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Acute noncontrast T1-weighted magnetic resonance imaging predicts chronic radiofrequency ablation lesions.
J Cardiovasc Electrophysiol. 2018 11; 29(11):1556-1562.JC

Abstract

BACKGROUND

Magnetic resonance imaging (MRI) has been used to visualize radiofrequency (RF) ablation lesions but the relationship between volumes that enhance in acute MRI and the chronic lesion size is unknown.

OBJECTIVES

The main goal was to use noncontrast (native) T1-weighted (T1w) MRI and late gadolinium enhancement (LGE)-MRI to visualize lesions acutely and chronically and correlate the acute area of enhancement with chronic lesion size in histology.

MATERIALS AND METHODS

In a canine (n = 9) model RF ablation lesions were created in both ventricles. Native T1w MRI and LGE-MRI were acquired acutely after the ablation procedure. After 8 weeks, another set of RF ablations was performed, and the MRI study was repeated. Volume and depth of enhancement in native T1w MRI and LGE-MRI acquired after the initial ablation procedure were correlated with chronic lesion volume and depth in histology.

RESULTS

Thirty-three lesions were analyzed. Native T1w MRI visualized the acute lesions but not the chronic lesions. LGE-MRI showed both acute and chronic lesions. Acute native T1w MRI volume (average of 102.1 ± 48.5 mm3) and depth (4.9 ± 1.2 mm) correlated well with chronic histological volume (105.9 ± 51.8 mm3) and depth (4.8 ± 1.3 mm) with R2 of 0.881 (P < 0.001) and 0.874 (P < 0.001), respectively. Acute LGE-MRI had a significantly higher volume of enhancement of 499.7 ± 214.4 mm3 (P < 0.001) and depth of 7.5 ± 1.8 mm (P < 0.001) when compared with chronic histological lesion volume and depth.

CONCLUSIONS

Native T1w MRI acquired acutely after RF ablation is a good predictor of chronic lesion size. Acute LGE-MRI significantly overestimates the chronic lesion size.

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Authors+Show Affiliations

Kholmovski EG
Division of Cardiovascular Medicine, CARMA Center, University of Utah, Salt Lake City, Utah. Department of Radiology and Imaging Sciences, UCAIR, University of Utah, Salt Lake City, Utah.
Silvernagel J
Department of Bioengineering, University of Utah, Salt Lake City, Utah. Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah.
Angel N
Department of Bioengineering, University of Utah, Salt Lake City, Utah. Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah.
Vijayakumar S
Division of Cardiovascular Medicine, CARMA Center, University of Utah, Salt Lake City, Utah. Department of Radiology and Imaging Sciences, UCAIR, University of Utah, Salt Lake City, Utah.
Thomas S
Department of Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.
Dosdall D
Department of Bioengineering, University of Utah, Salt Lake City, Utah. Department of Surgery, University of Utah, Salt Lake City, Utah. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah.
MacLeod R
Department of Bioengineering, University of Utah, Salt Lake City, Utah. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah.
Marrouche NF
Division of Cardiovascular Medicine, CARMA Center, University of Utah, Salt Lake City, Utah. Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah.
Ranjan R
Department of Bioengineering, University of Utah, Salt Lake City, Utah. Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah.

MeSH

AnimalsDogsHeart DiseasesMagnetic Resonance ImagingPredictive Value of TestsRadiofrequency Ablation

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30106244

Citation

Kholmovski, Eugene G., et al. "Acute Noncontrast T1-weighted Magnetic Resonance Imaging Predicts Chronic Radiofrequency Ablation Lesions." Journal of Cardiovascular Electrophysiology, vol. 29, no. 11, 2018, pp. 1556-1562.
Kholmovski EG, Silvernagel J, Angel N, et al. Acute noncontrast T1-weighted magnetic resonance imaging predicts chronic radiofrequency ablation lesions. J Cardiovasc Electrophysiol. 2018;29(11):1556-1562.
Kholmovski, E. G., Silvernagel, J., Angel, N., Vijayakumar, S., Thomas, S., Dosdall, D., MacLeod, R., Marrouche, N. F., & Ranjan, R. (2018). Acute noncontrast T1-weighted magnetic resonance imaging predicts chronic radiofrequency ablation lesions. Journal of Cardiovascular Electrophysiology, 29(11), 1556-1562. https://doi.org/10.1111/jce.13709
Kholmovski EG, et al. Acute Noncontrast T1-weighted Magnetic Resonance Imaging Predicts Chronic Radiofrequency Ablation Lesions. J Cardiovasc Electrophysiol. 2018;29(11):1556-1562. PubMed PMID: 30106244.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute noncontrast T1-weighted magnetic resonance imaging predicts chronic radiofrequency ablation lesions. AU - Kholmovski,Eugene G, AU - Silvernagel,Josh, AU - Angel,Nathan, AU - Vijayakumar,Sathya, AU - Thomas,Samuel, AU - Dosdall,Derek, AU - MacLeod,Rob, AU - Marrouche,Nassir F, AU - Ranjan,Ravi, Y1 - 2018/09/25/ PY - 2018/04/06/received PY - 2018/07/30/revised PY - 2018/08/03/accepted PY - 2018/8/15/pubmed PY - 2019/11/5/medline PY - 2018/8/15/entrez KW - LGE-MRI KW - cardiac magnetic resonance image KW - catheter ablation KW - lesion visualization KW - noncontrast MRI SP - 1556 EP - 1562 JF - Journal of cardiovascular electrophysiology JO - J Cardiovasc Electrophysiol VL - 29 IS - 11 N2 - BACKGROUND: Magnetic resonance imaging (MRI) has been used to visualize radiofrequency (RF) ablation lesions but the relationship between volumes that enhance in acute MRI and the chronic lesion size is unknown. OBJECTIVES: The main goal was to use noncontrast (native) T1-weighted (T1w) MRI and late gadolinium enhancement (LGE)-MRI to visualize lesions acutely and chronically and correlate the acute area of enhancement with chronic lesion size in histology. MATERIALS AND METHODS: In a canine (n = 9) model RF ablation lesions were created in both ventricles. Native T1w MRI and LGE-MRI were acquired acutely after the ablation procedure. After 8 weeks, another set of RF ablations was performed, and the MRI study was repeated. Volume and depth of enhancement in native T1w MRI and LGE-MRI acquired after the initial ablation procedure were correlated with chronic lesion volume and depth in histology. RESULTS: Thirty-three lesions were analyzed. Native T1w MRI visualized the acute lesions but not the chronic lesions. LGE-MRI showed both acute and chronic lesions. Acute native T1w MRI volume (average of 102.1 ± 48.5 mm3) and depth (4.9 ± 1.2 mm) correlated well with chronic histological volume (105.9 ± 51.8 mm3) and depth (4.8 ± 1.3 mm) with R2 of 0.881 (P < 0.001) and 0.874 (P < 0.001), respectively. Acute LGE-MRI had a significantly higher volume of enhancement of 499.7 ± 214.4 mm3 (P < 0.001) and depth of 7.5 ± 1.8 mm (P < 0.001) when compared with chronic histological lesion volume and depth. CONCLUSIONS: Native T1w MRI acquired acutely after RF ablation is a good predictor of chronic lesion size. Acute LGE-MRI significantly overestimates the chronic lesion size. SN - 1540-8167 UR - https://www.unboundmedicine.com/medline/citation/30106244/Acute_noncontrast_T1_weighted_magnetic_resonance_imaging_predicts_chronic_radiofrequency_ablation_lesions_ DB - PRIME DP - Unbound Medicine ER -