Cardiac diffusion-weighted and tensor imaging: A consensus statement from the special interest group of the Society for Cardiovascular Magnetic Resonance

Thanks to recent developments in cardiovascular magnetic resonance (CMR), cardiac diffusion-weighted magnetic resonance is fast emerging in a range of clinical applications. Cardiac diffusion-weighted imaging (cDWI) and diffusion tensor imaging (cDTI) now enable investigators and clinicians to asses...

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Main Authors: Erica Dall’Armellina, Daniel B. Ennis, Leon Axel, Pierre Croisille, Pedro F. Ferreira, Alexander Gotschy, David Lohr, Kevin Moulin, Christopher T. Nguyen, Sonja Nielles-Vallespin, William Romero, Andrew D. Scott, Christian Stoeck, Irvin Teh, Elizabeth M. Tunnicliffe, Magalie Viallon, Victoria Wang, Alistair A. Young, Jürgen E. Schneider, David E. Sosnovik
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Journal of Cardiovascular Magnetic Resonance
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Online Access:http://www.sciencedirect.com/science/article/pii/S1097664724011360
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author Erica Dall’Armellina
Daniel B. Ennis
Leon Axel
Pierre Croisille
Pedro F. Ferreira
Alexander Gotschy
David Lohr
Kevin Moulin
Christopher T. Nguyen
Sonja Nielles-Vallespin
William Romero
Andrew D. Scott
Christian Stoeck
Irvin Teh
Elizabeth M. Tunnicliffe
Magalie Viallon
Victoria Wang
Alistair A. Young
Jürgen E. Schneider
David E. Sosnovik
author_facet Erica Dall’Armellina
Daniel B. Ennis
Leon Axel
Pierre Croisille
Pedro F. Ferreira
Alexander Gotschy
David Lohr
Kevin Moulin
Christopher T. Nguyen
Sonja Nielles-Vallespin
William Romero
Andrew D. Scott
Christian Stoeck
Irvin Teh
Elizabeth M. Tunnicliffe
Magalie Viallon
Victoria Wang
Alistair A. Young
Jürgen E. Schneider
David E. Sosnovik
author_sort Erica Dall’Armellina
collection DOAJ
description Thanks to recent developments in cardiovascular magnetic resonance (CMR), cardiac diffusion-weighted magnetic resonance is fast emerging in a range of clinical applications. Cardiac diffusion-weighted imaging (cDWI) and diffusion tensor imaging (cDTI) now enable investigators and clinicians to assess and quantify the tridimensional microstructure of the heart. Free-contrast DWI is uniquely sensitized to the presence and displacement of water molecules within the myocardial tissue, including the intracellular, extracellular, and intravascular spaces. CMR can determine changes in microstructure by quantifying: a) mean diffusivity (MD)—measuring the magnitude of diffusion; b) fractional anisotropy (FA)—specifying the directionality of diffusion; c) helix angle (HA) and transverse angle (TA)—indicating the orientation of the cardiomyocytes; d) absolute sheetlet angle (E2A) and E2A mobility—measuring the alignment and systolic-diastolic mobility of the sheetlets, respectively.This document provides recommendations for both clinical and research cDWI and cDTI, based on published evidence when available and expert consensus when not. It introduces the cardiac microstructure focusing on the cardiomyocytes and their role in cardiac physiology and pathophysiology. It highlights methods, observations, and recommendations in terminology, acquisition schemes, postprocessing pipelines, data analysis, and interpretation of the different biomarkers. Despite the ongoing challenges discussed in the document and the need for ongoing technical improvements, it is clear that cDTI is indeed feasible, can be accurately and reproducibly performed and, most importantly, can provide unique insights into myocardial pathophysiology.
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spelling doaj-art-a17e9f29bd0e4c9c9cb6cb178aa831d82025-01-08T04:52:17ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-01271101109Cardiac diffusion-weighted and tensor imaging: A consensus statement from the special interest group of the Society for Cardiovascular Magnetic ResonanceErica Dall’Armellina0Daniel B. Ennis1Leon Axel2Pierre Croisille3Pedro F. Ferreira4Alexander Gotschy5David Lohr6Kevin Moulin7Christopher T. Nguyen8Sonja Nielles-Vallespin9William Romero10Andrew D. Scott11Christian Stoeck12Irvin Teh13Elizabeth M. Tunnicliffe14Magalie Viallon15Victoria Wang16Alistair A. Young17Jürgen E. Schneider18David E. Sosnovik19Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK; Corresponding author.Department of Radiology, Stanford University, Stanford, California, USADepartment of Radiology, NYU Grossman School of Medicine, New York, New York, USA; Division of Cardiology, Department of Internal Medicine, NYU Grossman School of Medicine, New York, New York, USAUniversity of Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, F-42270, Saint-Etienne, France; Department of Radiology, University Hospital Saint-Etienne, F-42055 Saint-Etienne, FranceRoyal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UKDepartment of Cardiology, University Hospital Zurich, Zurich, Switzerland; Institute for Biomedical Engineering, University and ETH Zurich, Zurich, SwitzerlandChair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center Wuerzburg (CHFC), University Hospital Wuerzburg, Wuerzburg, GermanyDepartment of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USAHarvard Medical School, Boston, Massachusetts, USA; Department of Biomedical Engineering, Case Western Reserve University and Lerner Research Institute Cleveland Clinic, Cleveland, Ohio, USA; Cardiovascular Innovation Research Center, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USARoyal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UKUniversity of Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, F-42270, Saint-Etienne, FranceRoyal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UKCenter for Preclinical Development, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Biomedical Engineering, University and ETH Zurich, Zurich, SwitzerlandBiomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UKOxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford and Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UKUniversity of Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, F-42270, Saint-Etienne, France; Department of Radiology, University Hospital Saint-Etienne, F-42055 Saint-Etienne, FranceDepartment of Radiology, Stanford University, Stanford, California, USAKings College, London, UKBiomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UKMartinos Center for Biomedical Imaging and Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USAThanks to recent developments in cardiovascular magnetic resonance (CMR), cardiac diffusion-weighted magnetic resonance is fast emerging in a range of clinical applications. Cardiac diffusion-weighted imaging (cDWI) and diffusion tensor imaging (cDTI) now enable investigators and clinicians to assess and quantify the tridimensional microstructure of the heart. Free-contrast DWI is uniquely sensitized to the presence and displacement of water molecules within the myocardial tissue, including the intracellular, extracellular, and intravascular spaces. CMR can determine changes in microstructure by quantifying: a) mean diffusivity (MD)—measuring the magnitude of diffusion; b) fractional anisotropy (FA)—specifying the directionality of diffusion; c) helix angle (HA) and transverse angle (TA)—indicating the orientation of the cardiomyocytes; d) absolute sheetlet angle (E2A) and E2A mobility—measuring the alignment and systolic-diastolic mobility of the sheetlets, respectively.This document provides recommendations for both clinical and research cDWI and cDTI, based on published evidence when available and expert consensus when not. It introduces the cardiac microstructure focusing on the cardiomyocytes and their role in cardiac physiology and pathophysiology. It highlights methods, observations, and recommendations in terminology, acquisition schemes, postprocessing pipelines, data analysis, and interpretation of the different biomarkers. Despite the ongoing challenges discussed in the document and the need for ongoing technical improvements, it is clear that cDTI is indeed feasible, can be accurately and reproducibly performed and, most importantly, can provide unique insights into myocardial pathophysiology.http://www.sciencedirect.com/science/article/pii/S1097664724011360Cardiovascular magnetic resonanceCardiac diffusion imagingCardiac diffusion tensor imagingMyocardial structureRecommendationsConsensus
spellingShingle Erica Dall’Armellina
Daniel B. Ennis
Leon Axel
Pierre Croisille
Pedro F. Ferreira
Alexander Gotschy
David Lohr
Kevin Moulin
Christopher T. Nguyen
Sonja Nielles-Vallespin
William Romero
Andrew D. Scott
Christian Stoeck
Irvin Teh
Elizabeth M. Tunnicliffe
Magalie Viallon
Victoria Wang
Alistair A. Young
Jürgen E. Schneider
David E. Sosnovik
Cardiac diffusion-weighted and tensor imaging: A consensus statement from the special interest group of the Society for Cardiovascular Magnetic Resonance
Journal of Cardiovascular Magnetic Resonance
Cardiovascular magnetic resonance
Cardiac diffusion imaging
Cardiac diffusion tensor imaging
Myocardial structure
Recommendations
Consensus
title Cardiac diffusion-weighted and tensor imaging: A consensus statement from the special interest group of the Society for Cardiovascular Magnetic Resonance
title_full Cardiac diffusion-weighted and tensor imaging: A consensus statement from the special interest group of the Society for Cardiovascular Magnetic Resonance
title_fullStr Cardiac diffusion-weighted and tensor imaging: A consensus statement from the special interest group of the Society for Cardiovascular Magnetic Resonance
title_full_unstemmed Cardiac diffusion-weighted and tensor imaging: A consensus statement from the special interest group of the Society for Cardiovascular Magnetic Resonance
title_short Cardiac diffusion-weighted and tensor imaging: A consensus statement from the special interest group of the Society for Cardiovascular Magnetic Resonance
title_sort cardiac diffusion weighted and tensor imaging a consensus statement from the special interest group of the society for cardiovascular magnetic resonance
topic Cardiovascular magnetic resonance
Cardiac diffusion imaging
Cardiac diffusion tensor imaging
Myocardial structure
Recommendations
Consensus
url http://www.sciencedirect.com/science/article/pii/S1097664724011360
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