Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment

Hosamadin Assadi; Bhalraam  Uthayachandran; Rui Li; James Wardley; Tha H. Nyi; Ciaran Grafton-Clarke; Andrew J. Swift; Ana Beatriz Solana; Jean-Paul Aben; Kurian Thampi; David Hewson; Chris Sawh; Richard Greenwood; Marina Hughes; Bahman Kasmai; Liang Zhong; Marcus Flather; Vassilios Vassiliou; Pankaj Garg

doi:10.1186/s41747-022-00299-5

Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment

Hosamadin Assadi, Bhalraam Uthayachandran, Rui Li, James Wardley, Tha H. Nyi , Ciaran Grafton-Clarke, Andrew J. Swift, Ana Beatriz Solana, Jean-Paul Aben, Kurian Thampi, David Hewson, Chris Sawh, Richard Greenwood, Marina Hughes, Bahman Kasmai, Liang Zhong, Marcus Flather, Vassilios Vassiliou, Pankaj Garg

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Abstract

Background: To validate the k-adaptive-t autocalibrating reconstruction for Cartesian sampling (kat-ARC), an exclusive sparse reconstruction technique for four-dimensional (4D) flow cardiac magnetic resonance (CMR) using conservation of mass principle applied to transvalvular flow.

Methods: This observational retrospective study (2020/21-075) was approved by the local ethics committee at the University of East Anglia. Consent was waived. Thirty-five patients who had a clinical CMR scan were included. CMR protocol included cine and 4D flow using Kat-ARC acceleration factor 6. No respiratory navigation was applied. For validation, the agreement between mitral net flow (MNF) and the aortic net flow (ANF) was investigated. Additionally, we checked the agreement between peak aortic valve velocity derived by 4D flow and that derived by continuous-wave Doppler echocardiography in 20 patients.

Results: The median age of our patient population was 63 years (interquartile range [IQR] 54–73), and 18/35 (51%) were male. Seventeen (49%) patients had mitral regurgitation, and seven (20%) patients had aortic regurgitation. Mean acquisition time was 8 ± 4 min. MNF and ANF were comparable: 60 mL (51−78) versus 63 mL (57−77), p = 0.310). There was an association between MNF and ANF (rho = 0.58, p < 0.001). Peak aortic valve velocity by Doppler and 4D flow were comparable (1.40 m/s, [1.30−1.75] versus 1.46 m/s [1.25−2.11], p = 0.602) and also correlated with each other (rho = 0.77, p < 0.001).

Conclusions: Kat-ARC accelerated 4D flow CMR quantified transvalvular flow in accordance with the conservation of mass principle and is primed for clinical translation.

Original language	English
Article number	46
Journal	European Radiology
Volume	6
DOIs	https://doi.org/10.1186/s41747-022-00299-5
Publication status	Published - 22 Sep 2022

Keywords

aortic valve
Blood flow velocity
Echocardiography (Doppler),
Magnetic resonance imaging
Mitral valve
Echocardiography (Doppler)
Aortic valve

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Assadi, H., Uthayachandran, B., Li, R., Wardley, J., Nyi , T. H., Grafton-Clarke, C., Swift, A. J., Solana, A. B., Aben, J-P., Thampi, K., Hewson, D., Sawh, C., Greenwood, R., Hughes, M., Kasmai, B., Zhong, L., Flather, M., Vassiliou, V., & Garg, P. (2022). Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment. European Radiology, 6, [46]. https://doi.org/10.1186/s41747-022-00299-5

Assadi, Hosamadin ; Uthayachandran, Bhalraam ; Li, Rui ; Wardley, James ; Nyi , Tha H. ; Grafton-Clarke, Ciaran ; Swift, Andrew J. ; Solana, Ana Beatriz ; Aben, Jean-Paul ; Thampi, Kurian ; Hewson, David ; Sawh, Chris ; Greenwood, Richard ; Hughes, Marina ; Kasmai, Bahman ; Zhong, Liang ; Flather, Marcus ; Vassiliou, Vassilios ; Garg, Pankaj. / Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment. In: European Radiology. 2022 ; Vol. 6.

@article{79ab9b2ccf214425a7a390f45548a0a7,

title = "Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment",

abstract = "Background: To validate the k-adaptive-t autocalibrating reconstruction for Cartesian sampling (kat-ARC), an exclusive sparse reconstruction technique for four-dimensional (4D) flow cardiac magnetic resonance (CMR) using conservation of mass principle applied to transvalvular flow. Methods: This observational retrospective study (2020/21-075) was approved by the local ethics committee at the University of East Anglia. Consent was waived. Thirty-five patients who had a clinical CMR scan were included. CMR protocol included cine and 4D flow using Kat-ARC acceleration factor 6. No respiratory navigation was applied. For validation, the agreement between mitral net flow (MNF) and the aortic net flow (ANF) was investigated. Additionally, we checked the agreement between peak aortic valve velocity derived by 4D flow and that derived by continuous-wave Doppler echocardiography in 20 patients. Results: The median age of our patient population was 63 years (interquartile range [IQR] 54–73), and 18/35 (51%) were male. Seventeen (49%) patients had mitral regurgitation, and seven (20%) patients had aortic regurgitation. Mean acquisition time was 8 ± 4 min. MNF and ANF were comparable: 60 mL (51−78) versus 63 mL (57−77), p = 0.310). There was an association between MNF and ANF (rho = 0.58, p < 0.001). Peak aortic valve velocity by Doppler and 4D flow were comparable (1.40 m/s, [1.30−1.75] versus 1.46 m/s [1.25−2.11], p = 0.602) and also correlated with each other (rho = 0.77, p < 0.001). Conclusions: Kat-ARC accelerated 4D flow CMR quantified transvalvular flow in accordance with the conservation of mass principle and is primed for clinical translation.",

keywords = "aortic valve, Blood flow velocity, Echocardiography (Doppler),, Magnetic resonance imaging, Mitral valve, Echocardiography (Doppler), Aortic valve",

author = "Hosamadin Assadi and Bhalraam Uthayachandran and Rui Li and James Wardley and Nyi, {Tha H.} and Ciaran Grafton-Clarke and Swift, {Andrew J.} and Solana, {Ana Beatriz} and Jean-Paul Aben and Kurian Thampi and David Hewson and Chris Sawh and Richard Greenwood and Marina Hughes and Bahman Kasmai and Liang Zhong and Marcus Flather and Vassilios Vassiliou and Pankaj Garg",

note = "Funding Information: PG and AJS are funded by Wellcome Trust Clinical Research Career Development Fellowships (220703/Z/20/Z & 205188/Z/16/Z). LZ is funded by the National Medical Research Council of Singapore (Grant Nos. NMRC/OFIRG/0018/2016, MOH-000351). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Rights retention statement: For the purpose of Open Access, these authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. ",

year = "2022",

month = sep,

day = "22",

doi = "10.1186/s41747-022-00299-5",

language = "English",

volume = "6",

journal = "European Radiology",

issn = "0938-7994",

publisher = "Springer",

}

Assadi, H, Uthayachandran, B, Li, R, Wardley, J, Nyi , TH, Grafton-Clarke, C, Swift, AJ, Solana, AB, Aben, J-P, Thampi, K, Hewson, D, Sawh, C, Greenwood, R, Hughes, M, Kasmai, B, Zhong, L, Flather, M , Vassiliou, V & Garg, P 2022, 'Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment', European Radiology, vol. 6, 46. https://doi.org/10.1186/s41747-022-00299-5

Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment. / Assadi, Hosamadin; Uthayachandran, Bhalraam ; Li, Rui; Wardley, James; Nyi , Tha H.; Grafton-Clarke, Ciaran; Swift, Andrew J.; Solana, Ana Beatriz; Aben, Jean-Paul; Thampi, Kurian; Hewson, David; Sawh, Chris; Greenwood, Richard; Hughes, Marina; Kasmai, Bahman; Zhong, Liang; Flather, Marcus ; Vassiliou, Vassilios ; Garg, Pankaj.

In: European Radiology, Vol. 6, 46, 22.09.2022.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment

AU - Assadi, Hosamadin

AU - Uthayachandran, Bhalraam

AU - Li, Rui

AU - Wardley, James

AU - Nyi , Tha H.

AU - Grafton-Clarke, Ciaran

AU - Swift, Andrew J.

AU - Solana, Ana Beatriz

AU - Aben, Jean-Paul

AU - Thampi, Kurian

AU - Hewson, David

AU - Sawh, Chris

AU - Greenwood, Richard

AU - Hughes, Marina

AU - Kasmai, Bahman

AU - Zhong, Liang

AU - Flather, Marcus

AU - Vassiliou, Vassilios

AU - Garg, Pankaj

N1 - Funding Information: PG and AJS are funded by Wellcome Trust Clinical Research Career Development Fellowships (220703/Z/20/Z & 205188/Z/16/Z). LZ is funded by the National Medical Research Council of Singapore (Grant Nos. NMRC/OFIRG/0018/2016, MOH-000351). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Rights retention statement: For the purpose of Open Access, these authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

PY - 2022/9/22

Y1 - 2022/9/22

N2 - Background: To validate the k-adaptive-t autocalibrating reconstruction for Cartesian sampling (kat-ARC), an exclusive sparse reconstruction technique for four-dimensional (4D) flow cardiac magnetic resonance (CMR) using conservation of mass principle applied to transvalvular flow. Methods: This observational retrospective study (2020/21-075) was approved by the local ethics committee at the University of East Anglia. Consent was waived. Thirty-five patients who had a clinical CMR scan were included. CMR protocol included cine and 4D flow using Kat-ARC acceleration factor 6. No respiratory navigation was applied. For validation, the agreement between mitral net flow (MNF) and the aortic net flow (ANF) was investigated. Additionally, we checked the agreement between peak aortic valve velocity derived by 4D flow and that derived by continuous-wave Doppler echocardiography in 20 patients. Results: The median age of our patient population was 63 years (interquartile range [IQR] 54–73), and 18/35 (51%) were male. Seventeen (49%) patients had mitral regurgitation, and seven (20%) patients had aortic regurgitation. Mean acquisition time was 8 ± 4 min. MNF and ANF were comparable: 60 mL (51−78) versus 63 mL (57−77), p = 0.310). There was an association between MNF and ANF (rho = 0.58, p < 0.001). Peak aortic valve velocity by Doppler and 4D flow were comparable (1.40 m/s, [1.30−1.75] versus 1.46 m/s [1.25−2.11], p = 0.602) and also correlated with each other (rho = 0.77, p < 0.001). Conclusions: Kat-ARC accelerated 4D flow CMR quantified transvalvular flow in accordance with the conservation of mass principle and is primed for clinical translation.

AB - Background: To validate the k-adaptive-t autocalibrating reconstruction for Cartesian sampling (kat-ARC), an exclusive sparse reconstruction technique for four-dimensional (4D) flow cardiac magnetic resonance (CMR) using conservation of mass principle applied to transvalvular flow. Methods: This observational retrospective study (2020/21-075) was approved by the local ethics committee at the University of East Anglia. Consent was waived. Thirty-five patients who had a clinical CMR scan were included. CMR protocol included cine and 4D flow using Kat-ARC acceleration factor 6. No respiratory navigation was applied. For validation, the agreement between mitral net flow (MNF) and the aortic net flow (ANF) was investigated. Additionally, we checked the agreement between peak aortic valve velocity derived by 4D flow and that derived by continuous-wave Doppler echocardiography in 20 patients. Results: The median age of our patient population was 63 years (interquartile range [IQR] 54–73), and 18/35 (51%) were male. Seventeen (49%) patients had mitral regurgitation, and seven (20%) patients had aortic regurgitation. Mean acquisition time was 8 ± 4 min. MNF and ANF were comparable: 60 mL (51−78) versus 63 mL (57−77), p = 0.310). There was an association between MNF and ANF (rho = 0.58, p < 0.001). Peak aortic valve velocity by Doppler and 4D flow were comparable (1.40 m/s, [1.30−1.75] versus 1.46 m/s [1.25−2.11], p = 0.602) and also correlated with each other (rho = 0.77, p < 0.001). Conclusions: Kat-ARC accelerated 4D flow CMR quantified transvalvular flow in accordance with the conservation of mass principle and is primed for clinical translation.

KW - aortic valve

KW - Blood flow velocity

KW - Echocardiography (Doppler),

KW - Magnetic resonance imaging

KW - Mitral valve

KW - Echocardiography (Doppler)

KW - Aortic valve

UR - http://www.scopus.com/inward/record.url?scp=85138274059&partnerID=8YFLogxK

U2 - 10.1186/s41747-022-00299-5

DO - 10.1186/s41747-022-00299-5

M3 - Article

VL - 6

JO - European Radiology

JF - European Radiology

SN - 0938-7994

M1 - 46

ER -

Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment

Abstract

Keywords

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