2024 | Anthony G. Christodoulou, Gastao Cruz, Ayda Arami, Sebastian Weingärtner, Jessica Artico, Dana Peters, Nicole Seiberlich
The article reviews the future of cardiovascular magnetic resonance (CMR) by focusing on two emerging approaches: "all-in-one" CMR and "real-time" CMR. The "all-in-one" approach aims to simultaneously acquire multiple contrasts and motion states in a single scan, while the "real-time" approach accelerates the examination to eliminate the need for breathholding and cardiac gating. The authors describe the vision, techniques, pros, cons, and open challenges of these approaches, with Part 1 focusing on "all-in-one" CMR.
**Key Points:**
1. **All-in-one CMR Vision:** This approach aims to capture multiple forms of information simultaneously, such as motion, relaxation, and contrast agent dynamics, in a single sequence. It can eliminate the need for multiple sequences and breathholds, reducing scan times and improving patient comfort.
2. **Techniques and Validation:** Recent advancements in pulse sequence design, image reconstruction, and analysis have enabled the development of methods for all-in-one CMR. These include techniques like joint T1/T2 mapping, magnetic resonance fingerprinting (MRF), and multitasking. Studies have shown promising results in terms of accuracy and precision.
3. **Advantages:** All-in-one CMR offers co-registered data, simplifies patient preparation, and reduces the complexity of multiparametric analysis. It allows for more flexible sequence designs and can potentially reduce scan times.
4. **Disadvantages:** The tightly coupled nature of all-in-one acquisitions can introduce confounders and computational bottlenecks. The acquisition of a continuous data block is prone to corruption and may require repeated scans if errors are not detected.
5. **Open Needs:** Before clinical deployment, challenges include full protocol development, integration into existing workflows, and leveraging the full information content of all-in-one protocols. Advances in artificial intelligence and machine learning are expected to play a crucial role in addressing these challenges.
The article concludes that while "all-in-one" CMR shows promise, significant technical and clinical research is needed to overcome current limitations and fully realize its potential.The article reviews the future of cardiovascular magnetic resonance (CMR) by focusing on two emerging approaches: "all-in-one" CMR and "real-time" CMR. The "all-in-one" approach aims to simultaneously acquire multiple contrasts and motion states in a single scan, while the "real-time" approach accelerates the examination to eliminate the need for breathholding and cardiac gating. The authors describe the vision, techniques, pros, cons, and open challenges of these approaches, with Part 1 focusing on "all-in-one" CMR.
**Key Points:**
1. **All-in-one CMR Vision:** This approach aims to capture multiple forms of information simultaneously, such as motion, relaxation, and contrast agent dynamics, in a single sequence. It can eliminate the need for multiple sequences and breathholds, reducing scan times and improving patient comfort.
2. **Techniques and Validation:** Recent advancements in pulse sequence design, image reconstruction, and analysis have enabled the development of methods for all-in-one CMR. These include techniques like joint T1/T2 mapping, magnetic resonance fingerprinting (MRF), and multitasking. Studies have shown promising results in terms of accuracy and precision.
3. **Advantages:** All-in-one CMR offers co-registered data, simplifies patient preparation, and reduces the complexity of multiparametric analysis. It allows for more flexible sequence designs and can potentially reduce scan times.
4. **Disadvantages:** The tightly coupled nature of all-in-one acquisitions can introduce confounders and computational bottlenecks. The acquisition of a continuous data block is prone to corruption and may require repeated scans if errors are not detected.
5. **Open Needs:** Before clinical deployment, challenges include full protocol development, integration into existing workflows, and leveraging the full information content of all-in-one protocols. Advances in artificial intelligence and machine learning are expected to play a crucial role in addressing these challenges.
The article concludes that while "all-in-one" CMR shows promise, significant technical and clinical research is needed to overcome current limitations and fully realize its potential.