Yun Shang1, Sebastian Theilenberg1, Boyu Peng2, Sachin R. Jambawalikar1,2, Laura M. Schreiber3,4, and Christoph Juchem1,2
1Department of Biomedical Engineering, Columbia University, New York, NY, United States, 2Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States, 3Section of Medical Physics, Department of Radiology, Mainz University Hospital, Mainz, Germany, 4Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center (CHFC), Würzburg, Germany
Synopsis
Cardiac MRI suffers susceptibility-induced artifacts due to B0
inhomogeneity across the heart. The lack of population data in cardiac B0
conditions and the practical inability to obtain such data in large populations
impedes the development of optimal cardiac B0 shim strategy. Here,
we establish population-based B0 conditions from readily available
CT images and simulate cardiac B0 maps of 254 CT subjects with broad
demographic parameters. The results are expected to develop optimal subject-
and population-specific cardiac B0 shim strategies.
Introduction
Cardiac MRI has been considered as a gold standard to
access cardiac function1. Cardiac
functional scans adopting balanced steady-state free precession (bSSFP)
sequences at 3 T and multiecho gradient echo (GRE) sequences at 7 T suffer from
susceptibility-induced artifacts2-6 (Figure 1)
in the myocardium due to B0 variations across the heart. The best
remedy to mitigate these issues is cardiac B0 shimming7, which requires in vivo B0 maps in the heart typically
acquired with breath-hold8. However, the lack of
population data in cardiac B0 conditions, especially for the patients
with impaired lung capability9, in pediatrics10, and in elderly11 who are not able to undergo
breath-hold for B0 acquisition, impedes the development of optimal
cardiac B0 shim strategy. To overcome this challenge, we propose to
investigate the cardiac B0 conditions in the population via B0
simulation from a large sample of CT images. This abstract presents the
preliminary results of cardiac B0 maps from 254 subjects as part of an ongoing research study with an enrollment goal of
1000 subjects. These B0 maps were analyzed with spherical harmonic
(SH) shimming. The resultant B0 conditions were investigated by
computing their correlations associated with the subjects' demographic
parameters. This study allows us to investigate the distributions and features
of cardiac B0 conditions in population groups and pave the way to
develop optimal cardiac B0 shim strategies.Methods
High-resolution CT images and
demographic parameters of 254 adult subjects (Female: 136, Male: 118) who
underwent a clinically indicated diagnostic CT scan were retrospectively
collected and anonymized in accordance with our institutional review board requirements. The normality of subjects’
demographic parameters, including age, height, weight, body mass index (BMI), was
tested using the Shapiro-Wilk test. Whole thoracic 3D CT images were down-sampled
from 0.7-1.3 mm resolution to 1.5 mm isotropic spatial resolution consistent across all subjects. Then, the
B0 distribution in the heart of each subject was calculated under
the background field strength of 3 T and 7 T by an established B0
simulation approach12,13. The field calculation was
performed in B0DETOX software14.
B0 maps are typically decomposed into SH
terms, and the coefficient of each term is scaled to the shim current of the corresponding
shim coil in practical B0 shimming. To investigate the B0
conditions associated with the best possible shim for the whole heart, the
simulated B0 maps of each subject were decomposed up to 2nd and 3rd SH order without constraints. Shim coils
in MR scanners typically have output limits due to shim capability of the hardware.
To investigate the impact of vendor-specific shim limits on the residual B0
inhomogeneity, we also performed the shim analysis up to 2nd SH order
at 3 T with calibrated shim limits of scanners at Columbia University, including
GE Premier, GE MR750, and Siemens Prisma. The shim analysis up to 3rd
SH order was performed using the same limits of the 2nd order while
leaving the 3rd order unlimited. Moreover, shim analysis at 7 T was
performed with calibrated shim limits up to 3rd order from Siemens
Terra at the University Hospital Würzburg (UKW), Germany. The resultant B0
inhomogeneity was presented as the standard deviation (σ) of the residual B0 distribution after removing corresponding SH shim terms.
To seek if population groups share specific
aspects of cardiac B0 shapes, we calculated the correlation between unconstrained SH
coefficients, B0 inhomogeneities at 3 T, and the height,
weight individually. The B0 inhomogeneity between female and male
groups was compared using the student’s t-test, and the significance criteria p<0.05 was adjusted using Bonferroni correction. Results
Figure 2 shows the distribution of the subjects’ demographic
parameters: age: 63±14 (Mean±SD) years (Shapiro-Wilk test: W=0.984, p-value<0.01), height:
1.67±0.11 m (W=0.987, p-value<0.05), weight 76.0±19.9 kg (W=0.965,
p-value<0.001), BMI: 27.1±6.3 kg/m2 (W=0.967, p-value<0.001). The SH coefficients up to 2nd
SH order and up to 3rd SH order were presented at 3 T (Figure 3) and
7 T (Figure 4). B0 inhomogeneity after unconstrained 2nd
and 3rd shim at 3 T were 36±6 Hz and 27±5 Hz, respectively,
while the corresponding results at 7 T were 83±13 Hz and 64±11 Hz. The shim
capability of GE Premier showed limitation at 2nd order while
Siemens Terra had limitations at 3rd SH order, especially for the Z3 term, leading to increased B0 inhomogeneity for some subjects after shim. The selected correlations
between B0 conditions and demographic parameters were shown in
Figure 5. Female subjects showed significantly lower B0 inhomogeneity
than male subjects before and after 2nd/3rd shim. Z3 term
and height have a maximum correlation of 0.343.Discussion
Here we present a detailed analysis of B0
conditions in the human heart from 254 subjects. The results suggest
the 2nd and 3rd
order SH shim requirements for the cardiac B0 shimming at 3 T and 7
T. The association between B0 conditions and demographic parameters allows
us further understand the distribution and detailed characterization of B0
field conditions in the heart. Future research will involve more CT subjects,
and the population analysis of cardiac B0 conditions is expected to enable
optimal subject- and population-specific cardiac B0 shim strategies
for clinical use cases.Acknowledgements
No acknowledgement found.References
1. Wieben O, Francois C, Reeder SB.
Cardiac MRI of ischemic heart disease at 3 T: potential and challenges. Eur. J.
Radiol. 2008;65(1):15-28.
2. Rajiah P, Bolen MA. Cardiovascular
MR imaging at 3 T: opportunities, challenges, and solutions. Radiographics.
2014;34(6):1612-35.
3. Schär M, Kozerke S, Fischer SE,
Boesiger P. Cardiac SSFP imaging at 3 Tesla. Magn. Reson. Med.
2004;51(4):799-806.
4. Meloni A, Hezel F, Positano V,
Keilberg P, Pepe A, Lombardi M, Niendorf T. Detailing magnetic field strength
dependence and segmental artifact distribution of myocardial effective
transverse relaxation rate at 1.5, 3.0, and 7.0 T. Magn. Reson. Med. 2014;71(6):2224-2230.
5. Hock M, Terekhov M, Stefanescu MR,
et al. B0 shimming of the human heart at 7T. Magn. Reson. Med.
2021;85(1):182-196.
6. Reiter T, Lohr D, Hock M, et al. On
the way to routine cardiac MRI at 7 Tesla-a pilot study on consecutive 84 examinations.
PLoS One. 2021;16(7):e0252797.
7. Kubach MR, Bornstedt A, Hombach V,
Merkle N, Schär M, Spiess J, Nienhaus GU, Rasche V. Cardiac phase-specific
shimming (CPSS) for SSFP MR cine imaging at 3 T. Phys. Med. Biol.
2009;54(20):N467.
8. Huelnhagen T, Hezel F, Serradas
Duarte T, et al. Myocardial effective transverse relaxation time Correlates
with left ventricular wall thickness: A 7.0 T MRI study. Magn. Reson. Med.
2017;77(6):2381-2389.
9. Pednekar AS, Wang H, Flamm S, Cheong
BY, Muthupillai R. Two-center clinical validation and quantitative assessment
of respiratory triggered retrospectively cardiac gated balanced-SSFP cine
cardiovascular magnetic resonance imaging in adults. J. Cardiovasc. Magn.
Reson. 2018;20(1):1-11.
10. Pednekar AS, Jadhav S, Noel C, Masand
P. Free-breathing Cardiorespiratory Synchronized Cine MRI for Assessment of
Left and Right Ventricular Volume and Function in Sedated Children and
Adolescents with Impaired Breath-holding Capacity. Radiology: Cardiothoracic
Imaging. 2019;1(2):e180027.
11. Kalva SP, Mueller PR. Vascular imaging
in the elderly. Radiol. Clin. North Am. 2008;46(4):663-683.
12. Shang Y, Theilenberg S, Schreiber LM,
Juchem C. Optimization of B0 Simulation Strategy in the Human Heart based on CT
Images at limited Field of View. Proc Int Soc Magn Reson Med 2021:3635.
13. Shang Y, Theilenberg S, Mattar W,
Terekhov M, Jambawalikar SR, Schreiber LM, Juchem C. High Resolution Simulation
of B0 Field Conditions in the Human Heart Based on Segmented CT Images. Proc
Int Soc Magn Reson Med 2019:2184.
14. Juchem
C. B0DETOX - B0 Detoxification Software for Magnetic Field Shimming. Columbia
TechVenture (CTV), License CU17326.
2017;innovation.columbia.edu/technologies/cu17326_b0detox