This research is funded by the North Shore Heart Research Foundation

Title: Establishment of a cardiac magnetic resonance imaging (CMR) research unit at Royal North Shore Hospital, University of Sydney

Investigators: Dr Gemma Figtree, Dr Stuart Grieve, Associate Professor Jane McCrohon, Dr Christopher Choong, Professor Stephen Hunyor, Associate Professor Leonard Kritharides, Dr Raj Puranik, Professor Helge Rasmussen, Dr Michael Ward.

Funded since January 2008

Overview

Magnetic resonance (MR) has revolutionised general body and organ imaging. However its application to the heart is still evolving rapidly, because of complexities in studying a moving organ. Unique challenges of cardiac MR (CMR) relate to the need for specialised hardware (‘coils') and complex software unique to the heart.

The support of the North Shore Heart Research Foundation has led to the establishment of a CMR facility dedicated to clinical and translational cardiac research. The long-term goal is to maximise diagnostic information with minimal radiation and invasive procedures. The project involves collaborating cardiologists, radiologists and scientists from the University of Sydney, Royal North Shore Hospital/North Shore Private Hospital, St Vincent's Hospital and Royal Prince Alfred Hospital.

Report

The CMR facility has attracted the expertise of internationally recognised researchers, as well as partner funding from the Medical Foundation, University of Sydney.

During the first 18 months of the project we established a research partnership with General Electric Healthcare and North Shore Radiology. We also installed the coil and software on an existing MRI scanner on the North Shore campus, performing the first cardiac scan on this scanner in November 2008.

Since then we have established protocols to:

• precisely delineate and quantify myocardial infarction
• assess myocardial perfusion in individuals with known coronary artery disease
• identify novel parameters of right ventricular function for use in patients with acute or chronic pulmonary hypertension.

We also aim to develop novel methods for characterising and assessing atherosclerotic plaque, both in native arteries and in coronary artery bypass grafts.

The combination of the new facility and the team of physicians and scientists it has brought together will allow us to contribute to advances in CMR at the level of acquisition, analysis and clinical application. It will also provide a unique phenotyping facility for cardiovascular research by collaborating scientists.

Examples of CMR images aquired on the 1.5 T General Electric MRI Scanner at Royal North Shore Hospital.

Left: 4-chamber slice obtained using FIESTA sequence illustrating abnormalities of the right ventricular free wall suggestive of arrhythmogenic right ventricular cardiomyopathy.

Right: 3D angiographic data set obtained after injection of gadolinium, allowing precise mapping of the left atrium prior to pulmonary vein isolation for atrial fibrillation.

Benefits

The facility has attracted a multi-campus and highly qualified team with complementary skills. This will allow the group to contribute at an international level to the development of MR for cardiovascular research and clinical applications, leading to precise characterisation of cardiac morphology, pathology and function with minimisation of exposure to radiation and invasive procedures.