iNav-based, Automated Coronary Magnetic Resonance Angiography for the Detection of Coronary Artery Stenosis (iNav-AUTO CMRA).

IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2024-09-16 DOI:10.1016/j.jocmr.2024.101097

Gregory Wood,Reza Hajhosseiny,Alexandra Uglebjerg Pedersen,Simon Littlewood,Tina Juul Hansen,Radhouene Neji,Karl P Kunze,Jens Wetzl,Bjarne Linde Nørgaard,Jesper Møller Jensen,Michael Maeng,Per Lav Madsen,Niels Vejlstrup,Claudia Prieto,René M Botnar,Won Yong Kim

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引用次数: 0

Abstract

BACKGROUND Coronary computed tomography angiography (CCTA) is recommended as the first line diagnostic imaging modality in low to intermediate risk individuals suspected of stable coronary artery disease (CAD). However, CCTA exposes patients to ionising radiation and potentially nephrotoxic contrast agents. Invasive coronary angiography (ICA) is the gold-standard investigation to guide coronary revascularisation strategy, however, invasive procedures incur an inherent risk to the patient. Coronary magnetic resonance angiography (Coronary MRA) avoids these issues. Nevertheless, clinical implementation is currently limited due to extended scanning durations, inconsistent image quality, and consequent lack of diagnostic accuracy. Several technical Coronary MRA innovations including advanced respiratory motion correction with 100% scan efficiency (no data rejection), fast image acquisition with motion-corrected undersampled image reconstruction and deep-learning (DL)-based automated planning have been implemented and now await clinical validation in multi-centre trials. METHODS The objective of the iNav-AUTO CMRA prospective multi-centre study is to evaluate the diagnostic accuracy of a newly developed, state-of-the-art, standardised, and automated Coronary MRA framework compared to CCTA in 230 patients undergoing clinical investigation for CAD. The study protocol mandates the administration of oral beta-blockers to decrease heart rate to below 60bpm and the use of sublingual nitroglycerine spray to induce vasodilation. Additionally, the study incorporates the utilisation of standardised postprocessing with sliding-thin-slab multiplanar reformatting, in combination with evaluation of the source images, to optimize the visualisation of coronary artery stenosis. DISCUSSION If proven effective, Coronary MRA could provide a non-invasive, needle-free, yet also clinically viable, alternative to CCTA. TRIAL REGISTRATION This study is registered at clinicaltrials.gov (NCT05473117).

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用于检测冠状动脉狭窄的基于 iNav 的自动冠状动脉磁共振血管造影术（iNav-AUTO CMRA）。

背景建议将冠状动脉计算机断层扫描血管造影术（CCTA）作为一线诊断成像方式，适用于怀疑患有稳定型冠状动脉疾病（CAD）的中低风险人群。然而，CCTA 会使患者暴露于电离辐射和潜在的肾毒性造影剂中。侵入性冠状动脉造影术（ICA）是指导冠状动脉血管重建策略的黄金标准检查方法，但侵入性程序会给患者带来固有风险。冠状动脉磁共振血管造影术（Coronary MRA）可避免这些问题。然而，由于扫描时间长、图像质量不稳定以及诊断准确性不足等原因，目前临床应用还很有限。iNav-AUTO CMRA 前瞻性多中心研究的目的是评估新开发的、最先进的标准化自动冠状动脉 MRA 框架与 CCTA 相比，在 230 名接受 CAD 临床检查的患者中的诊断准确性。研究方案要求口服β-受体阻滞剂将心率降至 60bpm 以下，并使用硝酸甘油舌下喷剂诱导血管扩张。此外，该研究还采用了滑动薄片多平面重新格式化的标准化后处理方法，并结合对源图像的评估，以优化冠状动脉狭窄的可视化。讨论如果证明有效，冠状动脉 MRA 可以提供一种无创、无针、临床上可行的方法来替代 CCTA。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.