Compressed SENSE single-breath-hold and free-breathing cine imaging for accelerated clinical evaluation of the left ventricle

Abstract

To assess the accuracy of compressed SENSE (CS-SENSE) cine cardiac magnetic resonance imaging (CMR) with and without breath-hold in comparison to standard cine CMR with breath-hold for the assessment of left ventricular (LV) function. Thirty-three healthy volunteers underwent balanced turbo field-echo cine CMR with breath-hold (BTFE-BH; reference standard), single breath-hold CS-SENSE (csBTFE-BH) cine CMR, and free-breathing (FB) CS-SENSE (csBTFE-FB) cine CMR on a 3 T MRI system. All images were acquired in stacks of eight short-axis sections. Image quality was assessed and compared by the Wilcoxon matched-pairs signed-rank test. End-diastolic volume, end-systolic volume, stroke volume, ejection fraction, LV end-diastolic (LVED) mass, regional myocardial wall motion, and scan time were compared by paired t-test, linear regression, and Bland-Altman analyses. All techniques provided acceptable image quality (score ≥3) for LV volumetric analysis in all participants (BTFE-BH [reference standard]: 5.00±0.00; csBTFE-BH: 4.03±0.17 [p<0.001]; csBTFE-FB: 3.76±0.44 [p<0.001]), with good agreement in LV function assessment; however, there was a slight but significant underestimation of LVED mass by csBTFE-FB (csBTFE-FB: 73.63±17.31 g versus BTFE-BH [reference standard]: 75.12±18.18 g, p=0.037). All methods showed a strong correlation with quantitative regional myocardial wall motion. Acquisition times for both csBTFE-BH and csBTFE-FB were significantly shorter than that for BTFE-BH (BTFE-BH [reference standard]: 89.3±5.70 seconds; csBTFE-BH: 24.42±2.18 seconds [p<0.001]; csBTFE-FB: 22.48±1.85 seconds [p<0.001]). LV function assessment with the novel CS-SENSE cine CMR is not inferior to standard cine CMR, irrespective of BH; however, LVED mass is underestimated by csBTFE-FB.