Analysis of confounders of the image quality of a high-resolution isotropic three-dimensional Dixon water-fat late gadolinium enhancement technique

ABSTRACT: Background: Three-dimensional (3D) water-fat separated late gadolinium enhancement (LGE) imaging is a cardiovascular magnetic resonance imaging technique allowing simultaneous assessment of and discrimination between cardiac fibrosis and myocardial fatty infiltration. The aim of this stud...

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Main Authors: Johanna Kuhnt, Edyta Blaszczyk, Leo Dyke Krüger, Leonhard Grassow, Claudia Prieto, René Botnar, Karl Philipp Kunze, Michaela Schmidt, Darian Steven Viezzer, Thomas Hadler, Maxmilian Fenski, Jeanette Schulz-Menger
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/S1097664725000341
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author Johanna Kuhnt
Edyta Blaszczyk
Leo Dyke Krüger
Leonhard Grassow
Claudia Prieto
René Botnar
Karl Philipp Kunze
Michaela Schmidt
Darian Steven Viezzer
Thomas Hadler
Maxmilian Fenski
Jeanette Schulz-Menger
author_facet Johanna Kuhnt
Edyta Blaszczyk
Leo Dyke Krüger
Leonhard Grassow
Claudia Prieto
René Botnar
Karl Philipp Kunze
Michaela Schmidt
Darian Steven Viezzer
Thomas Hadler
Maxmilian Fenski
Jeanette Schulz-Menger
author_sort Johanna Kuhnt
collection DOAJ
description ABSTRACT: Background: Three-dimensional (3D) water-fat separated late gadolinium enhancement (LGE) imaging is a cardiovascular magnetic resonance imaging technique allowing simultaneous assessment of and discrimination between cardiac fibrosis and myocardial fatty infiltration. The aim of this study is to systematically analyze the image quality of a 3D water-fat separated LGE research sequence and identify confounders of image quality Methods: In total, 126 patients and 12 healthy volunteers were included. Patients were included with inflammatory bowel disease (n=35), muscular dystrophy (n=38), hypertrophic cardiomyopathy (n=23) and paroxysmal atrial fibrillation (n=30). 3D water-fat separated LGE images were acquired at 1.5T (n=122) or 3T (n=16). Image quality was subjectively rated (4-point Likert scale) in six categories (overall image quality [OV], blood-myocardium border sharpness, LGE-remote/healthy myocardium border sharpness, fat suppression, myocardial nulling [MN], anatomical structures [AS]), additionally, the contrast ratio was calculated. Cardiac function, acquisition conditions, and demographic data were investigated as potential confounders for image quality and contrast ratio. Results: Fat suppression had the highest quality score (2.54±0.72), followed by AS (2.11±0.94) and MN (2.01±0.78). In total, 18 parameters showed a significant correlation with multiple image quality categories, most of which related to cardiac function, such as the cardiac index, which significantly correlated with OV (Wald Chi-squared=4.35; p<0.05), LGE-remote/healthy myocardium border sharpness (Wald Chi-squared=5.03; p<0.05), and AS (Wald Chi-square=16.00; p<0.001). Left ventricular mass index to height showed significant correlation with OV (Wald Chi-squared=7.57; p<0.01), blood-myocardium border sharpness (Wald Chi-squared=7.35; p<0.01), and contrast ratio (Wald Chi-squared=5.50; p<0.05). Furthermore, demographic parameters, such as body mass index (BMI), were identified as significant confounders, showing a notable correlation between BMI and the depiction of AS. (Wald Chi-square=11.14; p<0.01). Conclusion: In this study, 3D water-fat separated LGE imaging shows satifactory image quality, especially for water-fat separation. However, image quality may be affected by several other parameters such as patient obesity, high myocardial mass, and cardiac function. Trial Registration: 3000339
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spelling doaj-art-55c0f45a84d94cdc903a409dd9cdba912025-08-20T02:34:15ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127110187210.1016/j.jocmr.2025.101872Analysis of confounders of the image quality of a high-resolution isotropic three-dimensional Dixon water-fat late gadolinium enhancement techniqueJohanna Kuhnt0Edyta Blaszczyk1Leo Dyke Krüger2Leonhard Grassow3Claudia Prieto4René Botnar5Karl Philipp Kunze6Michaela Schmidt7Darian Steven Viezzer8Thomas Hadler9Maxmilian Fenski10Jeanette Schulz-Menger11Charité – Universitätsmedizin Berlin, corperate member of Freie Universität Berlin und Humbolt - Universität zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany; Working Group Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, Charité Medical Faculty, Max-Delbrück Center for Molecular Medicine, Helios Klinikum Berlin Buch, Department of Cardiology and Nephrology, Charité – Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, GermanyCharité – Universitätsmedizin Berlin, corperate member of Freie Universität Berlin und Humbolt - Universität zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany; Working Group Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, Charité Medical Faculty, Max-Delbrück Center for Molecular Medicine, Helios Klinikum Berlin Buch, Department of Cardiology and Nephrology, Charité – Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, GermanyCharité – Universitätsmedizin Berlin, corperate member of Freie Universität Berlin und Humbolt - Universität zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany; Working Group Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, Charité Medical Faculty, Max-Delbrück Center for Molecular Medicine, Helios Klinikum Berlin Buch, Department of Cardiology and Nephrology, Charité – Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, GermanyCharité – Universitätsmedizin Berlin, corperate member of Freie Universität Berlin und Humbolt - Universität zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany; Working Group Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, Charité Medical Faculty, Max-Delbrück Center for Molecular Medicine, Helios Klinikum Berlin Buch, Department of Cardiology and Nephrology, Charité – Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, GermanySchool of Biomedical Engineering, King´s College London, London, UK; School of Engineering and Institute for Biological and Medical Engineering, Santiago, Chile; Millennium Institute iHEALTH, Santiago, ChileSchool of Biomedical Engineering, King´s College London, London, UK; School of Engineering and Institute for Biological and Medical Engineering, Santiago, Chile; Millennium Institute iHEALTH, Santiago, ChileMR Research Collaborations, Siemens Healthcare Limited, Park View, Watchmoor Park, Surrey, UKSiemens Healthineers AG, Erlangen, GermanyCharité – Universitätsmedizin Berlin, corperate member of Freie Universität Berlin und Humbolt - Universität zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany; Working Group Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, Charité Medical Faculty, Max-Delbrück Center for Molecular Medicine, Helios Klinikum Berlin Buch, Department of Cardiology and Nephrology, Charité – Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, GermanyCharité – Universitätsmedizin Berlin, corperate member of Freie Universität Berlin und Humbolt - Universität zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany; Working Group Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, Charité Medical Faculty, Max-Delbrück Center for Molecular Medicine, Helios Klinikum Berlin Buch, Department of Cardiology and Nephrology, Charité – Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, GermanyCharité – Universitätsmedizin Berlin, corperate member of Freie Universität Berlin und Humbolt - Universität zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany; Working Group Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, Charité Medical Faculty, Max-Delbrück Center for Molecular Medicine, Helios Klinikum Berlin Buch, Department of Cardiology and Nephrology, Charité – Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, GermanyCharité – Universitätsmedizin Berlin, corperate member of Freie Universität Berlin und Humbolt - Universität zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany; Working Group Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, Charité Medical Faculty, Max-Delbrück Center for Molecular Medicine, Helios Klinikum Berlin Buch, Department of Cardiology and Nephrology, Charité – Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany; Corresponding author.ABSTRACT: Background: Three-dimensional (3D) water-fat separated late gadolinium enhancement (LGE) imaging is a cardiovascular magnetic resonance imaging technique allowing simultaneous assessment of and discrimination between cardiac fibrosis and myocardial fatty infiltration. The aim of this study is to systematically analyze the image quality of a 3D water-fat separated LGE research sequence and identify confounders of image quality Methods: In total, 126 patients and 12 healthy volunteers were included. Patients were included with inflammatory bowel disease (n=35), muscular dystrophy (n=38), hypertrophic cardiomyopathy (n=23) and paroxysmal atrial fibrillation (n=30). 3D water-fat separated LGE images were acquired at 1.5T (n=122) or 3T (n=16). Image quality was subjectively rated (4-point Likert scale) in six categories (overall image quality [OV], blood-myocardium border sharpness, LGE-remote/healthy myocardium border sharpness, fat suppression, myocardial nulling [MN], anatomical structures [AS]), additionally, the contrast ratio was calculated. Cardiac function, acquisition conditions, and demographic data were investigated as potential confounders for image quality and contrast ratio. Results: Fat suppression had the highest quality score (2.54±0.72), followed by AS (2.11±0.94) and MN (2.01±0.78). In total, 18 parameters showed a significant correlation with multiple image quality categories, most of which related to cardiac function, such as the cardiac index, which significantly correlated with OV (Wald Chi-squared=4.35; p<0.05), LGE-remote/healthy myocardium border sharpness (Wald Chi-squared=5.03; p<0.05), and AS (Wald Chi-square=16.00; p<0.001). Left ventricular mass index to height showed significant correlation with OV (Wald Chi-squared=7.57; p<0.01), blood-myocardium border sharpness (Wald Chi-squared=7.35; p<0.01), and contrast ratio (Wald Chi-squared=5.50; p<0.05). Furthermore, demographic parameters, such as body mass index (BMI), were identified as significant confounders, showing a notable correlation between BMI and the depiction of AS. (Wald Chi-square=11.14; p<0.01). Conclusion: In this study, 3D water-fat separated LGE imaging shows satifactory image quality, especially for water-fat separation. However, image quality may be affected by several other parameters such as patient obesity, high myocardial mass, and cardiac function. Trial Registration: 3000339http://www.sciencedirect.com/science/article/pii/S1097664725000341Cardiac magnetic resonance imagingIsotropic resolutionFat-water separationLate gadolinium enhancement3D whole heart imagingQuality assurance
spellingShingle Johanna Kuhnt
Edyta Blaszczyk
Leo Dyke Krüger
Leonhard Grassow
Claudia Prieto
René Botnar
Karl Philipp Kunze
Michaela Schmidt
Darian Steven Viezzer
Thomas Hadler
Maxmilian Fenski
Jeanette Schulz-Menger
Analysis of confounders of the image quality of a high-resolution isotropic three-dimensional Dixon water-fat late gadolinium enhancement technique
Journal of Cardiovascular Magnetic Resonance
Cardiac magnetic resonance imaging
Isotropic resolution
Fat-water separation
Late gadolinium enhancement
3D whole heart imaging
Quality assurance
title Analysis of confounders of the image quality of a high-resolution isotropic three-dimensional Dixon water-fat late gadolinium enhancement technique
title_full Analysis of confounders of the image quality of a high-resolution isotropic three-dimensional Dixon water-fat late gadolinium enhancement technique
title_fullStr Analysis of confounders of the image quality of a high-resolution isotropic three-dimensional Dixon water-fat late gadolinium enhancement technique
title_full_unstemmed Analysis of confounders of the image quality of a high-resolution isotropic three-dimensional Dixon water-fat late gadolinium enhancement technique
title_short Analysis of confounders of the image quality of a high-resolution isotropic three-dimensional Dixon water-fat late gadolinium enhancement technique
title_sort analysis of confounders of the image quality of a high resolution isotropic three dimensional dixon water fat late gadolinium enhancement technique
topic Cardiac magnetic resonance imaging
Isotropic resolution
Fat-water separation
Late gadolinium enhancement
3D whole heart imaging
Quality assurance
url http://www.sciencedirect.com/science/article/pii/S1097664725000341
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