Development and validation of cardiovascular MRI techniques on a low-field, ultra-wide bore system to assess patients with severe obesity

在低场、超宽孔径系统上开发和验证心血管 MRI 技术，以评估严重肥胖患者

• 批准号: 10357292
• 负责人: Orlando Paul Simonetti
• 金额: $ 57.65万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-15 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10357292
• 关键词: Address; Adipose tissue; Adult; Affect; American Heart Association; Body mass index; Breathing; Caliber; Cardiovascular Diagnostic Techniques; Cardiovascular Diseases; Cardiovascular system; Caring; Centers for Disease Control and Prevention (U.S.); Clinical; Clinical Management; Development; Diagnostic; Diagnostic Imaging; Dyslipidemias; Echocardiography; Epidemic; Equipment; Face; Goals; Healthcare; Heart Diseases; Heart failure; Hispanic; Hypertension; Image; Image Enhancement; Imaging Techniques; Incidence; Individual; Institution; Link; Machine Learning; Magnetic Resonance Imaging; Methods; Modality; Morbid Obesity; Morphologic artifacts; Myocardial tissue; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obesity Epidemic; Outcome; Patients; Physiologic pulse; Physiological; Population; Prevalence; Prognosis; Protocols documentation; Radiation; Radiation Dose Unit; Radiology Specialty; Reference Standards; Reporting; Reproducibility; Risk; Risk Factors; Safety; Scanning; Severities; Signal Transduction; Stroke; Structure; Symptoms; System; Techniques; Testing; Time; Validation; Walking; Weight; Work; X-Ray Computed Tomography; absorption; accurate diagnosis; attenuation; base; black women; cardiac magnetic resonance imaging; cardiovascular disorder risk; cardiovascular imaging; clinical care; data acquisition; denoising; design; diagnostic accuracy; diagnostic value; efficacy evaluation; experience; flexibility; functional disability; head-to-head comparison; healthy volunteer; image reconstruction; imaging biomarker; imaging modality; imaging platform; imaging system; implantable device; innovation; interest; lifetime risk; magnetic field; men; mortality risk; non-invasive imaging; novel; obese patients; patient population; prognostic value; reconstruction; single photon emission computed tomography; statistics; tool; ultrasound

Project Summary/Abstract Obesity has reached epidemic proportions in the USA, with more than 40% of the population classified as obese (body mass index (BMI) > 30 kg/m2), and nearly 10% as severely obese (BMI > 40 kg/m2). Cardiovascular disease (CVD), especially heart failure, is highly associated with obesity. Reliable non-invasive cardiovascular imaging tests are needed to provide accurate diagnosis and prognosis in this patient group. Unfortunately, obese patients present a diagnostic challenge to current non-invasive cardiovascular imaging modalities. Computed tomography and single-photon emission computed tomography can require excessive radiation for successful imaging of obese patients, while echocardiography suffers from limited windows and signal attenuation leading to degraded image quality. Magnetic resonance imaging (MRI) of obese patients at conventional field strengths (1.5T and 3.0T) is primarily limited by narrow patient bore and table weight limits. As lower field strength allows greater flexibility in magnet design, a new low-field (0.55T) MRI with a unique, ultra-wide 80 cm bore and 700 lb. table weight limit that can accommodate severely obese patients was recently announced by Siemens. One of the first such systems in the USA will be installed at our institution this summer. In this project, we will develop cardiovascular MRI techniques for this system, and demonstrate their clinical value in severely obese patients. Our group and others have recently shown initial feasibility of cardiovascular imaging at low field. We believe that this new low-field MRI platform, when combined with the advanced pulse sequences and image reconstruction methods developed by our team, can unlock the potential of this novel system as a more reliable means to provide non-invasive cardiovascular imaging to patients with severe obesity. Furthermore, the reduced field strength will make MRI safer and more effective in the growing number of patients with implanted devices. We will prove low-field MRI utility for CVD assessment. Aim 1 will establish the feasibility of low-field cardiovascular MRI regardless of body habitus. We will develop image acquisition and reconstruction techniques specifically designed to compensate for the reduced MR signal at 0.55T compared to higher field. This will offer a comprehensive assessment of cardiovascular structure and function, and myocardial tissue. Aim 2 will validate these techniques in normal weight to severely obese healthy individuals and CVD patients, by head-to-head comparison with standard 70 cm bore 1.5T MRI in those able to safely fit in both machines. Aim 3 will apply the validated techniques to evaluate the efficacy of a low-field cardiovascular MRI exam in heart failure patients who are severely obese (BMI > 40 kg/m2) and cannot be safely imaged on standard MRI systems. We will compare the comprehensive diagnostic value of 0.55T MRI against echocardiography, and will correlate MRI markers to clinical symptoms of heart failure severity determined by a six minute walk test in these patients. The cardiovascular techniques that we develop for this imminent novel 0.55 T MRI system provides a timely solution for effective clinical care and management of the increasing population of severely obese CVD patients.

项目摘要/摘要 肥胖症在美国已经达到了流行病，超过40％的人口归类为肥胖 （体重指数（BMI）> 30 kg/m2），近10％（BMI> 40 kg/m2）。心血管 疾病（CVD），尤其是心力衰竭，与肥胖高度相关。可靠的非侵入性心血管 需要进行成像测试以提供该患者组的准确诊断和预后。不幸的是，肥胖 患者对当前非侵入性心血管成像方式提出了诊断挑战。计算 断层扫描和单光子发射计算机断层扫描可能需要过多的辐射才能成功 肥胖患者的成像，而超声心动图的窗户有限，信号衰减领先 降低图像质量。肥胖患者的磁共振成像（MRI）在常规田间强度下 （1.5t和3.0t）主要受患者孔和桌子重量限制的限制。由于较低的场强允许 磁铁设计的灵活性更大，新的低场（0.55T）MRI具有独特的超宽80厘米孔和700磅的磁力。 西门子最近宣布了可容纳严重肥胖患者的餐桌体重极限。之一 美国第一个这样的系统将于今年夏天在我们的机构安装。在这个项目中，我们将开发 该系统的心血管MRI技术，并证明了它们在严重肥胖患者中的临床价值。 我们的小组和其他人最近在低场显示心血管成像的初始可行性。我们相信 当与高级脉冲序列和图像结合使用时，这个新的低场MRI平台 我们的团队开发的重建方法可以将这种新颖系统的潜力释放为更可靠的 为严重肥胖症患者提供非侵入性心血管成像的手段。此外，减少了 野外强度将使MRI更安全，更有效地在越来越多的植入设备患者中。 我们将证明用于CVD评估的低场MRI实用程序。 AIM 1将确定低场的可行性 心血管MRI不管身体习惯如何。我们将开发图像获取和重建技术 专门设计用于补偿与较高场相比，在0.55T时减少的MR信号。这将提供 对心血管结构和功能以及心肌组织的全面评估。 AIM 2将验证 这些技术以正常的重量对严重肥胖的健康个体和CVD患者进行 与标准的70厘米孔1.5T MRI的比较，可以安全地适合这两台机器。 AIM 3将应用 经过验证的技术来评估低场心血管MRI检查在心力衰竭患者中的​​功效 严重肥胖（BMI> 40 kg/m2），不能在标准MRI系统上安全成像。我们将比较 针对超声心动图的0.55T MRI的综合诊断值，并将MRI标记与 心力衰竭严重程度的临床症状由这些患者进行六分钟的步行测试确定。 我们为这款即将到来的小说0.55 T MRI系统开发的心血管技术提供了及时 解决严重肥胖CVD患者人群增加的有效临床护理和管理解决方案。