Optimizing Cine Cardiac MRI: Technical Advances and Clinical Applications.

Cine cardiac magnetic resonance imaging (MRI) is the gold standard for cardiac function assessment, offering exceptional spatial and temporal resolution in a non-invasive manner. Recently, there have been attempts to improve signal-to-noise ratio (SNR) and temporal resolution by optimizing pulse sequence parameters such as repetition time (TR), echo time (TE), flip angle (FA), and bandwidth (BW). Although the usual technique is balanced steady-state free precession (bSSFP), its performance is limited due to off-resonance effects, specific absorption rate (SAR) constraints, and susceptibility artifacts, particularly at ≥ 3 T scanners. Due to the lack of breath-hold capacity or arrhythmias in some patients, faster acquisition and motion robustness can be addressed such as wideband bSSFP and real-time imaging through compressed sensing (CS) and artificial intelligence (AI). For patients with severe metal artifacts from cardiac implantable electronic devices (CIEDs), the spoiled gradient recalled-echo (SPGR) sequence is an effective alternative due to its lower sensitivity to susceptibility artifacts. Additionally, innovations in B0/B1 shimming, AI-driven reconstruction, and 7 T MRI promise exceptional image quality but require careful validation and safety management. This review summarizes advances in parameter optimization, artifact mitigation, and sequence selection across magnetic field strengths to enable faster, safer, and more personalized cine cardiac MRI.