Isotropic, high-resolution, whole-chest inversion recovery contrast-enhanced magnetic resonance angiography in under 4.5 min using image-based navigator fluoro trigger

Jason Craft; Roosha Parikh; Josh Y Cheng; Nancy Diaz; Karl P Kunze; Michaela Schmidt; Radhouene Neji; Amanda Leung; Suzanne Weber; Jonathan Weber; Timothy Carter; Sylvia Biso; Ann-Marie Yamashita; Eric H Wolff; Claudia Prieto; Rene M Botnar

doi:10.3389/fcvm.2025.1549275

Isotropic, high-resolution, whole-chest inversion recovery contrast-enhanced magnetic resonance angiography in under 4.5 min using image-based navigator fluoro trigger

Jason Craft, Roosha Parikh, Josh Y Cheng, Nancy Diaz, Karl P Kunze, Michaela Schmidt, Radhouene Neji, Amanda Leung, Suzanne Weber, Jonathan Weber, Timothy Carter, Sylvia Biso, Ann-Marie Yamashita, Eric H Wolff, Claudia Prieto, Rene M Botnar

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Abstract

Background: Serial assessment of the thoracic aorta with magnetic resonance angiography (MRA) is desirable due to 3D volumetric dataset, high spatial resolution, and lack of ionizing radiation. Electrocardiogram (ECG) gated, contrast-enhanced (CE), inversion recovery gradient echo MRA is efficient and historically provides low artifact burden, but the window for imaging with weak albumin binding extracellular gadolinium based contrast agents is small. Our purpose was to acquire whole-chest gated CE-MRA with 1.2 mm ³ resolution using image-based navigator (iNAV) for motion correction/contrast monitoring, and variable density sampling in 4–5 min. Image quality and vessel diameter reproducibility are assessed against time resolved MRA (TR-MRA). Methods: iNAV CE-MRA and TR-MRA were obtained prospectively in 40 patients and reviewed by 3 blinded cardiologists for vessel diameter and image quality rated on a four point scale: (1) non-diagnostic; (2) poor-significant blurring; (3) good-mild blurring; and (4) excellent. Reproducibility and image quality were evaluated using the concordance correlation statistic and Cohen's kappa with mean differences evaluated using paired t-tests and repeat-measures ANOVA. Results: iNAV CE-MRA scan time was 4.2 ± 0.7 min. iNAV CE-MRA quality score was higher (p <.001); average difference was 1.4 ±.08 at the sinus of Valsalva (SOV), 1.3 ±.08 at the sinotubular junction (STJ), and.87 ±.10 at the ascending aorta (AAO). Major/minor diameter interobserver agreement was better for iNAV CE-MRA (SOV ICC =.87–.93; STJ ICC =.95–.96; AAO ICC =.96–.97) vs. TR-MRA (SOV ICC =.69–.82; STJ ICC =.78–.83; AAO ICC =.89), as was intraobserver agreement (SOV ICC =.93–.95; STJ ICC =.94–.96; AAO ICC =.96–.97) vs. TR-MRA (SOV ICC =.81–.88; STJ ICC =.72–.73; AAO ICC =.87–.93). Conclusion: iNAV CE-MRA is feasible within a clinically reasonable scan time, provides superior image quality, and measurement reproducibility vs. TR-MRA.

Original language	English
Article number	1549275
Pages (from-to)	1549275
Journal	Frontiers in Cardiovascular Medicine
Volume	12
DOIs	https://doi.org/10.3389/fcvm.2025.1549275
Publication status	Published - 2025

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fcvm-1-1549275Licence: CC BY

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Craft, J., Parikh, R., Cheng, J. Y., Diaz, N., Kunze, K. P., Schmidt, M., Neji, R., Leung, A., Weber, S., Weber, J., Carter, T., Biso, S., Yamashita, A.-M., Wolff, E. H., Prieto, C., & Botnar, R. M. (2025). Isotropic, high-resolution, whole-chest inversion recovery contrast-enhanced magnetic resonance angiography in under 4.5 min using image-based navigator fluoro trigger. Frontiers in Cardiovascular Medicine, 12, 1549275. Article 1549275. https://doi.org/10.3389/fcvm.2025.1549275

@article{9f539191784b4768919bf32805cfdf04,

title = "Isotropic, high-resolution, whole-chest inversion recovery contrast-enhanced magnetic resonance angiography in under 4.5 min using image-based navigator fluoro trigger",

abstract = "Background: Serial assessment of the thoracic aorta with magnetic resonance angiography (MRA) is desirable due to 3D volumetric dataset, high spatial resolution, and lack of ionizing radiation. Electrocardiogram (ECG) gated, contrast-enhanced (CE), inversion recovery gradient echo MRA is efficient and historically provides low artifact burden, but the window for imaging with weak albumin binding extracellular gadolinium based contrast agents is small. Our purpose was to acquire whole-chest gated CE-MRA with 1.2 mm 3 resolution using image-based navigator (iNAV) for motion correction/contrast monitoring, and variable density sampling in 4–5 min. Image quality and vessel diameter reproducibility are assessed against time resolved MRA (TR-MRA). Methods: iNAV CE-MRA and TR-MRA were obtained prospectively in 40 patients and reviewed by 3 blinded cardiologists for vessel diameter and image quality rated on a four point scale: (1) non-diagnostic; (2) poor-significant blurring; (3) good-mild blurring; and (4) excellent. Reproducibility and image quality were evaluated using the concordance correlation statistic and Cohen's kappa with mean differences evaluated using paired t-tests and repeat-measures ANOVA. Results: iNAV CE-MRA scan time was 4.2 ± 0.7 min. iNAV CE-MRA quality score was higher (p <.001); average difference was 1.4 ±.08 at the sinus of Valsalva (SOV), 1.3 ±.08 at the sinotubular junction (STJ), and.87 ±.10 at the ascending aorta (AAO). Major/minor diameter interobserver agreement was better for iNAV CE-MRA (SOV ICC =.87–.93; STJ ICC =.95–.96; AAO ICC =.96–.97) vs. TR-MRA (SOV ICC =.69–.82; STJ ICC =.78–.83; AAO ICC =.89), as was intraobserver agreement (SOV ICC =.93–.95; STJ ICC =.94–.96; AAO ICC =.96–.97) vs. TR-MRA (SOV ICC =.81–.88; STJ ICC =.72–.73; AAO ICC =.87–.93). Conclusion: iNAV CE-MRA is feasible within a clinically reasonable scan time, provides superior image quality, and measurement reproducibility vs. TR-MRA.",

author = "Jason Craft and Roosha Parikh and Cheng, {Josh Y} and Nancy Diaz and Kunze, {Karl P} and Michaela Schmidt and Radhouene Neji and Amanda Leung and Suzanne Weber and Jonathan Weber and Timothy Carter and Sylvia Biso and Ann-Marie Yamashita and Wolff, {Eric H} and Claudia Prieto and Botnar, {Rene M}",

note = "Publisher Copyright: 2025 Craft, Parikh, Cheng, Diaz, Kunze, Schmidt, Neji, Leung, Weber, Weber, Carter, Biso, Yamashita, Wolff, Prieto and Botnar.",

year = "2025",

doi = "10.3389/fcvm.2025.1549275",

language = "English",

volume = "12",

pages = "1549275",

journal = "Frontiers in Cardiovascular Medicine",

issn = "2297-055X",

publisher = "Frontiers Media S.A.",

}

Craft, J, Parikh, R, Cheng, JY, Diaz, N, Kunze, KP, Schmidt, M, Neji, R, Leung, A, Weber, S, Weber, J, Carter, T, Biso, S, Yamashita, A-M, Wolff, EH, Prieto, C & Botnar, RM 2025, 'Isotropic, high-resolution, whole-chest inversion recovery contrast-enhanced magnetic resonance angiography in under 4.5 min using image-based navigator fluoro trigger', Frontiers in Cardiovascular Medicine, vol. 12, 1549275, pp. 1549275. https://doi.org/10.3389/fcvm.2025.1549275

TY - JOUR

T1 - Isotropic, high-resolution, whole-chest inversion recovery contrast-enhanced magnetic resonance angiography in under 4.5 min using image-based navigator fluoro trigger

AU - Craft, Jason

AU - Parikh, Roosha

AU - Cheng, Josh Y

AU - Diaz, Nancy

AU - Kunze, Karl P

AU - Schmidt, Michaela

AU - Neji, Radhouene

AU - Leung, Amanda

AU - Weber, Suzanne

AU - Weber, Jonathan

AU - Carter, Timothy

AU - Biso, Sylvia

AU - Yamashita, Ann-Marie

AU - Wolff, Eric H

AU - Prieto, Claudia

AU - Botnar, Rene M

N1 - Publisher Copyright: 2025 Craft, Parikh, Cheng, Diaz, Kunze, Schmidt, Neji, Leung, Weber, Weber, Carter, Biso, Yamashita, Wolff, Prieto and Botnar.

PY - 2025

Y1 - 2025

N2 - Background: Serial assessment of the thoracic aorta with magnetic resonance angiography (MRA) is desirable due to 3D volumetric dataset, high spatial resolution, and lack of ionizing radiation. Electrocardiogram (ECG) gated, contrast-enhanced (CE), inversion recovery gradient echo MRA is efficient and historically provides low artifact burden, but the window for imaging with weak albumin binding extracellular gadolinium based contrast agents is small. Our purpose was to acquire whole-chest gated CE-MRA with 1.2 mm 3 resolution using image-based navigator (iNAV) for motion correction/contrast monitoring, and variable density sampling in 4–5 min. Image quality and vessel diameter reproducibility are assessed against time resolved MRA (TR-MRA). Methods: iNAV CE-MRA and TR-MRA were obtained prospectively in 40 patients and reviewed by 3 blinded cardiologists for vessel diameter and image quality rated on a four point scale: (1) non-diagnostic; (2) poor-significant blurring; (3) good-mild blurring; and (4) excellent. Reproducibility and image quality were evaluated using the concordance correlation statistic and Cohen's kappa with mean differences evaluated using paired t-tests and repeat-measures ANOVA. Results: iNAV CE-MRA scan time was 4.2 ± 0.7 min. iNAV CE-MRA quality score was higher (p <.001); average difference was 1.4 ±.08 at the sinus of Valsalva (SOV), 1.3 ±.08 at the sinotubular junction (STJ), and.87 ±.10 at the ascending aorta (AAO). Major/minor diameter interobserver agreement was better for iNAV CE-MRA (SOV ICC =.87–.93; STJ ICC =.95–.96; AAO ICC =.96–.97) vs. TR-MRA (SOV ICC =.69–.82; STJ ICC =.78–.83; AAO ICC =.89), as was intraobserver agreement (SOV ICC =.93–.95; STJ ICC =.94–.96; AAO ICC =.96–.97) vs. TR-MRA (SOV ICC =.81–.88; STJ ICC =.72–.73; AAO ICC =.87–.93). Conclusion: iNAV CE-MRA is feasible within a clinically reasonable scan time, provides superior image quality, and measurement reproducibility vs. TR-MRA.

AB - Background: Serial assessment of the thoracic aorta with magnetic resonance angiography (MRA) is desirable due to 3D volumetric dataset, high spatial resolution, and lack of ionizing radiation. Electrocardiogram (ECG) gated, contrast-enhanced (CE), inversion recovery gradient echo MRA is efficient and historically provides low artifact burden, but the window for imaging with weak albumin binding extracellular gadolinium based contrast agents is small. Our purpose was to acquire whole-chest gated CE-MRA with 1.2 mm 3 resolution using image-based navigator (iNAV) for motion correction/contrast monitoring, and variable density sampling in 4–5 min. Image quality and vessel diameter reproducibility are assessed against time resolved MRA (TR-MRA). Methods: iNAV CE-MRA and TR-MRA were obtained prospectively in 40 patients and reviewed by 3 blinded cardiologists for vessel diameter and image quality rated on a four point scale: (1) non-diagnostic; (2) poor-significant blurring; (3) good-mild blurring; and (4) excellent. Reproducibility and image quality were evaluated using the concordance correlation statistic and Cohen's kappa with mean differences evaluated using paired t-tests and repeat-measures ANOVA. Results: iNAV CE-MRA scan time was 4.2 ± 0.7 min. iNAV CE-MRA quality score was higher (p <.001); average difference was 1.4 ±.08 at the sinus of Valsalva (SOV), 1.3 ±.08 at the sinotubular junction (STJ), and.87 ±.10 at the ascending aorta (AAO). Major/minor diameter interobserver agreement was better for iNAV CE-MRA (SOV ICC =.87–.93; STJ ICC =.95–.96; AAO ICC =.96–.97) vs. TR-MRA (SOV ICC =.69–.82; STJ ICC =.78–.83; AAO ICC =.89), as was intraobserver agreement (SOV ICC =.93–.95; STJ ICC =.94–.96; AAO ICC =.96–.97) vs. TR-MRA (SOV ICC =.81–.88; STJ ICC =.72–.73; AAO ICC =.87–.93). Conclusion: iNAV CE-MRA is feasible within a clinically reasonable scan time, provides superior image quality, and measurement reproducibility vs. TR-MRA.

UR - http://www.scopus.com/inward/record.url?scp=105005094464&partnerID=8YFLogxK

U2 - 10.3389/fcvm.2025.1549275

DO - 10.3389/fcvm.2025.1549275

M3 - Article

C2 - 40371067

SN - 2297-055X

VL - 12

SP - 1549275

JO - Frontiers in Cardiovascular Medicine

JF - Frontiers in Cardiovascular Medicine

M1 - 1549275

ER -

Isotropic, high-resolution, whole-chest inversion recovery contrast-enhanced magnetic resonance angiography in under 4.5 min using image-based navigator fluoro trigger

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