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Part 2 - Coronary angiography with gadofosveset trisodium: a prospective intra-subject comparison for dose optimization for 100 % efficiency imaging.

ABSTRACT: Three tesla (3T) coronary magnetic resonance angiography (MRA) may be optimized using gadolinium-based contrast agents (GBCA) such as gadofosveset trisodium. The goal of this study was to evaluate if there is a qualitative or quantitative improvement in the coronary arteries with variation in contrast dose.Twenty-eight healthy volunteers were prospectively recruited for coronary MRA at 3T using a steady state injection technique for 3D radial whole-heart image acquisition with retrospective respiratory self-gating (ClinicalTrials.gov identifier: NCT01853592). Nineteen volunteers completed both single- and double-dose imaging instances (0.03 and 0.06 mmol/kg, respectively). Intra-individual comparison of image quality was assessed by measurement of apparent signal/contrast-to-noise ratio (aSNR/aCNR) and subjective evaluation of image quality by 2 independent reviewers.The average duration of coronary MRA acquisition was 7.2 ± 1.2 min. There was significantly higher (60 %, p < 0.001) aSNR of the aorta and right/left ventricle for the double dose compared to single dose injection scheme and aSNR of the coronary arteries increased by 70 % (p < 0.001) for the double dose injection. aCNR increased by +55 % and +60 % in the ventricles and coronary arteries, respectively (p < 0.001). Overall segmental artery visualization for single dose was possible 47 % of the time, which improved to 60 % with double dose (p = 0.019), predominantly driven by improvements in more distal segment visualization (+40 % improvement in mid arterial segments, p = 0.013).Gadofosveset trisodium dose of 0.06 mmol/kg significantly quantitatively and qualitatively improves the coronary artery image quality compared to 0.03 mmol/kg at 3T for moderate duration (6-8 min) steady state contrast enhanced coronary MRA.

SUBMITTER: Ahlman MA

PROVIDER: S-EPMC4804531 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Part 2 - Coronary angiography with gadofosveset trisodium: a prospective intra-subject comparison for dose optimization for 100 % efficiency imaging.

Ahlman Mark A MA Raman Fabio S FS Pang Jianing J Zemrak Filip F Sandfort Veit V Penzak Scott R SR Fan Zhaoyang Z Liu Songtao S Li Debiao D Bluemke David A DA

BMC cardiovascular disorders 20160322

<h4>Background</h4>Three tesla (3T) coronary magnetic resonance angiography (MRA) may be optimized using gadolinium-based contrast agents (GBCA) such as gadofosveset trisodium. The goal of this study was to evaluate if there is a qualitative or quantitative improvement in the coronary arteries with variation in contrast dose.<h4>Methods</h4>Twenty-eight healthy volunteers were prospectively recruited for coronary MRA at 3T using a steady state injection technique for 3D radial whole-heart image ...[more]

PMID: 27004532

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Project description:AimsCoronary computed tomography angiography is increasingly employed in the emergency department for suspected acute coronary syndrome patients. The HEART score has been proposed for initial risk stratification in these patients. The aim of this study was to investigate the diagnostic value and efficiency of the HEART score before coronary computed tomography angiography.Methods and resultsWe included patients suspected of acute coronary syndrome who underwent coronary computed tomography angiography in the emergency department. Based on the HEART score, patients were stratified as low-risk (HEART≤3), intermediate-risk (HEART4-6) and high-risk (HEART≥7). We assessed coronary computed tomography angiography for the presence of significant coronary artery disease (>50% stenosis). The primary outcome, the level of major adverse cardiac events, was a composite endpoint of all-cause mortality, acute coronary syndrome or coronary revascularisation within 30 days. The study population consisted of 340 patients (mean age: 55.6±10.1 years, 44.7% women), major adverse cardiac events occurred in 45 (13.2%) patients. The incidence of major adverse cardiac events in patients stratified as low-risk (35.0%), intermediate-risk (56.8%) and high-risk (8.2%) was 3.4%, 12.4% and 60.7%, respectively. All four low-risk patients with major adverse cardiac events had a HEART score of three. An algorithm where coronary computed tomography angiography is reserved for patients with HEART 3-6 resulted in a sensitivity of 97.8%, specificity of 84.1%, negative predictive value of 99.6% and positive predictive value of 48.4%, while reducing the need for coronary computed tomography angiography by 22% (n=75).ConclusionThe predictive value of coronary computed tomography angiography for 30-day major adverse cardiac events in suspected acute coronary syndrome patients is good, and reserving coronary computed tomography angiography for HEART score 3-6 patients reduces the number of needed coronary computed tomography angiograms without affecting diagnostic accuracy.

Project description:The stop signal task has been used to quantify the human inhibitory control. The inter-subject and intra-subject variability was investigated under the inhibition of human response with a realistic environmental scenario. In present study, we used a battleground scenario where a sniper-scope picture was the background, a target picture was a go signal, and a nontarget picture was a stop signal. The task instructions were to respond on the target image and inhibit the response if a nontarget image appeared. This scenario produced a threatening situation and endorsed the evaluation of how subject's response inhibition manifests in a real situation. In this study, 32 channels of electroencephalography (EEG) signals were collected from 20 participants during successful stop (response inhibition) and failed stop (response) trials. These EEG signals were used to predict two possible outcomes: successful stop or failed stop. The inter-subject variability (between-subjects) and intra-subject variability (within-subjects) affect the performance of participants in the classification system. The EEG signals of successful stop versus failed stop trials were classified using quadratic discriminant analysis (QDA) and linear discriminant analysis (LDA) (i.e., parametric) and K-nearest neighbor classifier (KNNC) and Parzen density-based (PARZEN) (i.e., nonparametric) under inter- and intra-subject variability. The EEG activities were found to increase during response inhibition in the frontal cortex (F3 and F4), presupplementary motor area (C3 and C4), parietal lobe (P3 and P4), and occipital (O1 and O2) lobe. Therefore, power spectral density (PSD) of EEG signals (1-50Hz) in F3, F4, C3, C4, P3, P4, O1, and O2 electrodes were measured in successful stop and failed stop trials. The PSD of the EEG signals was used as the feature input for the classifiers. Our proposed method shows an intra-subject classification accuracy of 97.61% for subject 15 with QDA classifier in C3 (left motor cortex) and an overall inter-subject classification accuracy of 71.66% ± 9.81% with the KNNC classifier in F3 (left frontal lobe). These results display how inter-subject and intra-subject variability affects the performance of the classification system. These findings can be used effectively to improve the psychopathology of attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), schizophrenia, and suicidality.

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Part 2 - Coronary angiography with gadofosveset trisodium: a prospective intra-subject comparison for dose optimization for 100 % efficiency imaging.

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Part 2 - Coronary angiography with gadofosveset trisodium: a prospective intra-subject comparison for dose optimization for 100 % efficiency imaging.

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