# Free-breathing and simultaneous multislice cine DENSE myocardial strain imaging

> **NIH NIH R01** · UNIVERSITY OF VIRGINIA · 2022 · $385,320

## Abstract

Project summary
 The use and value of myocardial strain imaging have been increasing during the past 10 years. Among
many applications, the most prominent include (a) the evaluation of cardiotoxicity in cancer patients undergoing
chemotherapy, (b) prognosis and risk stratification in aortic stenosis, and (c) diagnosis and prognosis in
undifferentiated left ventricular hypertrophy. We have developed Cine Displacement Encoding with Stimulated
Echoes (DENSE) strain MRI, shared the method with other sites, and applied it to patient selection and procedure
guidance in cardiac resynchronization therapy (CRT) for heart failure (HF). Cine DENSE is highly accurate and
reproducible for the quantification of global and segmental myocardial strain, it is emerging as a gold standard
technique, and it is being implemented by major manufacturers. However, current cine DENSE imaging requires
multiple breathhold acquisitions or inefficient and inconvenient free-breathing acquisitions using diaphragm-
based navigators, and neither approach is well suited for a rapid and efficient multiparametric cardiac MRI
protocol or for sick patients with difficulty with breathhold-based protocols. In addition, inline strain analysis is
not available and thus this task is performed offline on a workstation. With these limitations, more convenient
methods such as feature tracking are often used, even though they are less accurate, less reproducible for
segmental analysis, and/or less prognostic. This project will develop cine DENSE into a method that retains high
accuracy and reproducibility and is also fast and easy-to-use. To achieve this goal, we propose four specific
aims. In Aim 1, we will develop an efficient self-navigated free-breathing cine DENSE method, and in Aim 2 we
will develop accelerated cine DENSE using simultaneous multislice methods. The methods in Aims 1 and 2 will
be combined to enable accelerated free-breathing imaging. In Aim 3, we will develop methods for fully automatic
displacement and strain analysis, enabling the implementation of inline strain mapping. Finally, in Aim 4 we will
validate the methods developed in Aims 1-3 in healthy volunteers and HF patients scheduled to undergo CRT.
Altogether, this project will result in a fast, reproducible, convenient and well-validated myocardial strain imaging
method that will be broadly useful for the field of cardiac imaging.

## Key facts

- **NIH application ID:** 10418633
- **Project number:** 5R01HL147104-04
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** Frederick H Epstein
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $385,320
- **Award type:** 5
- **Project period:** 2019-07-17 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10418633

## Citation

> US National Institutes of Health, RePORTER application 10418633, Free-breathing and simultaneous multislice cine DENSE myocardial strain imaging (5R01HL147104-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10418633. Licensed CC0.

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