Phase ordering with automatic window selection (PAWS): A novel motion-resistant technique for 3D coronary imaging

Jhooti, Permi; Gatehouse, Peter; Keegan, Jennifer; Bunce, Nicholas; Taylor, Andrew M.; Firmin, David N.

doi:10.1002/(sici)1522-2594(200003)43:3<470::aid-mrm20>3.0.co;2-u

Cited by 76 publications

(66 citation statements)

References 13 publications

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“…This could be done for example by increasing the acquisition windows within the cardiac and/or respiratory cycles (taking advantage of the motion insensitivity of radial imaging, and possibly combined with motion correction [38]), by parallel imaging (perhaps in conjunction with new 32-channel receiver systems) or by reducing the intershot repetition time to one heartbeat. As with all free-breathing coronary studies, the scan-time can be prolonged when the subject's breathing pattern drifts, and our methods would therefore benefit greatly from techniques such as PAWS [39] or 3D-MAG [40], which can mitigate this problem to some extent.…”

Section: Discussionmentioning

confidence: 99%

Coronary vessel-wall and lumen imaging using radial k-space acquisition with MRI at 3 Tesla

et al. 2006

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This study investigates the feasibility of imaging the coronary lumen and vessel-wall, using MRI with a radial k-space trajectory at 3 T. Such radial trajectories offer the advantage of greater vessel sharpness than traditional Cartesian trajectories. This field strength offers an increased signal-to-noise ratio (SNR) compared with 1.5 T, which compensates for the slight SNR reduction due to the radial sequence. Images of the coronary lumen were acquired for seven healthy volunteers. In ten volunteers the vessel wall was scanned, with blood suppression using oblique-slab adiabatic re-inversion. Scans were performed during free breathing, using prospective respiratory navigator-gating. Coronary lumen scans had SNR of 16.0+/-1.9 and contrast-to-noise ratio (CNR) of 10.3+/-2.1, showing acceptable image quality. Vessel wall images showed good image quality, with mean SNR of 16.6+/-2.0/5.8+/-2.8/10.1+/-2.2 for vessel wall/lumen/epicardial fat. The wall-blood CNR was 10.7+/-2.7, and wall-fat CNR was 6.5+/-2.5. It is concluded that radial gradient-echo imaging at 3 T is a promising method for coronary vessel-wall imaging, and is also feasible for imaging the coronary lumen.

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Section: Discussionmentioning

confidence: 99%

Coronary vessel-wall and lumen imaging using radial k-space acquisition with MRI at 3 Tesla

et al. 2006

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“…Phase ordering with automatic window selection 11 was implemented to maximize the respiratory efficiency. For the left main stem, left anterior descending (LAD), and left circumflex coronary arteries, a 3-dimensional volume was imaged by use of a 3-point plan-scan tool with the center of the volume focused on the left main coronary artery.…”

Section: Cardiovascular Magnetic Resonancementioning

confidence: 99%

Role of Cardiovascular Magnetic Resonance as a Gatekeeper to Invasive Coronary Angiography in Patients Presenting With Heart Failure of Unknown Etiology

et al. 2011

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Background-In patients presenting with new-onset heart failure of uncertain etiology, the role of coronary angiography (CA) is unclear. Although conventionally performed to differentiate underlying coronary artery disease from dilated cardiomyopathy, CA is associated with a risk of complications and may not detect an ischemic cause resulting from arterial recanalization or an embolic episode. In this study, we assessed the diagnostic accuracy of a cardiovascular magnetic resonance (CMR) protocol incorporating late gadolinium enhancement (LGE) and magnetic resonance CA as a noninvasive gatekeeper to CA in determining the etiology of heart failure in this subset of patients. Methods and Results-One hundred twenty consecutive patients underwent CMR and CA. The etiology was ascribed by a consensus panel that used the results of the CMR scans. Similarly, a separate consensus group ascribed an underlying cause by using the results of CA. The diagnostic accuracy of both strategies was compared against a gold-standard panel that made a definitive judgment by reviewing all clinical data. The study was powered to show noninferiority between the 2 techniques. The sensitivity of 100%, specificity of 96%, and diagnostic accuracy of 97% for LGE-CMR were equivalent to CA (sensitivity, 93%; specificity, 96%; and diagnostic accuracy, 95%). As a gatekeeper to CA, LGE-CMR was also found to be a cheaper diagnostic strategy in a decision tree model when United Kingdom-based costs were assumed. The economic merits of this model would change, depending on the relative costs of LGE-CMR and CA in any specific healthcare system. Conclusion-This study showed that LGE-CMR is a safe, clinically effective, and potentially economical gatekeeper to CA in patients presenting with heart failure of uncertain etiology.

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“…3D motion adapted gating 3D-MAG is a 3D extension of the multi-level approach PAWS (phase-ordering with automatic window selection) and does not require predefined gating windows [26]. The navigator information is used in real-time to decide prospectively which part of the 3D-k-space should be acquired next.…”

Section: Standard Navigatormentioning

confidence: 99%

3D motion adapted gating (3D MAG): a new navigator technique for accelerated acquisition of free breathing navigator gated 3D coronary MR-angiography

et al. 2005

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This study aimed to evaluate the influence of a new navigator technique (3D MAG) on navigator efficiency, total acquisition time, image quality and diagnostic accuracy. Fifty-six patients with suspected coronary artery disease underwent free breathing navigator gated coronary MRA (Intera, Philips Medical Systems, 1.5 T, spatial resolution 0.9x0.9x3 mm3) with and without 3D MAG. Evaluation of both sequences included: 1) navigator scan efficiency, 2) total acquisition time, 3) assessment of image quality and 4) detection of stenoses >50%. Average navigator efficiencies of the LCA and RCA were 43+/-12% and 42+/-12% with and 36+/-16% and 35+/-16% without 3D MAG (P<0.01). Scan time was reduced from 12 min 7 s without to 8 min 55 s with 3D MAG for the LCA and from 12 min 19 s to 9 min 7 s with 3D MAG for the RCA (P<0.01). The average scores of image quality of the coronary MRAs with and without 3D MAG were 3.5+/-0.79 and 3.46+/-0.84 (P>0.05). There was no significant difference in the sensitivity and specificity in the detection of coronary artery stenoses between coronary MRAs with and without 3D MAG (P>0.05). 3D MAG provides accelerated acquisition of navigator gated coronary MRA by about 19% while maintaining image quality and diagnostic accuracy.

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Phase ordering with automatic window selection (PAWS): A novel motion-resistant technique for 3D coronary imaging

Cited by 76 publications

References 13 publications

Coronary vessel-wall and lumen imaging using radial k-space acquisition with MRI at 3 Tesla

Coronary vessel-wall and lumen imaging using radial k-space acquisition with MRI at 3 Tesla

Role of Cardiovascular Magnetic Resonance as a Gatekeeper to Invasive Coronary Angiography in Patients Presenting With Heart Failure of Unknown Etiology

3D motion adapted gating (3D MAG): a new navigator technique for accelerated acquisition of free breathing navigator gated 3D coronary MR-angiography

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