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, the most common type of heart disease, originates from narrowing of the small coronary blood vessels that supply blood and oxygen to the heart. Proper diagnosis and prognosis of ischemic heart disease are, therefore, of paramount importance in the management of the patients who would otherwise be vulnerable to heart attacks or sudden death.

Assessment of vascular reactivity of the heart muscle is the hallmark of stress testing in cardiac imaging aimed at evaluating the presence and staging of ischemic heart disease. This is routinely performed 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 patients cannot exercise to a level where the underlying disease can accurately be determined.

For those 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 with a pharmacological stress test.

Nuclear imaging methods are hampered by the need for radioactive tracers, which limit serial exams; and poor imaging resolution, which limits accurate detection of disease. Other methods, particularly first-pass perfusion MRI, require exogenous contrast agents to assess blood myocardial flow. This is particularly limiting in patients with chronic kidney disease, who often present with ischemic heart disease. Cardiac Blood-Oxygen-Level-Dependent (BOLD) Magnetic Resonance Imaging (MRI) is an alternative to contrast-enhanced approaches as it relies on endogenous contrast from changes in blood oxygenation 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 heart disease.

 

Technology Description

Dr. Dharmakumar and Dr. Yang of Cedars-Sinai Medical Center have developed a new cardiac BOLD MRI approach for examining ischemic heart disease. 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

The disclosed method has many benefits:

• High reproducibility;

• Precise;

• Improved patient comfort; and

• Artifact-free imaging.

 

Applications

Diagnostis and prognostis of ischemic heart disease.

 

Intellectual Property

• PCT application PCT/US2016/054890 filed.

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