Improved Workflow for Quantification of Right Ventricular Volumes Using Free-Breathing Motion Corrected Cine Imaging.

Abstract

Cardiac MR traditionally requires breath-holding for cine imaging. Younger or less stable patients benefit from free-breathing during cardiac MR but current free-breathing cine images can be spatially blurred. Motion corrected re-binning (MOC) is a novel approach that acquires and then reformats real-time images over multiple cardiac cycles with high spatial resolution. The technique was previously limited by reconstruction time but distributed computing has reduced these times. Using this technique, left ventricular volumetry has compared favorably to breath-held balanced steady-state free precession cine imaging (BH), the current gold-standard, however, right ventricular volumetry validation remains incomplete, limiting the applicability of MOC in clinical practice. Fifty subjects underwent cardiac MR for evaluation of right ventricular size and function by end-diastolic (EDV) and end-systolic (ESV) volumetry. Measurements using MOC were compared to those using BH. Pearson correlation coefficients and Bland-Altman plots tested agreement across techniques. Total scan plus reconstruction times were tested for significant differences using paired t-test. Volumes obtained by MOC compared favorably to BH (R = 0.9911 for EDV, 0.9690 for ESV). Combined acquisition and reconstruction time (previously reported) were reduced 37% for MOC, requiring a mean of 5.2min compared to 8.2min for BH (p < 0.0001). Right ventricular volumetry compares favorably to BH using MOC image reconstruction, but is obtained in a fraction of the time. Combined with previous validation of its use for the left ventricle, this novel method now offers an alternative imaging approach in appropriate clinical settings.