Fast high-resolution late gadolinium enhancement magnetic resonance imaging for an accurate detection of myocardial radiofrequency catheter ablation lesions

Abstract Funding Acknowledgements Type of funding sources: None. Background Whole- heart high-resolution free-breathing late gadolinium enhancement (HR-LGE) is a key sequence for detecting radiofrequency catheter ablation (RFCA) lesions. However, long acquisition time is the main limitation especially for dyspneic and claustrophobic patients. Purpose We aimed to introduce an accelerated HR-LGE technique for the detection of myocardial RFCA lesions. Method An under sampled (3-fold) navigator-gated whole- heart HR-LGE (acquired resolution of 1.25 mm3) sequence combined with advanced patch-based low-rank reconstruction was implemented on a 1.5 CMR scanner. Three sheep prospectively underwent radiofrequency ablation at multiple endocardial and epicardial sites. The animals were imaged 3 months later using conventional post-contrast LGE (PSIR, voxel size 1.8x1.4x6mm) and the proposed sequence. A reader graded image quality and diagnostic value of both LGE imaging. Results The acceleration allowed for acquisition times of 3 min 22s ± 20 s at 1.25 mm resolution. Compared with 2D PSIR, HR-LGE showed comparable image quality (P= 0.03). All LGE- positive segments on 2D PSIR in LV myocardium were also detected on HR-LGE (6 segments). Two additional enhanced segments were only visible on HR-LGE (8 segments). LGE-positive segments in RV myocardium were detected on HR-LGE (4 segments) while 2D PSIR was either definitely negative (2 segments) or uncertain (2 segments). Conclusion Accelerated whole-heart HR- LGE allows an accurate detection of left and right myocardial RFCA lesions.