Hybrid Phase ordering with Automatic Window Selection (HybridPAWS) improves respiratory-navigator efficiency during 3D late-gadolinium enhancement CMR in patients with chronic heart failure and irregular respiratory pattern

Abstract

Summary Hybrid Phase ordering with Automatic Window Selection (HybridPAWS) improves respiratory-navigator efficiency during 3D late-gadolinium enhancement CMR in patients with chronic heart failure and irregular respiratory pattern. When there is a low gating efficiency (<40%) observed with standard respiratory-gated method, HybridPAWS technique resulted in a significantly greater improvement in navigator efficiency. Background Three-dimensional (3D) inversion recovery cardiac magnetic resonance (CMR) imaging is beginning to be utilised to characterise areas of late gadolinium enhancement (LGE) with high spatial resolution. This is important for tissue heterogeneity assessment in heart failure patients. The 3D CMR data are acquired during free breathing with the application of a respiratory navigator. However, a major challenge of its wider clinical application is the prolonged acquisition time in patients with irregular respiratory breathing pattern (Figure 1). The increased scan time can accentuate the effect of contrast kinetics on the quality of LGE-CMR images. In order to improve respiratory gating efficiency, we have implemented interleaved Radial Phase Encoding-Phase ordering with Automatic Window Selection for a Cartesian sampling scheme (HybridPAWS). With this