Top

Published in:

Open Access 01-01-2020 | Magnetic Resonance Imaging | Cardiac

Early detection of heart function abnormality by native T1: a comparison of two T1 quantification methods

Authors: Pandji Triadyaksa, Dirkjan Kuijpers, Tugba Akinci D’Antonoli, Jelle Overbosch, Mieneke Rook, J. Martijn van Swieten, Matthijs Oudkerk, Paul E. Sijens

Published in: European Radiology | Issue 1/2020

Abstract

Objective

To compare the robustness of native T1 mapping using mean and median pixel-wise quantification methods.

Methods

Fifty-seven consecutive patients without overt signs of heart failure were examined in clinical routine for suspicion of cardiomyopathy. MRI included the acquisition of native T1 maps by a motion-corrected modified Look-Locker inversion recovery sequence at 1.5 T. Heart function status according to four established volumetric left ventricular (LV) cardio MRI parameter thresholds was used for retrospective separation into subgroups of normal (n = 26) or abnormal heart function (n = 31). Statistical normality of pixel-wise T1 was tested on each myocardial segment and mean and median segmental T1 values were assessed.

Results

Segments with normally distributed pixel-wise T1 (57/58%) showed no difference between mean and median quantification in either patient group, while differences were highly significant (p < 0.001) for the respective 43/42% non-normally distributed segments. Heart function differentiation between two patient groups was significant in 14 myocardial segments (p < 0.001–0.040) by median quantification compared with six (p < 0.001–0.042) by using the mean. The differences by median quantification were observed between the native T1 values of the three coronary artery territories of normal heart function patients (p = 0.023) and insignificantly in the abnormal patients (p = 0.053).

Conclusion

Median quantification increases the robustness of myocardial native T1 definition, regardless of statistical normality of the data. Compared with the currently prevailing method of mean quantification, differentiation between LV segments and coronary artery territories is better and allows for earlier detection of heart function impairment.

Key Points

• Median pixel-wise quantification of native T1 maps is robust and can be applied regardless of the statistical distribution of data points.

• Median quantification is more sensitive to early heart function abnormality compared with mean quantification.

• The new method yields significant native T1 value differentiation between the three coronary artery territories.

Available only for authorised users

Puntmann VO, Peker E, Chandrashekhar Y, Nagel E (2016) T1 mapping in characterizing myocardial disease. Circ Res 119:277–299. https://doi.org/10.1161/CIRCRESAHA.116.307974 CrossRefPubMed

Raman FS, Kawel-Boehm N, Gai N et al (2013) Modified look-locker inversion recovery T1 mapping indices: assessment of accuracy and reproducibility between magnetic resonance scanners. J Cardiovasc Magn Reson 15:64. https://doi.org/10.1186/1532-429X-15-64 CrossRefPubMedPubMedCentral

Roujol S, Weingärtner S, Foppa M et al (2014) Accuracy, precision, and reproducibility of four T1 mapping sequences: a head-to-head comparison of MOLLI, ShMOLLI, SASHA, and SAPPHIRE. Radiology 272:683–689. https://doi.org/10.1148/radiol.14140296 CrossRefPubMedPubMedCentral

Weingärtner S, Meßner NM, Budjan J et al (2016) Myocardial T1-mapping at 3T using saturation-recovery: reference values, precision and comparison with MOLLI. J Cardiovasc Magn Reson 18:84. https://doi.org/10.1186/s12968-016-0302-x CrossRefPubMedPubMedCentral

Teixeira T, Hafyane T, Stikov N, Akdeniz C, Greiser A, Friedrich MG (2016) Comparison of different cardiovascular magnetic resonance sequences for native myocardial T1 mapping at 3T. J Cardiovasc Magn Reson 18:65. https://doi.org/10.1186/s12968-016-0286-6

Kellman P, Hansen MS (2014) T1-mapping in the heart: accuracy and precision. J Cardiovasc Magn Reson 16:2. https://doi.org/10.1186/1532-429X-16-2 CrossRefPubMedPubMedCentral

Olivieri LJ, Kellman P, McCarter RJ, Cross RR, Hansen MS, Spurney CF (2016) Native T1 values identify myocardial changes and stratify disease severity in patients with Duchenne muscular dystrophy. J Cardiovasc Magn Reson 18:72. https://doi.org/10.1186/s12968-016-0292-8

Rogers T, Dabir D, Mahmoud I et al (2013) Standardization of T1 measurements with MOLLI in differentiation between health and disease - the ConSept study. J Cardiovasc Magn Reson 15:78. https://doi.org/10.1186/1532-429X-15-78 CrossRefPubMedPubMedCentral

Mordi I, Carrick D, Bezerra H, Tzemos N (2016) T1 and T2 mapping for early diagnosis of dilated non-ischaemic cardiomyopathy in middle-aged patients and differentiation from normal physiological adaptation. Eur Heart J Cardiovasc Imaging 17:797–803. https://doi.org/10.1093/ehjci/jev216 CrossRefPubMed

10.

Soslow JH, Damon SM, Crum K et al (2016) Increased myocardial native T1 and extracellular volume in patients with Duchenne muscular dystrophy. J Cardiovasc Magn Reson 18:5. https://doi.org/10.1186/s12968-016-0224-7 CrossRefPubMedPubMedCentral

11.

Dabir D, Child N, Kalra A et al (2014) Reference values for healthy human myocardium using a T1 mapping methodology: results from the international T1 multicenter cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 16:69. https://doi.org/10.1186/s12968-014-0069-x CrossRefPubMedPubMedCentral

12.

Pica S, Sado DM, Maestrini V et al (2014) Reproducibility of native myocardial T1 mapping in the assessment of Fabry disease and its role in early detection of cardiac involvement by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 16:99. https://doi.org/10.1186/s12968-014-0099-4 CrossRefPubMedPubMedCentral

13.

Goebel J, Seifert I, Nensa F et al (2016) Can native T1 mapping differentiate between healthy and diffuse diseased myocardium in clinical routine cardiac MR imaging? PLoS One 11:e0155591. https://doi.org/10.1371/journal.pone.0155591 CrossRefPubMedPubMedCentral

14.

Yu L, Sun J, Sun J et al (2018) Early detection of myocardial involvement by T ₁ mapping of cardiac MRI in idiopathic inflammatory myopathy. J Magn Reson Imaging 48:415–422. https://doi.org/10.1002/jmri.25945 CrossRefPubMed

15.

Treibel TA, Zemrak F, Sado DM et al (2015) Extracellular volume quantification in isolated hypertension - changes at the detectable limits? J Cardiovasc Magn Reson 17:74. https://doi.org/10.1186/s12968-015-0176-3 CrossRefPubMedPubMedCentral

16.

Piechnik SK, Ferreira VM, Dall’Armellina E et al (2010) Shortened modified Look-Locker inversion recovery (ShMOLLI) for clinical myocardial T1-mapping at 1.5 and 3 T within a 9 heartbeat breathhold. J Cardiovasc Magn Reson 12:69. https://doi.org/10.1186/1532-429X-12-69 CrossRefPubMedPubMedCentral

17.

Messroghli DR, Plein S, Higgins DM et al (2006) Human myocardium: single-breath-hold MR T1 mapping with high spatial resolution--reproducibility study. Radiology 238:1004–1012. https://doi.org/10.1148/radiol.2382041903 CrossRefPubMed

18.

Chin CW, Semple S, Malley T et al (2014) Optimization and comparison of myocardial T1 techniques at 3T in patients with aortic stenosis. Eur Heart J Cardiovasc Imaging 15:556–565. https://doi.org/10.1093/ehjci/jet245 CrossRefPubMed

19.

Reiter U, Reiter G, Dorr K, Greiser A, Maderthaner R, Fuchsjäger M (2014) Normal diastolic and systolic myocardial T1 values at 1.5-T MR imaging: correlations and blood normalization. Radiology 271:365–372. https://doi.org/10.1148/radiol.13131225

20.

Cameron D, Vassiliou VS, Higgins DM, Gatehouse PD (2018) Towards accurate and precise T 1 and extracellular volume mapping in the myocardium: a guide to current pitfalls and their solutions. MAGMA 31:143–163. https://doi.org/10.1007/s10334-017-0631-2 CrossRefPubMed

21.

Saiviroonporn P, Viprakasit V, Boonyasirinant T, Khuhapinant A, Wood JC, Krittayaphong R (2011) Comparison of the region-based and pixel-wise methods for cardiac T2* analysis in 50 transfusion-dependent Thai thalassemia patients. J Comput Assist Tomogr 35:375–381. https://doi.org/10.1097/RCT.0b013e31820eaaf2

22.

Ferguson MR, Otto RK, Bender MA, Kolokythas O, Friedman SD (2013) Liver and heart MR relaxometry in iron loading: reproducibility of three methods. J Magn Reson Imaging 38:987–990. https://doi.org/10.1002/jmri.23937

23.

Positano V, Meloni A, Santarelli MF et al (2015) Fast generation of T2* maps in the entire range of clinical interest: application to thalassemia major patients. Comput Biol Med 56:200–210. https://doi.org/10.1016/j.compbiomed.2014.10.020 CrossRefPubMed

24.

Roller FC, Kriechbaum S, Breithecker A et al (2019) Correlation of native T1 mapping with right ventricular function and pulmonary haemodynamics in patients with chronic thromboembolic pulmonary hypertension before and after balloon pulmonary angioplasty. Eur Radiol 29:1565–1573CrossRef

25.

Kawel-Boehm N, Maceira A, Valsangiacomo-Buechel ER et al (2015) Normal values for cardiovascular magnetic resonance in adults and children. J Cardiovasc Magn Reson 17:29. https://doi.org/10.1186/s12968-015-0111-7 CrossRefPubMedPubMedCentral

26.

Xue H, Shah S, Greiser A et al (2012) Motion correction for myocardial T1 mapping using image registration with synthetic image estimation. Magn Reson Med 67:1644–1655. https://doi.org/10.1002/mrm.23153 CrossRefPubMed

27.

Rinta-Kiikka I, Tuohinen S, Ryymin P et al (2014) Correlation of electrocardiogram and regional cardiac magnetic resonance imaging findings in ST-elevation myocardial infarction: a literature review. Ann Noninvasive Electrocardiol 19:509–523. https://doi.org/10.1111/anec.12210 CrossRefPubMed

28.

BenSaida A (2014) Shapiro-Wilk and Shapiro-Francia normality tests. In: MATLAB Cent. File Exch. Available via https://nl.mathworks.com/matlabcentral/fileexchange/13964-shapiro-wilk-and-shapiro-francia-normality-tests. Accessed 24 Mar 2017

29.

Leys C, Ley C, Klein O, Bernarda P, Licata L (2013) Detecting outliers: do not use standard deviation around the mean, use absolute deviation around the median. J Exp Soc Psychol 49:764–766. https://doi.org/10.1016/j.jesp.2013.03.013

30.

Rousseeuw PJ, Croux C (1993) Alternatives to the median absolute deviation. J Am Stat Assoc 88:1273–1283. https://doi.org/10.1080/01621459.1993.10476408 CrossRef

31.

Messroghli DR, Moon JC, Ferreira VM et al (2017) Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: a consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson 19:75. https://doi.org/10.1186/s12968-017-0389-8 CrossRefPubMedPubMedCentral

32.

Kellman P, Arai AE, Xue H (2013) T1 and extracellular volume mapping in the heart: estimation of error maps and the influence of noise on precision. J Cardiovasc Magn Reson 15:56. https://doi.org/10.1186/1532-429X-15-56 CrossRefPubMedPubMedCentral

33.

Liu A, Wijesurendra RS, Francis JM et al (2016) Adenosine stress and rest T1 mapping can differentiate between ischemic, infarcted, remote, and normal myocardium without the need for gadolinium contrast agents. JACC Cardiovasc Imaging 9:27–36. https://doi.org/10.1016/J.JCMG.2015.08.018 CrossRefPubMedPubMedCentral

34.

Arnold JR, Karamitsos TD, Bhamra-Ariza P et al (2012) Myocardial oxygenation in coronary artery disease: insights from blood oxygen level–dependent magnetic resonance imaging at 3 tesla. J Am Coll Cardiol 59:1954–1964. https://doi.org/10.1016/J.JACC.2012.01.055 CrossRefPubMed

35.

Ferreira VM (2018) T1 mapping of the remote myocardium. J Am Coll Cardiol 71:779–781. https://doi.org/10.1016/j.jacc.2017.12.021 CrossRefPubMed

36.

Camici PG, d’Amati G, Rimoldi O (2015) Coronary microvascular dysfunction: mechanisms and functional assessment. Nat Rev Cardiol 12:48–62. https://doi.org/10.1038/nrcardio.2014.160 CrossRefPubMed

37.

Fonarow GC, Hsu JJ (2016) Left ventricular ejection fraction: What Is “Normal”? JACC Heart Fail 4:511–513. https://doi.org/10.1016/J.JCHF.2016.03.021 CrossRefPubMed

38.

Petersen SE, Aung N, Sanghvi MM et al (2017) Reference ranges for cardiac structure and function using cardiovascular magnetic resonance (CMR) in Caucasians from the UK Biobank population cohort. J Cardiovasc Magn Reson 19:18. https://doi.org/10.1186/s12968-017-0327-9 CrossRefPubMedPubMedCentral

39.

Liu CY, Liu YC, Wu C et al (2013) Evaluation of age-related interstitial myocardial fibrosis with cardiac magnetic resonance contrast-enhanced T1 mapping: MESA (multi-ethnic study of atherosclerosis). J Am Coll Cardiol 62:1280–1287. https://doi.org/10.1016/j.jacc.2013.05.078 CrossRefPubMed

40.

Piechnik SK, Ferreira VM, Lewandowski AJ et al (2013) Normal variation of magnetic resonance T1 relaxation times in the human population at 1.5 T using ShMOLLI. J Cardiovasc Magn Reson 15:13. https://doi.org/10.1186/1532-429X-15-13 CrossRefPubMedPubMedCentral

41.

Nickander J, Lundin M, Abdula G et al (2017) Blood correction reduces variability and gender differences in native myocardial T1 values at 1.5 T cardiovascular magnetic resonance – a derivation/validation approach. J Cardiovasc Magn Reson 19:41. https://doi.org/10.1186/s12968-017-0353-7 CrossRefPubMedPubMedCentral

42.

Rauhalammi SMO, Mangion K, Barrientos PH et al (2016) Native myocardial longitudinal ( T₁ ) relaxation time: regional, age, and sex associations in the healthy adult heart. J Magn Reson Imaging 44:541–548. https://doi.org/10.1002/jmri.25217 CrossRefPubMedPubMedCentral

43.

Shao J, Liu D, Sung K, Nguyen KL, Hu P (2017) Accuracy, precision, and reproducibility of myocardial T1 mapping: a comparison of four T1 estimation algorithms for modified look-locker inversion recovery (MOLLI). Magn Reson Med 78:1746–1756. https://doi.org/10.1002/mrm.26565

44.

Crea F, Camici PG, Bairey Merz CN (2014) Coronary microvascular dysfunction: an update. Eur Heart J 35:1101–1111. https://doi.org/10.1093/eurheartj/eht513 CrossRefPubMed

45.

Dal Lin C, Tona F, Osto E (2015) Coronary microvascular function and beyond: the crosstalk between hormones, cytokines, and neurotransmitters. Int J Endocrinol 2015:1–17. https://doi.org/10.1155/2015/312848 CrossRef

Title: Early detection of heart function abnormality by native T1: a comparison of two T1 quantification methods
Authors: Pandji Triadyaksa
Dirkjan Kuijpers
Tugba Akinci D’Antonoli
Jelle Overbosch
Mieneke Rook
J. Martijn van Swieten
Matthijs Oudkerk
Paul E. Sijens
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Cardiomyopathy
Published in: European Radiology / Issue 1/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06364-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early detection of heart function abnormality by native T1: a comparison of two T1 quantification methods

Abstract

Objective

Methods

Results

Conclusion

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Key Points

Please log in to get access to this content

Other articles of this Issue 1/2020

The clinical value of F-18 FDG PET/CT in differentiating malignant from benign lesions in pneumoconiosis patients

No evidence of improved efficacy of covered stents over uncovered stents in percutaneous palliation of malignant hilar biliary obstruction: results of a prospective randomized trial

MRI-based radiomics nomogram may predict the response to induction chemotherapy and survival in locally advanced nasopharyngeal carcinoma

Dual-layer spectral CT improves image quality of multiphasic pancreas CT in patients with pancreatic ductal adenocarcinoma

Breast MRI in the era of diffusion weighted imaging: do we still need signal-intensity time curves?

Quality of science and reporting of radiomics in oncologic studies: room for improvement according to radiomics quality score and TRIPOD statement