How low can we go? The effect of acquisition duration on cardiac volume and function measurements in free-running cardiac and respiratory motion-resolved 5D whole-heart cine MRI at 1.5T.

Abstract

Introduction: Cardiovascular magnetic resonance (CMR) is the gold standard for assessing cardiac volumes and function using 2D breath-held cine imaging. This technique, however, requires a reliable ECG signal, repetitive breath-holds, and the time-consuming and proficiency-demanding planning of cardiac views. Recently, a free-running framework has been developed for cardiac and respiratory motion-resolved 5D whole-heart imaging without the need for an ECG signal, repetitive breath-holds, and meticulous plan scanning. In this study, we investigate the impact of acquisition time on cardiac volumetric and functional measurements, when using free-running imaging, compared to reference standard 2D cine imaging.

Methods: Sixteen healthy adult volunteers underwent CMR at 1.5T, including standard 2D breath-held cine imaging and free-running imaging using acquisition durations ranging from 1 to 6min in randomized order. All datasets were anonymized and analysed for left-ventricular end-systolic and end-diastolic volumes, as well as ejection fraction. In a subset of data, intra- and inter-observer agreement was assessed. In addition, image quality and observer confidence were scored using a 4-point Likert scale. Finally, acquisition efficiency was reported for both imaging techniques, which was defined as the time required for data sampling divided by the total scan time.

Results: No significant differences in left-ventricular EDV and ESV were found between free-running imaging for 1, 2, 3, 5, and 6minutes and standard 2D breath-held cine imaging. Biases in EDV ranged from -2.4 to -7.4mL, while biases in ESV ranged from -3.8 to 2.1mL. No significant differences in ejection fraction were found between free-running imaging of any acquisition duration and standard 2D breath-held cine imaging. Biases in ejection fraction ranged from -2.8% to 0.94%. Both image quality and observer confidence in free-running imaging improved when the acquisition duration increased. However, they were always lower than standard 2D breath-held cine imaging. Acquisition efficiency improved from 13% for standard 2D cine imaging to 50% or higher for free-running imaging.

Discussion: Free-running CMR with an acquisition duration as short as one minute can provide left-ventricular cardiac volumes and ejection fraction comparable to standard 2D breath-held cine imaging, albeit at the expense of both image quality and observer confidence.