Cloud-processed 4D CMR flow imaging for pulmonary flow quantification

Raluca G. Chelu*, Kevin W. Wanambiro, Albert Hsiao, Laurens E. Swart, Teun Voogd, Allard T. van den Hoven, Matthijs van Kranenburg, Adriaan Coenen, Sara Boccalini, Piotr A. Wielopolski, Mika W. Vogel, Gabriel P. Krestin, Shreyas S. Vasanawala, Ricardo P J Budde, Jolien W. Roos-Hesselink, Koen Nieman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives In this study, we evaluated a cloud-based platform for cardiac magnetic resonance (CMR) four-dimensional (4D) flow imaging, with fully integrated correction for eddy currents, Maxwell phase effects, and gradient field non-linearity, to quantify forward flow, regurgitation, and peak systolic velocity over the pulmonary artery. Methods We prospectively recruited 52 adult patients during one-year period from July 2014. The 4D flow and planar (2D) phase-contrast (PC) were acquired during same scanning session, but 4D flow was scanned after injection of a gadolinium-based contrast agent. Eddy-currents were semi-automatically corrected using the web-based software. Flow over pulmonary valve was measured and the 4D flow values were compared against the 2D PC ones. Results The mean forward flow was 92 (±30) ml/cycle measured with 4D flow and 86 (±29) ml/cycle measured with 2D PC, with a correlation of 0.82 and a mean difference of −6 ml/cycle (−41–29). For the regurgitant fraction the correlation was 0.85 with a mean difference of −0.95% (−17–15). Mean peak systolic velocity measured with 4D flow was 92 (±49) cm/s and 108 (±56) cm/s with 2D PC, having a correlation of 0.93 and a mean difference of 16 cm/s (−24–55). Conclusion 4D flow imaging post-processed with an integrated cloud-based application accurately quantifies pulmonary flow. However, it may underestimate the peak systolic velocity.

Original languageEnglish
Pages (from-to)1849-1856
Number of pages8
JournalEuropean Journal of Radiology
Volume85
Issue number10
DOIs
Publication statusPublished - 1 Oct 2016
Externally publishedYes

Keywords

  • 4D CMR flow imaging
  • Eddy current correction
  • Flow visualization
  • Phase contrast
  • Pulmonary regurgitant fraction

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