Cloud-processed 4D CMR flow imaging for pulmonary flow quantification

Raluca Chelu, Kevin Wanambiro, A Hsiao, Laurens Swart, Teun Voogd, Allard Hoven, Matthijs Kranenburg, Adriaan Coenen, Sara Boccalini, Piotr Wielopolski, MW Vogel, Gabriel Krestin, SS Vasanawala, Ricardo Budde, Jolien Roos - Hesselink, Koen Nieman

Research output: Contribution to journalArticleAcademicpeer-review


Objectives: In this study, we evaluated a cloud-based platform for cardiac magnetic resonance (CMR) four-dimensional (4D) flow imaging, with fully integrated correction for eddy currents, Maxwell phase effects, and gradient field non-linearity, to quantify forward flow, regurgitation, and peak systolic velocity over the pulmonary artery. Methods: We prospectively recruited 52 adult patients during one-year period from July 2014. The 4D flow and planar (2D) phase-contrast (PC) were acquired during same scanning session, but 4D flow was scanned after injection of a gadolinium-based contrast agent. Eddy-currents were semi-automatically corrected using the web-based software. Flow over pulmonary valve was measured and the 4D flow values were compared against the 2D PC ones. Results: The mean forward flow was 92 (+/- 30) ml/cycle measured with 4D flow and 86 (+/- 29) ml/cycle measured with 2D PC, with a correlation of 0.82 and a mean difference of -6 ml/cycle (-41-29). For the regurgitant fraction the correlation was 0.85 with a mean difference of -0.95% (-17-15). Mean peak systolic velocity measured with 4D flow was 92 (+/- 49) cm/s and 108 (+/- 56) cm/s with 2D PC, having a correlation of 0.93 and a mean difference of 16 cm/s (-24-55). Conclusion: 4D flow imaging post-processed with an integrated cloud-based application accurately quantifies pulmonary flow. However, it may underestimate the peak systolic velocity. (C) 2016 Published by Elsevier Ireland Ltd.
Original languageEnglish
Pages (from-to)1849-1856
Number of pages8
JournalEuropean Journal of Radiology
Issue number10
Publication statusPublished - 2016


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