Premature ventricular contractions (PVCs) are common arrhythmia encountered in patients with and without structural heart disease. Although often benign and asymptomatic, they may also cause palpitations, exercise intolerance, presyncope, and reduced quality of life, and in some patients can contribute to PVC-induced cardiomyopathy or trigger malignant ventricular arrhythmias. Their clinical significance depends on symptom burden, PVC frequency, ventricular function, and the presence of underlying myocardial disease. Diagnostic evaluation includes electrocardiography, ambulatory rhythm monitoring, echocardiography, exercise testing, and cardiac magnetic resonance imaging for tissue characterization and risk stratification. Management ranges from reassurance and lifestyle modification to pharmacologic therapy and catheter ablation. Beta-blockers and nondihydropyridine calcium channel blockers remain common first-line options, whereas antiarrhythmic drugs may be considered in carefully selected patients. Catheter ablation is an effective treatment for symptomatic PVCs, high PVC burden, and PVC-induced cardiomyopathy, with high procedural success rates and favorable effects on arrhythmic burden and ventricular function. Novel approaches, including electrocardiographic imaging-guided planning, pulsed field ablation, stereotactic radioablation, neuromodulation, and renal denervation, may further expand future therapeutic options. This review summarizes the pathophysiology, clinical implications, diagnostic evaluation, and contemporary management of PVCs, with emphasis on medical therapy, catheter ablation, and emerging treatments.

The pathogenesis of Takotsubo syndrome (TTS) is poorly understood, but differences in outcome depending on the triggering factor imply differences in the pathophysiology. Beyond the established trigger-based InterTAK (International Takotsubo Registry) classification, the newly proposed distinction between primary and secondary TTS aims to differentiate emotionally primed heart dysfunction from TTS driven by direct myocardial injury. To explore these potential differences, we utilized cardiovascular magnetic resonance imaging to assess left ventricular function, myocardial edema, and myocardial injury across the InterTAK classification and between primary and secondary TTS. For this multicenter cohort study, 110 patients (95% female, age 66±12 years) from the InterTAK registry were included who received cardiovascular magnetic resonance 3 (interquartile range, 2-5) days after symptom onset. Cardiovascular magnetic resonance included assessment of myocardial function, edema (T2-weighted spin-echo and T2-mapping when available), and late gadolinium enhancement. No significant differences were observed in left ventricular volumes, function, or mass across the 3 InterTAK groups or between primary and secondary TTS. Patients with emotional triggers exhibited significantly larger myocardial edema (72% versus 60% for physical triggers; P<0.01), supported by higher T2-mapping values in a subset of 22 patients with T2-mapping. In multivariable regression, only emotional trigger (P<0.01) and the absence of coronary artery disease (P=0.04) were independently associated with the extent of myocardial edema. Secondary TTS showed a higher prevalence of focal or patchy late gadolinium enhancement (primary 19%, secondary 54%; P<0.01). In multivariable logistic regression, secondary TTS (P<0.01) and early cardiovascular magnetic resonance (P=0.02) were associated with the presence of any late gadolinium enhancement. TTS due to emotional stress is associated with larger myocardial edema, and secondary TTS exhibited late gadolinium enhancement more frequently, indicative of direct myocardial damage. These findings suggest that emotionally primed heart dysfunction and direct myocardial injury contribute to TTS pathophysiology to varying extents, influenced by both the triggering factor and preexisting conditions.

Cardiovascular magnetic resonance (CMR) is the gold standard imaging modality for evaluating cardiac structure, function, and myocardial tissue characteristics, yet its widespread adoption remains limited by cost, technological complexity, and infrastructure barriers-especially in low- and middle-income countries (LMICs). Recent advances in low-field (LF) CMR, particularly around 0.55 Tesla, demonstrate that strong diagnostic performance can be achieved despite reduced signal-to-noise ratios. Optimized hardware, including advanced gradient coils and radiofrequency systems, as well as AI-driven image reconstruction techniques, has greatly enhanced image quality. LF magnets offer notable advantages that reduce infrastructure demands and simplify protocols-both critical for lower resource settings. Clinical applications in cardiac function, tissue characterization, flow quantification, and even interventional procedures have expanded through sequences adapted to LFs, including novel approaches to myocardial mapping and real-time imaging. Concurrently, cryogen-free magnet designs and smaller system footprints have simplified installation and lowered operational costs. These developments bolster the feasibility of scaling CMR in environments where high-field scanners are prohibitively expensive or challenging to maintain. Moreover, greater accessibility to LF CMR could help bridge global disparities in cardiovascular diagnostics, enabling earlier detection of cardiomyopathies and ischemic heart disease in underserved regions. Although challenges remain-such as reduced signal-to-noise ratio, slower acquisition times, and limited availability of cardiac-specific hardware-ongoing innovations and collaborative global initiatives position LF CMR as a transformative, sustainable solution for modern cardiovascular care worldwide.

While cardiac magnetic resonance (CMR) provides prognostic value in transthyretin cardiac amyloidosis (ATTR-CA), current ATTR-CA staging relies on serum biomarkers. We evaluated the incremental value of incorporating CMR parameters into the National Amyloidosis Center (NAC) staging and assessed their utility in guiding evaluation for advanced heart failure (HF) therapies and emerging disease-modifying treatments. We retrospectively analyzed a multicenter cohort of 266 ATTR-CA patients who underwent CMR between 2007-2023. Cox regressions were used to assess time to death. A baseline model was constructed using the NAC stage. CMR predictor variables were selected a priori based on clinical relevance and non-collinearity, then refined using stepwise backward elimination regression with NAC stage control; variables retained in ≥60% of 1,000 bootstrapped samples were included. Internal validation was performed via bootstrapping, with performance reported as Harrell's C-statistic and calibration slope. Decision curve analysis evaluated clinical utility.85 patients (32%) died over a median follow up of 20 months (IQR 8-35). Extracellular volume (ECV ≥59%, HR 2.45, 95% CI 1.2-5.2, p = 0.020) and indexed left atrial volume (LAVi ≥54 ml/m2, HR 2.00, 95% CI 1.1-3.7, p = 0.026) were independently associated with mortality after NAC adjustment and improved prognostic accuracy across all biomarker stages. When risk prediction was framed around initiation of advanced HF or emerging disease-modifying therapies, incorporating CMR alongside NAC staging facilitated identification of 28 additional high-risk patients per 1,000. CMR-derived ECV and LAVi were associated with incremental prognostic value in ATTR-CA beyond biomarker staging and may inform clinical risk stratification.

To evaluate real-world use of advanced cardiovascular imaging in less common and rare rheumatic immune-mediated inflammatory diseases (IMIDs) and identify variation in practice to inform future studies and clinical guidelines. A retrospective, multi-centre quality improvement project was conducted across four major hospitals in the UK. Adults with systemic lupus erythematosus, systemic sclerosis, inflammatory myopathy, vasculitis or primary Sjögren's disease who underwent cardiac magnetic resonance (CMR), CT coronary angiography (CTCA) or positron emission tomography (PET) between January 2023 and December 2024 were included. Demographics, underlying IMID, cardiovascular risk factors, imaging indications, findings and management were extracted using a standardised proforma and analysed. A total of 294 imaging studies were performed in 261 patients (72.4% female, 65.9% aged 40-74 years) comprising 137 (46.6%) CMR, 40 (13.6%) CTCA, and 117 (39.8%) PET scans. Indications varied by modality and centre. Cardiovascular abnormalities were reported in 175/294 (59.5%), most commonly in vasculitis (53.7%). Notably, 54/63 (85.7%) of abnormal PET and 61/89 (68.5%) of abnormal CMR scans were in asymptomatic patients. Imaging findings prompted cardiology referral/ongoing follow-up in 59.5% and changes to IMID treatment in 31.3%, but only 23.1% were discussed in a formal multidisciplinary team (MDT). Advanced cardiovascular imaging frequently identifies cardiovascular involvement in rheumatic IMIDs, including in asymptomatic patients. Treatment adjustments occurred in a third of patients, although largely undertaken outside established MDT processes. These findings emphasise the need for better understanding of imaging-based findings and for cardio-rheumatology MDTs to support integrated decision-making to improve patient outcomes.

FDG PET for cardiac sarcoidosis: Protocol optimization, quantification, pitfalls, and multimodality imaging integration.

This study aimed to compare the effects of Del Nido cardioplegia (DNC) and conventional cold blood cardioplegia (CBC) on early myocardial functional recovery, as assessed by cardiac magnetic resonance imaging, in patients with reduced ejection fraction undergoing concomitant coronary artery bypass grafting (CABG) and mitral valve replacement (MVR). This single-center prospective study was conducted between April 2024 and January 2025 and included 42 patients with a left ventricular ejection fraction (LVEF) <45% who underwent concomitant CABG and MVR. The mean age was 62.2±10.6 years, and 69.0% (n=29) of the patients were male. Patients were divided into two groups according to the myocardial protection strategy used: CBC (n=23) and DNC (n=19). Preoperative demographic, laboratory, and echocardiographic data were collected, and CMR was performed approximately 1 week before surgery to establish baseline values. Intraoperative parameters, postoperative clinical, laboratory, and echocardiographic findings as well as follow-up CMR findings obtained 1 month postoperatively were analyzed and compared between the groups. The aortic cross-clamp time was significantly longer in the DNC group than in the CBC group (p=0.016), whereas the total volume of infused cardioplegia was comparable between the groups (p=0.323). Intraoperative blood transfusion requirements were significantly higher in the DNC group (p=0.013). Regarding myocardial recovery, the DNC group demonstrated superior biventricular improvement. Significant reductions in left ventricular end-diastolic volume (p<0.001) and end-systolic volume (p<0.001) indicated pronounced reverse remodeling and were accompanied by a modest increase in LVEF (p=0.046). Similarly, postoperative right ventricular (RV) function was significantly better in the DNC group (p=0.026), with a significant decrease in the RV end-systolic volume index (p=0.025), reflecting improved systolic emptying. Although in-hospital mortality was numerically higher in the DNC group (31.6% vs. 8.7%), the difference was not statistically significant (p=0.112). Importantly, all deaths were associated with refractory low cardiac output syndrome during the postoperative intensive care unit stay. CMR findings suggest that DNC may be a safe and effective myocardial protection strategy in patients with reduced LVEF undergoing CABG and MVR. Furthermore, DNC appeared superior to CBC in promoting early biventricular reverse remodeling in this study population. The higher mortality observed in the DNC group may be attributable to the small sample size, longer cross-clamp times, greater operative complexity, and potential selection bias.

In patients with Duchenne muscular dystrophy (DMD), the gene transfer therapy delandistrogene moxeparvovec delivers a functional form of dystrophin, which has been shown to stabilize or slow disease progression. We assessed cardiac safety of delandistrogene moxeparvovec in clinical trials with ≤ 5years of follow-up. Data were collected from clinical trials 101 (NCT03375164, n = 4), 102 (NCT03769116, n = 41), ENDEAVOR (NCT04626674, n = 48), and EMBARK (NCT05096221, n = 125), which excluded patients with left ventricular ejection fraction (LVEF) < 40%. Adverse events and cardiac echocardiography were assessed regularly in all trials. TroponinI was assessed regularly in ENDEAVOR and EMBARK. Cardiac magnetic resonance imaging (MRI; without gadolinium enhancement) was assessed within an EMBARK substudy. Of 218 patients (baseline mean age [range], 6.4 [3.2-20.2] years; mean LVEF [range], 63.8% [48.9-78.0%]), 210 (96%) were ambulatory; 216 received delandistrogene moxeparvovec treatment. Two myocarditis cases were reported within 4days after delandistrogene moxeparvovec infusion; both resolved within 3weeks. Except in the two myocarditis cases, troponinI fluctuations were asymptomatic. Thirteen patients with baseline and postbaseline echocardiography data had elevated troponinI at baseline; 1year post infusion, only one of these patients had LVEF < 50%. LVEF in all four patients with 5-year follow-up remained > 50%. Although cardiac MRI without gadolinium revealed no relevant differences in heart function between patients 1 or 2years after delandistrogene moxeparvovec versus patients 1year after placebo infusion, subclinical fibrosis cannot be ruled out. Results from delandistrogene moxeparvovec trials with 1 to 5years of follow-up suggest a manageable cardiac safety profile in this study population of predominantly younger, ambulatory patients with DMD who had no signs of persistent treatment-related cardiac injury.

To demonstrate that a recently reported bright ferritin magnetic resonance imaging (MRI) platform can track transplanted human pluripotent stem cell (hPSC)-derived cardiomyocytes (hPSC-CMs) longitudinally and on-demand in the rat heart. Ferritin-overexpressing hPSCs were differentiated into cardiomyocytes and assessed for cell viability, contractile functional proteins, and electrophysiological properties in vitro. In an immunodeficient rat model, hPSC-CMs injected into the left ventricular myocardium were tracked on cardiac MRI at 3 Tesla over 8 weeks in both healthy and infarcted hearts. Longitudinal MRI was accompanied by MnCl2 supplementation for on-demand recall of bright signal from ferritin-overexpressing hPSC-CMs. MRI findings were corroborated against histological validation. Ferritin-overexpressing hPSC-CMs displayed normal morphological and functional phenotypes and created viable grafts in vivo. On-demand recall of bright contrast on MRI was achieved, regardless of interval post-cell transplantation, via MnCl2 administration to precisely map surviving hPSC-CMs in both healthy and infarcted hearts. The spatial distribution of hPSC-CMs on MRI was confirmed throughout the heart by histology. Echocardiography confirmed MnCl2 had no impact on cardiac function, although in vitro tests revealed transiently dampened calcium handling and contractility, an effect from which cells fully recovered after removing MnCl2. Bright ferritin MRI allows longitudinal, non-invasive, and on-demand imaging of the distribution of viable transplanted hPSC-CMs in the healthy and infarcted rat heart.

Sex-based differences in mitral and tricuspid valve disease in the era of transcatheter therapies: a contemporary review.

We evaluated cardiac extracellular volume (ECV) fraction, a sign of inflammation and fibrosis, in 10 individuals with chronic Hepatitis C virus (HCV) infection prior to treatment using cardiac magnetic resonance (CMR) at 3 T. Compared to age-matched, healthy volunteers, HCV-infected individuals had significantly increased ECV fraction (0.30 ± 0.03 vs. 0.26 ± 0.03, p = 0.0036) regardless of myocardial damage markers, hypertension as a comorbidity, smoking pack-years or fibrosis stage. Our results show that untreated hepatitis C is associated with the development of extrahepatic manifestations even before the onset of liver fibrosis, highlighting that early HCV treatment is prudent to reduce all-cause morbidity.

To evaluate the diagnostic and prognostic utility of multi-chamber myocardial strain, and its correlation with native T1 mapping and late gadolinium enhancement (LGE) imaging, by cardiac magnetic resonance (CMR) in cardiac amyloidosis. A total of 47 patients were retrospectively included and the strain of the ventricles and atria were quantified. Native T1 and Query Amyloid Late Enhancement (QALE) values were assessed. Follow-up data on major adverse cardiovascular events (MACE) were retrieved from medical records. Spearman correlations between strain, LGE, and mapping were assessed. The strain parameters were analyzed using receiver operating characteristic curves and Cox regression analysis. LV strain indices, RV GLS, RV GRS, LA reservoir, LA conduit strain, and RA reservoir strain demonstrated diagnostic ability ( P <0.05), with the highest diagnostic accuracy for LV GCS (AUC=0.897; cutoff=-12.9). Native T1 and QALE showed moderate correlations with LV and LA strain, reflecting amyloid infiltration and fibrosis-related dysfunction. For prognosis, RV GLS (AUC=0.687; cutoff=-12.5) and RA conduit strain (AUC=0.737; cutoff=+10) independently predicted MACE on univariable Cox analysis (HR=1.05 and 0.96; P <0.05). Importantly, multivariable Cox regression identified LV GLS (HR=5.27; P =0.016) and LA reservoir strain (HR=0.025; P =0.03) as strong independent predictors of MACE. Multi-chamber strain, and its integration with T1 and QALE, enhances diagnostic accuracy and prognostic precision in cardiac amyloidosis, enabling earlier recognition of myocardial dysfunction.

Correlation across modalities and clinical phenotypes between left Ventricular global longitudinal strain by echocardiography and cardiac magnetic resonance.

Purpose. Intramyocardial hemorrhage following revascularized myocardial infarction is associated with increased mortality and morbidity. T2* cardiac MRI is the noninvasive imaging standard for visualizing the chronic iron deposits from hemorrhagic myocardial infarction (hMI). However, the impact of spatial resolution on detection performance of these iron deposits remains unclear.Methods. We investigated the influence of spatial resolution on the detection of iron deposits following hMI using (i) digital phantom simulations across voxel sizes (0.4-2.0 mm2in-plane; 2-8 mm slice thickness) at multiple Signal-to-noise ratio (SNR) levels, (ii)ex-vivoswine hearts (n= 10) with 8 week hMI.ex-vivoimaging studies employed multi-gradient-echo sequences with various in-plane and through-plane resolutions with minimal SNR constraints (Unconstrained Acquisitions) and within-vivotime constraints (Constrained Acquisitions), and (iii)in-vivoT2* imaging at standard spatial resolution (1.6 × 1.6 × 6 mm3). Detection performance was assessed using receiver operating characteristics analysis and its area-under-the-curve (AUC), along with SNR and contrast-to-noise-ratio. Histopathology and mass spectrometry validated iron distribution.Results. Simulations demonstrated that finer voxels minimized partial volume but reduced SNR, while coarser voxels increased SNR but masked focal lesions. Optimal performance (AUC = 0.80) was identified at 1.3-1.6 mm2pixel size with 2-4 mm slice thickness underConstrained Acquisitions. Detection accuracy declined sharply for iron depositions that were thin in the transmural direction (<1 mm) with limited pixel representation at clinical resolutions. Inductively coupled plasma mass spectrometry confirmed significantly elevated iron content in hMI regions vs remote myocardium (45.1 ± 9.3 vs 35.3 ± 4.7μg g-1,p= 0.012) and correlated with the transmural width of hMI remnants (R2= 0.83).Conclusion. Spatial resolution critically determines the detectability of chronic iron remnants on T2* maps. While current clinical protocols can identify larger deposits, small (<1 mm) yet proinflammatory lesions may be missed. These results highlight the need for technical improvements to enhance detection.

Epicardial Fat-Mediated Pericardial Restraint Across HFpEF Phenogroups with Preserved and Impaired Right Ventricle: Insights from Cardiac MRI and Exercise Hemodynamics

Differential blood oxygenation between the right and left heart (ΔSO2) is an indicator of cardiovascular function currently assessed in clinical practice by invasive right heart catheterization. Cardiac MRI can non-invasively quantify ΔSO2 with quantitative susceptibility mapping (QSM) using a prospective navigator gated 3D cartesian acquisition. However, this method suffers from long acquisition time and reduced robustness. Here, a free-breathing cardiac QSM using spiral sampling and deep learning motion compensation is proposed. A retrospective self-gated stack-of-spirals multi-echo gradient echo sequence is combined with implicit neural representation (INR) learning for image reconstruction. The self-gating signals measure superior-inferior cardiac and respiratory motion thus allowing k-space binning. Using a physics-informed signal model and the spatiotemporal coordinate input, INR infers motion fields as well as motion-corrected water, fat, and field maps. Then, QSM and ΔSO2 are accordingly computed. Data were acquired in 10 healthy subjects. For comparison, a free-breathing prospective navigator ECG-triggered Cartesian acquisition (NAV) was performed. INR reconstructed motion-corrected water, fat, R2* and field maps were successfully obtained in all subjects. INR-QSM showed superior image quality (p = 0.0067) and equivalent ΔSO2 measurement in the heart (r = 0.74, p < 0.001; 1.07% ± 3.52% bias/limits of agreement) compared to the reference NAV-QSM. This study demonstrated the feasibility of INR for compensation of cardiac and respiratory motion in free-breathing 3D cardiac QSM.

FedSemiDG: Domain generalized federated semi-supervised medical image segmentation.

People living with HIV experience accelerated aging, increasing their risk of age-related diseases. Chronic inflammation may play an important role in premature vascular aging and myocardial fibrosis, leading to cardiac dysfunction. We conducted a cross-sectional pilot study of matched veterans with and without HIV receiving care at the Providence VA Medical Center to explore the relationship between systemic inflammation, myocardial fibrosis, and subclinical cardiac disease in HIV. Participants were extensively phenotyped with questionnaires, physical exam, stress test, echocardiogram, cardiac MRI, coronary calcium score, and blood measurement of markers of inflammation and fibrosis. Multivariable linear regressions were used to investigate the associations. 21 veterans with HIV (mean age 54 years; 71% White, 29% Black) and 20 controls (mean age 56 years; 70% White, 30% Black) were included. We found higher growth differentiation factor (GDF)-15 blood levels, increased extracellular volume, and lower right heart function on MRI among patients with HIV, suggesting the presence of increased myocardial fibrosis and subclinical myocardial dysfunction in this population. Limited data from this pilot study suggest that HIV may be associated with increased cardiac fibrosis and decreased right ventricular function. This study highlights the need for larger longitudinal studies to better understand the trajectory of HIV-associated cardiac changes and help improve cardiac disease prevention in this population.

Low-field MRI has recently gained interest due to its potential for increased accessibility, reduced cost, and improved safety. However, high-quality anatomical imaging and robust tissue characterization remains an active area of research, particularly when aiming for a simple, one-click scan that captures all relevant information in a single acquisition. Bright-blood imaging is widely used for visualizing cardiac structures and coronary arteries, whereas black-blood is optimal for delineating the myocardium, atrial and vessel walls. High-resolution imaging is required for the accurate detection and segmentation of small anatomical structures, such as the coronary arteries, to enable assessment of narrowing or blockages. Co-registered mapping enables quantitative myocardial tissue characterization, offering valuable clinical information for the detection of myocardial abnormalities. In this study, we sought to develop a novel free-breathing, motion-compensated 3D multi-contrast high-resolution cardiac MR sequence for simultaneous assessment of whole-heart cardiovascular anatomy via bright- and black-blood imaging and myocardial tissue quantification by joint and mapping at 0.55 T in a single scan. Data were acquired over six interleaved contrasts with various preparation modules using a variable flip angle bSSFP spiral-like readout with 2D image-based navigation for translational motion correction, resulting in a predictable acquisition time of min. Images were reconstructed using non-rigid motion corrected iterative sensitivity encoding followed by high-dimensional patch-based low-rank denoising, resulting in the acquisition, reconstruction and quantitative mapping time of min. In the phantom study, sequence performance was evaluated using correlation and Bland-Altman analysis against reference gold-standard and clinical mapping methods. Invivo, 3D bright- and black-blood volumes were assessed in multiple views, and vessel sharpness was quantified from multiplanar images. For joint mapping, bull's-eye plots were generated to evaluate the mean, standard deviation, and coefficient of variation for apical, mid-cavity, and basal segments, and results were summarized using violin plots. Differences between the proposed 3D sequence and established 2D methods were analyzed with a two-tailed -test. In the phantom study, a small positive bias in of was observed compared with inversion recovery spin-echo and with MOLLI, while for biases of compared with spin-echo and with prep bSSFP were found. Invivo, statistically similar values of and values of were obtained, with differences versus MOLLI of ( ) and versus prep bSSFP of ( ). The proposed sequence demonstrated high image quality and accurate mapping despite the inherent limitations of low-field strength, suggesting its feasibility for comprehensive cardiac assessment in resource-limited environments.

To evaluate the diagnostic accuracy and quantitative agreement of A-LIKNet (attention-incorporated network for sharing low-rank, image, and k-space information) deep learning (DL)-accelerated 2D cardiac CINE MRI acquired in a single breath-hold, compared with standard multi-breath-hold CINE sequences, for assessing biventricular volumes and function. In this single-center study, A-LIKNet DL-reconstructed CINE images were acquired at 3 acceleration factors (8×, 16×, and 24×) in 42 subjects using a single breath-hold protocol. Quantitative parameters, including left and right ventricular end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and left ventricle myocardial mass (MM), were derived from standardized segmentation workflows. These were compared against standard multi-breath-hold CINE sequences and tested for agreement using Bland-Altman analysis and linear regression. Image quality was assessed using the coefficient of variation (CoV). Excellent agreement was observed between A-LIKNet DL-accelerated and standard CINE imaging for EDV, ESV, SV, and EF, with 95% limits of agreement (LoA) falling within predefined equivalence margins for nearly all parameters. No significant proportional bias was detected. Myocardial mass showed wider variability and exceeded equivalence thresholds, likely due to less distinct epicardial borders in higher acceleration. CoV values increased with higher acceleration, reflecting mild degradation in image quality, although segmentation performance remained robust across all levels. A-LIKNet deep learning accelerated CINE sequences enable rapid and reliable assessment of cardiac function with excellent agreement to standard imaging. From a clinical perspective, image quality remains acceptable up to an acceleration factor of 16×, supporting routine application, while 24× acceleration may be reserved for selected use cases requiring maximal speed.