Wideband late gadolinium enhanced magnetic resonance imaging for imaging myocardial scar without image artefacts induced by implantable cardioverter-defibrillator: a feasibility study at 3 T

Aims Late gadolinium enhanced ([GE) magnetic resonance imaging (MRI) is a useful tool for facilitating ventricular tachycardia (VT) ablation. Unfortunately, most VT ablation candidates often have prophylactic implantable cardioverter-defibrillator (ICD) and do not undergo cardiac MRI largely due to image artefacts generated by ICD. A prior study has reported success of 'wideband' LGE MRI for imaging myocardial scar without image artefacts induced by ICD at 1.5T. The purpose of this study was to widen the availability of wideband [GE MRI to 3T, since it has the potential to achieve higher spatial resolution than 1.5T. Methods and results We compared the performance of standard and wideband LGE MR1 pulse sequences in phantoms and canines with myocardial lesions created by radiofrequency ablation. Standard LGE MRI produced image artefacts induced by ICD and 49% accuracy in detecting 97 myocardial scars examined in this study, whereas wideband LGE M RI produced artefact-free images and 94% accuracy in detecting scars. The mean image quality score (1 -= non diagnostic, 2 = poor, 3 = adequate, 4 = good, 5 = excellent) was significantly (P < 0.001) higher for wideband (3.7 +/- 0.8) than for standard LGE MRI (2.1 +/- 0.7). The mean artefact level score (1 = minimal, 2 = mild, 3 = moderate, 4 = severe, 5 = nondiagnostic) was significantly (P < 0.001) lower for wideband (2.1 +/- 0.8) than for standard LGE MRI (4.0 +/- 0.6). Wideband LGE MRI agreed better with gross pathology than standard LGE MRI. Conclustion This study demonstrates the feasibility of wideband LGE MRI for suppression of image artefacts induced by ICD at 3T.