# Improved Imaging of Fibrosis in Atrial Fibrillation

> **NIH NIH R01** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2024 · $745,510

## Abstract

Project Summary
In the United States, atrial fibrillation (AF) is the second most common cardiovascular condition in adults, after
hypertension, affecting 33 million individuals worldwide, with more than 7 million patients in the U.S. and
Europe, over 400,000 U.S. hospital admissions per year, 5 million office visits per year, 276,000 emergency
room visits per year, a $26 billion annual increase in U.S. healthcare costs, and a five-fold and an almost two-
fold increase in the risk of stroke and mortality, respectively. A key marker in the disease process is the
collagen and fibrosis formation in the left atrium (LA). MR imaging methods have been developed to assess
the left atrium, including fibrosis but are still unreliable and controversial. Specifically, late gadolinium
enhancement (LGE) MRI has played a key role as a non-invasive imaging tool for in vivo visualization and
quantification of atrial fibrosis. However, the inconsistent image quality and the significant amount of expert-
level supervision involved in the fibrosis quantification process are major roadblocks to its reproducibility. This
proposal offers a new MRI imaging technique and an associated machine learning approach to better assess
the left atrium and to determine the repeatability of these measurements. Aim 1 will introduce robust and
repeatable MRI acquisition and reconstruction methods for obtaining isotropic resolution in a fixed time of LGE
images of the left atrium. Unique motion compensation models will be integrated into the reconstruction
methods for the LGE data. Aim 2 will provide accurate machine learning based methods for segmenting the left
atrium wall and assessing atrial myocardium fibrosis. Aim 3 will rigorously test and further refine the non-
invasive fibrosis assessment methods in an experimental canine model with fibrosis. Aim 4 will quantify the
reproducibility of the new acquisition, reconstruction, and post-processing methods compared to existing
methods in patients. This proposal will directly impact clinical science and standards of care in cardiology and
AF management through significant improvements to LGE imaging of left atrial fibrosis. Technological
contributions of this work will further impact the field of biomedical image analysis through the improvement of
MRI-based techniques for imaging cardiac tissue structure. To promote transparency and reproducibility, the
proposed efforts will be released as open-source tools consistent with the principles of reproducible research
and open science practices. This open-source nature will further make this project a catalyst for future
methodological innovations and clinical investigations. Our long-term goal is to streamline and standardize
atrial fibrosis quantification for the clinical management of AF patients, and this project will establish the
groundwork for achieving this goal.

## Key facts

- **NIH application ID:** 10805449
- **Project number:** 5R01HL162353-03
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Edward VR DiBella
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $745,510
- **Award type:** 5
- **Project period:** 2022-03-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10805449

## Citation

> US National Institutes of Health, RePORTER application 10805449, Improved Imaging of Fibrosis in Atrial Fibrillation (5R01HL162353-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10805449. Licensed CC0.

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