Comparison between compressed sensing and segmented cine cardiac magnetic resonance: a meta-analysis

Abstract

Purpose: Highly accelerated compressed sensing cine has allowed for quantification of ventricular function in a single breath hold. However, compared to segmented breath hold techniques, there may be underestimation or overestimation of LV volumes. Furthermore, a heterogeneous sample of techniques have been used in volunteers and patients for pre-clinical and clinical use. This can complicate individual comparisons where small, but statistically significant differences exist in left ventricular morphological and/or functional parameters. This meta-analysis aims to provide a comparison of conventional cine versus compressed sensing based reconstruction techniques in patients and volunteers.

Methods: Two investigators performed systematic searches for eligible studies using PubMed/MEDLINE and Web of Science to identify studies published 1/1/2010-3/1/2021. Ultimately, 15 studies were included for comparison between compressed sensing cine and conventional imaging.

Results: Compared to conventional cine, there were small, statistically significant overestimation of LV mass, underestimation of stroke volume and LV end diastolic volume (mean difference 2.65 g [CL 0.57-4.73], 2.52 mL [CL 0.73-4.31], and 2.39 mL [CL 0.07-4.70], respectively). Attenuated differences persisted across studies using prospective gating (underestimated stroke volume) and non-prospective gating (underestimation of stroke volume, overestimation of mass). There were no significant differences in LV volumes or LV mass with high or low acceleration subgroups in reference to conventional cine except slight underestimation of ejection fraction among high acceleration studies. Reduction in breath hold acquisition time ranged from 33 to 64%, while reduction in total scan duration ranged from 43 to 97%.

Conclusion: LV volume and mass assessment using compressed sensing CMR is accurate compared to conventional parallel imaging cine.

Keywords: Cine MRI; Compressed sensing; Real-time cine; Review article.

Fig. 1

PRISMA flow-chart. There were 15 studies included in the meta-analysis after screening 149 records from PubMed, MEDLINE and Web of Science. There were 2 studies whose missing data was filled in after contacting authors and 1 study that contributed two sets of compressed sensing comparisons and was included twice in pooled analyses

Fig. 2

Pooled results, all studies. Comparison between compressed-sensing and control sequences. Pooled comparisons of left ventricular parameters between compressed-sensing and control sequences among included studies demonstrated small, statistically significant differences underestimations of LVEDV and LVSV, as well as slight overestimation of LV mass compared with the reference group (p ≤ 0.05)

Fig. 3

Subgroup analysis results, prospective gating. Comparison of sequences stratified by gating method. Left ventricular parameter comparisons stratified by prospective gating yielded similar but attenuated underestimation of stroke volume

Fig. 4

Subgroup analysis results, non-prospective gating or no gating. Comparison of sequences stratified by gating method. Ungated/retrospective gating demonstrated slight overestimation of LV mass and underestimation of LVSV compared with reference

Fig. 5

Subgroup analysis results, high acceleration factor (≥ 11). Comparison of sequences stratified by acceleration factor. High (≥ 11) acceleration factor CS sequences demonstrated non-significant differences except slightly underestimated LVEF

Fig. 6

Subgroup analysis results, low acceleration factor (< 11). Low (< 11) acceleration factor sequences demonstrated attenuated non-significant differences compared with all pooled studies