Gray-Blood Late Gadolinium Enhancement (GB-LGE) for Improved Myocardial Scar Evaluation

Motivation: Traditional bright-blood late gadolinium enhancement (BB-LGE) technique often obscures the visualization of endocardial LGE. In contrast, black blood technique overcomes this limitation but sacrifices contrast between the myocardium and blood pool. Goal(s): By selecting specific TI (inversion time) values, gray blood images can be generated to achieve the desired contrast among the blood pool, myocardium, and scar tissue. Approach: We conducted a comparative analysis of image quality, diagnostic confidence score, detection of delayed enhancement lesions, and the contrast-to-noise ratio (CNR) between BB-LGE and GB-LGE. Results: The implementation of GB-LGE enhances diagnostic confidence and improves CNR between the blood pool and myocardial scar tissue. Impact: The proposed GB-LGE sequence in this study enhances scar detection rates and diagnostic confidence, addressing limitations associated with equipment and technology. It optimizes clinical workflow efficiency while offering a universal approach with potential for widespread adoption.