A validation study of novel full free-breathing cardiac magnetic resonance comparing to traditional breath-holding method: correlation of cardiac magnetic resonance-derived multi parameters

Background Conventional cardiac magnetic resonance (CMR) imaging typically requires patients to hold their breath, with nearly 50% of the total scan time spent resting between breath-holds. This practice limits the widespread adoption of CMR, especially in settings where breath-holding is difficult for patients. Furthermore, suboptimal image quality often results from poor breath-holding, which can compromise diagnostic accuracy. The study has advanced a novel full free-breathing CMR techniques, incorporating compressed sensing and motion correction (Moco) technologies, which can significantly shorten the scanning time. Purpose The aim of this study is to evaluate whether novel full free-breathing CMR can replace traditional breath-holding method while maintaining diagnostic quality. Methods Patients who underwent full free-breathing CMR examinations between June 1 and 30, 2024, were prospectively included in the analysis. Key parameters, including image acquisition time and left ventricular function measurements, were compared with those obtained from traditional breath-holding CMR. Additionally, data from full free-breathing and breath-holding T1 mapping and late gadolinium enhancement (LGE) scans conducted between November 15 and December 14 were analysed. Group comparisons were made using the Wilcoxon signed-rank test or paired t-test. Consistency testing was performed using Kappa, Bland-Altman, and linear regression analyses. Results A total of 282 patients (median age, 53 years [38, 63]; range, 10-82 years; 154 men) were evaluated. The mean acquisition time for full free-breathing CMR was 22.6±3.7 minutes. Compared with traditional breath-holding CMR, measurements of the end-diastolic volume (EDV), end-systolic volume (ESV), EDV index, and ESV index obtained using free-breathing CMR were slightly higher (all P<0.05), while left ventricular ejection fraction (LVEF) and left ventricular mass (LVM) were slightly lower (both P<0.05) . However, there was good consistency and correlation between the two methods (r values: 0.82–0.98) (Figure 1). Native T1 and LGE values were also highly correlated (r values: 0.83–0.98) (Figure 2). Conclusion Full free-breathing CMR is feasible and effective in clinical practice. It significantly shortens examination time and can replace conventional breath-holding CMR without compromising diagnostic accuracy.Figure1 Figure2