Allison Perry

By

College: Medicine

New Technology Helps Gill Heart Institute Physicians Unmask Artifacts Left By Implantable Cardiac Devices

Published: Jul 25, 2014

LEXINGTON, Ky. (July 25, 2014) -- Most people hear the word "artifact" and think of amazing items found by archeologists at a dig -- objects that shed light on bygone cultures.

 

For Dr. Vincent Sorrell, and his colleagues on the Gill Heart Institute's Advanced Cardiovascular Imaging team, the thought of artifacts means a challenge but one they have worked to overcome.

 

"In the imaging world, an artifact corrupts our ability to see and makes it harder, if not impossible, to diagnose a patient properly," explains Sorrell.  "And in the world of cardiac imaging, artifacts make a challenging job even more challenging."

 

Magnetic Resonance Imaging (MRI) is a unique diagnostic tool that, unlike CAT scans or X-rays, doesn't require the use of radiation or contrast agents to develop an image. Its relative safety and level of visual detail have made it a popular option for the diagnosis of disease.  However, MRI was designed to capture still images -- of the brain, for example. And so special expertise is required when physicians use MRI to look at a beating heart.

 

"It's a carefully choreographed process," says Dr. Steve Leung, associate director for Advanced Cardiovascular Imaging at the Gill and, according to Sorrell, "the brains behind the operation." 

 

"With cardiac MRI, we have to time our pictures in concert with the patient's heartbeat and breathing in order to get interpretable images.  A lot of effort goes into getting good pictures on a moving target.  So when there are factors that add artifacts to an image, it's that much more difficult to make a diagnosis."

 

The major culprits for artifacts in cardiac imaging are implantable cardiac devices (ICDs) such as pacemakers or defibrillators.  The metal in devices like these distort the magnetic field that creates an MRI image and can render the data useless to diagnosticians.

 

"Most MRI centers won't scan patients with ICDs at all because of the theoretical risk involved in using a magnetic field near an object, such as a pacemaker, that has metal parts," Leung says. "Extensive research has demonstrated that, with the proper precautions and expertise in place, we can, in fact, perform MRIs on patients with ICDs.  But now we have a new hurdle, and that is the ability to diagnose patients when artifacts from an ICD interfere."

 

Out of this conundrum was born a search for a way around the problem. And as the team explored options, they zeroed in on changes to the sequencing -- software that, in essence, tells the MRI equipment what to do and when.

 

"UK is unique in that we are not an island," Leung said. "We are clinicians, but there are also physicists, software engineers, and biomedical engineers, all within walking distance of one another. And so we have this incredible talent pool that has allowed us to obtain technology that almost nobody else has, so that patients with ICDs can have equal access to quality cardiac MRI."

 

Networking with colleagues in California, the team was able to access new sequencing software that "unmasks" the tissue surrounding an ICD.

 

"The very first time we used this new sequencing technique, we found a scar indicative of myocarditis, or inflammation of the heart muscle, that had been masked by the artifact created by the patient's ICD," says Leung.  "It was actually pretty impressive." 

 

According to Sorrell, this advance in imaging technology is likely to have significant impact on patients with heart problems and ICDs. 

 

"MRI is available everywhere, but the expertise required for cardiac MRI, combined with the technology that makes us able to read MRI in patients with ICDs, that's a really small subset of medical centers who are capable of performing this technique. And now Gill has this newer technology that makes it even more precise, and we're just one of a handful in the U.S.," Sorrell says.

 

"I think that's why we get referrals from multiple states, from way outside the region, because people realize that what we do here at the Gill is unique."

 

This and the many other resources at the Gill Heart Institute are meaningful for Kentucky, where heart disease and stroke account for more than a third of all deaths annually.

 

"For the last 50 years or so, we've been very good at calculating the heart's pumping efficiency -- called ejection fraction -- as a means of evaluating heart disease and heart failure," Sorrell says. "But the heart is much more complex than its overall end product efficiency. Advances in imaging techniques are beginning to reveal the complex nature of the fibers that make up heart muscle, and how those fibers align and work in perfect synchrony to create a healthy, efficient heart beat."

 

"Being able to understand a disease at its early stage, before it starts to change the efficacy of that ejection fraction, that's going to be the way we start to identify early forms of treatment to prevent heart failure.  Not just treat heart failure, but catch it before it's there."

 

 

 

 

sorrell_see_progress.jpgleung_uknow.g24.png
November
 
 
 
 
 
 
1
Free Saturday Swing Dance Lessons
College of Pharmacy Open House
Iron Pour
UK Women's Choir 20th Anniversary Concert
Adventure Hiking & Rappelling @ Red River Gorge
Pickin' Time Mountain Music and Harvest Day
Purposeful Retirement: Planning Your Next Stage of Life
Diwali Dhoom 2014
Sat
2
UK Percussion Ensemble
Day Hike
Curator Tour: Take My Word For It
Sun
3
Industry Career Week: Resumes and Cover Letters
Kentucky Volleyball vs. Morehead State
Mon
4
Industry Career Week: How to Impress Your Boss in 90 Days
Rock Star Professionalism Series
UK Lab Band
Tue
5
Industry Career Week: Networking and Job Search
Social Enterprise and Innovation / Certified Nonprofit Professional Program Informational Meeting
Circle of Love Name Distribution
Appalachian Forum with Dr. Fran Ansley
Dana Harper Gallery Reception
Wed
6
Career Assessment Workshop
LNFS Presents: Zona Sur
LNFS Presents: The Grand Budapest Hotel
UK Jazz Ensemble
Circle of Love Name Distribution
Abstract Workshop
Lauren Potter
Thu
7
LNFS Presents: V for Vendetta
Last Day to Withdraw or Reduce Course Load
Circle of Love Name Distribution
R.C. May Photography Lecture Series: Marvin Heiferman
Men's Soccer vs. Charlotte
Kentucky Volleyball vs. Georgia
Free Friday Evening Swing Dance
Fri
8
Kentucky Football vs. Georgia
Free Saturday Swing Dance Lessons
The Power of Poetry
The Lexington Lowdown and Free Lindy Hop Workshop
Swing Dance Featuring Live music by"The Metrognomes Orchestra"
Sat
9
UK Combos Concert
Kentucky Volleyball vs. Missouri
Sun
10
Circle of Love Name Distribution
Mon
11
UK Sax Ensembles
Job Club - Interviewing Strategies
Undergraduate Research Information Session
Jose Abisambra Presentation on Current Alzheimer's Research
Women of the World: Judy Smith
Tue
12
Internship Info Session
LNFS Presents: Reservoir Dogs
Refugee Life in America
#UKEDTALKS: International Opportunities for Education Majors
Leadership Assessment
Wed
13
Career Assessment Workshop
LNFS Presents: Iron Man 3
Chili and Pie Cook-Off Supper
#TrendingTopics: Vegetarians vs. Meat-Eaters
Campus Polar Plunge to benefit Special Olympics KY
LNFS Presents: La Demora
Thu
14
LNFS Presents: Pretty in Pink
LNFS Presents: Mean Girls
Fri
15
Free Saturday Swing Dance Lessons
Sat
16
Kentucky Volleyball vs. Florida
Greek Cinematography: Critical Approach and Discussion
"Storied Streets" Documentary Showing about Experiences of Homelessness
Sun
17
The Vexillology (the study of maps) Contest
UK Rep Bands Concert
College of Agriculture, Food & Environment 2014 Celebration of Land-Grant Research
Amanda Rogers, "Black Flags, ISIS 'Swag' & Jihadi Rap: Marketing Militancy after the Arab Spring"
Stories of Homelessness: Panel Discussion
Mon
18
The Vexillology (the study of maps) Contest
A Positive Approach to Caregiving Conference
Education Abroad Open House
CatWatch Party
Appalachian Forum and Film Screening of "Up the Ridge"
Tue
19
The Vexillology (the study of maps) Contest
LNFS Presents: The Princess and the Frog
Pinterest Party
International Games Day
Global Design with Phil Duncan
Caregiver Support Group
OXFAM Social Issues Banquet
Wed
20
The Vexillology (the study of maps) Contest
Much Ado About Nothing
LNFS Presents: I Travel Because I Have To, I Come Back Because I Love You
LNFS Presents: The Big Lebowski
International Education Week Keynote Speaker: Christie Vilsack, Senior Advisor for International Education at USAID
Tobacco-free Tailgate 5 Year Anniversary
Bollywood Night
Thu
21
The Vexillology (the study of maps) Contest
Much Ado About Nothing
LNFS Presents: Water For Elephants
4th Annual Markesbery Symposium on Aging & Dementia
Freedom from Fear: On Black Childhood and Other Dangers
Bouldering @ Stone Fort
MEAT.
Fri
22
The Vexillology (the study of maps) Contest
Much Ado About Nothing
Bouldering @ Stone Fort
Free Saturday Swing Dance Lessons
Sat
23
The Vexillology (the study of maps) Contest
Much Ado About Nothing
Bouldering @ Stone Fort
UK Symphony Band and UK Concert Band
Sun
24
The Vexillology (the study of maps) Contest
Free Thanksgiving Shuttle to Blue Grass Airport
Mon
25
Free Thanksgiving Shuttle to Blue Grass Airport
Job Club - What is your money habitude?
Multicultural Student Thanksgiving Dinner
Tue
26
Thanksgiving - Academic Holidays
Free Thanksgiving Shuttle to Blue Grass Airport
Wed
27
Thanksgiving - Academic Holidays
Thu
28
Thanksgiving - Academic Holidays
Fri
29
Thanksgiving - Academic Holidays
Free Saturday Swing Dance Lessons
Kentucky Volleyball vs. Arkansas
Sat
30
 
Sun
 
 
 
 
 
 

Repeats every week until Sat Nov 29 2014 except Sat Sep 20 2014, Sat Oct 18 2014.
Sat, 11/22/2014

Sun, 11/23/2014

Mon, 11/24/2014

Reset Page