Cardiac function evaluation in healthy volunteers and patients with implantable cardioverter-defibrillators using high-bandwidth spoiled gradient-echo cine

Background: Implantable cardioverter-defibrillators (ICDs) cause banding artifacts around areas of B0 inhomogeneity in conventional steady-state free precession (SSFP) cine sequences. Alternatively, high-bandwidth gradient-recalled echo (GRE) cine sequences can be used to minimize artifacts in the m...

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Main Authors: Calder D. Sheagren, Naseem Shadafny, Terenz Escartin, Maria Terricabras, Christopher C. Cheung, Idan Roifman, Graham A. Wright
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Journal of Cardiovascular Magnetic Resonance
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Online Access:http://www.sciencedirect.com/science/article/pii/S1097664725000559
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author Calder D. Sheagren
Naseem Shadafny
Terenz Escartin
Maria Terricabras
Christopher C. Cheung
Idan Roifman
Graham A. Wright
author_facet Calder D. Sheagren
Naseem Shadafny
Terenz Escartin
Maria Terricabras
Christopher C. Cheung
Idan Roifman
Graham A. Wright
author_sort Calder D. Sheagren
collection DOAJ
description Background: Implantable cardioverter-defibrillators (ICDs) cause banding artifacts around areas of B0 inhomogeneity in conventional steady-state free precession (SSFP) cine sequences. Alternatively, high-bandwidth gradient-recalled echo (GRE) cine sequences can be used to minimize artifacts in the myocardium. In this study, we assessed the bias and interobserver variability in cardiac volumes and ejection fractions between GRE cines in acquired in the presence of ICDS and ground-truth SSFP cines (without ICDs present) in a population of healthy volunteers. Further, a small cohort of ICD patients was recruited and scanned to demonstrate clinical feasibility. Methods: High-bandwidth GRE cine was performed in 11 healthy volunteers with taped ICDs mimicking clinical implants. After the ICD was removed, ground-truth SSFP cine was performed. Two observers separately assessed image quality metrics and contoured the cine images to return cardiac volumes and ejection fractions. Nine patients with an ICD were also scanned with the GRE cine protocol before contrast administration; data were contoured by two observers and analyzed for interobserver agreement. Results: In the healthy volunteer dataset, no statistically significant differences were found when comparing volumes or ejection fractions between sequences (p > 0.05). Statistically significant differences were found when comparing right ventricular ejection fraction (RVEF) (p = 0.009) and right ventricular end-systolic volume (p = 0.029) between observers, with no other significant interobserver differences. The interobserver variability of patient left ventricular ejection fraction and RVEF data was 3–4%, with lower image quality metrics for patient scans than volunteer scans. Conclusion: GRE cine imaging in healthy volunteers with taped ICDs demonstrated good agreement with SSFP cine, but increased interobserver variability. In patients, reducing the breath-hold duration caused a decrease in image quality, with GRE cine imaging in patients with ICDs demonstrating poorer image quality and greater interobserver variability than in healthy volunteer studies. Future work is needed to improve GRE cine image quality in patients with ICDs to reduce interobserver variability and improve clinical confidence.
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spelling doaj-art-4f95579723a04ad7b9e76eee5b9ff9f52025-08-20T02:34:16ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127110189310.1016/j.jocmr.2025.101893Cardiac function evaluation in healthy volunteers and patients with implantable cardioverter-defibrillators using high-bandwidth spoiled gradient-echo cineCalder D. Sheagren0Naseem Shadafny1Terenz Escartin2Maria Terricabras3Christopher C. Cheung4Idan Roifman5Graham A. Wright6Department of Medical Biophysics, University of Toronto, 101 College St, Toronto, M5G 1L7 Ontario, Canada; Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, M4N 3M5 Ontario, Canada; Corresponding author.Schulich Heart Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, M4N 3M5 Ontario, CanadaDepartment of Medical Biophysics, University of Toronto, 101 College St, Toronto, M5G 1L7 Ontario, Canada; Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, M4N 3M5 Ontario, CanadaSchulich Heart Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, M4N 3M5 Ontario, CanadaSchulich Heart Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, M4N 3M5 Ontario, CanadaSchulich Heart Research Program, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, M4N 3M5 Ontario, CanadaDepartment of Medical Biophysics, University of Toronto, 101 College St, Toronto, M5G 1L7 Ontario, Canada; Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, M4N 3M5 Ontario, CanadaBackground: Implantable cardioverter-defibrillators (ICDs) cause banding artifacts around areas of B0 inhomogeneity in conventional steady-state free precession (SSFP) cine sequences. Alternatively, high-bandwidth gradient-recalled echo (GRE) cine sequences can be used to minimize artifacts in the myocardium. In this study, we assessed the bias and interobserver variability in cardiac volumes and ejection fractions between GRE cines in acquired in the presence of ICDS and ground-truth SSFP cines (without ICDs present) in a population of healthy volunteers. Further, a small cohort of ICD patients was recruited and scanned to demonstrate clinical feasibility. Methods: High-bandwidth GRE cine was performed in 11 healthy volunteers with taped ICDs mimicking clinical implants. After the ICD was removed, ground-truth SSFP cine was performed. Two observers separately assessed image quality metrics and contoured the cine images to return cardiac volumes and ejection fractions. Nine patients with an ICD were also scanned with the GRE cine protocol before contrast administration; data were contoured by two observers and analyzed for interobserver agreement. Results: In the healthy volunteer dataset, no statistically significant differences were found when comparing volumes or ejection fractions between sequences (p > 0.05). Statistically significant differences were found when comparing right ventricular ejection fraction (RVEF) (p = 0.009) and right ventricular end-systolic volume (p = 0.029) between observers, with no other significant interobserver differences. The interobserver variability of patient left ventricular ejection fraction and RVEF data was 3–4%, with lower image quality metrics for patient scans than volunteer scans. Conclusion: GRE cine imaging in healthy volunteers with taped ICDs demonstrated good agreement with SSFP cine, but increased interobserver variability. In patients, reducing the breath-hold duration caused a decrease in image quality, with GRE cine imaging in patients with ICDs demonstrating poorer image quality and greater interobserver variability than in healthy volunteer studies. Future work is needed to improve GRE cine image quality in patients with ICDs to reduce interobserver variability and improve clinical confidence.http://www.sciencedirect.com/science/article/pii/S1097664725000559Cine imagingImplantable cardioverter-defibrillatorHigh-bandwidth gradient-echo
spellingShingle Calder D. Sheagren
Naseem Shadafny
Terenz Escartin
Maria Terricabras
Christopher C. Cheung
Idan Roifman
Graham A. Wright
Cardiac function evaluation in healthy volunteers and patients with implantable cardioverter-defibrillators using high-bandwidth spoiled gradient-echo cine
Journal of Cardiovascular Magnetic Resonance
Cine imaging
Implantable cardioverter-defibrillator
High-bandwidth gradient-echo
title Cardiac function evaluation in healthy volunteers and patients with implantable cardioverter-defibrillators using high-bandwidth spoiled gradient-echo cine
title_full Cardiac function evaluation in healthy volunteers and patients with implantable cardioverter-defibrillators using high-bandwidth spoiled gradient-echo cine
title_fullStr Cardiac function evaluation in healthy volunteers and patients with implantable cardioverter-defibrillators using high-bandwidth spoiled gradient-echo cine
title_full_unstemmed Cardiac function evaluation in healthy volunteers and patients with implantable cardioverter-defibrillators using high-bandwidth spoiled gradient-echo cine
title_short Cardiac function evaluation in healthy volunteers and patients with implantable cardioverter-defibrillators using high-bandwidth spoiled gradient-echo cine
title_sort cardiac function evaluation in healthy volunteers and patients with implantable cardioverter defibrillators using high bandwidth spoiled gradient echo cine
topic Cine imaging
Implantable cardioverter-defibrillator
High-bandwidth gradient-echo
url http://www.sciencedirect.com/science/article/pii/S1097664725000559
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