A new artificial intelligence (AI) method of heart imaging could improve patient care, allowing doctors to examine their hearts for scar tissue while eliminating the need for contrast injections required for traditional cardiovascular magnetic resonance imaging (CMR).
The team behind the technology, from UVA Health in Virginia, USA, compared the AI approach, known as Virtual Native Enhancement (VNE), to contrast-enhanced CMR scans now used to monitor hypertrophic cardiomyopathy, the most common genetic heart disease.
As part of their study, the researchers found that VNE produced higher quality images and better-captured evidence of scarring in the heart, all without injecting the standard contrast medium needed for CMR.
“This is a potentially important advance, especially if it can be extended to other patient groups,” said study researcher Christopher Kramer, chief of the Division of Cardiovascular Medicine at UVA Health.
He added: “Being able to identify scars in the heart, a major contributor to the progression of heart failure and sudden cardiac death, without contrast, would be very important. CMR scans would be performed without contrast, which cost and each risk, albeit low, of the contrast agent.”
Hypertrophic cardiomyopathy is the most common hereditary heart disease and the most common cause of sudden cardiac death in young athletes. It causes the heart muscle to thicken and stiffen, reducing its ability to pump blood and requiring close monitoring by doctors.
According to the researchers, the new VNE technology will allow doctors to image the heart more often and faster. It can also help doctors detect subtle changes in the heart sooner, although more tests are needed to confirm that.
They added that the technology would also benefit patients who are allergic to the contrast agent injected for CMR, as well as patients with severely failing kidneys, a group who avoid using the agent.
The new approach uses AI to enhance “T1 maps” of heart tissue created by magnetic resonance imaging (MRI). These maps are combined with enhanced MRI “lines,” which are like movies of moving tissue — in this case, the beating heart. Overlaying the two types of images creates the artificial VNE image, the researchers explained.
Based on this input, the technology can produce something nearly identical to the traditional contrast-enhanced CMR heart scans doctors are used to reading — only better, the researchers concluded. “Avoiding the use of contrast and improving image quality in CMR would ultimately only help patients and physicians,” Kramer said.
While the new research explores the potential of VNE in patients with hypertrophic cardiomyopathy, the technology’s makers see it could be used for many other heart conditions as well.
“While currently validated in the HCM population, there is a clear path to extend the technology to a wider range of myocardial pathologies,” they wrote. “VNE has tremendous potential to improve clinical practice, reduce scanning time and costs, and expand the reach of CMR in the near future.”