Abstract #0787

Preliminary clinical application of free-breathing black-blood myocardial scar imaging in patients with cardiac implantable devices

Pauline Gut^1,2,3, Hubert Cochet^3,4, Panagiotis Antiochos⁵, Guido Caluori³, Baptiste Durand³, Marion Constantin³, Konstantinos Vlachos³, Kalvin Narceau³, Ambra Masi⁵, Jürg Schwitter^2,5,6, Frederic Sacher^3,7, Pierre Jaïs^3,7, Matthias Stuber^1,3,8, and Aurélien Bustin^1,3,9

¹Diagnostic and Interventional Radiology, University Hospital of Lausanne, Lausanne, Switzerland, ²Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland, ³Heart Rhythm Disease, IHU LIRYC, Pessac, France, ⁴Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, Pessac, France, ⁵Division of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland, ⁶CMR Center, University Hospital of Lausanne, Lausanne, Switzerland, ⁷Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, Pessac, France, ⁸CIBM Center for Biomedical Imaging, Lausanne, Switzerland, ⁹Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, Pessac, Switzerland

Synopsis

Keywords: Inflammation, Infiltration, Tissue Characterization, Implantable cardiac devices, myocardial scar detection, black-blood imaging, motion correction

Motivation: Breath-held wideband black-blood imaging enhances myocardial scar detection in ICD patients, offering better scar-to-blood contrast and reduced device-related artifacts compared to conventional PSIR imaging. However, this sequence is ineffective for severely ill patients who are unable to hold their breath.

Goal(s): To improve myocardial lesion detection in ICD patients who cannot hold their breath.

Approach: A 2D free-breathing wideband black-blood sequence with non-rigid motion correction was developed, incorporating wideband adiabatic inversion recovery and wideband T2 preparation, and was tested in 15 patients with cardiac implants.

Results: Wideband pulses suppressed ICD artifacts. Motion correction improved scar sharpness, image entropy, and provided excellent scar depiction.

Impact: Our findings support the clinical use of the proposed sequence for more accurate myocardial scar detection in patients with implantable cardiac devices, without long and tedious breath-holds, which could influence treatment decisions and improve outcomes by preventing sudden cardiac death.

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