The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Dudley J Pennell - One of the best experts on this subject based on the ideXlab platform.
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standardized image interpretation and post processing in Cardiovascular Magnetic Resonance 2020 update
Journal of Cardiovascular Magnetic Resonance, 2020Co-Authors: Jeanette Schulzmenger, Matthias G Friedrich, Florian Von Knobelsdorffbrenkenhoff, David A Bluemke, Jens Bremerich, Scott D Flamm, Mark A Fogel, Raymond J Kim, Christopher M Kramer, Dudley J PennellAbstract:With mounting data on its accuracy and prognostic value, Cardiovascular Magnetic Resonance (CMR) is becoming an increasingly important diagnostic tool with growing utility in clinical routine. Given its versatility and wide range of quantitative parameters, however, agreement on specific standards for the interpretation and post-processing of CMR studies is required to ensure consistent quality and reproducibility of CMR reports. This document addresses this need by providing consensus recommendations developed by the Task Force for Post-Processing of the Society for Cardiovascular Magnetic Resonance (SCMR). The aim of the Task Force is to recommend requirements and standards for image interpretation and post-processing enabling qualitative and quantitative evaluation of CMR images. Furthermore, pitfalls of CMR image analysis are discussed where appropriate. It is an update of the original recommendations published 2013.
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SCMR Position Paper (2020) on clinical indications for Cardiovascular Magnetic Resonance
Journal of Cardiovascular Magnetic Resonance, 2020Co-Authors: Tim Leiner, Subha V Raman, Matthias G Friedrich, Raad Mohiaddin, Jan Bogaert, Vivek Muthurangu, Saul Myerson, Andrew J. Powell, Dudley J PennellAbstract:The Society for Cardiovascular Magnetic Resonance (SCMR) last published its comprehensive expert panel report of clinical indications for CMR in 2004. This new Consensus Panel report brings those indications up to date for 2020 and includes the very substantial increase in scanning techniques, clinical applicability and adoption of CMR worldwide. We have used a nearly identical grading system for indications as in 2004 to ensure comparability with the previous report but have added the presence of randomized controlled trials as evidence for level 1 indications. In addition to the text, tables of the consensus indication levels are included for rapid assimilation and illustrative figures of some key techniques are provided.
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Cardiovascular Magnetic Resonance determinants of left ventricular noncompaction
American Journal of Cardiology, 2014Co-Authors: Dana Dawson, Sanjay K Prasad, Dudley J Pennell, Alicia M Maceira, David J Mclernon, Vimal Raj, Michael P Frenneaux, Philip J KilnerAbstract:Insufficient precision remains in accurately identifying left ventricular noncompaction (LVNC) from the healthy normal morphologic spectrum. We aim to provide a better distinction between normal left ventricular trabeculations and LVNC. We used a previously well-defined cohort of 120 healthy volunteers for normal reference values of the trabecular/compacted ratio derived from a consistent selection of short-axis Cardiovascular Magnetic Resonance images. We performed forward selection of logistic regression models, selecting the best model that was subsequently assessed for discrimination and calibration, validated, and converted into a clinical diagnostic chart to benchmark the boundaries of detection from a cohort of 30 patients considered to have LVNC. We showed that 3 combinations of a maximal end-diastolic trabecular/compacted ratio (≥1 [apex], >1.8 [midcavity]), (>2 [apex], ≥0.6 [midcavity]), or (>0.5 [base], >1.8 [midcavity]) separate the cohorts with the highest accuracy (C statistic [95% confidence interval] of 0.9749 (0.9748 to 0.9751) for the diagnostic chart). Quantitative Cardiovascular Magnetic Resonance also shows that patients considered to have LVNC have a significantly reduced ejection fraction compared with normal volunteers. At midcavity and apical level, it is difficult to identify papillary muscles that are replaced by a dense trabecular meshwork. In conclusion, we developed a new, refined, diagnostic tool for identifying LVNC, based on an a priori assessment of the trabecular architecture in healthy volunteers.
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international survey of t2 Cardiovascular Magnetic Resonance in β thalassemia major
Haematologica, 2013Co-Authors: John Paul Carpenter, Dudley J Pennell, Michael Roughton, Paul Kirk, Lisa J Anderson, John V B Porter, Malcolm J Walker, Renzo Galanello, Fabrice Danjou, Gian Luca ForniAbstract:Accumulation of myocardial iron is the cause of heart failure and early death in most transfused thalassemia major patients. T2* Cardiovascular Magnetic Resonance provides calibrated, reproducible measurements of myocardial iron. However, there are few data regarding myocardial iron loading and its relation to outcome across the world. A survey is reported of 3,095 patients in 27 worldwide centers using T2* Cardiovascular Magnetic Resonance. Data on baseline T2* and numbers of patients with symptoms of heart failure at first scan (defined as symptoms and signs of heart failure with objective evidence of left ventricular dysfunction) were requested together with more detailed information about patients who subsequently developed heart failure or died. At first scan, 20.6% had severe myocardial iron (T2*≤ 10 ms), 22.8% had moderate myocardial iron (T2* 10-20 ms) and 56.6% of patients had no iron loading (T2*>20 ms). There was significant geographical variation in myocardial iron loading (24.8-52.6%; P<0.001). At first scan, 85 (2.9%) of 2,915 patients were reported to have heart failure (81.2% had T2* <10 ms; 98.8% had T2* <20 ms). During follow up, 108 (3.8%) of 2,830 patients developed new heart failure. Of these, T2* at first scan had been less than 10 ms in 96.3% and less than 20 ms in 100%. There were 35 (1.1%) cardiac deaths. Of these patients, myocardial T2* at first scan had been less than 10 ms in 85.7% and less than 20 ms in 97.1%. Therefore, in this worldwide cohort of thalassemia major patients, over 43% had moderate/severe myocardial iron loading with significant geographical differences, and myocardial T2* values less than 10 ms were strongly associated with heart failure and death.
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standardized image interpretation and post processing in Cardiovascular Magnetic Resonance society for Cardiovascular Magnetic Resonance scmr board of trustees task force on standardized post processing
Journal of Cardiovascular Magnetic Resonance, 2013Co-Authors: Jeanette Schulzmenger, Matthias G Friedrich, Florian Von Knobelsdorffbrenkenhoff, David A Bluemke, Jens Bremerich, Scott D Flamm, Mark A Fogel, Raymond J Kim, Christopher M Kramer, Dudley J PennellAbstract:With mounting data on its accuracy and prognostic value, Cardiovascular Magnetic Resonance (CMR) is becoming an increasingly important diagnostic tool with growing utility in clinical routine. Given its versatility and wide range of quantitative parameters, however, agreement on specific standards for the interpretation and post-processing of CMR studies is required to ensure consistent quality and reproducibility of CMR reports. This document addresses this need by providing consensus recommendations developed by the Task Force for Post Processing of the Society for Cardiovascular MR (SCMR). The aim of the task force is to recommend requirements and standards for image interpretation and post processing enabling qualitative and quantitative evaluation of CMR images. Furthermore, pitfalls of CMR image analysis are discussed where appropriate.
Matthias Gutberlet - One of the best experts on this subject based on the ideXlab platform.
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Cardiovascular Magnetic Resonance in nonischemic myocardial inflammation expert recommendations
Journal of the American College of Cardiology, 2018Co-Authors: Vanessa M Ferreira, Leslie T. Cooper, Udo Sechtem, Jeanette Schulzmenger, Godtfred Holmvang, Matthias Gutberlet, Christopher M Kramer, Iacopo Carbone, Ingrid Kindermann, Peter LiuAbstract:Abstract This JACC Scientific Expert Panel provides consensus recommendations for an update of the Cardiovascular Magnetic Resonance (CMR) diagnostic criteria for myocardial inflammation in patients with suspected acute or active myocardial inflammation (Lake Louise Criteria) that include options to use parametric mapping techniques. While each parameter may indicate myocardial inflammation, the authors propose that CMR provides strong evidence for myocardial inflammation, with increasing specificity, if the CMR scan demonstrates the combination of myocardial edema with other CMR markers of inflammatory myocardial injury. This is based on at least one T2-based criterion (global or regional increase of myocardial T2 relaxation time or an increased signal intensity in T2-weighted CMR images), with at least one T1-based criterion (increased myocardial T1, extracellular volume, or late gadolinium enhancement). While having both a positive T2-based marker and a T1-based marker will increase specificity for diagnosing acute myocardial inflammation, having only one (i.e., T2-based OR T1-based) marker may still support a diagnosis of acute myocardial inflammation in an appropriate clinical scenario, albeit with less specificity. The update is expected to improve the diagnostic accuracy of CMR further in detecting myocardial inflammation.
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clinical characteristics and Cardiovascular Magnetic Resonance findings in stress takotsubo cardiomyopathy
JAMA, 2011Co-Authors: Ingo Eitel, Matthias Gutberlet, Florian Von Knobelsdorffbrenkenhoff, Marco Francone, Peter Bernhardt, Iacopo Carbone, Kai Muellerleile, Annachiara Aldrovandi, Steffen Desch, Oliver StrohmAbstract:Context Stress cardiomyopathy (SC) is a transient form of acute heart failure triggered by stressful events and associated with a distinctive left ventricular (LV) contraction pattern. Various aspects of its clinical profile have been described in small single-center populations, but larger, multicenter data sets have been lacking so far. Furthermore, it remains difficult to quickly establish diagnosis on admission. Objectives To comprehensively define the clinical spectrum and evolution of SC in a large population, including tissue characterization data from Cardiovascular Magnetic Resonance (CMR) imaging; and to establish a set of CMR criteria suitable for diagnostic decision making in patients acutely presenting with suspected SC. Design, setting, and patients Prospective study conducted at 7 tertiary care centers in Europe and North America between January 2005 and October 2010 among 256 patients with SC assessed at the time of presentation as well as 1 to 6 months after the acute event. Main outcome measures Complete recovery of LV dysfunction. Results Eighty-one percent of patients (n = 207) were postmenopausal women, 8% (n = 20) were younger women (aged ≤50 years), and 11% (n = 29) were men. A stressful trigger could be identified in 182 patients (71%). Cardiovascular Magnetic Resonance imaging data (available for 239 patients [93%]) revealed 4 distinct patterns of regional ventricular ballooning: apical (n = 197 [82%]), biventricular (n = 81 [34%]), midventricular (n = 40 [17%]), and basal (n = 2 [1%]). Left ventricular ejection fraction was reduced (48% [SD, 11%]; 95% confidence interval [CI], 47%-50%) in all patients. Stress cardiomyopathy was accurately identified by CMR using specific criteria: a typical pattern of LV dysfunction, myocardial edema, absence of significant necrosis/fibrosis, and markers for myocardial inflammation. Follow-up CMR imaging showed complete normalization of LV ejection fraction (66% [SD, 7%]; 95% CI, 64%-68%) and inflammatory markers in the absence of significant fibrosis in all patients. Conclusions The clinical profile of SC is considerably broader than reported previously. Cardiovascular Magnetic Resonance imaging at the time of initial clinical presentation may provide relevant functional and tissue information that might aid in the establishment of the diagnosis of SC.
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clinical characteristics and Cardiovascular Magnetic Resonance findings in stress takotsubo cardiomyopathy
JAMA, 2011Co-Authors: Ingo Eitel, Matthias Gutberlet, Florian Von Knobelsdorffbrenkenhoff, Marco Francone, Peter Bernhardt, Iacopo Carbone, Kai Muellerleile, Annachiara Aldrovandi, Steffen Desch, Oliver StrohmAbstract:Context Stress cardiomyopathy (SC) is a transient form of acute heart failure triggered by stressful events and associated with a distinctive left ventricular (LV) contraction pattern. Various aspects of its clinical profile have been described in small single-center populations, but larger, multicenter data sets have been lacking so far. Furthermore, it remains difficult to quickly establish diagnosis on admission. Objectives To comprehensively define the clinical spectrum and evolution of SC in a large population, including tissue characterization data from Cardiovascular Magnetic Resonance (CMR) imaging; and to establish a set of CMR criteria suitable for diagnostic decision making in patients acutely presenting with suspected SC. Design, Setting, and Patients Prospective study conducted at 7 tertiary care centers in Europe and North America between January 2005 and October 2010 among 256 patients with SC assessed at the time of presentation as well as 1 to 6 months after the acute event. Main Outcome Measures Complete recovery of LV dysfunction. Results Eighty-one percent of patients (n = 207) were postmenopausal women, 8% (n = 20) were younger women (aged ≤50 years), and 11% (n = 29) were men. A stressful trigger could be identified in 182 patients (71%). Cardiovascular Magnetic Resonance imaging data (available for 239 patients [93%]) revealed 4 distinct patterns of regional ventricular ballooning: apical (n = 197 [82%]), biventricular (n = 81 [34%]), midventricular (n = 40 [17%]), and basal (n = 2 [1%]). Left ventricular ejection fraction was reduced (48% [SD, 11%]; 95% confidence interval [CI], 47%-50%) in all patients. Stress cardiomyopathy was accurately identified by CMR using specific criteria: a typical pattern of LV dysfunction, myocardial edema, absence of significant necrosis/fibrosis, and markers for myocardial inflammation. Follow-up CMR imaging showed complete normalization of LV ejection fraction (66% [SD, 7%]; 95% CI, 64%-68%) and inflammatory markers in the absence of significant fibrosis in all patients. Conclusions The clinical profile of SC is considerably broader than reported previously. Cardiovascular Magnetic Resonance imaging at the time of initial clinical presentation may provide relevant functional and tissue information that might aid in the establishment of the diagnosis of SC.
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prognostic significance and determinants of myocardial salvage assessed by Cardiovascular Magnetic Resonance in acute reperfused myocardial infarction
Journal of the American College of Cardiology, 2010Co-Authors: Ingo Eitel, Matthias Gutberlet, Gerhard Schuler, Steffen Desch, Georg Fuernau, Lysann Hildebrand, Holger ThieleAbstract:Objectives The aim of the study was to determine the prognostic significance and determinants of myocardial salvage assessed by Cardiovascular Magnetic Resonance (CMR) in reperfused ST-segment elevation myocardial infarction. Background In acute myocardial infarction, CMR can retrospectively detect the myocardium at risk and the irreversible injury. This allows for quantifying the extent of salvaged myocardium after reperfusion as a potential strong end point for clinical trials and outcome. Methods We analyzed 208 consecutive ST-segment elevation myocardial infarction patients undergoing primary angioplasty Results The median MSI was 48 (interquartile range 27 to 73). Major adverse Cardiovascular events were significantly lower in the MSI ≥ median group (2.9% vs. 22.1%, p Conclusions This study for the first time demonstrates that the MSI assessed by CMR predicts the outcome in acute reperfused ST-segment elevation myocardial infarction. Therefore, MSI assessment has important implications for patient prognosis as well as for the design of future trials intended to test new reperfusion therapy efficacy. (Myocardial Salvage Assessed by Cardiovascular Magnetic Resonance—Impact on Outcome; NCT00952224).
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inflammation in takotsubo cardiomyopathy insights from Cardiovascular Magnetic Resonance imaging
European Radiology, 2010Co-Authors: Ingo Eitel, C Lucke, Matthias Grothoff, Mahdi Sareban, Gerhard Schuler, Holger Thiele, Matthias GutberletAbstract:Objective Takotsubo cardiomyopathy (TTC) is an increasingly recognised acute cardiac syndrome, whose underlying pathophysiological mechanisms remain unknown. Inflammation might play a role as this has been shown in endomyocardial biopsies. The aim of this study was to assess inflammatory parameters in patients with TTC using a comprehensive Cardiovascular Magnetic Resonance imaging (CMR) approach.
Eike Nagel - One of the best experts on this subject based on the ideXlab platform.
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standardized Cardiovascular Magnetic Resonance imaging cmr protocols 2020 update
Journal of Cardiovascular Magnetic Resonance, 2020Co-Authors: Christopher M Kramer, Scott D Flamm, Raymond J Kim, Chiara Bucciarelliducci, J Barkhausen, Eike NagelAbstract:This document is an update to the 2013 publication of the Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Protocols. Concurrent with this publication, 3 additional task forces will publish documents that should be referred to in conjunction with the present document. The first is a document on the Clinical Indications for CMR, an update of the 2004 document. The second task force will be updating the document on Reporting published by that SCMR Task Force in 2010. The 3rd task force will be updating the 2013 document on Post-Processing. All protocols relative to congenital heart disease are covered in a separate document. The section on general principles and techniques has been expanded as more of the techniques common to CMR have been standardized. A section on imaging in patients with devices has been added as this is increasingly seen in day-to-day clinical practice. The authors hope that this document continues to standardize and simplify the patient-based approach to clinical CMR. It will be updated at regular intervals as the field of CMR advances.
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three dimensional balanced steady state free precession myocardial perfusion Cardiovascular Magnetic Resonance at 3t using dual source parallel rf transmission initial experience
Journal of Cardiovascular Magnetic Resonance, 2014Co-Authors: Roy Jogiya, Andreas Schuster, Eike Nagel, Manish Motwani, Sebastian Kozerke, Arshad Zaman, Marc Kouwenhoven, Sven PleinAbstract:Background The purpose of this study was to establish the feasibility of three-dimensional (3D) balanced steady-state-free-precession (bSSFP) myocardial perfusion Cardiovascular Magnetic Resonance (CMR) at 3T using local RF shimming with dual-source RF transmission, and to compare it with spoiled gradient echo (TGRE) acquisition.
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standardized Cardiovascular Magnetic Resonance cmr protocols 2013 update
Journal of Cardiovascular Magnetic Resonance, 2013Co-Authors: Christopher M Kramer, Scott D Flamm, Raymond J Kim, J Barkhausen, Eike NagelAbstract:This document is an update to the 2008 publication of the Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Protocols. Since the time of the original publication, 3 additional task forces (Reporting, Post-Processing, and Congenital Heart Disease) have published documents that should be referred to in conjunction with the present document. The section on general principles and techniques has been expanded as more of the techniques common to CMR have been standardized. There is still a great deal of development in the area of tissue characterization/mapping, so these protocols have been in general left as optional. The authors hope that this document continues to standardize and simplify the patient-based approach to clinical CMR. It will be updated at regular intervals as the field of CMR advances.
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native myocardial t1 mapping by Cardiovascular Magnetic Resonance imaging in subclinical cardiomyopathy in patients with systemic lupus erythematosus
Circulation-cardiovascular Imaging, 2013Co-Authors: Valentina O Puntmann, David Dcruz, Zachary Smith, Ana Pastor, Peng Choong, Tobias Voigt, Gerald Carrwhite, Shirish Sangle, Tobias Schaeffter, Eike NagelAbstract:Background— Increased systemic inflammation has been linked to myocardial dysfunction and heart failure in patients with systemic lupus erythematosus (SLE). Accurate detection of early myocardial changes may be able to guide preventive intervention. We investigated whether multiparametric imaging by Cardiovascular Magnetic Resonance can detect differences between controls and asymptomatic SLE patients. Methods and Results— A total of 33 SLE predominantly female patients (mean age, 40±9 years) underwent Cardiovascular Magnetic Resonance for routine assessment of myocardial perfusion, function, and late gadolinium enhancement. T1 mapping was performed in single short-axis slice before and after 15 minutes of gadolinium administration. Twenty-one subjects with a low pretest probability and normal Cardiovascular Magnetic Resonance served as a control group. Both groups had similar left ventricular volumes and mass and normal global systolic function. SLE patients had significantly reduced longitudinal strain (controls versus SLE, −20±2% versus −17±3%; P <0.01) and showed intramyocardial and pericardial late gadolinium enhancement. SLE patients had significantly increased native myocardial T1 (1056±27 versus 1152±46 milliseconds; P <0.001) and extracellular volume fraction (26±5% versus 30±6%; P =0.007) and reduced postcontrast myocardial T1 (454±53 versus 411±62 milliseconds; P =0.01). T1-derived indices were associated with longitudinal strain ( r =0.37–0.47) but not with the presence of late gadolinium enhancement. Native myocardial T1 values showed the greatest concordance with the presence of clinical diagnosis of SLE. Conclusions— In patients with SLE and free of cardiac symptoms, there is evidence of subclinical perimyocardial impairment. We further demonstrate that T1 mapping may have potential to detect subclinical myocardial involvement in patients with SLE.
Matthias G Friedrich - One of the best experts on this subject based on the ideXlab platform.
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standardized image interpretation and post processing in Cardiovascular Magnetic Resonance 2020 update
Journal of Cardiovascular Magnetic Resonance, 2020Co-Authors: Jeanette Schulzmenger, Matthias G Friedrich, Florian Von Knobelsdorffbrenkenhoff, David A Bluemke, Jens Bremerich, Scott D Flamm, Mark A Fogel, Raymond J Kim, Christopher M Kramer, Dudley J PennellAbstract:With mounting data on its accuracy and prognostic value, Cardiovascular Magnetic Resonance (CMR) is becoming an increasingly important diagnostic tool with growing utility in clinical routine. Given its versatility and wide range of quantitative parameters, however, agreement on specific standards for the interpretation and post-processing of CMR studies is required to ensure consistent quality and reproducibility of CMR reports. This document addresses this need by providing consensus recommendations developed by the Task Force for Post-Processing of the Society for Cardiovascular Magnetic Resonance (SCMR). The aim of the Task Force is to recommend requirements and standards for image interpretation and post-processing enabling qualitative and quantitative evaluation of CMR images. Furthermore, pitfalls of CMR image analysis are discussed where appropriate. It is an update of the original recommendations published 2013.
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SCMR Position Paper (2020) on clinical indications for Cardiovascular Magnetic Resonance
Journal of Cardiovascular Magnetic Resonance, 2020Co-Authors: Tim Leiner, Subha V Raman, Matthias G Friedrich, Raad Mohiaddin, Jan Bogaert, Vivek Muthurangu, Saul Myerson, Andrew J. Powell, Dudley J PennellAbstract:The Society for Cardiovascular Magnetic Resonance (SCMR) last published its comprehensive expert panel report of clinical indications for CMR in 2004. This new Consensus Panel report brings those indications up to date for 2020 and includes the very substantial increase in scanning techniques, clinical applicability and adoption of CMR worldwide. We have used a nearly identical grading system for indications as in 2004 to ensure comparability with the previous report but have added the presence of randomized controlled trials as evidence for level 1 indications. In addition to the text, tables of the consensus indication levels are included for rapid assimilation and illustrative figures of some key techniques are provided.
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quantification of lv function and mass by Cardiovascular Magnetic Resonance multi center variability and consensus contours
Journal of Cardiovascular Magnetic Resonance, 2015Co-Authors: Avan Suinesiaputra, Raymond Y Kwong, Matthias G Friedrich, Jeanette Schulzmenger, David A Bluemke, Christopher M Kramer, Sven Plein, Brett R Cowan, Jos J M Westenberg, Alistair A YoungAbstract:Background High reproducibility of LV mass and volume measurement from cine Cardiovascular Magnetic Resonance (CMR) has been shown within single centers. However, the extent to which contours may vary from center to center, due to different training protocols, is unknown. We aimed to quantify sources of variation between many centers, and provide a multi-center consensus ground truth dataset for benchmarking automated processing tools and facilitating training for new readers in CMR analysis.
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standardized image interpretation and post processing in Cardiovascular Magnetic Resonance society for Cardiovascular Magnetic Resonance scmr board of trustees task force on standardized post processing
Journal of Cardiovascular Magnetic Resonance, 2013Co-Authors: Jeanette Schulzmenger, Matthias G Friedrich, Florian Von Knobelsdorffbrenkenhoff, David A Bluemke, Jens Bremerich, Scott D Flamm, Mark A Fogel, Raymond J Kim, Christopher M Kramer, Dudley J PennellAbstract:With mounting data on its accuracy and prognostic value, Cardiovascular Magnetic Resonance (CMR) is becoming an increasingly important diagnostic tool with growing utility in clinical routine. Given its versatility and wide range of quantitative parameters, however, agreement on specific standards for the interpretation and post-processing of CMR studies is required to ensure consistent quality and reproducibility of CMR reports. This document addresses this need by providing consensus recommendations developed by the Task Force for Post Processing of the Society for Cardiovascular MR (SCMR). The aim of the task force is to recommend requirements and standards for image interpretation and post processing enabling qualitative and quantitative evaluation of CMR images. Furthermore, pitfalls of CMR image analysis are discussed where appropriate.
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T2-weighted Cardiovascular Magnetic Resonance in acute cardiac disease
Journal of Cardiovascular Magnetic Resonance, 2011Co-Authors: Ingo Eitel, Matthias G FriedrichAbstract:Cardiovascular Magnetic Resonance (CMR) using T2-weighted sequences can visualize myocardial edema. When compared to previous protocols, newer pulse sequences with substantially improved image quality have increased its clinical utility. The assessment of myocardial edema provides useful incremental diagnostic and prognostic information in a variety of clinical settings associated with acute myocardial injury. In patients with acute chest pain, T2-weighted CMR is able to identify acute or recent myocardial ischemic injury and has been employed to distinguish acute coronary syndrome (ACS) from non-ACS as well as acute from chronic myocardial infarction. T2-weighted CMR can also be used to determine the area at risk in reperfused and non-reperfused infarction. When combined with contrast-enhanced imaging, the salvaged area and thus the success of early coronary revascularization can be quantified. Strong evidence for the prognostic value of myocardial salvage has enabled its use as a primary endpoint in clinical trials. The present article reviews the current evidence and clinical applications for T2-weighted CMR in acute cardiac disease and gives an outlook on future developments. "The principle of all things is water" Thales of Miletus (624 BC - 546 BC)
Christopher M Kramer - One of the best experts on this subject based on the ideXlab platform.
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standardized image interpretation and post processing in Cardiovascular Magnetic Resonance 2020 update
Journal of Cardiovascular Magnetic Resonance, 2020Co-Authors: Jeanette Schulzmenger, Matthias G Friedrich, Florian Von Knobelsdorffbrenkenhoff, David A Bluemke, Jens Bremerich, Scott D Flamm, Mark A Fogel, Raymond J Kim, Christopher M Kramer, Dudley J PennellAbstract:With mounting data on its accuracy and prognostic value, Cardiovascular Magnetic Resonance (CMR) is becoming an increasingly important diagnostic tool with growing utility in clinical routine. Given its versatility and wide range of quantitative parameters, however, agreement on specific standards for the interpretation and post-processing of CMR studies is required to ensure consistent quality and reproducibility of CMR reports. This document addresses this need by providing consensus recommendations developed by the Task Force for Post-Processing of the Society for Cardiovascular Magnetic Resonance (SCMR). The aim of the Task Force is to recommend requirements and standards for image interpretation and post-processing enabling qualitative and quantitative evaluation of CMR images. Furthermore, pitfalls of CMR image analysis are discussed where appropriate. It is an update of the original recommendations published 2013.
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standardized Cardiovascular Magnetic Resonance imaging cmr protocols 2020 update
Journal of Cardiovascular Magnetic Resonance, 2020Co-Authors: Christopher M Kramer, Scott D Flamm, Raymond J Kim, Chiara Bucciarelliducci, J Barkhausen, Eike NagelAbstract:This document is an update to the 2013 publication of the Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Protocols. Concurrent with this publication, 3 additional task forces will publish documents that should be referred to in conjunction with the present document. The first is a document on the Clinical Indications for CMR, an update of the 2004 document. The second task force will be updating the document on Reporting published by that SCMR Task Force in 2010. The 3rd task force will be updating the 2013 document on Post-Processing. All protocols relative to congenital heart disease are covered in a separate document. The section on general principles and techniques has been expanded as more of the techniques common to CMR have been standardized. A section on imaging in patients with devices has been added as this is increasingly seen in day-to-day clinical practice. The authors hope that this document continues to standardize and simplify the patient-based approach to clinical CMR. It will be updated at regular intervals as the field of CMR advances.
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Cardiovascular Magnetic Resonance in nonischemic myocardial inflammation expert recommendations
Journal of the American College of Cardiology, 2018Co-Authors: Vanessa M Ferreira, Leslie T. Cooper, Udo Sechtem, Jeanette Schulzmenger, Godtfred Holmvang, Matthias Gutberlet, Christopher M Kramer, Iacopo Carbone, Ingrid Kindermann, Peter LiuAbstract:Abstract This JACC Scientific Expert Panel provides consensus recommendations for an update of the Cardiovascular Magnetic Resonance (CMR) diagnostic criteria for myocardial inflammation in patients with suspected acute or active myocardial inflammation (Lake Louise Criteria) that include options to use parametric mapping techniques. While each parameter may indicate myocardial inflammation, the authors propose that CMR provides strong evidence for myocardial inflammation, with increasing specificity, if the CMR scan demonstrates the combination of myocardial edema with other CMR markers of inflammatory myocardial injury. This is based on at least one T2-based criterion (global or regional increase of myocardial T2 relaxation time or an increased signal intensity in T2-weighted CMR images), with at least one T1-based criterion (increased myocardial T1, extracellular volume, or late gadolinium enhancement). While having both a positive T2-based marker and a T1-based marker will increase specificity for diagnosing acute myocardial inflammation, having only one (i.e., T2-based OR T1-based) marker may still support a diagnosis of acute myocardial inflammation in an appropriate clinical scenario, albeit with less specificity. The update is expected to improve the diagnostic accuracy of CMR further in detecting myocardial inflammation.
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quantification of lv function and mass by Cardiovascular Magnetic Resonance multi center variability and consensus contours
Journal of Cardiovascular Magnetic Resonance, 2015Co-Authors: Avan Suinesiaputra, Raymond Y Kwong, Matthias G Friedrich, Jeanette Schulzmenger, David A Bluemke, Christopher M Kramer, Sven Plein, Brett R Cowan, Jos J M Westenberg, Alistair A YoungAbstract:Background High reproducibility of LV mass and volume measurement from cine Cardiovascular Magnetic Resonance (CMR) has been shown within single centers. However, the extent to which contours may vary from center to center, due to different training protocols, is unknown. We aimed to quantify sources of variation between many centers, and provide a multi-center consensus ground truth dataset for benchmarking automated processing tools and facilitating training for new readers in CMR analysis.
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adenosine stress Cardiovascular Magnetic Resonance with variable density spiral pulse sequences accurately detects coronary artery disease initial clinical evaluation
Circulation-cardiovascular Imaging, 2014Co-Authors: Michael Salerno, Angela M Taylor, Yang Yang, Sujith Kuruvilla, Michael Ragosta, Craig H Meyer, Christopher M KramerAbstract:Background— Adenosine stress Cardiovascular Magnetic Resonance perfusion imaging can be limited by motion-induced dark-rim artifacts, which may be mistaken for true perfusion abnormalities. A high-resolution variable-density spiral pulse sequence with a novel density compensation strategy has been shown to reduce dark-rim artifacts in first-pass perfusion imaging. We aimed to assess the clinical performance of adenosine stress Cardiovascular Magnetic Resonance using this new perfusion sequence to detect obstructive coronary artery disease. Methods and Results— Cardiovascular Magnetic Resonance perfusion imaging was performed during adenosine stress (140 μg/kg per minute) and at rest on a Siemens 1.5-T Avanto scanner in 41 subjects with chest pain scheduled for coronary angiography. Perfusion images were acquired during injection of 0.1 mmol/kg Gadolinium-diethylenetriaminepentacetate at 3 short-axis locations using a saturation recovery interleaved variable-density spiral pulse sequence. Significant stenosis was defined as >50% by quantitative coronary angiography. Two blinded reviewers evaluated the perfusion images for the presence of adenosine-induced perfusion abnormalities and assessed image quality using a 5-point scale (1 [poor] to 5 [excellent]). The prevalence of obstructive coronary artery disease by quantitative coronary angiography was 68%. The average sensitivity, specificity, and accuracy were 89%, 85%, and 88%, respectively, with a positive predictive value and negative predictive value of 93% and 79%, respectively. The average image quality score was 4.4±0.7, with only 1 study with more than mild dark-rim artifacts. There was good inter-reader reliability with a κ statistic of 0.67. Conclusions— Spiral adenosine stress Cardiovascular Magnetic Resonance results in high diagnostic accuracy for the detection of obstructive coronary artery disease with excellent image quality and minimal dark-rim artifacts.