Comparison of long and short axis quantification of left ventricular volume parameters by cardiovascular magnetic resonance, with ex-vivo validation

<p>Abstract</p> <p>Background</p> <p>The purpose of the study was to compare the accuracy and evaluation time of quantifying left ventricular (LV), left atrial (LA) volume and LV mass using short axis (SAX) and long axis (LAX) methods when using cardiovascular magnetic resonance (CMR).</p> <p>Materials and methods</p> <p>We studied 12 explanted canine hearts and 46 patients referred for CMR (29 male, age 47 ± 18 years) in a clinical 1.5 T CMR system, using standard cine sequences. In standard short axis stacks of various slice thickness values in dogs and 8 mm slice thickness (gap 2 mm) in patients, we measured LV volumes using reference slices in a perpendicular, long axis orientation using certified software. Volumes and mass were also measured in six radial long axis (LAX) views.</p> <p>LV parameters were also assessed for intra- and inter-observer variability. In 24 patients, we also analyzed reproducibility and evaluation time of two very experienced (> 10 years of CMR reading) readers for SAX and LAX.</p> <p>Results</p> <p>In the explanted dog hearts, there was excellent agreement between ex vivo data and LV mass and volume data as measured by all methods for both, LAX (r²= 0.98) and SAX (r²= 0.88 to 0.98). LA volumes, however, were underestimated by 13% using the LAX views. In patients, there was a good correlation between all three assessed methods (r²≥ 0.95 for all). In experienced clinical readers, left-ventricular volumes and ejection fraction as measured in LAX views showed a better inter-observer reproducibility and a 27% shorter evaluation time.</p> <p>Conclusion</p> <p>When compared to an ex vivo standard, both, short axis and long axis techniques are highly accurate for the quantification of left ventricular volumes and mass. In clinical settings, however, the long axis approach may be more reproducible and more time-efficient. Therefore, the rotational long axis approach is a viable alternative for the clinical assessment of cardiac volumes, function and mass.</p

Imaging atherosclerosis with hybrid [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography imaging: What Leonardo da Vinci could not see

Prodigious efforts and landmark discoveries have led toward significant advances in our understanding of atherosclerosis. Despite significant efforts, atherosclerosis continues globally to be a leading cause of mortality and reduced quality of life. With surges in the prevalence of obesity and diabetes, atherosclerosis is expected to have an even more pronounced impact upon the global burden of disease. It is imperative to develop strategies for the early detection of disease. Positron emission tomography (PET) imaging utilizing [18F]fluorodeoxyglucose (FDG) may provide a non-invasive means of characterizing inflammatory activity within atherosclerotic plaque, thus serving as a surrogate biomarker for detecting vulnerable plaque. The aim of this review is to explore the rationale for performing FDG imaging, provide an overview into the mechanism of action, and summarize findings from the early application of FDG PET imaging in the clinical setting to evaluate vascular disease. Alternative imaging biomarkers and approaches are briefly discussed. © 2012 The Author(s)

Understanding the cardiac phenotype of endurance athletes: a cardiovascular magnetic resonance (cmr) study

Bibliography: p. 276-308Some pages are in colour.Includes copy of ethics approval. Original copy with original Partial Copyright Licence