Publications by authors named "Shivraman Giri"

Cardiac magnetic resonance myocardial perfusion imaging can detect coronary artery disease and is an alternative to single-photon emission computed tomography or positron emission tomography. However, the complex, non-linear MR signal and the lack of robust quantification of myocardial blood flow have hindered its widespread clinical application thus far. Recently, a new Bayesian approach was developed for brain imaging and evaluation of perfusion indexes (Kudo et al.

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Standardized magnetic resonance imaging (MRI) protocols are important for the diagnosis and monitoring of patients with multiple sclerosis (MS). The Consortium of Multiple Sclerosis Centers (CMSC) convened an international panel of MRI experts to review and update the current guidelines. The objective was to update the standardized MRI protocol and clinical guidelines for diagnosis and follow-up of MS and develop strategies for advocacy, dissemination, and implementation.

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To evaluate k-t accelerated 3D cine b-SSFP (balanced steady state free precession) as magnetic resonance imaging (MRI) technique for aortic annular area measurement in transcatheter aortic valve replacement (TAVR) planning compared to computed tomography angiography (CTA) and other non-contrast MRI sequences with reduced imaging time and without contrast administration. 6 volunteers and 7 TAVR candidates were prospectively enrolled. The volunteers underwent an MRI while TAVR candidates underwent an MRI and CTA.

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The presented analysis of multisite, multiplatform clinical oncology trial data sought to enhance quantitative utility of the apparent diffusion coefficient (ADC) metric, derived from diffusion-weighted magnetic resonance imaging, by reducing technical interplatform variability owing to systematic gradient nonlinearity (GNL). This study tested the feasibility and effectiveness of a retrospective GNL correction (GNC) implementation for quantitative quality control phantom data, as well as in a representative subset of 60 subjects from the ACRIN 6698 breast cancer therapy response trial who were scanned on 6 different gradient systems. The GNL ADC correction based on a previously developed formalism was applied to trace-DWI using system-specific gradient-channel fields derived from vendor-provided spherical harmonic tables.

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Background: Comparing cardiovascular magnetic resonance (CMR) angiography with computed tomography angiography (CTA), a major deficiency has been its inability to reliably image peripheral vascular calcifications that may impact the choice of interventional strategy and influence patient prognosis. Recently, MRI using a proton density-weighted, in-phase stack of stars (PDIP-SOS) technique has proved capable of detecting these calcifications. The goal of the present study was two-fold: (1) to determine whether magnetic field strength impacts the apparent size and conspicuity of ilio-femoral arterial calcifications; and (2) to determine whether the technique can be accurately applied to image aorto-iliac arterial calcifications.

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Objective: The aim of this study was to determine whether it is feasible to visualize the coronary origins in patients with congenital heart disease (CHD) using single-shot coronary quiescent-interval slice-selective (QISS) magnetic resonance angiography (MRA) with compressed sensing (CS).

Methods: This retrospective study leveraged a parent study, which aimed to compare breath-hold, 2.1-fold accelerated, 2-shot coronary QISS MRA and clinical standard contrast-enhanced (CE) MRA in 14 patients with CHD (mean age, 17.

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Objective: The purpose of this study is to evaluate feasibility, image quality (IQ), and accuracy of noncontrast hybrid arterial spin labeling (NoHASL) magnetic resonance angiography (MRA) compared with time of flight (TOF) MRA and contrast-enhanced (CE) MRA in patients with known/suspected cerebrovascular ischemia.

Methods: Thirty inpatients were imaged at 1.5 T.

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Article Synopsis
  • - The study aimed to assess the visibility of pulmonary arteries using a new nonenhanced imaging method called radial QISS MRA, contrasting it with traditional CTA and CEMRA techniques for detecting pulmonary embolism.
  • - Researchers evaluated breath-hold and free-breathing versions of radial QISS MRA on 14 subjects, including one with existing pulmonary embolism, and found that pulmonary artery branches were clearly visible in both methods, with minimal blurring in free-breathing scans.
  • - The results indicated that radial QISS MRA could effectively identify pulmonary emboli, showing comparable clarity to CEMRA and CTA, while also reducing the risks associated with radiation exposure and iodinated contrast agents.
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Objectives: Our objectives involved identifying whether repeated averaging in basal and mid left ventricular myocardial levels improves precision and correlation with collagen volume fraction for 11 heartbeat MOLLI T mapping versus assessment at a single ventricular level.

Materials And Methods: For assessment of T mapping precision, a cohort of 15 healthy volunteers underwent two CMR scans on separate days using an 11 heartbeat MOLLI with a 5(3)3 beat scheme to measure native T and a 4(1)3(1)2 beat post-contrast scheme to measure post-contrast T , allowing calculation of partition coefficient and ECV. To assess correlation of T mapping with collagen volume fraction, a separate cohort of ten aortic stenosis patients scheduled to undergo surgery underwent one CMR scan with this 11 heartbeat MOLLI scheme, followed by intraoperative tru-cut myocardial biopsy.

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Purpose: The aim of this study was to prospectively evaluate the technical feasibility of a noncontrast magnetic resonance angiography (MRA) protocol using investigational prototype self-navigated 3D (SN3D) radial whole-heart and quiescent-interval single-shot (QISS) pulse sequences regarding their potential in planning transcatheter aortic valve replacement (TAVR).

Materials And Methods: Five patients (76±7 y) with severe aortic valve stenosis and prior computed tomographic angiography (CTA) for TAVR planning and 10 healthy volunteers (28±6 y) underwent noncontrast MRA on a 1.5 T system.

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Aims: To determine the clinical impact of lipoprotein apheresis in patients with refractory angina and raised lipoprotein(a) > 500 mg/L on the primary end point of quantitative myocardial perfusion, as well as secondary end points including atheroma burden, exercise capacity, symptoms, and quality of life.

Methods: We conducted a single-blinded randomized controlled trial in 20 patients with refractory angina and raised lipoprotein(a) > 500 mg/L, with 3 months of blinded weekly lipoprotein apheresis or sham, followed by crossover. The primary endpoint was change in quantitative myocardial perfusion reserve (MPR) assessed by cardiovascular magnetic resonance.

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Article Synopsis
  • The study introduces a new imaging technique called rotating single-shot acquisition (RoSA) to enhance the speed and quality of high-resolution diffusion-weighted imaging.
  • RoSA achieves faster imaging by using a single rotating blade for acquiring images in different directions and utilizes similarities between images for better reconstruction, while also employing parallel imaging to improve quality.
  • Results show that RoSA is significantly faster (12 times) than traditional methods while maintaining comparable or superior image quality, making it a promising tool for brain imaging.
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Objectives: This study sought to evaluate the image quality and diagnostic accuracy of noncontrast quiescent-interval single-shot (QISS) magnetic resonance angiography (MRA) versus iodine-contrast computed tomography angiography (CTA) in patients with peripheral artery disease (PAD), with invasive digital subtraction angiography (DSA) as the reference standard.

Background: QISS is a recently introduced noncontrast MRA technique. Although the diagnostic accuracy of QISS is reportedly similar to that of contrast-enhanced MRA, its performance compared with contrast-enhanced CTA, the most frequently used noninvasive modality for evaluation of PAD, is unknown.

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Background: The high incidence of renal insufficiency in patients with Peripheral Arterial Disease raises the concern for nephrogenic systemic fibrosis (NSF) with respect to contrast enhanced MRA. The risk of NSF is eliminated with non-contrast enhanced magnetic resonance angiography. The purpose of the current study is to compare image quality and diagnostic performance of non-contrast enhanced Quiescent Interval Single Shot (QISS) magnetic resonance angiography at 3 T versus CT angiography for evaluation of lower extremity Peripheral Arterial Disease (PAD).

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Background: Dark blood imaging of the heart is conventionally performed using a breath-hold, dual-inversion Cartesian fast spin-echo pulse sequence. Our aim was to develop a faster, more flexible approach that would be less motion-sensitive and provide better image quality. For this purpose, we implemented a prototype radial balanced steady-state free precession (bSSFP) pulse sequence.

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Article Synopsis
  • Magnetic resonance imaging (MRI) phantoms, specifically nickel-chloride agarose gels, were developed to accurately simulate blood and myocardial T1 and T2 values for long-term testing of myocardial imaging techniques.
  • Over a 12-month study, these phantoms exhibited minimal changes in T1 and ECV values, demonstrating their reliability for quality assurance in MRI protocols.
  • The research highlights the importance of such phantoms in enhancing the accuracy of myocardial tissue characterization through T1 mapping, paving the way for consistent results across different MRI centers.
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Aims: To use cardiac magnetic resonance (CMR) imaging with quantitative T2 mapping as surrogate for myocardial water content in patients with advanced decompensated heart failure (ADHF), compare these values with T2-values observed in chronic heart failure, and evaluate the change with decongestive therapy.

Methods And Results: Volumetric CMR measurements and quantitative T2 mapping were performed in 18 consecutive ADHF patients with clinical signs of volume overload. Eleven patients with stable heart failure were used as controls.

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Purpose: The presence of vascular calcifications helps to determine percutaneous access for interventional vascular procedures and has prognostic value for future cardiovascular events. Unlike CT, standard MRI techniques are insensitive to vascular calcifications. In this prospective study, we tested a proton density-weighted, in-phase (PDIP) three-dimensional (3D) stack-of-stars gradient-echo pulse sequence with approximately 1 mm isotropic spatial resolution at 1.

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Purpose: To test the feasibility of a quiescent interval low-angle shot (QLASH) sequence for nonenhanced MR angiography (MRA) of the extracranial carotid arteries at 3 T.

Methods: The extracranial carotid arteries were imaged using QLASH MRA in healthy volunteers and patients with carotid arterial disease. The impact of three gating strategies (electrocardiographic-gated, pulse-gated, ungated) was evaluated.

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Background: Thoracic and abdominal 4D flow MRI is typically acquired in combination with navigator respiration control which can result in highly variable scan efficiency (Seff) and thus total scan time due to inter-individual variability in breathing patterns. The aim of this study was to test the feasibility of an improved respiratory control strategy based on diaphragm navigator gating with fixed Seff, respiratory driven phase encoding, and a navigator training phase.

Methods: 4D flow MRI of the thoracic aorta was performed in 10 healthy subjects at 1.

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Purpose: To quantify the accuracy of three-dimensional (3D) radial arterial spin labeled (ASL) magnetic resonance angiography (MRA) using vascular models of carotid stenosis.

Methods: Eight vascular models were imaged at 1.5 Tesla using pulsatile flow waveforms at rates found in the internal carotid arteries (100-400 mL/min).

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Purpose: For the application of compressive sensing to parallel MRI, Poisson disk sampling (PDS) has been shown to generate superior results compared with random sampling methods. However, due to its limited flexibility to incorporate additional constraints, PDS is not readily extendible to dynamic applications. Here, we propose and validate a pseudo-random sampling technique that allows incorporating constraints specific to dynamic imaging.

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Purpose: We hypothesized that non-contrast-enhanced MR angiography (NEMRA) could be performed without cardiac gating by using a variant of the quiescent-inflow single-shot (QISS) technique.

Methods: Ungated QISS (UnQISS) MRA was evaluated in eight patients with peripheral arterial disease at 1.5T.

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Purpose: Both CT and MR angiography are accurate for the evaluation of luminal abnormalities in peripheral arterial disease (PAD). However, only CT (requiring exposure to potentially hazardous ionizing radiation) provides a reliable means to detect vascular calcifications. In this study, we demonstrate the feasibility of detecting peripheral arterial calcifications with MRI.

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