title: Head-to-head comparison of eight late gadolinium-enhanced cardiac MR (LGE CMR) sequences at 1.5 tesla: from bench to bedside.
abstract: OBJECTIVE
  To compare-theoretically and experimentally-clinically available two-dimensional/three-dimensional (2D/3D), breathhold and non-breathhold, inversion-recovery (IR) gradient-echo (GRE) sequences used to differentiate between nonviable injured and normal myocardium with late gadolinium-enhanced techniques (IR-GRE2D sequence is used as a reference), and to evaluate their respective clinical benefit.
  
  
  METHODS
  Six breathhold (2D-IR-GRE, 3D-IR-GRE, balanced steady-state free precession 2D-IR-bSSFP and 3D-IR-bSSFP, phase-sensitive 2D-PSIR-GRE, and 2D-PSIR-bSSFP) and two non-breathhold late gadolinium-enhanced techniques (single-shot 2D-ssbSSFP and 2D-PSIR-ssbSSFP) were consecutively performed in 32 coronary artery disease patients with chronic myocardial infarction. Qualitative assessment and manual planimetry were performed by two independent observers. Quantitative assessment was based on percentage signal intensity elevation between injured and normal myocardium and contrast-to-noise ratio. Theoretical simulations were compared with experimental measurements performed on phantoms with various concentrations of gadolinium.
  
  
  RESULTS
  The 3D-IR-GRE image quality appeared better than the other 2D and 3D sequences, showing better delineation of complex nontransmural lesions, with significantly higher percentage signal intensity and contrast-to-noise ratio. PSIR techniques appeared more limited in differentiating sub-endocardial lesions and intracavity blood pool, but in all other cases were comparable to the other techniques. Single-shot PSIR-ssbSSFP appeared to be a valuable alternative technique when breathhold cannot be achieved.
  
  
  CONCLUSIONS
  We recommend 3D-IR-GRE as the method of choice for late gadolinium-enhanced cardiac magnetic resonance imaging in clinical practice.
authors.affiliation: Hopital Universitaire de Genève, Genève, Switzerland. magalie.viallon@hcuge.ch
authors.forename: Magalie
authors.initials: M
authors.lastname: Viallon
authors.forename: Alexis
authors.initials: A
authors.lastname: Jacquier
authors.forename: Carmen
authors.initials: C
authors.lastname: Rotaru
authors.forename: Bénédicte M A
authors.initials: BM
authors.lastname: Delattre
authors.forename: Nathan
authors.initials: N
authors.lastname: Mewton
authors.forename: Fabrice
authors.initials: F
authors.lastname: Vincent
authors.forename: Pierre
authors.initials: P
authors.lastname: Croisille
mesh_terms: D005260:Female; D005682:Gadolinium; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D009206:Myocardium / Q000473:pathology*; D015588:Observer Variation; D019047:Phantoms, Imaging
chemical_list: D005682:Gadolinium