# Pre-Procedural Evaluation of High-Risk Patients using Next-Generation Radial QISS

> **NIH NIH R01** · ENDEAVOR HEALTH CLINICAL OPERATIONS · 2020 · $355,500

## Abstract

The overall goals of this project are to develop and validate robust, <20-minute MRI strategies for pre-procedural
high-resolution imaging of the great vessels, free from the need for contrast agents or electrocardiographic
(ECG) gating.
 The use of pre-procedural CT angiography (CTA) and contrast-enhanced MRA (CEMRA) provides critical
structural information that is essential for optimal patient outcomes. However, most patients undergoing
transcatheter aortic valve replacement (TAVR) or pulmonary vein isolation (PVI) are elderly, and many suffer
from multi-system vascular disorders or other co-morbidities. The high incidence of renal dysfunction in these
patients raises serious concerns for giving contrast agents. With severe renal dysfunction, CTA is
contraindicated due to the risk of contrast-induced nephropathy, while CEMRA is contraindicated due to the risks
of nephrogenic systemic fibrosis and tissue-deposition of gadolinium more generally. We hypothesize that next-
generation optimized imaging strategies (OIS) based on single-shot radial quiescent-interval slice-selective
(QISS) MRA will provide a high-impact benefit to patient care by enabling the creation of artifact-free
angiographic images with near isotropic spatial resolution, without the need for contrast agents. Moreover, each
OIS will be highly efficient with a total exam time <20 minutes. Both breath-hold and free-breathing strategies
will be explored. Technical enhancements will include: (1) undersampled single-shot radial acquisitions to
reduce sensitivity to cardiac arrhythmias, (2) iterative reconstruction using non-Cartesian SENSE or compressed
sensing to improve the image quality of highly-undersampled radial scans, (3) navigator-gated 2D acquisitions
to eliminate the need for breath-holding, (4) retrospective motion correction using affine or nonrigid
transformations so as to facilitate the creation of maximum intensity projections and volume renderings, (5)
strategic application of disk-shaped pseudocontinuous arterial spin labeling (PCASL) regions to enable the
creation of vessel-selective angiograms; (6) M-mode gating to improve the robustness of cardiac synchronization
while eliminating the need for electrocardiographic (ECG) leads. (7) simultaneous multi-slice methods to
facilitate efficient coverage of large vascular regions and minimize the likelihood of image misregistration for
breath-hold exams; (8) frequency-swept acquisitions to mitigate banding artifacts.
 This proposal entails an initial 3-year technical development phase followed by a 2-year research trial to
validate the optimized imaging strategies. The specific aims for our five-year proposal are as follows:
 1. To develop <20-minute optimized imaging strategies for near isotropic imaging of the great vessels,
 free from the need for contrast agents or ECG gating.
 2. To perform a single-center research trial in patients scheduled for TAVR or PVI, in order to validate the
 performance of breath-hold and fr...

## Key facts

- **NIH application ID:** 9839656
- **Project number:** 5R01HL137920-03
- **Recipient organization:** ENDEAVOR HEALTH CLINICAL OPERATIONS
- **Principal Investigator:** Robert R. Edelman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $355,500
- **Award type:** 5
- **Project period:** 2017-12-15 → 2021-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9839656

## Citation

> US National Institutes of Health, RePORTER application 9839656, Pre-Procedural Evaluation of High-Risk Patients using Next-Generation Radial QISS (5R01HL137920-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9839656. Licensed CC0.

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