Why the study?
Multi-slice GRE MRE for measuring aortic stiffness requires multiple breath-holds that can be challenging for patients, prompting evaluation of a multi-slice spin-echo echo-planar imaging sequence under free-breathing and single-breath-hold protocols.
Does multi-slice SE-EPI MRE provide reproducible and repeatable estimates of in vivo abdominal aortic stiffness compared to GRE MRE in healthy subjects?
Does multi-slice SE-EPI MRE provide reproducible and repeatable estimates of in vivo abdominal aortic stiffness compared to GRE MRE in healthy subjects?
Multi-slice SE-EPI MRE is a feasible, reproducible, and faster alternative to GRE MRE for estimating abdominal aortic stiffness, particularly useful for patients unable to hold their breath.
SE-EPI MRE offers a feasible breath-hold-free option for aortic stiffness; leaves open validation and clinical utility in patients.
INTRODUCTION: Magnetic resonance elastography (MRE)-derived aortic stiffness is a potential biomarker for multiple cardiovascular diseases. Currently, gradient-recalled echo (GRE) MRE is a widely accepted technique to estimate aortic stiffness. However, multi-slice GRE MRE requires multiple breath-holds (BHs), which can be challenging for patients who cannot consistently hold their breath. The aim of this study was to investigate the feasibility of a multi-slice spin-echo echo-planar imaging (SE-EPI) MRE sequence for quantifying in vivo aortic stiffness using a free-breathing (FB) protocol and a single-BH protocol. METHOD: On Scanner 1, 25 healthy subjects participated in the validation of FB SE-EPI against FB GRE. On Scanner 2, another 15 healthy subjects were recruited to compare FB SE-EPI with single-BH SE-EPI. Among all volunteers, five participants were studied on both scanners to investigate the inter-scanner reproducibility of FB SE-EPI aortic MRE. Bland-Altman analysis, Lin's concordance correlation coefficient (LCCC) and coefficient of variation (COV) were evaluated. The phase-difference signal-to-noise ratios (PD SNR) were compared. RESULTS: Aortic MRE using FB SE-EPI and FB GRE yielded similar stiffnesses (paired t-test, P = 0.19), with LCCC = 0.97. The FB SE-EPI measurements were reproducible (intra-scanner LCCC = 0.96) and highly repeatable (LCCC = 0.99). The FB SE-EPI MRE was also reproducible across different scanners (inter-scanner LCCC = 0.96). Single-BH SE-EPI scans yielded similar stiffness to FB SE-EPI scans (LCCC = 0.99) and demonstrated a low COV of 2.67% across five repeated measurements. CONCLUSION: Multi-slice SE-EPI aortic MRE using an FB protocol or a single-BH protocol is reproducible and repeatable with advantage over multi-slice FB GRE in reducing acquisition time. Additionally, FB SE-EPI MRE provides a potential alternative to BH scans for patients who have challenges in holding their breath.
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Dong et al. (2020) studied this question.
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