Modified wideband 3D late gadolinium enhancement (LGE) MRI for patients with implantable cardiac devices

Background Late gadolinium enhancement (LGE) cardiac MRI is the clinical gold standard for non-invasive assessment of myocardial viability and plays an important role in guiding catheter ablation of ventricular tachycardia (VT). The majority of VT patients have implanted cardiac devices such as implantable cardioverter defibrillators (ICDs). The presence of ICDs gives rise to strong off-resonance within the myocardium. This produces hyper-intensity (HI) artifacts in LGE, which can mask scar tissue, compromising the diagnostic value of LGE. Recent studies show that HI artifacts can be eliminated by using a wideband inversion recovery (IR) pulse in the LGE sequence. However, the current wideband LGE is a 2D sequence, which limits spatial resolution, especially slice thickness (8 mm). This is problematic for using LGE to guide catheter ablation of VT. High resolution LGE is feasible using a 3D LGE sequence. However, no prior studies have explored 3D LGE under the influence of strong off-resonance imposed by ICDs.