Latest Advances in Clinical and Pre-Clinical Cardiovascular Magnetic Resonance Imaging

Volume 1

by

Christakis Constantinides

DOI: 10.2174/97816080580681140101
eISBN: 978-1-60805-806-8, 2013
ISBN: 978-1-60805-807-5
ISSN: 2351-9843

  
  




This e-book series presents readers with information about state-of-the-art developments in clinical and pre-clinical cardiovascular m...[view complete introduction]
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Table of Contents

Foreword 1 , Pp. i-ii (2)

Klaas Nicolay and Gustav J. Strijkers
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Foreword 2 , Pp. iii

Scott Reeder
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Preface , Pp. iv-v (2)

Christakis Constantinides
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List of Contributors , Pp. vi-vii (2)

Christakis Constantinides
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CMR in Heart Failure: Current and Emerging Clinical Applications , Pp. 3-40 (38)

Andrew J. Ludman, L. Ceri Davies and Steffen E. Petersen
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CMR Applications in Ischemic Heart Disease , Pp. 41-63 (23)

Stamatios Lerakis and John Palios
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Applications of Displacement-Encoded MRI in Cardiovascular Disease , Pp. 64-83 (20)

Han Wen and Pierre Croisille
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Flow Quantification: 1D to 4D , Pp. 84-106 (23)

Christopher J. Francois
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Spinning to a Different Beat: Non-Proton Cardiac NMR and MRI , Pp. 107-129 (23)

Mangala Srinivas and I. Jolanda M. de Vries
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Technical Advances - Fast Imaging Acquisition Techniques , Pp. 130-162 (33)

Jürgen E. Schneider
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Regional Cardiac Function: Across Mammalian Species Comparison - the Paradigm of Murine MR Image-Based Phenotyping , Pp. 163-198 (36)

Stelios Angeli and Christakis Constantinides
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Mapping Myocardial Fiber Structure Using Diffusion Tensor Imaging , Pp. 199-223 (25)

Osama Abdullah, Arnold David Gomez, Christopher L. Welsh and Edward Hsu
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List of Abbrevaitions , Pp. 224-230 (7)

Christakis Constantinides
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Index , Pp. 231-246 (16)

Christakis Constantinides
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Foreword

The eBook “Latest Advances in Cardiovascular MRI” is an enthusiastic account of the state-of-the-art in preclinical and clinical cardiovascular MRI. The editor Christakis Constantinidis and all the individual contributors are to be congratulated for providing an excellent overview of the capabilities of this remarkable technology. Ever since the realization in the seventies that MR had extraordinary medical potential, basic scientists and clinicians alike have begun to explore its utility for in vivo studies of the heart and the vascular system. The cardiovascular system poses many challenges to MR imaging and spectroscopy because of the contractile motion and the flow of the blood as well as the macroscopic displacements resulting from respiratory activity. With phenomenal advances in MR hardware, pulse sequence capabilities, image reconstruction techniques and improved triggering and gating approaches, the routine acquisition of high-quality MR images of heart and blood vessels in man has become reality for quite some time. The availability of such tools for use in preclinical studies on small animals has considerably lagged behind, especially for research in mice, due to the small size of the relevant structures and the very high rates of cardiac motion and arterial blood flow. Small animal counterparts of many cardiovascular MRI techniques that had been in use for human studies for quite a while only recently became available. This process of reverse translation from the clinical to the preclinical setting is in fact of vital importance to the field as it can be expected to speed up further developments of the technology. Biomedical studies in small animals and in particular mice are crucial for gaining insights in the pathophysiological processes underlying cardiovascular diseases. For these reasons, the advancement of the field of cardiovascular MR requires a sound balance between preclinical and clinical activities and needs an active exchange of ideas on measurement concepts as well as healthcare challenges between basic biomedical and clinical researchers.

The present eBook is an excellent illustration of the remarkably broad utility of cardiovascular MRI, describing recent clinical advances and developments at the technological and preclinical level. All of the contributors are experts in their respective domains of the field. The book addresses a topic that is of great societal importance, since cardiovascular diseases continue to be main causes of death and ii morbidity worldwide and have an enormous impact on the costs of healthcare systems. Therefore there is a pressing need for developing more effective diagnostic procedures that can be used to guide clinical management of patients and that can provide quantitative prognostic biomarkers for steering therapy and for follow-up. MRI provides a wealth of different types of information on the cardiovascular system, ranging from plain anatomy and basic function to tissue micro-architecture and cellular metabolism and therefore is ideally suited to reshape the practice of cardiovascular patient care. The field witnesses many exciting developments to speed up the rate of MR image acquisitions, whilst maintaining high data quality. This will drastically shorten scan times and thus alleviate one of the major hurdles for advancing MRI in the clinic. The field is thereby also making big steps towards becoming more patient-friendly and more cost effective.

The eBook is highly recommended both for cardiovascular MRI experts and novices.

Klaas Nicolay, Ph.D. & Gustav J. Strijkers, Ph.D.
(Professor of Biomedical NMR & Associate Professor of Biomedical NMR)
Department of Biomedical Engineering
Eindhoven University of Technology
Eindhoven
The Netherlands
and
Centre for Imaging Research & Education Eindhoven
The Netherlands


Cardiac magnetic resonance imaging has witnessed tremendous advances since its introduction in the early 1990’s. Although MRI has played a central role in medical imaging since the mid-1980’s, cardiac MRI has only truly blossomed over the past decade. Advances in magnet hardware technology, and key developments such as segmented k-space acquisitions, advanced motion encoding techniques, ultra-rapid perfusion imaging and delayed myocardial enhancement imaging have all contributed to a revolution in how patients with ischemic and non-ischemic heart disease are diagnosed and treated.

Fundamental to this revolution has been tremendous advances, both in hardware technology and our understanding of MR physics as applied to cardiac MRI. High-field strength magnets (1.5T, 3T, and even 7T), ultra-rapid gradients, and advances in phased array coil technology with parallel imaging reconstruction algorithms that have lead to important advances in cardiac imaging strategies. Indeed, cardiac MRI is a widely accepted method as the “gold standard” for detection and characterization of many forms of cardiac disease.

Despite pessimism on the continued role of MRI in clinical care in this environment of declining reimbursement, I am highly optimistic that the safety, accuracy and increasing availability of cardiac MRI will ensure a bright future. For these reasons, this textbook is particularly timely. Dr. Constantinides has assembled a team of international recognized experts presenting a highly innovative synergistic juxtaposition of advances in clinical cardiac MRI and technical and pre-clinical advances. The two sections of this textbook are highly complementary and will be of great interest to clinicians with interests in advanced clinical applications, and to physicists and engineers interested in advanced technological advancements in cardiovascular imaging, but with a clinical context to understand the role of this important technology.

Scott Reeder, MD. Ph.D.
Associate Professor
Chief of MR Radiology
Cardiovascular Imaging Section
University of Wisconsin Madison
USA


Preface

A tremendous scientific growth has been evidenced in the field of Magnetic Resonance Imaging (MRI) over the past 70 years, ever since the inception and independent demonstration of the phenomenon in condensed matter by Felix Bloch and Edward Purcell in 1946.

Within more than a decade after the initial clinical images became available in the early 1980’s, techniques such as myocardial tagging, segmented k-space, multi- slice and multi-phase cardiac imaging, introduced cardiovascular imaging to the scientific community, and opened new avenues for the study of global cardiac morphology, perfusion, flow, metabolism, and function, in health and disease. Noted advances, such as the introduction of ultrafast imaging acquisition techniques, MR microscopy, 1H and 31P spectroscopy, regional strain and diffusion imaging, established cardiovascular MRI as one of the prominent and advanced scientific tools available nowadays. Concurrently, clinical applications facilitated detailed studies of cardiovascular pathology, including coronary artery disease (ischemia and myocardial infarction (MI)), congenital heart disease and heart failure, both in the acute and chronic stages, under rest, and following pharmacological or exercise-induced stress. Such applications allowed assessment of critical functional, perfusion, and viability biomarkers for long-term prognosis, striving to establish MRI as the ‘one-stop shop’ in everyday clinical practice.

On the forefront of pre-clinical work, mouse cardiac MRI emerged as a logical consequence to the genome mapping initiatives amidst parallel developments and progress in human cardiac MRI in the late 1980’s and early 1990’s. With the complete characterization of the mouse and human genomes (a National Institutes of Health initiative) in 2002 and 2003 respectively, a plethora of mouse studies emerged targeting the cardiovascular system with genetic modifications, marking the onset of the molecular physiology, proteomics, and (structural and functional) genomics era.

While image-based phenotyping has been a major long-term scientific goal, aiming to high-throughput cardiac studies of pathology, to-this-date, it still remains elusive. Human and mouse cardiac pathological MRI studies have advanced mostly as parallel efforts, unsupported thus far by major National or International policies or consortia that would strategically coordinate multi-center studies under carefully-controlled and normalized protocols, as such would establish the knowledge-platform to benefit cardiovascular disease, molecular genomics, or related/emerging technological advances, with an envisaged tremendous impact for translational research to man.

Collectively, this effort summarizes extensively (with the exception of molecular imaging) the most recent clinical and basic science developments in the field of cardiac MRI, with multiple contributions from prominent researchers and scientists throughout the world. The topics are categorized in two parts; Part I concentrates on clinical advances in ischemic heart disease, heart failure, flow and quantification and cardiac and multinuclear spectroscopy. Part II focuses on pre- clinical work, including fast imaging techniques, regional functional quantification, and fiber structure characterization.

I am hopeful that the book will serve to readers as a reference guidebook for the current status and future directions of cardiac MRI.

With a great sense of responsibility I express my gratitude and dedicate this book to my parents Elpida and Demetris and to my friend Dr. Andreas Lanitis for their true love, generous encouragement, advice and support over the years.

Christakis Constantinides, Ph.D.
Chi Biomedical Limited
Nicosia
Cyprus
E-mail: Christakis.Constantinides@gmail.com

List of Contributors

Editor(s):
Christakis Constantinides Ph.D.
Chi Biomedical Limited
Nicosia
Cyprus




Contributor(s):
Andrew J. Ludman
Centre for Advanced Cardiovascular Imaging
NIHR CVBRU at Barts, London Chest Hospital
Bonner Road
London, E2 9JX
UK


Arnold David Gomez
Department of Bioengineering
University of Utah
Utah
USA


Christakis Constantinides
Chi Biomedical Limited
36 Parthenonos Street
Apartment 303, Strovolos
Nicosia, 2021
Cyprus


Christopher J. Francois
Department of Radiology
University of Wisconsin
600 Highland Avenue
Madison
WI, 53792
USA


Christopher L. Welsh
Department of Bioengineering
University of Utah
Utah
USA


Edward Hsu
Department of Bioengineering
University of Utah
Utah
USA


Han Wen
National Heart Lung and Blood Institute
National Institutes of Health
Bethesda
MD, 20892
USA


I. Jolanda M. de Vries
Department of Tumor Immunology
Radboud University Nijmegen Medical Center (RUNMC)
278, Nijmegen Center for Molecular Life Sciences (NCMLS)
Nijmegen
The Netherlands


John Palios
Emory University School of Medicine
Division of Cardiology, The Emory Healthcare
1365 Clifton Road, NE, Suite AT 503
Atlanta
Georgia, 30322
USA


Jürgen E. Schneider
BHF Experimental MR Unit, Radcliffe Department of Medicine
Division of Cardiovascular Medicine
University of Oxford
Oxford
UK


L. Ceri Davies
Centre for Advanced Cardiovascular Imaging
NIHR CVBRU at Barts, London Chest Hospital
Bonner Road
London, E2 9JX
UK


Mangala Srinivas
Department of Tumor Immunology
Radboud University Nijmegen Medical Center (RUNMC)
278, Nijmegen Center for Molecular Life Sciences (NCMLS)
Nijmegen
The Netherlands


Osama Abdullah
Department of Bioengineering
University of Utah
Utah
USA


Pierre Croisille
Department of Radiology
University Hospital Saint-Etienne, University Jean Monnet
CREATIS, CNRS 5220, INSERM U1044, University of Lyon
France


Stamatios Lerakis
Emory University School of Medicine, Division of Cardiology, The Emory Healthcare
1365 Clifton Road, NE, Suite AT 503
Atlanta
Georgia, 30322
USA


Steffen E. Petersen
Centre for Advanced Cardiovascular Imaging
NIHR CVBRU at Barts, London Chest Hospital
Bonner Road
London, E2 9JX
UK


Stelios Angeli
Prognosis Advanced Diagnostic Center
2 Tefkrou Anthia Street
Larnaca, 2021
Cyprus




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