Automated quantitative stress perfusion cardiac magnetic resonance in pediatric patients

Cian Scannell; Hadeer Hasaneen; Gerald Greil; Tarique Hussain; Reza Razavi; Jack Lee; Kuberan Pushparajah; Phuoc Duong; Amedeo Chiribiri

doi:10.3389/fped.2021.699497

Automated quantitative stress perfusion cardiac magnetic resonance in pediatric patients

Cian Scannell, Hadeer Hasaneen, Gerald Greil, Tarique Hussain, Reza Razavi, Jack Lee, Kuberan Pushparajah, Phuoc Duong, Amedeo Chiribiri

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Abstract

Background: Myocardial ischemia occurs in pediatrics, as a result of both congenital and acquired heart diseases, and can lead to further adverse cardiac events if untreated. The aim of this work is to assess the feasibility of fully automated, high resolution, quantitative stress myocardial perfusion cardiac magnetic resonance (CMR) in a cohort of pediatric patients and to evaluate its agreement with the coronary anatomical status of the patients. Methods: Fourteen pediatric patients, with 16 scans, who underwent dual-bolus stress perfusion CMR were retrospectively analyzed. All patients also had anatomical coronary assessment with either CMR, CT, or X-ray angiography. The perfusion CMR images were automatically processed and quantified using an analysis pipeline previously developed in adults. Results: Automated perfusion quantification was successful in 15/16 cases. The coronary perfusion territories supplied by vessels affected by a medium/large aneurysm or stenosis (according to the AHA guidelines), induced by Kawasaki disease, an anomalous origin, or interarterial course had significantly reduced myocardial blood flow (MBF) (median (interquartile range), 1.26 (1.05, 1.67) ml/min/g) as compared to territories supplied by unaffected coronaries [2.57 (2.02, 2.69) ml/min/g, p < 0.001] and territories supplied by vessels with a small aneurysm [2.52 (2.45, 2.83) ml/min/g, p = 0.002]. Conclusion: Automatic CMR-derived MBF quantification is feasible in pediatric patients, and the technology could be potentially used for objective non-invasive assessment of ischemia in children with congenital and acquired heart diseases.

Original language	English
Article number	699497
Number of pages	1
Journal	Frontiers in Pediatrics
Volume	9
DOIs	https://doi.org/10.3389/fped.2021.699497
Publication status	Published - 3 Sept 2021

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@article{2f0c0ad13db248e7aacc60cc179ab0d9,

title = "Automated quantitative stress perfusion cardiac magnetic resonance in pediatric patients",

abstract = "Background: Myocardial ischemia occurs in pediatrics, as a result of both congenital and acquired heart diseases, and can lead to further adverse cardiac events if untreated. The aim of this work is to assess the feasibility of fully automated, high resolution, quantitative stress myocardial perfusion cardiac magnetic resonance (CMR) in a cohort of pediatric patients and to evaluate its agreement with the coronary anatomical status of the patients. Methods: Fourteen pediatric patients, with 16 scans, who underwent dual-bolus stress perfusion CMR were retrospectively analyzed. All patients also had anatomical coronary assessment with either CMR, CT, or X-ray angiography. The perfusion CMR images were automatically processed and quantified using an analysis pipeline previously developed in adults. Results: Automated perfusion quantification was successful in 15/16 cases. The coronary perfusion territories supplied by vessels affected by a medium/large aneurysm or stenosis (according to the AHA guidelines), induced by Kawasaki disease, an anomalous origin, or interarterial course had significantly reduced myocardial blood flow (MBF) (median (interquartile range), 1.26 (1.05, 1.67) ml/min/g) as compared to territories supplied by unaffected coronaries [2.57 (2.02, 2.69) ml/min/g, p < 0.001] and territories supplied by vessels with a small aneurysm [2.52 (2.45, 2.83) ml/min/g, p = 0.002]. Conclusion: Automatic CMR-derived MBF quantification is feasible in pediatric patients, and the technology could be potentially used for objective non-invasive assessment of ischemia in children with congenital and acquired heart diseases.",

author = "Cian Scannell and Hadeer Hasaneen and Gerald Greil and Tarique Hussain and Reza Razavi and Jack Lee and Kuberan Pushparajah and Phuoc Duong and Amedeo Chiribiri",

note = "Funding Information: Funding. This work was supported by the King's College London & Imperial College London EPSRC Centre for Doctoral Training in Medical Imaging [EP/L015226/1]; Philips Healthcare; The Department of Health via the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre award to Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust; The NIHR Cardiovascular MedTech Co-operative; The British Heart Foundation [TG/18/2/33768]; and The Centre of Excellence in Medical Engineering funded by the Wellcome Trust and EPSRC [WT 203148/Z/16/Z]. Funding Information: This work was supported by the King{\textquoteright}s College London & Imperial College London EPSRC Centre for Doctoral Training in Medical Imaging [EP/L015226/1]; Philips Healthcare; The Department of Health via the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre award to Guy{\textquoteright}s & St Thomas{\textquoteright} NHS Foundation Trust in partnership with King{\textquoteright}s College London and King{\textquoteright}s College Hospital NHS Foundation Trust; The NIHR Cardiovascular MedTech Co-operative; The British Heart Foundation [TG/18/2/33768]; and The Centre of Excellence in Medical Engineering funded by the Wellcome Trust and EPSRC [WT 203148/Z/16/Z]. Publisher Copyright: {\textcopyright} Copyright {\textcopyright} 2021 Scannell, Hasaneen, Greil, Hussain, Razavi, Lee, Pushparajah, Duong and Chiribiri.",

year = "2021",

month = sep,

day = "3",

doi = "10.3389/fped.2021.699497",

language = "English",

volume = "9",

journal = "Frontiers in Pediatrics",

issn = "2296-2360",

publisher = "Frontiers Media S.A.",

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TY - JOUR

T1 - Automated quantitative stress perfusion cardiac magnetic resonance in pediatric patients

AU - Scannell, Cian

AU - Hasaneen, Hadeer

AU - Greil, Gerald

AU - Hussain, Tarique

AU - Razavi, Reza

AU - Lee, Jack

AU - Pushparajah, Kuberan

AU - Duong, Phuoc

AU - Chiribiri, Amedeo

N1 - Funding Information: Funding. This work was supported by the King's College London & Imperial College London EPSRC Centre for Doctoral Training in Medical Imaging [EP/L015226/1]; Philips Healthcare; The Department of Health via the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre award to Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust; The NIHR Cardiovascular MedTech Co-operative; The British Heart Foundation [TG/18/2/33768]; and The Centre of Excellence in Medical Engineering funded by the Wellcome Trust and EPSRC [WT 203148/Z/16/Z]. Funding Information: This work was supported by the King’s College London & Imperial College London EPSRC Centre for Doctoral Training in Medical Imaging [EP/L015226/1]; Philips Healthcare; The Department of Health via the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre award to Guy’s & St Thomas’ NHS Foundation Trust in partnership with King’s College London and King’s College Hospital NHS Foundation Trust; The NIHR Cardiovascular MedTech Co-operative; The British Heart Foundation [TG/18/2/33768]; and The Centre of Excellence in Medical Engineering funded by the Wellcome Trust and EPSRC [WT 203148/Z/16/Z]. Publisher Copyright: © Copyright © 2021 Scannell, Hasaneen, Greil, Hussain, Razavi, Lee, Pushparajah, Duong and Chiribiri.

PY - 2021/9/3

Y1 - 2021/9/3

N2 - Background: Myocardial ischemia occurs in pediatrics, as a result of both congenital and acquired heart diseases, and can lead to further adverse cardiac events if untreated. The aim of this work is to assess the feasibility of fully automated, high resolution, quantitative stress myocardial perfusion cardiac magnetic resonance (CMR) in a cohort of pediatric patients and to evaluate its agreement with the coronary anatomical status of the patients. Methods: Fourteen pediatric patients, with 16 scans, who underwent dual-bolus stress perfusion CMR were retrospectively analyzed. All patients also had anatomical coronary assessment with either CMR, CT, or X-ray angiography. The perfusion CMR images were automatically processed and quantified using an analysis pipeline previously developed in adults. Results: Automated perfusion quantification was successful in 15/16 cases. The coronary perfusion territories supplied by vessels affected by a medium/large aneurysm or stenosis (according to the AHA guidelines), induced by Kawasaki disease, an anomalous origin, or interarterial course had significantly reduced myocardial blood flow (MBF) (median (interquartile range), 1.26 (1.05, 1.67) ml/min/g) as compared to territories supplied by unaffected coronaries [2.57 (2.02, 2.69) ml/min/g, p < 0.001] and territories supplied by vessels with a small aneurysm [2.52 (2.45, 2.83) ml/min/g, p = 0.002]. Conclusion: Automatic CMR-derived MBF quantification is feasible in pediatric patients, and the technology could be potentially used for objective non-invasive assessment of ischemia in children with congenital and acquired heart diseases.

AB - Background: Myocardial ischemia occurs in pediatrics, as a result of both congenital and acquired heart diseases, and can lead to further adverse cardiac events if untreated. The aim of this work is to assess the feasibility of fully automated, high resolution, quantitative stress myocardial perfusion cardiac magnetic resonance (CMR) in a cohort of pediatric patients and to evaluate its agreement with the coronary anatomical status of the patients. Methods: Fourteen pediatric patients, with 16 scans, who underwent dual-bolus stress perfusion CMR were retrospectively analyzed. All patients also had anatomical coronary assessment with either CMR, CT, or X-ray angiography. The perfusion CMR images were automatically processed and quantified using an analysis pipeline previously developed in adults. Results: Automated perfusion quantification was successful in 15/16 cases. The coronary perfusion territories supplied by vessels affected by a medium/large aneurysm or stenosis (according to the AHA guidelines), induced by Kawasaki disease, an anomalous origin, or interarterial course had significantly reduced myocardial blood flow (MBF) (median (interquartile range), 1.26 (1.05, 1.67) ml/min/g) as compared to territories supplied by unaffected coronaries [2.57 (2.02, 2.69) ml/min/g, p < 0.001] and territories supplied by vessels with a small aneurysm [2.52 (2.45, 2.83) ml/min/g, p = 0.002]. Conclusion: Automatic CMR-derived MBF quantification is feasible in pediatric patients, and the technology could be potentially used for objective non-invasive assessment of ischemia in children with congenital and acquired heart diseases.

UR - http://www.scopus.com/inward/record.url?scp=85115211303&partnerID=8YFLogxK

U2 - 10.3389/fped.2021.699497

DO - 10.3389/fped.2021.699497

M3 - Article

SN - 2296-2360

VL - 9

JO - Frontiers in Pediatrics

JF - Frontiers in Pediatrics

M1 - 699497

ER -

Automated quantitative stress perfusion cardiac magnetic resonance in pediatric patients

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