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
September
 
1
Employee Educational Assistance Award
Labor Day - Academic Holiday
Mon
2
Employee Educational Assistance Award
Internship Info Session
Student/Faculty/Staff Mixer
Tue
3
Employee Educational Assistance Award
LNFS Presents: The Wolf of Wall Street
Last Day to Add a Class
Last Day to Drop a Course with 80% Refund
UK Volunteer Fair
Wed
4
LNFS Presents: Children of Men
LNFS Presents: How To Train Your Dragon 2
Black and Latino Male Initiative
Advance Your Swagger: A Night with Fonzworth Bentely
Thu
5
Kentucky Volleyball vs. Northern Iowa
Kentucky Volleyball vs. USC
LNFS Presents: Spirited Away
LNFS Presents: Mulan
Fri
6
Free Saturday Swing Dance Lessons
Kentucky Football vs. Ohio
#maxfest (Ukirklex Campus Ministry)
Kentucky Volleyball vs. Creighton
Lets Swing Dance!
Sat
7
Kentucky Women's Soccer vs. Morehead State
Sun
8
Diversity Organization's Council
Kosher/Soul? (Jewish, African American & Appalachian culture Fuse)
Mon
9
Working Moms Connection
Job Club - Job Search Strategies for Fall
Rock Star Professionalism Series
Tue
10
Massage on the Go
College: Do the Right Thing- A conversation with Dr. Smith
The Future of Islam
LNFS Presents: Fight Club
Wed
11
9/11 Vigil
UKNABJ presents: Ferguson, Missouri: A look at media, politics and black youth in the U.S.
LNFS Presents: Mr & Mrs Smith
Duo Damiana, Molly Barth and Dieter Hennings
LNFS Presents: 22 Jump Street
Thu
12
LNFS Presents: Searching For Sugarman
LNFS Presents: Sin City
Fri
13
Free Saturday Swing Dance Lessons
Men's Soccer vs. ETSU
Sat
14
Kentucky Women's Soccer vs. Pepperdine
Sun
15
Kentucky Week Farmer's MarCat and Craft Fair
Majestic U.N.I.T.Y.
Mon
16
Justice Delayed not Justice Denied: A Talk with Dough Jones
PRHBTN Gallery Reception and Concert
Men's Soccer vs. Xavier
Chellgren Seminar Series: Buck Ryan
Tue
17
Internship Info Session
Last Day to Drop a Course Without Appearing on Transcript
Caregiver Support Group
LNFS Presents: The Immigrant
Big Blue Commonwealth
Wed
18
LNFS Presents: Watermark
LNFS Presents: X-Men: Days of Future Past
Ryan Gardner Guest Trumpet Recital
Kentucky Volleyball vs. Lipscomb
Thu
19
LNFS Presents: A Band Called Death
LNFS Presents: Prisoners
The Case for Fossil Fuels-PEIK Seminar
Men's Soccer vs. Furman
Fri
20
Rock Climbing @ Red River Gorge
College of Pharmacy Open House
Kentucky Volleyball vs. Xavier
Sat
21
 
Sun
22
Diana Ferrus: 'Writing poetry has allowed me to live': Cultural Resistance in South Africa
Kentucky Law Schools Forum
Mon
23
Pinterest Party
University of Kentucky Chamber Winds
Employer Showcase
Job Club - 10 Questions to Ask Prior to Starting a Business
Men's Soccer vs. Lousville
Tue
24
Employer Showcase
Last Day to Drop a Course with 50% Refund
UK Elder Care Lunch & Learn
BPH Open House
Documentary Film Screening - Heaven + Earth + Joe Davis
LNFS Presents: Saving Mr. Banks
Wed
25
LNFS Presents: Culture Jam
LNFS Presents: Maleficent
¡Baila!
Thu
26
LNFS Presents: Ponyo
LNFS Presents: The Little Mermaid
Opening Night Bohemiam Festival
White Water Rafting @ Chattooga River
Women's Soccer vs. Mississippi State
Fri
27
White Water Rafting @ Chattooga River
Kentucky Football vs. Vanderbilt
Free Saturday Swing Dance Lessons
Green Apple Day of Service: "Pick It Up"
Swing Dancing!
Sat
28
White Water Rafting @ Chattooga River
UK Chorale
Dirty Dancing Trip
Kentucky Women's Soccer vs. Auburn
Sun
29
 
Mon
30
#TrendingTopics: Immigration Reform
Apollo Duo - Flute and Percussion Guest Recital
Tue
 
 
 
 
Reset Page