Wideband joint black- and bright-blood late gadolinium enhancement imaging in patients with cardiac implantable devices

Motivation: Wideband bright-blood late gadolinium enhancement (LGE) enables artifact-free imaging of myocardial scars in patients with implantable cardioverter defibrillators (ICDs). Unfortunately, the poor scar-blood contrast makes it difficult to depict subendocardial scars. Goal(s): To improve myocardial scar visualization and localization in ICD patients. Approach: We propose a 2D breath-hold single-shot ECG-triggered gradient echo wideband joint black- and bright-blood (wideband SPOT) LGE sequence to improve scar visualization and localization, while limiting ICD-artifacts. Wideband was implemented in an adiabatic inversion pulse and in an adiabatic T2 preparation. Results: Wideband SPOT successfully suppressed ICD-artifacts while improving scar detection, and provided same image quality than reference wideband bright-blood. Impact: This new technology will enable radiologists and cardiologists to detect and localize myocardial scars more accurately in ICD patients by eliminating ICD hyperintensity artifacts and enhancing scar tissue with unprecedented contrast.