title: 3D late gadolinium enhancement in a single prolonged breath-hold using supplemental oxygenation and hyperventilation.
abstract: OBJECTIVE
  To evaluate the feasibility of three-dimensional (3D) single breath-hold late gadolinium enhancement (LGE) of the left ventricle (LV) using supplemental oxygen and hyperventilation and compressed-sensing acceleration.
  
  
  METHODS
  Breath-hold metrics [breath-hold duration, diaphragmatic/LV position drift, and maximum variation of R wave to R wave (RR) interval] without and with supplemental oxygen and hyperventilation were assessed in healthy adult subjects using a real-time single shot acquisition. Ten healthy subjects and 13 patients then underwent assessment of the proposed 3D breath-hold LGE acquisition (field of view = 320 × 320 × 100 mm(3) , resolution = 1.6 × 1.6 × 5.0 mm(3) , acceleration rate of 4) and a free-breathing acquisition with right hemidiaphragm navigator (NAV) respiratory gating. Semiquantitative grading of overall image quality, motion artifact, myocardial nulling, and diagnostic value was performed by consensus of two blinded observers.
  
  
  RESULTS
  Supplemental oxygenation and hyperventilation increased the breath-hold duration (35 ± 11 s to 58 ± 21 s; P < 0.0125) without significant impact on diaphragmatic/LV position drift or maximum variation of RR interval (both P > 0.01). LGE images were of similar quality when compared with free-breathing acquisitions, but with reduced total scan time (85 ± 22 s to 35 ± 6 s; P < 0.001).
  
  
  CONCLUSIONS
  Supplemental oxygenation and hyperventilation allow for prolonged breath-holding and enable single breath-hold 3D accelerated LGE with similar image quality as free breathing with NAV.
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Roujol
authors.forename: Tamer A
authors.initials: TA
authors.lastname: Basha
authors.forename: Mehmet
authors.initials: M
authors.lastname: Akçakaya
authors.forename: Murilo
authors.initials: M
authors.lastname: Foppa
authors.forename: Raymond H
authors.initials: RH
authors.lastname: Chan
authors.forename: Kraig V
authors.initials: KV
authors.lastname: Kissinger
authors.forename: Beth
authors.initials: B
authors.lastname: Goddu
authors.forename: Sophie
authors.initials: S
authors.lastname: Berg
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Manning
authors.forename: Reza
authors.initials: R
authors.lastname: Nezafat
mesh_terms: D000328:Adult; D016477:Artifacts; D062485:Breath Holding; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D006985:Hyperventilation; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009942:Organometallic Compounds / Q000008:administration & dosage*; D010100:Oxygen / Q000008:administration & dosage*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D010100:Oxygen
keywords: 3D acquisition; acceleration techniques; breath-hold; compressed sensing; hyperventilation; late gadolinium enhancement; left ventricle; myocardial viability