Browsing by Author "Ferreira, Vanessa M."

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    Artificial Intelligence for Contrast-Free MRI: Scar Assessment in Myocardial Infarction Using Deep Learning-Based Virtual Native Enhancement
    (American Heart Association, 2022-11-15) Zhang, Qiang; Burrage, Matthew K.; Shanmuganathan, Mayooran; Gonzales, Ricardo A.; Lukaschuk, Elena; Thomas, Katharine E.; Mills, Rebecca; Pelado, Joana Leal; Nikolaidou, Chrysovalantou; Popescu, Iulia A.; Lee, Yung P.; Zhang, Xinheng; Dharmakumar, Rohan; Myerson, Saul G.; Rider, Oliver; Oxford Acute Myocardial Infarction (OxAMI) Study; Channon, Keith M.; Neubauer, Stefan; Piechnik, Stefan K.; Ferreira, Vanessa M.; Medicine, School of Medicine
    Background: Myocardial scar is currently assessed non-invasively using cardiovascular magnetic resonance (CMR) late gadolinium enhancement (LGE) as an imaging gold-standard. However, a contrast-free approach would provide many advantages, including a faster and cheaper scan, without contrast-associated problems. Methods: Virtual Native Enhancement (VNE) is a novel technology that can produce virtual LGE-like images, without the need for contrast. VNE combines cine imaging and native T1-maps to produce LGE-like images using artificial intelligence (AI). VNE was developed for patients with prior myocardial infarction on 4271 datasets (912 patients), where each dataset is comprised of slice position-matched cine, T1-maps and LGE images. After quality control, 3002 datasets (775 patients) were used for development, and 291 datasets (68 patients) for testing. The VNE generator was trained using generative adversarial networks, employing two adversarial discriminators to improve the image quality. The left ventricle was contoured semi-automatically. Myocardial scar volume was quantified using the full width at half maximum method. Scar transmurality was measured using the centerline chord method and visualized on bull’s eye plots. Lesion quantification by VNE and LGE were compared using linear regression, Pearson correlation (R) and intraclass correlation coefficients (ICC). Proof-of-principle histopathological comparison of VNE in a porcine model of myocardial infarction was also performed. Results: VNE provided significantly better image quality than LGE on blinded analysis by 5 independent operators on 291 datasets (all p<0.001). VNE correlated strongly with LGE in quantifying scar size (R=0.89, ICC=0.94) and transmurality (R=0.84, ICC=0.90) in 66 patients (277 test datasets). Two CMR experts reviewed all test image slices and reported an overall accuracy of 84% of VNE in detecting scar when compared with LGE, with specificity of 100% and sensitivity of 77%. VNE also showed excellent visuospatial agreement with histopathology in 2 cases of a porcine model of myocardial infarction. Conclusions: VNE demonstrated high agreement with LGE-CMR for myocardial scar assessment in patients with prior myocardial infarction in visuospatial distribution and lesion quantification, with superior image quality. VNE is a potentially transformative AI-based technology, with promise to reduce scan times and costs, increase clinical throughput, and improve the accessibility of CMR in the very-near future.
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    Cardiovascular magnetic resonance in women with cardiovascular disease: position statement from the Society for Cardiovascular Magnetic Resonance (SCMR)
    (Elsevier, 2021-05-10) Ordovas, Karen G.; Baldassarre, Lauren A.; Bucciarelli‑Ducci, Chiara; Carr, James; Fernandes, Juliano Lara; Ferreira, Vanessa M.; Frank, Luba; Mavrogeni, Sophie; Ntusi, Ntobeko; Ostenfeld, Ellen; Parwani, Purvi; Pepe, Alessia; Raman, Subha V.; Sakuma, Hajime; Schulz‑Menger, Jeanette; Sierra‑Galan, Lilia M.; Valente, Anne Marie; Srichai, Monvadi B.; Medicine, School of Medicine
    This document is a position statement from the Society for Cardiovascular Magnetic Resonance (SCMR) on recommendations for clinical utilization of cardiovascular magnetic resonance (CMR) in women with cardiovascular disease. The document was prepared by the SCMR Consensus Group on CMR Imaging for Female Patients with Cardiovascular Disease and endorsed by the SCMR Publications Committee and SCMR Executive Committee. The goals of this document are to (1) guide the informed selection of cardiovascular imaging methods, (2) inform clinical decision-making, (3) educate stakeholders on the advantages of CMR in specific clinical scenarios, and (4) empower patients with clinical evidence to participate in their clinical care. The statements of clinical utility presented in the current document pertain to the following clinical scenarios: acute coronary syndrome, stable ischemic heart disease, peripartum cardiomyopathy, cancer therapy-related cardiac dysfunction, aortic syndrome and congenital heart disease in pregnancy, bicuspid aortic valve and aortopathies, systemic rheumatic diseases and collagen vascular disorders, and cardiomyopathy-causing mutations. The authors cite published evidence when available and provide expert consensus otherwise. Most of the evidence available pertains to translational studies involving subjects of both sexes. However, the authors have prioritized review of data obtained from female patients, and direct comparison of CMR between women and men. This position statement does not consider CMR accessibility or availability of local expertise, but instead highlights the optimal utilization of CMR in women with known or suspected cardiovascular disease. Finally, the ultimate goal of this position statement is to improve the health of female patients with cardiovascular disease by providing specific recommendations on the use of CMR.
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    The Society for Cardiovascular Magnetic Resonance Registry at 150,000
    (Elsevier, 2024-07-04) Tong, Matthew S.; Slivnick, Jeremy A.; Sharif, Behzad; Kim, Han W.; Young, Alistair A.; Sierra-Galan, Lilia M.; Mukai, Kanae; Farzaneh-Far, Afshin; Al-Kindi, Sadeer; Chan, Angel T.; Dibu, George; Elliott, Michael D.; Ferreira, Vanessa M.; Grizzard, John; Kelle, Sebastian; Lee, Simon; Malahfji, Maan; Petersen, Steffen E.; Polsani, Venkateshwar; Toro-Salazar, Olga H.; Shaikh, Kamran A.; Shenoy, Chetan; Srichai, Monvadi B.; Stojanovska, Jadranka; Tao, Qian; Wei, Janet; Weinsaft, Jonathan W.; Wince, W. Benjamin; Chudgar, Priya D.; Judd, Matthew; Judd, Robert M.; Shah, Dipan J.; Simonetti, Orlando P.; Medicine, School of Medicine
    Background: Cardiovascular magnetic resonance (CMR) is increasingly utilized to evaluate expanding cardiovascular conditions. The Society for Cardiovascular Magnetic Resonance (SCMR) Registry is a central repository for real-world clinical data to support cardiovascular research, including those relating to outcomes, quality improvement, and machine learning. The SCMR Registry is built on a regulatory-compliant, cloud-based infrastructure that houses searchable content and Digital Imaging and Communications in Medicine images. The goal of this study is to summarize the status of the SCMR Registry at 150,000 exams. Methods: The processes for data security, data submission, and research access are outlined. We interrogated the Registry and presented a summary of its contents. Results: Data were compiled from 154,458 CMR scans across 20 United States sites, containing 299,622,066 total images (∼100 terabytes of storage). Across reported values, the human subjects had an average age of 58 years (range 1 month to >90 years old), were 44% (63,070/145,275) female, 72% (69,766/98,008) Caucasian, and had a mortality rate of 8% (9,962/132,979). The most common indication was cardiomyopathy (35,369/131,581, 27%), and most frequently used current procedural terminology code was 75561 (57,195/162,901, 35%). Macrocyclic gadolinium-based contrast agents represented 89% (83,089/93,884) of contrast utilization after 2015. Short-axis cines were performed in 99% (76,859/77,871) of tagged scans, short-axis late gadolinium enhancement (LGE) in 66% (51,591/77,871), and stress perfusion sequences in 30% (23,241/77,871). Mortality data demonstrated increased mortality in patients with left ventricular ejection fraction <35%, the presence of wall motion abnormalities, stress perfusion defects, and infarct LGE, compared to those without these markers. There were 456,678 patient-years of all-cause mortality follow-up, with a median follow-up time of 3.6 years. Conclusion: The vision of the SCMR Registry is to promote evidence-based utilization of CMR through a collaborative effort by providing a web mechanism for centers to securely upload de-identified data and images for research, education, and quality control. The Registry quantifies changing practice over time and supports large-scale real-world multicenter observational studies of prognostic utility.