CMR System Research Articles

Outcomes and efficacy of robotic-assisted radical prostatectomy using the CMR Versius platform: a prospective study on 118 patients with 1-year follow-up.

To evaluate the outcomes and efficacy of robot-assisted radical prostatectomy (RARP) using the Versius robotic surgical system, aiming to provide comprehensive data on perioperative outcomes, postoperative recovery, and complications. All cases of RARP using the CMR Versius platform performed at Cairo University Hospitalover a two-year period were enrolled in this study. All patients had pathologically confirmed prostate cancer in both localized and locally advanced stages. Data were prospectively collected including preoperative parameters as patients' demographics, serum PSA, and Gleason score after trans-rectal ultrasound guided biopsy. Intraoperative parameters and complications were assessed. Postoperatively, we monitored the oncological and functional outcomes such as continence and sexual functions for at least 12months. Follow up of PSA was done at 6weeks, 3 and 6months, postoperatively. One-hundred-and-eighteen patients continued the follow-up till 12months. The median patient age was 64.26 ± 7.13years. The median PSA value at diagnosis was 9(4.16-64) ng/ml and the median prostate size was 50 (20-167) grams. The mean docking time, console time, and the total operative time were 13.17 ± 1.157, 194.75 ± 24.3 and 225.76 ± 25min, respectively and the median blood loss was 307.46 ± 61.44ml. The mean hospital stay and the mean catheter time were 2.16 ± 0.867 and 7.26 ± 1.441days, respectively. Forty-nine patients underwent nerve-sparing RARP (bilateral in 41 patients and unilateral in 8 patients). Post-operative continence and potency showed progressive improvement over time during follow-up. Twelve months postoperatively, 90.7% of patients were totally continent and 49% of those patients who underwent nerve-sparing RARP (24/49) were potent. With a positive safety profile and a successful oncological outcome, the use of the CMR system for robot-assisted radical prostatectomy presents a safe and promising method in the surgical management of prostate cancer.

T2 mapping post acute myocardial infarction: a novel technique in assessing myocardial edema

ObjectiveCardiovascular magnetic resonance (CMR) is considered the gold standard imaging modality for assessing myocardial infarction lesions, offering precise myocardial tissue characterization. Elevated transverse relaxation time (T2) serves as a specific indicator of increased myocardial water content, thus becoming a valuable index for myocardial edema. However, conventional T2-weighted CMR sequence exhibits several limitations, primarily providing qualitative information. In contrast, recently developed quantitative T2 mapping techniques overcome these limitations, enabling a more reliable assessment of myocardial edema. These techniques offer the advantage of diagnosing and monitoring myocardial injury without the necessity of contrast agents. Our study aims to add to a growing literature demonstrating the efficacy of quantitative T2 mapping technique to detect and quantify regions of myocardial edema post-myocardial infarction.ResultNative T1 and T2 mapping accurately identified myocardial edema in all patients enrolled in the study. Notably, native T1 and T2 values exhibited a significant elevation in the infarcted myocardium compared to the remote myocardium (for T1: 1295.50 ± 87.65 vs. 1074.95 ± 92.86 ms, respectively; and for T2: 74.63 ± 6.51 vs. 52.53 ± 6.26 ms, respectively; p < 0.0001 for both). Microvascular obstruction was observed in 12 out of 20 patients, affecting one or more myocardial segments within the infarct areas. Among this subgroup, regions with a microvascular obstruction within the infarct zone displayed lower T1 and T2 values compared to areas of infarction without microvascular obstruction (for T1: 1115.05 ± 64.70 vs. 1295.50 ± 87.65 ms, respectively; and for T2: 53.65 ± 3.56 vs. 74.63 ± 6.51 ms, respectively; p < 0.0001 for both). Additionally, we provided reference values for myocardial T1 and T2 specific to our facility’s 1.5 Tesla CMR system, applicable to both infarct and remote myocardium.ConclusionParametric T1 and T2 mapping techniques can detect and quantify myocardial edema resulting from myocardial infarction. The presence of microvascular obstruction that results from revascularization injury affects both T1 and T2 values. This information can be used and has broad clinical implications for diagnosis and guiding or monitoring the treatment of myocardial infarction.

Unveiling the unseen: next-generation cardiac magnetic resonance imaging

Unveiling the unseen: next-generation cardiac magnetic resonance imaging Cardiovascular disease (CVD) claims over 1.8 million European lives yearly, surpassing cancer, chronic respiratory disease and diabetes fatalities. Cardiac magnetic resonance imaging (CMR) is crucial for understanding and treating CVD, offering radiation-free comprehensive heart assessment. However, current CMR systems are slow, complex and require specialised expertise, limiting widespread adoption. SMHEART aims to revolutionise CMR with a one-click approach, creating a unique 3D whole-heart volume for automated cardiology diagnosis, prognosis and therapy selection. This project streamlines CMR, facilitating broader acceptance and optimising its impact on personalised patient care, including diagnosis, risk stratification, therapy selection, monitoring and image-guided interventions.

ECMR 1-12 - Performance of a Wide-bore Low-field 0.55T CMR System vs Higher Field CMR: A Pilot Study

ECMR 1-12 - Performance of a Wide-bore Low-field 0.55T CMR System vs Higher Field CMR: A Pilot Study

Inactivation of Target RNA Cleavage of a III-B CRISPR-Cas System Induces Robust Autoimmunity in Saccharolobus islandicus.

Type III CRISPR-Cas systems show the target (tg)RNA-activated indiscriminate DNA cleavage and synthesis of oligoadenylates (cOA) and a secondary signal that activates downstream nuclease effectors to exert indiscriminate RNA/DNA cleavage, and both activities are regulated in a spatiotemporal fashion. In III-B Cmr systems, cognate tgRNAs activate the two Cmr2-based activities, which are then inactivated via tgRNA cleavage by Cmr4, but how Cmr4 nuclease regulates the Cmr immunization remains to be experimentally characterized. Here, we conducted mutagenesis of Cmr4 conserved amino acids in Saccharolobus islandicus, and this revealed that Cmr4α RNase-dead (dCmr4α) mutation yields cell dormancy/death. We also found that plasmid-borne expression of dCmr4α in the wild-type strain strongly reduced plasmid transformation efficiency, and deletion of CRISPR arrays in the host genome reversed the dCmr4α inhibition. Expression of dCmr4α also strongly inhibited plasmid transformation with Cmr2αHD and Cmr2αPalm mutants, but the inhibition was diminished in Cmr2αHD,Palm. Since dCmr4α-containing effectors lack spatiotemporal regulation, this allows an everlasting interaction between crRNA and cellular RNAs to occur. As a result, some cellular RNAs, which are not effective in mediating immunity due to the presence of spatiotemporal regulation, trigger autoimmunity of the Cmr-α system in the S. islandicus cells expressing dCmr4α. Together, these results pinpoint the crucial importance of tgRNA cleavage in autoimmunity avoidance and in the regulation of immunization of type III systems.

Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance

BackgroundIntracranial artery dissection (IAD) often causes headache and cerebral vascular ischemic events. The imaging characteristics of IAD remain unclear. This study aims to characterize the appearance of culprit and non-culprit IAD using high-resolution cardiovascular magnetic resonance imaging (hrCMR) and quantify the incremental value of hrCMR in identifying higher risk lesions.MethodsImaging data from patients who underwent intervention examination or treatment using digital subtraction angiography (DSA) and hrCMR using a 3 T CMR system within 30 days after the onset of neurological symptoms were collected. The CMR protocol included diffusion-weighted imaging (DWI), black blood T1-, T2- and contrast-enhanced T1-weighted sequences. Lesions were classified as culprit and non-culprit according to imaging findings and patient clinical presentations. Univariate and multivariate analyses were performed to assess the difference between culprit and non-culprit lesions and complementary value of hrCMR in identifying higher risk lesions.ResultsIn total, 75 patients were included in this study. According to the morphology, lesions could be classified into five types: Type I, classical dissection (n = 50); Type II, fusiform aneurysm (n = 1); Type III, long dissected aneurysm (n = 3); Type IV, dolichoectatic dissecting aneurysm (n = 9) and Type V, saccular aneurysm (n = 12). Regression analyses showed that age and hypertension were both associated with culprit lesions (age: OR, 0.83; 95% CI 0.75–0.92; p < 0.001 and hypertension: OR, 66.62; 95% CI 5.91–751.11; p = 0.001). Hematoma identified by hrCMR was significantly associated with culprit lesions (OR, 16.80; 95% CI 1.01–280.81; p = 0.037). Moreover, 17 cases (16 lesions were judged to be culprit) were diagnosed as IAD but not visible in DSA and 15 were Type I lesion.ConclusionhrCMR is helpful in visualizing and characterizing IAD. It provides a significant complementary value over DSA for the diagnosis of IAD.

CRISPR-Cas adaptive immune systems in Sulfolobales: genetic studies and molecular mechanisms.

CRISPR-Cas systems provide the small RNA-based adaptive immunity to defend against invasive genetic elements in archaea and bacteria. Organisms of Sulfolobales, an order of thermophilic acidophiles belonging to the Crenarchaeotal Phylum, usually contain both type I and type III CRISPR-Cas systems. Two species, Saccharolobus solfataricus and Sulfolobus islandicus, have been important models for CRISPR study in archaea, and knowledge obtained from these studies has greatly expanded our understanding of molecular mechanisms of antiviral defense in all three steps: adaptation, expression and crRNA processing, and interference. Four subtypes of CRISPR-Cas systems are common in these organisms, including I-A, I-D, III-B, and III-D. These cas genes form functional modules, e.g., all genes required for adaptation and for interference in the I-A immune system are clustered together to form aCas and iCas modules. Genetic assays have been developed to study mechanisms of adaptation and interference by different CRISPR-Cas systems in these model archaea, and these methodologies are useful in demonstration of the protospacer-adjacent motif (PAM)-dependent DNA interference by I-A interference modules and multiple interference activities by III-B Cmr systems. Ribonucleoprotein effector complexes have been isolated for Sulfolobales III-B and III-D systems, and their biochemical characterization has greatly enriched the knowledge of molecular mechanisms of these novel antiviral immune responses.

T1 mapping performance and measurement repeatability: results from the multi-national T1 mapping standardization phantom program (T1MES)

BackgroundThe T1 Mapping and Extracellular volume (ECV) Standardization (T1MES) program explored T1 mapping quality assurance using a purpose-developed phantom with Food and Drug Administration (FDA) and Conformité Européenne (CE) regulatory clearance. We report T1 measurement repeatability across centers describing sequence, magnet, and vendor performance.MethodsPhantoms batch-manufactured in August 2015 underwent 2 years of structural imaging, B0 and B1, and “reference” slow T1 testing. Temperature dependency was evaluated by the United States National Institute of Standards and Technology and by the German Physikalisch-Technische Bundesanstalt. Center-specific T1 mapping repeatability (maximum one scan per week to minimum one per quarter year) was assessed over mean 358 (maximum 1161) days on 34 1.5 T and 22 3 T magnets using multiple T1 mapping sequences. Image and temperature data were analyzed semi-automatically. Repeatability of serial T1 was evaluated in terms of coefficient of variation (CoV), and linear mixed models were constructed to study the interplay of some of the known sources of T1 variation.ResultsOver 2 years, phantom gel integrity remained intact (no rips/tears), B0 and B1 homogenous, and “reference” T1 stable compared to baseline (% change at 1.5 T, 1.95 ± 1.39%; 3 T, 2.22 ± 1.44%). Per degrees Celsius, 1.5 T, T1 (MOLLI 5s(3s)3s) increased by 11.4 ms in long native blood tubes and decreased by 1.2 ms in short post-contrast myocardium tubes. Agreement of estimated T1 times with “reference” T1 was similar across Siemens and Philips CMR systems at both field strengths (adjusted R2 ranges for both field strengths, 0.99–1.00). Over 1 year, many 1.5 T and 3 T sequences/magnets were repeatable with mean CoVs < 1 and 2% respectively. Repeatability was narrower for 1.5 T over 3 T. Within T1MES repeatability for native T1 was narrow for several sequences, for example, at 1.5 T, Siemens MOLLI 5s(3s)3s prototype number 448B (mean CoV = 0.27%) and Philips modified Look-Locker inversion recovery (MOLLI) 3s(3s)5s (CoV 0.54%), and at 3 T, Philips MOLLI 3b(3s)5b (CoV 0.33%) and Siemens shortened MOLLI (ShMOLLI) prototype 780C (CoV 0.69%). After adjusting for temperature and field strength, it was found that the T1 mapping sequence and scanner software version (both P < 0.001 at 1.5 T and 3 T), and to a lesser extent the scanner model (P = 0.011, 1.5 T only), had the greatest influence on T1 across multiple centers.ConclusionThe T1MES CE/FDA approved phantom is a robust quality assurance device. In a multi-center setting, T1 mapping had performance differences between field strengths, sequences, scanner software versions, and manufacturers. However, several specific combinations of field strength, sequence, and scanner are highly repeatable, and thus, have potential to provide standardized assessment of T1 times for clinical use, although temperature correction is required for native T1 tubes at least.

A three-dimensional (3D) printed biomimetic hierarchical scaffold with a covalent modular release system for osteogenesis

Hydroxyapatite (HA) ceramics are well known for their biocompatibility, bioactivity, and osteoconductive nature. However, limited hierarchical structure and lack of ease in modularity hinder the widespread application of conventional HA ceramics. By using three-dimensional printing (3DP) techniques with multiple materials, including HA, complex biological and mechanical architecture of natural organisms can be achieved through biomimetics. In this study, we designed an osteoid, biomimetic, hierarchical, porous HA ceramic 3D printed scaffold (3DPs). Further incorporation of a covalent, modular, controlled release system (CMR), based on Watson-Crick's complementary oligonucleotides, and was added to carry a bone morphogenetic protein-2 (BMP2) peptide. The choice of a HA biomimetic scaffold housing BMP2 protein fragments was selected to successfully promote osteogenesis both in vitro and in vivo. Scanning electron microscopy, micro-computed tomography analysis and computer fluid dynamics simulations of the 3DPs showed a uniform biomimetic hierarchical structure and an effective interior permeability. Active molecules were found bound with high stability and modular to the scaffold surface via the CMR system. After 7 days of incubation under physiological conditions, approximately 90% of active factors remained bound. Compared to control groups, the 3DPs-CMR-BMP2 group significantly enhanced cell proliferation and adhesion. Moreover, the 3DPs-CMR-BMP2 group exhibited more extensive and sustained osteogenic effects through upregulated expression of osteogenic factors and enhanced calcium deposition, as compared to study and control groups. Furthermore, ectopic osteogenesis and a critical calvarial defect model confirmed that the 3DPs-CMR-BMP2 group significantly promoted in vivo bone healing versus control. Thus, our results showed that biomimetic hierarchical 3DPs with a CMR system successfully promote cell proliferation, adhesion, differentiation and osteogenesis, on a continuous cycle. The biomimetic hierarchical 3DPs with a CMR system offers a promising multi-functional, bone substitute material for treatment of patients with bone defects.

Bayesian intravoxel incoherent motion parameter mapping in the human heart

BackgroundIntravoxel incoherent motion (IVIM) imaging of diffusion and perfusion in the heart suffers from high parameter estimation error. The purpose of this work is to improve cardiac IVIM parameter mapping using Bayesian inference.MethodsA second-order motion-compensated diffusion weighted spin-echo sequence with navigator-based slice tracking was implemented to collect cardiac IVIM data in early systole in eight healthy subjects on a clinical 1.5 T CMR system. IVIM data were encoded along six gradient optimized directions with b-values of 0–300 s/mm2. Subjects were scanned twice in two scan sessions one week apart to assess intra-subject reproducibility. Bayesian shrinkage prior (BSP) inference was implemented to determine IVIM parameters (diffusion D, perfusion fraction F and pseudo-diffusion D*). Results were compared to least-squares (LSQ) parameter estimation. Signal-to-noise ratio (SNR) requirements for a given fitting error were assessed for the two methods using simulated data. Reproducibility analysis of parameter estimation in-vivo using BSP and LSQ was performed.ResultsBSP resulted in reduced SNR requirements when compared to LSQ in simulations. In-vivo, BSP analysis yielded IVIM parameter maps with smaller intra-myocardial variability and higher estimation certainty relative to LSQ. Mean IVIM parameter estimates in eight healthy subjects were (LSQ/BSP): 1.63 ± 0.28/1.51 ± 0.14·10−3 mm2/s for D, 13.13 ± 19.81/13.11 ± 5.95% for F and 201.45 ± 313.23/13.11 ± 14.53·10−3 mm2/s for D∗. Parameter variation across all volunteers and measurements was lower with BSP compared to LSQ (coefficient of variation BSP vs. LSQ: 9% vs. 17% for D, 45% vs. 151% for F and 111% vs. 155% for D∗). In addition, reproducibility of the IVIM parameter estimates was higher with BSP compared to LSQ (Bland-Altman coefficients of repeatability BSP vs. LSQ: 0.21 vs. 0.26·10−3 mm2/s for D, 5.55 vs. 6.91% for F and 15.06 vs. 422.80·10−3 mm2/s for D*).ConclusionRobust free-breathing cardiac IVIM data acquisition in early systole is possible with the proposed method. BSP analysis yields improved IVIM parameter maps relative to conventional LSQ fitting with fewer outliers, improved estimation certainty and higher reproducibility. IVIM parameter mapping holds promise for myocardial perfusion measurements without the need for contrast agents.

Hyperpolarized 13C urea myocardial first-pass perfusion imaging using velocity-selective excitation

BackgroundA velocity-selective binomial excitation scheme for myocardial first-pass perfusion measurements with hyperpolarized 13C substrates, which preserves bolus magnetization inside the blood pool, is presented. The proposed method is evaluated against gadolinium-enhanced 1H measurements in-vivo.MethodsThe proposed excitation with an echo-planar imaging readout was implemented on a clinical CMR system. Dynamic myocardial stress perfusion images were acquired in six healthy pigs after bolus injection of hyperpolarized 13C urea with the velocity-selective vs. conventional excitation, as well as standard 1H gadolinium-enhanced images. Signal-to-noise, contrast-to-noise (CNR) and homogeneity of semi-quantitative perfusion measures were compared between methods based on first-pass signal-intensity time curves extracted from a mid-ventricular slice. Diagnostic feasibility is demonstrated in a case of septal infarction.ResultsVelocity-selective excitation provides over three-fold reduction in blood pool signal with a two-fold increase in myocardial CNR. Extracted first-pass perfusion curves reveal a significantly reduced variability of semi-quantitative first-pass perfusion measures (12–20%) for velocity-selective excitation compared to conventional excitation (28–93%), comparable to that of reference 1H gadolinium data (9–15%). Overall image quality appears comparable between the velocity-selective hyperpolarized and gadolinium-enhanced imaging.ConclusionThe feasibility of hyperpolarized 13C first-pass perfusion CMR has been demonstrated in swine. Comparison with reference 1H gadolinium data revealed sufficient data quality and indicates the potential of hyperpolarized perfusion imaging for human applications.

Griffiths phase and temporal effects in phase separated manganites

Phenomenological description of relaxation phenomena in magnetic and transport properties of perovskite manganites has been presented. The approach is based on generalization of some hypotheses appropriate to the Preisach picture of magnetization process for half-metallic ferromagnets and on an assumption that in doped manganites the phase separated state exists near the magnetic ordering temperature. For systems with the percolation type of a ferromagnet–paramagnet transition, distinctive features in relaxation of magnetization and resistivity have been found. The relaxation is shown to be most pronounced near the transition temperature, and to be an approximately logarithmic function of time. The theoretical results replicate a broad spectrum of behavior observed experimentally on time dependence of magnetization and resistivity of CMR systems and allow a direct comparison with available experimental data. We propose an additional experimental test to distinguish between the percolation scenario of magnetic and transport transitions in doped manganites, and the ferromagnetic polaron picture. In particular, an anomalously slow relaxation to zero of the order parameter can be considered as a key feature of the Griffiths-like phase transition in doped manganites. It is also shown that a system with the Griffiths-like state will exhibit nonequilibrium aging and rejuvenation phenomena, which in many aspects resemble that of a spin glass. We hope that experimental observation of a set of time decay properties will provide a settlement of apparently conflicting results obtained for different characteristics of phase-separated manganites.

Bipartite recognition of target RNAs activates DNA cleavage by the Type III-B CRISPR–Cas system

CRISPR-Cas systems eliminate nucleic acid invaders in bacteria and archaea. The effector complex of the Type III-B Cmr system cleaves invader RNAs recognized by the CRISPR RNA (crRNA ) of the complex. Here we show that invader RNAs also activate the Cmr complex to cleave DNA. As has been observed for other Type III systems, Cmr eliminates plasmid invaders in Pyrococcus furiosus by a mechanism that depends on transcription of the crRNA target sequence within the plasmid. Notably, we found that the target RNA per se induces DNA cleavage by the Cmr complex in vitro. DNA cleavage activity does not depend on cleavage of the target RNA but notably does require the presence of a short sequence adjacent to the target sequence within the activating target RNA (rPAM [RNA protospacer-adjacent motif]). The activated complex does not require a target sequence (or a PAM) in the DNA substrate. Plasmid elimination by the P. furiosus Cmr system also does not require the Csx1 (CRISPR-associated Rossman fold [CARF] superfamily) protein. Plasmid silencing depends on the HD nuclease and Palm domains of the Cmr2 (Cas10 superfamily) protein. The results establish the Cmr complex as a novel DNA nuclease activated by invader RNAs containing a crRNA target sequence and a rPAM.

The CRISPR-associated Csx1 protein of Pyrococcus furiosus is an adenosine-specific endoribonuclease.

Prokaryotes are frequently exposed to potentially harmful invasive nucleic acids from phages, plasmids, and transposons. One method of defense is the CRISPR-Cas adaptive immune system. Diverse CRISPR-Cas systems form distinct ribonucleoprotein effector complexes that target and cleave invasive nucleic acids to provide immunity. The Type III-B Cmr effector complex has been found to target the RNA and DNA of the invader in the various bacterial and archaeal organisms where it has been characterized. Interestingly, the gene encoding the Csx1 protein is frequently located in close proximity to the Cmr1-6 genes in many genomes, implicating a role for Csx1 in Cmr function. However, evidence suggests that Csx1 is not a stably associated component of the Cmr effector complex, but is necessary for DNA silencing by the Cmr system in Sulfolobus islandicus. To investigate the function of the Csx1 protein, we characterized the activity of recombinant Pyrococcus furiosus Csx1 against various nucleic acid substrates. We show that Csx1 is a metal-independent, endoribonuclease that acts selectively on single-stranded RNA and cleaves specifically after adenosines. The RNA cleavage activity of Csx1 is dependent upon a conserved HEPN motif located within the C-terminal domain of the protein. This motif is also key for activity in other known ribonucleases. Collectively, the findings indicate that invader silencing by Type III-B CRISPR-Cas systems relies both on RNA and DNA nuclease activities from the Cmr effector complex as well as on the affiliated, trans-acting Csx1 endoribonuclease.

An archaeal CRISPR type III-B system exhibiting distinctive RNA targeting features and mediating dual RNA and DNA interference.

CRISPR-Cas systems provide a small RNA-based mechanism to defend against invasive genetic elements in archaea and bacteria. To investigate the in vivo mechanism of RNA interference by two type III-B systems (Cmr-α and Cmr-β) in Sulfolobus islandicus, a genetic assay was developed using plasmids carrying an artificial mini-CRISPR (AC) locus with a single spacer. After pAC plasmids were introduced into different strains, Northern analyses confirmed that mature crRNAs were produced from the plasmid-borne CRISPR loci, which then guided gene silencing to target gene expression. Spacer mutagenesis identified a trinucleotide sequence in the 3′-region of crRNA that was crucial for RNA interference. Studying mutants lacking Cmr-α or Cmr-β system showed that each Cmr complex exhibited RNA interference. Strikingly, these analyses further revealed that the two Cmr systems displayed distinctive interference features. Whereas Cmr-β complexes targeted transcripts and could be recycled in RNA cleavage, Cmr-α complexes probably targeted nascent RNA transcripts and remained associated with the substrate. Moreover, Cmr-β exhibited much stronger RNA cleavage activity than Cmr-α. Since we previously showed that S. islandicus Cmr-α mediated transcription-dependent DNA interference, the Cmr-α constitutes the first CRISPR system exhibiting dual targeting of RNA and DNA.

Quantitative and qualitative adenosine perfusion magnetic resonance imaging for the detection of coronary artery disease at 3 Tesla

Background Adenosine perfusion cardiac magnetic resonance imaging (CMR) at 3 Tesla has been suggested to yield superior diagnostic accuracy in comparison to 1.5 Tesla. We sought to evaluate its diagnostic accuracy in a patient cohort with intermediate risk and typical angina symptoms in comparison to quantitative coronary analysis (QCA) and fractional flow reserve (FFR). Methods Eighty-six patients with intermediate risk, angina pectoris, and suspected coronary artery disease were enrolled into the study. All patients were examined in a 3 T CMR system including functional imaging of the left ventricle, adenosine and rest perfusion imaging using a bolus of 0.075 mmol/kg gadolinium based contrast agent (Dotarem, Guerbet, France), respectively. CMR studies were performed within 1 week prior to invasive coronary angiography which included QCA and FFR. Myocardial perfusion reserve (MPR) was calculated and correlated to FFR. Visual analysis of the perfusion sequences were compared to QCA. All measurements were performed by two blinded and experienced observers in consensus. Results Visual CMR analysis resulted in a specificity of 0.88 and sensitivity of 0.96 for the detection of ac oronary artery stenosis ≥70% as quantified by QCA on a per patient basis. ROC analysis for MPR yielded specificity of 1.0 and sensitivity of 0.9 for the detection of a coronary artery with reduced FFR (≤0.8) on a per vessel basis. Conclusions Qualitative and quantitative analysis of adenosine perfusion CMR at 3 Tesla are able to detect significant coronary artery disease with high diagnostic accuracies, respectively. 3 Tesla CMR might thus serve as an important non-invasive diagnostic tool in clinical work-up of the evaluation of coronary artery disease. Funding Partly funded by a research grant from Guerbet.

ChemInform Abstract: Molecular Spintronics Based on Single‐Molecule Magnets Composed of Multiple‐Decker Phthalocyaninato Terbium(III) Complex

AbstractReview: 142 refs.

Molecular Spintronics Based on Single‐Molecule Magnets Composed of Multiple‐Decker Phthalocyaninato Terbium(III) Complex

Unlike electronics, which is based on the freedom of the charge of an electron whose memory is volatile, spintronics is based on the freedom of the charge, spin, and orbital of an electron whose memory is non-volatile. Although in most GMR, TMR, and CMR systems, bulk or classical magnets that are composed of transition metals are used, this Focus Review considers the growing use of single-molecule magnets (SMMs) that are composed of multinuclear metal complexes and nanosized magnets, which exhibit slow magnetic-relaxation processes and quantum tunneling. Molecular spintronics, which combines spintronics and molecular electronics, is an emerging field of research. Using molecules is advantageous because their electronic and magnetic properties can be manipulated under specific conditions. Herein, recent developments in [LnPc]-based multiple-decker SMMs on surfaces for molecular spintronic devices are presented. First, we discuss the strategies for preparing single-molecular-memory devices by using SMMs. Next, we focus on the switching of the Kondo signal of [LnPc]-based multiple-decker SMMs that are adsorbed onto surfaces, their characterization by using STM and STS, and the relationship between the molecular structure, the electronic structure, and the Kondo resonance of [TbPc(2)]. Finally, the field-effect-transistor (FET) properties of surface-adsorbed [LnPc(2)] and [Ln(2)Pc(3)] cast films are reported, which is the first step towards controlling SMMs through their spins for applications in single-molecular memory and spintronics devices.

First pass vasodilator-stress myocardial perfusion CMR in mice on a whole-body 3Tesla scanner: validation against microspheres

Summary Summary: We report the feasibility of first pass vasodilator-stress myocardial perfusion CMR in mice on a whole-body 3Tesla scanner and demonstrate a 2.6 fold increase of stress over rest myocardial blood flow in good agreement with microspheres. Background Animal models are important to develop our understanding of the pathophysiology of cardiovascular disease and for the development of new therapies. While coronary autoregulation maintains resting myocardial blood flow (MBF) constant over a wide range of pathological conditions, MBF reserve during hyperaemic stress is impaired in several common disease processes. First pass contrast-enhanced myocardial perfusion is the standard CMR method for the estimation of MBF and MBF reserve in man, but is challenging in rodents because of the constraints related to the high temporal and spatial resolution requirements. Murine first pass myocardial perfusion at rest can be performed on a whole-body 3 Tesla CMR system. Hyperaemic myocardial stress perfusion CMR in mice has however not been reported.

Flow measurement by cardiovascular magnetic resonance: a multi-centre multi-vendor study of background phase offset errors that can compromise the accuracy of derived regurgitant or shunt flow measurements.

AimsCardiovascular magnetic resonance (CMR) allows non-invasive phase contrast measurements of flow through planes transecting large vessels. However, some clinically valuable applications are highly sensitive to errors caused by small offsets of measured velocities if these are not adequately corrected, for example by the use of static tissue or static phantom correction of the offset error. We studied the severity of uncorrected velocity offset errors across sites and CMR systems.Methods and ResultsIn a multi-centre, multi-vendor study, breath-hold through-plane retrospectively ECG-gated phase contrast acquisitions, as are used clinically for aortic and pulmonary flow measurement, were applied to static gelatin phantoms in twelve 1.5 T CMR systems, using a velocity encoding range of 150 cm/s. No post-processing corrections of offsets were implemented. The greatest uncorrected velocity offset, taken as an average over a 'great vessel' region (30 mm diameter) located up to 70 mm in-plane distance from the magnet isocenter, ranged from 0.4 cm/s to 4.9 cm/s. It averaged 2.7 cm/s over all the planes and systems. By theoretical calculation, a velocity offset error of 0.6 cm/s (representing just 0.4% of a 150 cm/s velocity encoding range) is barely acceptable, potentially causing about 5% miscalculation of cardiac output and up to 10% error in shunt measurement.ConclusionIn the absence of hardware or software upgrades able to reduce phase offset errors, all the systems tested appeared to require post-acquisition correction to achieve consistently reliable breath-hold measurements of flow. The effectiveness of offset correction software will still need testing with respect to clinical flow acquisitions.