title: Wideband late gadolinium enhanced magnetic resonance imaging for imaging myocardial scar without image artefacts induced by implantable cardioverter-defibrillator: a feasibility study at 3 T.
abstract: OBJECTIVE
  Late gadolinium enhanced (LGE) magnetic resonance imaging (MRI) is a useful tool for facilitating ventricular tachycardia (VT) ablation. Unfortunately, most VT ablation candidates often have prophylactic implantable cardioverter-defibrillator (ICD) and do not undergo cardiac MRI largely due to image artefacts generated by ICD. A prior study has reported success of 'wideband' LGE MRI for imaging myocardial scar without image artefacts induced by ICD at 1.5T. The purpose of this study was to widen the availability of wideband LGE MRI to 3T, since it has the potential to achieve higher spatial resolution than 1.5T.
  
  
  RESULTS
  We compared the performance of standard and wideband LGE MRI pulse sequences in phantoms and canines with myocardial lesions created by radiofrequency ablation. Standard LGE MRI produced image artefacts induced by ICD and 49% accuracy in detecting 97 myocardial scars examined in this study, whereas wideband LGE MRI produced artefact-free images and 94% accuracy in detecting scars. The mean image quality score (1 = nondiagnostic, 2 = poor, 3 = adequate, 4 = good, 5 = excellent) was significantly (P < 0.001) higher for wideband (3.7 ± 0.8) than for standard LGE MRI (2.1 ± 0.7). The mean artefact level score (1 = minimal, 2 = mild, 3 = moderate, 4 = severe, 5 = nondiagnostic) was significantly (P < 0.001) lower for wideband (2.1 ± 0.8) than for standard LGE MRI (4.0 ± 0.6). Wideband LGE MRI agreed better with gross pathology than standard LGE MRI.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility of wideband LGE MRI for suppression of image artefacts induced by ICD at 3T.
authors.affiliation: CARMA Center, Division of Cardiology, Internal Medicine, University of Utah, 30 North 1900 East, Rm 4A100, Salt Lake City, UT 84132, USA ravi.ranjan@hsc.uah.edu.
authors.forename: Ravi
authors.initials: R
authors.lastname: Ranjan
authors.affiliation: CARMA Center, Division of Cardiology, Internal Medicine, University of Utah, 30 North 1900 East, Rm 4A100, Salt Lake City, UT 84132, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McGann
authors.affiliation: UCAIR, Department of Radiology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Eun-Kee
authors.initials: EK
authors.lastname: Jeong
authors.affiliation: UCAIR, Department of Radiology, University of Utah, Salt Lake City, UT, USA.
authors.forename: KyungPyo
authors.initials: K
authors.lastname: Hong
authors.affiliation: CARMA Center, Division of Cardiology, Internal Medicine, University of Utah, 30 North 1900 East, Rm 4A100, Salt Lake City, UT 84132, USA UCAIR, Department of Radiology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Eugene G
authors.initials: EG
authors.lastname: Kholmovski
authors.affiliation: CARMA Center, Division of Cardiology, Internal Medicine, University of Utah, 30 North 1900 East, Rm 4A100, Salt Lake City, UT 84132, USA.
authors.forename: Josh
authors.initials: J
authors.lastname: Blauer
authors.affiliation: CARMA Center, Division of Cardiology, Internal Medicine, University of Utah, 30 North 1900 East, Rm 4A100, Salt Lake City, UT 84132, USA.
authors.forename: Brent D
authors.initials: BD
authors.lastname: Wilson
authors.affiliation: CARMA Center, Division of Cardiology, Internal Medicine, University of Utah, 30 North 1900 East, Rm 4A100, Salt Lake City, UT 84132, USA.
authors.forename: Nassir F
authors.initials: NF
authors.lastname: Marrouche
authors.affiliation: UCAIR, Department of Radiology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kim
mesh_terms: D000818:Animals; D016477:Artifacts; D017115:Catheter Ablation / Q000379:methods; D002921:Cicatrix / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D017147:Defibrillators, Implantable; D004285:Dogs; D005240:Feasibility Studies; D005682:Gadolinium; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009206:Myocardium / Q000473:pathology*; D019047:Phantoms, Imaging; D025321:Surgery, Computer-Assisted / Q000379:methods; D017180:Tachycardia, Ventricular / Q000601:surgery
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: Implantable cardioverter-defibrillator; Late gadolinium enhanced magnetic resonance imaging; Radiofrequency ablation; Ventricular tachycardia