A Radiation-Free, Non-Contrast-Enhanced Imaging Approach for Reliable Detection and Characterization of Myocardial Blood Flow in the Diagnosis and Prognosis of Ischemic Heart Disease Based on Blood-Oxygen-Level-Dependent MRI

Tech ID: dha000929

 

Introduction

Ischemic Heart Disease (IHD) originates from narrowing of the small coronary blood vessels that supply blood and oxygen to the heart and is known to be the most common type of heart disease. Proper diagnosis and prognosis of IHD are, therefore, of paramount importance in the management of the vulnerable patient.

 

Assessment of vascular reactivity in the heart is the hallmark of stress testing in cardiac imaging aimed at evaluating the presence and staging of IHD. This is routinely done using nuclear medicine approaches relying on radionuclide injection in conjunction with exercise to identify territories of the heart muscle that are subtended by a suspected narrowed coronary artery. However, exercise is not feasible in more than 50% of cases, as some patient cannot exercise to a level where derangements can accurately be assessed.

 

For patients contraindicated for exercise stress test, imaging exams are typically administered in conjunction with a coronary vasodilator, to pharmacologically stimulate myocardial hyperemia. It is estimated that 10 million patients undergo cardiac stress tests every year in the USA of whom 60% are evaluated using a pharmacological stress test.

 

Nuclear imaging methods are hampered by the need for radioactive tracers, which limits serial exams, and poor imaging resolution, which limits accurate detection of disease. Other methods, particularly first-pass perfusion MRI, are limited by the need for use of exogenous contrast agents to assess blood myocardial flow, especially in patients with chronic kidney disease. Cardiac Blood-Oxygen-Level-Dependent (BOLD) Magnetic Resonance Imaging (MRI) is an alternative to contrast-enhanced approaches as it relies on endogenous contrast characteristics to evaluate ischemic heart disease. However, the state-of-the-art cardiac BOLD MRI methods are plagued with significant image artifacts, especially under pharmacological stress. Hence, there is a need in the art for markedly improving cardiac BOLD MRI that can yield a reliable method for assessing ischemic heard disease.

 

Technology Description

Dr. Dharmakumar and Dr. Yang of the Cedars-Sinai Medical Center have developed a new cardiac BOLD MRI approach for examining IHD. Their approach relies on the determination of coronary dynamic parameters through serial imaging to significantly increase the sensitivity and specificity of cardiac BOLD MRI, while enhancing several important work flow considerations (patient comfort, ease of use, etc.).  

 

Stage of Development

Clinical Data

 

Advantages/Novelty

• High reproducibility

• Precise

• Improved patient comfort

• Artifact-free imaging

 

Applications

Diagnosis and prognosis of ischemic heart disease

 

Intellectual Property

• PCT application PCT/US2016/054890 filed

o Nationalized in the U.S.

Patent Information:
Category(s):
Diagnostic
For Information, Contact:
Julien Brohan
julien.brohan@cshs.org
Inventors:
Rohan Dharmakumar
Hsin-Jung Yang
Keywords:
Cardiovascular
Imaging