Edoardo Conte, MD
Cardiologist
Centro Cardiologico Monzino
Andrea Annoni, MD
Radiologist
Centro Cardiologico Monzino
Alberto Formenti, MD
Radiologist
Centro Cardiologico Monzino
Elisabetta Mancini, MD
Radiologist
Centro Cardiologico Monzino
Paola Gripari, MD, PhD
Cardiologist
Centro Cardiologico Monzino, IRCCS
Mark Rabbat, MD
Associate Professor of Medicine and Radiology. Division of Cardiology
Loyola University Medical Center
Mauro Pepi, MD
Director Cardiac Imaging Dpt
Centro Cardiologico Monzino, IRCCS, Milan ITALY
Gianluca Pontone, MD, PhD
Cardiologist, Radiologist
Centro Cardiologico Monzino
Background:
Cardiac magnetic resonance (CMR) has been used in clinical practice to evaluate cardiac volumes and function due to its accuracy and high reproducibility. Single breath-hold three-dimensional (3D) sequences have been investigated in order to accelerate image acquisition and mitigating limitations of multiple sequential 2D acquisitions. In this study was evaluated the accuracy and reproducibility of single breath hold 3D-dimensional cine k-adaptive-t Autocalibrating Reconstruction for Cartesian sampling (3D cine kat-ARC) for quantification of left (LV) and right ventricular (RV) volume and LV mass in clinical practice.
Methods: 74 patients (44 men, mean age 51.7 ± 17.3 years, mean BSA = 1.89 ± 0.2 m2) underwent to cardiac magnetic resonance (Optima MR 450w, GE Healthcare, Waukesha, WI). 2D cine Balanced Steady-State Free Precession (2D cine bSSFP) and 3D cine kat-ARC were acquired in the whole population in short-axis view. Subsequently the whole population was divided in three subgroups (dilated, hypetrophic and others phenotype). Analysis of biventricular volumes and function was performed using an off-line workstation (CVI 42 , Circle Cardiovascular Imaging, Calgary, Canada, v.5.6.4).Two expert double-blinded operators performed the imaging analysis.Data were analyzed using student t-test, Linear regression and Bland-Altman plots, η2 coefficient and intraclass correlation coefficient (ICC).
Results: All the sequences were considered diagnostic and analyzable. Imaging time was significantly shorter for the 3D cine kat-ARC sequence (p < 0.001). Time of analysis was similar (p = 0.4). The interoperator variability was satisfying (p > 0.05). The 3D cine kat-ARC yielded not statistically different values to that measured by the 2D cine bSSFP technique (p > 0.05). Bland-Altman analysis showed strong agreement between the two sequences and the linear regression yielded good agreement for all measurements (r: 0.82). The subgroup analysis revealed a significant statistically difference (p = 0.04) for LVEF in the dilated phenotype with a minimum trend of overestimation for the 3D cine kat ARC (2D cine-SSFP LVEF = 46.44±15.83 % vs. 3D cine kat-ARC = 48.36±16.50 %)
Conclusion:
3D cine kat-ARC is an accurate and reproducible technique for the evaluation of LV and RV EDV, ESV, SV, EF and LV mass within a single breath hold. However, great care must be taken in the dilated phenotype where possible minimal error in the estimation of EF could happen.