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Effective Study: Development and Application of a Question-Driven, Time-Effective Cardiac Magnetic Resonance Scanning Protocol

Torlasco, C; Castelletti, S; Soranna, D; Volpato, V; Figliozzi, S; Menacho, K; Cernigliaro, F; ... Parati, G; + view all (2022) Effective Study: Development and Application of a Question-Driven, Time-Effective Cardiac Magnetic Resonance Scanning Protocol. Journal of the American Heart Association , 11 (1) , Article e022605. 10.1161/JAHA.121.022605. Green open access

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Abstract

BACKGROUND: Long scanning times impede cardiac magnetic resonance (CMR) clinical uptake. A “one‐size‐fits‐all” shortened, focused protocol (eg, only function and late‐gadolinium enhancement) reduces scanning time and costs, but provides less information. We developed 2 question‐driven CMR and stress‐CMR protocols, including tailored advanced tissue characterization, and tested their effectiveness in reducing scanning time while retaining the diagnostic performances of standard protocols. METHODS AND RESULTS: Eighty three consecutive patients with cardiomyopathy or ischemic heart disease underwent the tailored CMR. Each scan consisted of standard cines, late‐gadolinium enhancement imaging, native T1‐mapping, and extracellular volume. Fat/edema modules, right ventricle cine, and in‐line quantitative perfusion mapping were performed as clinically required. Workflow was optimized to avoid gaps. Time target was <30 minutes for a CMR and <35 minutes for a stress‐CMR. CMR was considered impactful when its results drove changes in diagnosis or management. Advanced tissue characterization was considered impactful when it changed the confidence level in the diagnosis. The quality of the images was assessed. A control group of 137 patients was identified among scans performed before February 2020. Compared with standard protocols, the average scan duration dropped by >30% (CMR: from 42±8 to 28±6 minutes; stress‐CMR: from 50±10 to 34±6 minutes, both P<0.0001). Independent on the protocol, CMR was impactful in ≈60% cases, and advanced tissue characterization was impactful in >45% of cases. Quality grading was similar between the 2 protocols. Tailored protocols did not require additional staff. CONCLUSIONS: Tailored CMR and stress‐CMR protocols including advanced tissue characterization are accurate and time‐effective for cardiomyopathies and ischemic heart disease

Type: Article
Title: Effective Study: Development and Application of a Question-Driven, Time-Effective Cardiac Magnetic Resonance Scanning Protocol
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1161/JAHA.121.022605
Publisher version: https://doi.org/10.1161/JAHA.121.022605
Language: English
Additional information: © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/).
Keywords: cardiomyopathy, cardiovascular magnetic resonance, ischemic heart disease, rapid scanning, time‐effectiveness
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/10141695
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