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dc.contributor.authorCheriyan, Joseph
dc.contributor.authorRoberts, Alexandra
dc.contributor.authorRoberts, Caleb
dc.contributor.authorGraves, Martin
dc.contributor.authorPatterson, Ilse
dc.contributor.authorSlough, Rhys A
dc.contributor.authorSchroyer, Rosemary
dc.contributor.authorFernando, Disala
dc.contributor.authorKumar, Subramanya
dc.contributor.authorLee, Sarah
dc.contributor.authorParker, Geoffrey JM
dc.contributor.authorSarov-Blat, Lea
dc.contributor.authorMcEniery, Carmel
dc.contributor.authorMiddlemiss, Jessica
dc.contributor.authorSprecher, Dennis
dc.contributor.authorJaniczek, Robert L
dc.date.accessioned2022-04-01T23:30:34Z
dc.date.available2022-04-01T23:30:34Z
dc.date.issued2022-03-27
dc.identifier.issn1053-1807
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/335695
dc.description.abstractBACKGROUND: Methods for accurate quantification of lung fluid in heart failure (HF) are needed. Dynamic contrast-enhanced (DCE)-MRI may be an appropriate modality. PURPOSE: DCE-MRI evaluation of fraction of fluid volume in the interstitial lung space (ve ) and vascular permeability (Ktrans ). STUDY TYPE: Prospective, single-center method validation. POPULATION: Seventeen evaluable healthy volunteers (HVs), 12 participants with HF, and 3 with acute decompensated HF (ADHF). FIELD STRENGTH/SEQUENCE: T1 mapping (spoiled gradient echo variable flip angle acquisition) followed by dynamic series (three-dimensional spoiled gradient-recalled echo acquisitions [constant echo time, repetition time, and flip angle at 1.5 T]). ASSESSMENT: Three whole-chest scans were acquired: baseline (Session 1), 1-week later (Session 2), following exercise (Session 3). Extended Tofts model quantified ve and Ktrans (voxel-wise basis); total lung median measures were extracted and fitted via repeat measure analysis of variance (ANOVA) model. Patient tolerability of the scanning protocol was assessed. STATISTICAL TESTS: This was constructed as an experimental medicine study. PRIMARY ENDPOINTS: Ktrans and ve at baseline (HV vs. HF), change in Ktrans and ve following exercise, and following lung congestion resolution (ADHF). Ktrans and ve were fitted separately using ANOVA. Secondary endpoint: repeatability, that is, within-participant variability in ve and Ktrans between sessions (coefficient of variation estimated via mixed effects model). RESULTS: There was no significant difference in mean Ktrans between HF and HV (P ≤ 0.17): 0.2216 minutes-1 and 0.2353 minutes-1 (Session 1), 0.2044 minutes-1 and 0.2567 minutes-1 (Session 2), 0.1841 minutes-1 and 0.2108 minutes-1 (Session 3), respectively. ve was greater in the HF group (all scans, P ≤ 0.02). Results were repeatable between Sessions 1 and 2; mean values for HF and HV were 0.4946 and 0.3346 (Session 1), 0.4353 and 0.3205 (Session 2), respectively. There was minimal difference in Ktrans or ve between scans for participants with ADHF (small population precluded significance testing). Scanning was well tolerated. DATA CONCLUSION: While no differences were detected in Ktrans , ve was greater in chronic HF patients vs. HV, augmented beyond plasma and intracellular volume. DCE-MRI is a valuable diagnostic and physiologic tool to evaluate changes in fluid volume in the interstitial lung space associated with symptomatic HF. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 2.
dc.format.mediumPrint-Electronic
dc.publisherWiley
dc.rightsAll Rights Reserved
dc.rights.urihttp://www.rioxx.net/licenses/all-rights-reserved
dc.subjectDCE-MRI
dc.subjectedema
dc.subjectheart failure
dc.subjectlung congestion
dc.subjectpulmonary interstitium
dc.titleEvaluation of Dynamic Contrast-Enhanced MRI Measures of Lung Congestion and Endothelial Permeability in Heart Failure: A Prospective Method Validation Study.
dc.typeArticle
dc.publisher.departmentDepartment of Medicine, Clinical Pharmacology Unit
dc.date.updated2022-04-01T09:40:02Z
prism.publicationDate2022
prism.publicationNameJ Magn Reson Imaging
dc.identifier.doi10.17863/CAM.83131
dcterms.dateAccepted2022-03-14
rioxxterms.versionofrecord10.1002/jmri.28174
rioxxterms.versionAM
dc.contributor.orcidCheriyan, Joseph [0000-0001-6921-1592]
dc.contributor.orcidGraves, Martin [0000-0003-4327-3052]
dc.contributor.orcidSprecher, Dennis [0000-0001-5338-0148]
dc.identifier.eissn1522-2586
rioxxterms.typeJournal Article/Review
cam.issuedOnline2022-03-27
cam.orpheus.success2022-04-01 - Embargo set during processing via Fast-track
cam.depositDate2022-04-01
pubs.licence-identifierapollo-deposit-licence-2-1
pubs.licence-display-nameApollo Repository Deposit Licence Agreement
rioxxterms.freetoread.startdate2023-03-27


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