Cardiac MR elastography for quantitative assessment of elevated myocardial stiffness in cardiac amyloidosis

Arvin Forghanian-Arani, Shivaram P. Arunachalam, Ian C Y Chang, Francis Baffour, Phillip J. Rossman, Kevin J. Glaser, Joshua D Trazasko, Kiaran Patrick McGee, Armando Manduca, Martha Grogan, Angela Dispenzieri, Richard Lorne Ehman, Philip A Araoz

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Abstract

Purpose: To evaluate if cardiac magnetic resonance elastography (MRE) can measure increased stiffness in patients with cardiac amyloidosis. Myocardial tissue stiffness plays an important role in cardiac function. A noninvasive quantitative imaging technique capable of measuring myocardial stiffness could aid in disease diagnosis, therapy monitoring, and disease prognostic strategies. We recently developed a high-frequency cardiac MRE technique capable of making noninvasive stiffness measurements. Materials and Methods: In all, 16 volunteers and 22 patients with cardiac amyloidosis were enrolled in this study after Institutional Review Board approval and obtaining formal written consent. All subjects were imaged head-first in the supine position in a 1.5T closed-bore MR imager. 3D MRE was performed using 5mm isotropic resolution oblique short-axis slices and a vibration frequency of 140Hz to obtain global quantitative in vivo left ventricular stiffness measurements. The median stiffness was compared between the two cohorts. An octahedral shear strain signal-to-noise ratio (OSS-SNR) threshold of 1.17 was used to exclude exams with insufficient motion amplitude. Results: Five volunteers and six patients had to be excluded from the study because they fell below the 1.17 OSS-SNR threshold. The myocardial stiffness of cardiac amyloid patients (median: 11.4 kPa, min: 9.2, max: 15.7) was significantly higher (P=0.0008) than normal controls (median: 8.2 kPa, min: 7.2, max: 11.8). Conclusion: This study demonstrates the feasibility of 3D high-frequency cardiac MRE as a contrast-agent-free diagnostic imaging technique for cardiac amyloidosis. Level of Evidence: 2 J. Magn. Reson. Imaging 2017.

Original languageEnglish (US)
JournalJournal of Magnetic Resonance Imaging
DOIs
StateAccepted/In press - 2017

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Elasticity Imaging Techniques
Amyloidosis
Signal-To-Noise Ratio
Volunteers
Research Ethics Committees
Supine Position
Feasibility Studies
Diagnostic Imaging
Vibration
Amyloid
Contrast Media
Head

Keywords

  • #cardiac amyloidosis
  • #cardiac MRE
  • Magnetic resonance elastography
  • Myocardial stiffness
  • Quantitative stiffness imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{206c8eaf7da8405c96e25d4076bee4b1,
title = "Cardiac MR elastography for quantitative assessment of elevated myocardial stiffness in cardiac amyloidosis",
abstract = "Purpose: To evaluate if cardiac magnetic resonance elastography (MRE) can measure increased stiffness in patients with cardiac amyloidosis. Myocardial tissue stiffness plays an important role in cardiac function. A noninvasive quantitative imaging technique capable of measuring myocardial stiffness could aid in disease diagnosis, therapy monitoring, and disease prognostic strategies. We recently developed a high-frequency cardiac MRE technique capable of making noninvasive stiffness measurements. Materials and Methods: In all, 16 volunteers and 22 patients with cardiac amyloidosis were enrolled in this study after Institutional Review Board approval and obtaining formal written consent. All subjects were imaged head-first in the supine position in a 1.5T closed-bore MR imager. 3D MRE was performed using 5mm isotropic resolution oblique short-axis slices and a vibration frequency of 140Hz to obtain global quantitative in vivo left ventricular stiffness measurements. The median stiffness was compared between the two cohorts. An octahedral shear strain signal-to-noise ratio (OSS-SNR) threshold of 1.17 was used to exclude exams with insufficient motion amplitude. Results: Five volunteers and six patients had to be excluded from the study because they fell below the 1.17 OSS-SNR threshold. The myocardial stiffness of cardiac amyloid patients (median: 11.4 kPa, min: 9.2, max: 15.7) was significantly higher (P=0.0008) than normal controls (median: 8.2 kPa, min: 7.2, max: 11.8). Conclusion: This study demonstrates the feasibility of 3D high-frequency cardiac MRE as a contrast-agent-free diagnostic imaging technique for cardiac amyloidosis. Level of Evidence: 2 J. Magn. Reson. Imaging 2017.",
keywords = "#cardiac amyloidosis, #cardiac MRE, Magnetic resonance elastography, Myocardial stiffness, Quantitative stiffness imaging",
author = "Arvin Forghanian-Arani and Arunachalam, {Shivaram P.} and Chang, {Ian C Y} and Francis Baffour and Rossman, {Phillip J.} and Glaser, {Kevin J.} and Trazasko, {Joshua D} and McGee, {Kiaran Patrick} and Armando Manduca and Martha Grogan and Angela Dispenzieri and Ehman, {Richard Lorne} and Araoz, {Philip A}",
year = "2017",
doi = "10.1002/jmri.25678",
language = "English (US)",
journal = "Journal of Magnetic Resonance Imaging",
issn = "1053-1807",
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TY - JOUR

T1 - Cardiac MR elastography for quantitative assessment of elevated myocardial stiffness in cardiac amyloidosis

AU - Forghanian-Arani, Arvin

AU - Arunachalam, Shivaram P.

AU - Chang, Ian C Y

AU - Baffour, Francis

AU - Rossman, Phillip J.

AU - Glaser, Kevin J.

AU - Trazasko, Joshua D

AU - McGee, Kiaran Patrick

AU - Manduca, Armando

AU - Grogan, Martha

AU - Dispenzieri, Angela

AU - Ehman, Richard Lorne

AU - Araoz, Philip A

PY - 2017

Y1 - 2017

N2 - Purpose: To evaluate if cardiac magnetic resonance elastography (MRE) can measure increased stiffness in patients with cardiac amyloidosis. Myocardial tissue stiffness plays an important role in cardiac function. A noninvasive quantitative imaging technique capable of measuring myocardial stiffness could aid in disease diagnosis, therapy monitoring, and disease prognostic strategies. We recently developed a high-frequency cardiac MRE technique capable of making noninvasive stiffness measurements. Materials and Methods: In all, 16 volunteers and 22 patients with cardiac amyloidosis were enrolled in this study after Institutional Review Board approval and obtaining formal written consent. All subjects were imaged head-first in the supine position in a 1.5T closed-bore MR imager. 3D MRE was performed using 5mm isotropic resolution oblique short-axis slices and a vibration frequency of 140Hz to obtain global quantitative in vivo left ventricular stiffness measurements. The median stiffness was compared between the two cohorts. An octahedral shear strain signal-to-noise ratio (OSS-SNR) threshold of 1.17 was used to exclude exams with insufficient motion amplitude. Results: Five volunteers and six patients had to be excluded from the study because they fell below the 1.17 OSS-SNR threshold. The myocardial stiffness of cardiac amyloid patients (median: 11.4 kPa, min: 9.2, max: 15.7) was significantly higher (P=0.0008) than normal controls (median: 8.2 kPa, min: 7.2, max: 11.8). Conclusion: This study demonstrates the feasibility of 3D high-frequency cardiac MRE as a contrast-agent-free diagnostic imaging technique for cardiac amyloidosis. Level of Evidence: 2 J. Magn. Reson. Imaging 2017.

AB - Purpose: To evaluate if cardiac magnetic resonance elastography (MRE) can measure increased stiffness in patients with cardiac amyloidosis. Myocardial tissue stiffness plays an important role in cardiac function. A noninvasive quantitative imaging technique capable of measuring myocardial stiffness could aid in disease diagnosis, therapy monitoring, and disease prognostic strategies. We recently developed a high-frequency cardiac MRE technique capable of making noninvasive stiffness measurements. Materials and Methods: In all, 16 volunteers and 22 patients with cardiac amyloidosis were enrolled in this study after Institutional Review Board approval and obtaining formal written consent. All subjects were imaged head-first in the supine position in a 1.5T closed-bore MR imager. 3D MRE was performed using 5mm isotropic resolution oblique short-axis slices and a vibration frequency of 140Hz to obtain global quantitative in vivo left ventricular stiffness measurements. The median stiffness was compared between the two cohorts. An octahedral shear strain signal-to-noise ratio (OSS-SNR) threshold of 1.17 was used to exclude exams with insufficient motion amplitude. Results: Five volunteers and six patients had to be excluded from the study because they fell below the 1.17 OSS-SNR threshold. The myocardial stiffness of cardiac amyloid patients (median: 11.4 kPa, min: 9.2, max: 15.7) was significantly higher (P=0.0008) than normal controls (median: 8.2 kPa, min: 7.2, max: 11.8). Conclusion: This study demonstrates the feasibility of 3D high-frequency cardiac MRE as a contrast-agent-free diagnostic imaging technique for cardiac amyloidosis. Level of Evidence: 2 J. Magn. Reson. Imaging 2017.

KW - #cardiac amyloidosis

KW - #cardiac MRE

KW - Magnetic resonance elastography

KW - Myocardial stiffness

KW - Quantitative stiffness imaging

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