Saturday, May 17, 2025
5/17/2025
Fast and Accurate Cardiovascular MRI with Hyper 4D-Flow - 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 specifically 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 flow encoded (“4D-Flow”) MRI exams that depict and measure blood flow 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 flow 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 specific 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 specific 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 flow. This compre- hensive approach to the problem will improve diagnostic accuracy and clinical confidence in decision making for pediatric patients with CHD patients, by providing fast, accurate, and robust evaluation of hemodynamics.
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