Multiparametric quantitative cardiovascular magnetic resonance (CMR) imaging is a powerful tool for myocardial morphological and functional assessment and tissue characterization. It provides objective, reproducible measurements appropriate for diagnosing and longitudinal monitoring of both focal and diffuse cardiovascular diseases. CMR has unparalleled flexibility: it is sensitive to a wide range of physical and physiological processes such as motion, T1 and T2 relaxation (biomarkers for e.g., fibrosis, edema, and inflammation), blood flow, diffusion, and more. However, the multiparameter sensitivity of CMR is also its weakness, as sequentially targeting each of these individual processes requires an inefficient mixture of electrocardiogram triggering, respiratory control, and precise pulse sequence timing. This complicated, disjointed imaging paradigm has limited the adoption of multiparametric quantitative CMR to only specialized imaging centers, and has prevented it from reaching its full potential.
In this article collection, we will showcase the results of ongoing research in simultaneous multiparametric and multidimensional CMR that will enable the transition of the current sequential MR imaging model into a new, single push-button MRI model, capable of simultaneously capturing multiple types of contrast and quantitative maps of tissue properties from one comprehensive, continuous dataset. This transition from sequential “single color” imaging to simultaneous “prismatic” imaging is going to revolutionize all branches of diagnostic MRI, but its impact will undoubtedly be most profound in the cardiovascular domain where it will eliminate the need for respiratory or ECG triggering or gating, thus bringing CMR to patient groups that are currently not able to benefit from its full diagnostic potential.
So far, multidimensionality has been used to achieve a better workflow with equivalent results, which itself has the potential to increase access to CMR (e.g. patients suffering from various types of arrhythmia, breathing difficulties, and in the developing world where technologist training is a burden or scanner throughput is at a premium due to few scanners). The greater potential of multidimensional imaging is to provide additional value, not just equivalent results, through novel time-resolved quantification, study of interaction between parameters. Furthermore, the rich multiparametric information in multidimensional CMR images is spatiotemporally co-registered, and therefore ready-made for development of artificial intelligence tools for diagnosis, risk prediction, therapy monitoring and more.
As is befitting the publication featuring the word ‘Frontiers’ in its title, this collection of invited articles will contain reports on existing research that is already producing tangible, peer reviewed scientific results on this side of the Frontier, but also it will provide an outlook, a projection of what lies in the future, right behind the horizon. Our aim is to present a convincing case that the transition to continuous, multiparametric and multidimensional MRI is within our reach, and that the question is not if but when it’s going to happen.
Multiparametric quantitative cardiovascular magnetic resonance (CMR) imaging is a powerful tool for myocardial morphological and functional assessment and tissue characterization. It provides objective, reproducible measurements appropriate for diagnosing and longitudinal monitoring of both focal and diffuse cardiovascular diseases. CMR has unparalleled flexibility: it is sensitive to a wide range of physical and physiological processes such as motion, T1 and T2 relaxation (biomarkers for e.g., fibrosis, edema, and inflammation), blood flow, diffusion, and more. However, the multiparameter sensitivity of CMR is also its weakness, as sequentially targeting each of these individual processes requires an inefficient mixture of electrocardiogram triggering, respiratory control, and precise pulse sequence timing. This complicated, disjointed imaging paradigm has limited the adoption of multiparametric quantitative CMR to only specialized imaging centers, and has prevented it from reaching its full potential.
In this article collection, we will showcase the results of ongoing research in simultaneous multiparametric and multidimensional CMR that will enable the transition of the current sequential MR imaging model into a new, single push-button MRI model, capable of simultaneously capturing multiple types of contrast and quantitative maps of tissue properties from one comprehensive, continuous dataset. This transition from sequential “single color” imaging to simultaneous “prismatic” imaging is going to revolutionize all branches of diagnostic MRI, but its impact will undoubtedly be most profound in the cardiovascular domain where it will eliminate the need for respiratory or ECG triggering or gating, thus bringing CMR to patient groups that are currently not able to benefit from its full diagnostic potential.
So far, multidimensionality has been used to achieve a better workflow with equivalent results, which itself has the potential to increase access to CMR (e.g. patients suffering from various types of arrhythmia, breathing difficulties, and in the developing world where technologist training is a burden or scanner throughput is at a premium due to few scanners). The greater potential of multidimensional imaging is to provide additional value, not just equivalent results, through novel time-resolved quantification, study of interaction between parameters. Furthermore, the rich multiparametric information in multidimensional CMR images is spatiotemporally co-registered, and therefore ready-made for development of artificial intelligence tools for diagnosis, risk prediction, therapy monitoring and more.
As is befitting the publication featuring the word ‘Frontiers’ in its title, this collection of invited articles will contain reports on existing research that is already producing tangible, peer reviewed scientific results on this side of the Frontier, but also it will provide an outlook, a projection of what lies in the future, right behind the horizon. Our aim is to present a convincing case that the transition to continuous, multiparametric and multidimensional MRI is within our reach, and that the question is not if but when it’s going to happen.
