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Erschienen in: The International Journal of Cardiovascular Imaging 12/2018

19.06.2018 | Original Paper

CMR-guidance of passively tracked endomyocardial biopsy in an in vivo porcine model

verfasst von: P. Behm, M. Gastl, A. Jahn, A. Rohde, S. Haberkorn, S. Krueger, S. Weiss, B. Schnackenburg, M. Sager, K. Düring, H. Clogenson, P. Horn, R. Westenfeld, M. Kelm, M. Neizel-Wittke, F. Bönner

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 12/2018

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Abstract

Endomyocardial biopsy (EMB) is considered to be the diagnostic gold-standard in detection of myocardial-inflammation. EMB is usually conducted under fluoroscopy without any specific target information. Specific target-information provided by cardiovascular magnetic resonance (CMR) may improve specificity of EMB. The aim was to investigate feasibility and safety of CMR-guided and targeted EMB in a preclinical-model using passively-tracked devices. Procedures were performed on a MRI-System equipped with an Interventional Software-Platform for real-time imaging. Ex vivo experiments were conducted to optimize visibility of the guide-sheath. In vivo experiments were conducted in 2 pigs for technical feasibility assessment and in 4 pigs after acute myocardial infarction to test feasibility of guided and lesion targeted EMB. For anatomical real-time imaging a single-shot-balanced-SSFP-sequence was applied. Myocardial targets were identified under real-time imaging (single-shot-T2 (sshT2) and single-shot Late-Gadolinium-Enhancement (sshLGE) sequences). Ex vivo experiments demonstrated best visibility of continuously labelled guide-sheath. CMR-guided EMB was feasible in all cases without major complications. Likewise, lesion-targeting endomyocardial biopsy was feasible in two cases. Biopsies exhibited appropriate sizes and qualities. Real-time lesion sequences revealed comparable CNR values to clinical-protocols. Real-time imaging of lesions showed following signal- and contrast-to-noise ratios (SNR/CNR): SNR of sshT2- and sshLGE was 124 ± 35 and 67 ± 51 respectively, whereas CNR was 81 ± 30 and 57 ± 44. This study demonstrates feasibility and safety of CMR-guided and basically targeted EMB with passively-tracked devices. Signal-to-noise ratios of real-time sequences is non-inferior to standard sequences for lesion detection. CMR-guidance may improve diagnostic accuracy of EMB since CMR can detect myocardial-targets under real-time-imaging.
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Metadaten
Titel
CMR-guidance of passively tracked endomyocardial biopsy in an in vivo porcine model
verfasst von
P. Behm
M. Gastl
A. Jahn
A. Rohde
S. Haberkorn
S. Krueger
S. Weiss
B. Schnackenburg
M. Sager
K. Düring
H. Clogenson
P. Horn
R. Westenfeld
M. Kelm
M. Neizel-Wittke
F. Bönner
Publikationsdatum
19.06.2018
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 12/2018
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-018-1402-5

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