Wednesday, May 8, 2024
5/8/2024
PROJECT SUMMARY Congenital heart disease (CHD) affects about 40,000 births per year (1%) in the United States. Estimates indicate that over 1 million children and 1.4 million adults with CHD are living in the United States. This project speci¿cally aims to develop and clinically evaluate a magnetic resonance imaging (MRI) method to assess car- diovascular hemodynamics in pediatric CHD patients, when imaging is most needed. Individuals born with CHD require a lifetime of clinical care, especially during surgical planning and repair. This includes monitoring and/or serial interventions that mandate multiple echocardiography, CT, or MRI exams. Under most circumstances, MRI is the clinically preferred imaging modality for these patients owing to soft tissue contrast, clear depiction of complex anatomies, capability to quantify cardiac function, and the lack of ionizing radiation. Moreover, the ability to acquire 3D+time ¿ow encoded (“4D-Flow”) MRI exams that depict and measure blood ¿ow dynamics is an increasingly impactful clinical tool in adult patients, but several challenges persist in pediatric patients. Current pediatric cardiovascular 4D-Flow exams are slow to acquire (¿20-min with moderate spatial and tem- poral resolution), have unacceptable ¿ow measurement accuracy and precision (oftentimes >20%), can have long reconstruction times (several hours), and have inadequate clinical robustness (>10% of exams with unac- ceptable image quality). These are unacceptable clinical limitations that interfere with clinical care. To overcome these limitations, we have planned three speci¿c aims to develop our Hyper 4D-Flow MRI exam. [AIM-1] To enable fast, accurate, and robust image acquisitions with Hyper 4D-Flow. [AIM-2] To enable fast and accurate image reconstructions of Hyper 4D-Flow. [AIM-3] To demonstrate the diagnostic value of “push-button” Hyper 4D-Flow in pediatric patients with CHD. Successful completion of the proposed speci¿c aims will make available a validated, “push-button”, multi- vendor deployable Hyper 4D-Flow MRI exam that enables fast (¿5-min scan time and ¿30-min reconstruction), accurate (<5% bias), precise (95%-CIs<5%), and robust measurements (>95% of exams with diagnostic image quality; no need for post-acquisition corrections of background phase-induced errors) of blood ¿ow. This compre- hensive approach to the problem will improve diagnostic accuracy and clinical con¿dence in decision making for pediatric patients with CHD patients, by providing fast, accurate, and robust evaluation of hemodynamics.
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