ArticleJournal of magnetic resonance imaging : JMRI2026
Free-Breathing Dynamic, Regularized, Adaptive Cluster Optimization (DRACO) Cine Cardiac MRI in Atrial Fibrillation.
Article in Journal of magnetic resonance imaging : JMRI, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Editorial for "Free-Breathing Dynamic, Regularized, Adaptive Cluster Optimization (DRACO) Cine Cardiac MRI in Atrial Fibrillation".Journal of magnetic resonance imaging : JMRI · 2026Article
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7 authors.
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Abstract
backgroundExisting strategies for free-breathing cine cardiac MR, including real-time imaging, struggle with complex arrhythmias such as atrial fibrillation (AF). Dynamic regularized adaptive clustering optimization (DRACO) has been proposed to generate high-quality and quantifiable breath-held cine images for patients in AF. PURPOSE: To tailor DRACO for free-breathing and evaluate its potential to simultaneously handle cardiac and respiratory motion. STUDY TYPE: Prospective. SUBJECTS: 10 sinus rhythm (10 males), 20 AF (18 males). FIELD STRENGTH/SEQUENCE: 3.0 T, balanced steady-state free precession (bSSFP) with sorted golden-step, ECG-gated segmented cine, and real-time. ASSESSMENT: Patients were imaged using the golden-step sequence under breath-held and free-breathing conditions, and the reference bSSFP cine sequence. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), edge sharpness, and image quality (4-point Likert scale) were assessed. STATISTICAL TESTS: Paired t-test, Friedman test, regression analysis, Fleiss' Kappa. Significance level p < 0.05.
resultsThe SNR and CNR values of DRACO images showed no significant differences between breath-held and free-breathing conditions in both sinus rhythm (SNR p = 0.53; CNR p = 0.87) and in AF (SNR p = 0.56; CNR p = 0.55). Image sharpness was not significantly different between breath-held and free-breathing in both sinus rhythm (p = 0.24) and AF (p = 0.79). In AF patients, breath-held DRACO and free-breathing DRACO had significantly higher image quality scores than real-time cine. In sinus rhythm patients, there was no significant difference (p = 0.13) between breath-held or free-breathing DRACO and segmented cine. Despite significant within-patient ejection fraction (EF) differences between breath-held versus free-breathing in 80% of sinus rhythm and 70% of AF patients, the average EF between breath-held versus free-breathing DRACO showed high correlation (sinus rhythm R DATA
conclusionDRACO is robust to respiratory motion and AF-related irregular cardiac motion. It enables high-quality cine image generation in both regular and irregular cardiac motion, with or without breath holding. LEVEL OF EVIDENCE: 1: TECHNICAL EFFICACY: Stage 2.
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