The National Heart, Lung, and Blood Institute of the National Institutes of Health has issued a three-year grant of more than $1 million to researchers at Case Western Reserve University School of Medicine who are investigating a new imaging approach for diagnosing peripheral arterial disease.

The pledged $1,118,556 in funding will be applied to the development and testing of new, non-contrast-enhanced magnetic resonance angiography methods that require no established gadolinium-based contrast agents, in the hope that the findings will lead to new alternatives to standard, noninvasive techniques that do use such dyes, such as contrast-enhanced computerized tomography angiography (CTA) and contrast-enhanced MRA.

“Current MRA methods have problems that limit their widespread clinical applicability, including undesired suppression of signals, making the blockage look worse than it is,” Dr. Sanjay Rajagopalan, the Herman K. Hellerstein MD Professor of Medicine and Radiology and director of the Cardiovascular Research Institute at Case Western Reserve University School of Medicine, said in a statement.
The use of contrast dyes is not always suitable for select patients, particularly those with chronic kidney disease, a condition that is on the rise in the U.S. due to increasing rates of diabetes and hypertension.

With his colleagues, Rajagopalan plans to evaluate a number of techniques, including Fourier-based, velocity-selective magnetization preparation, which magnetically tags flowing blood and produces paired images of the target tissue under “control” and “tagged” conditions. This provides clear visibility of blood vessels without the use of contrast dyes and suppresses background tissue without disturbing arterial blood, thereby creating robust angiographic image contrast.

Clinical studies conducted will be compared to those of contrast-enhanced studies for detecting vessel narrowing or blockage, as well as intra- and inter-observer agreements. In addition, researchers will also evaluate the feasibility of high-rate scan acceleration of up to sixfold, using compressed sensing combined with parallel imaging in the calf.

Rajagopalan says the techniques produced in the project may also have high applicability in other medical procedures, including venography; vessel wall imaging; and perfusion imaging.

“A non-contrast-enhanced MRA would be ideal in such patients and certainly has demonstrated promising results,” he said.

More than 200 million people worldwide are afflicted with peripheral arterial disease, a common and potentially serious circulatory condition.

Case Western Reserve University School of Medicine did not respond for comment.

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