T1 mapping in cardiomyopathy at cardiac MR

Comparison with endomyocardial biopsy

Christopher Sibley, Radwa A. Noureldin, Neville Gai, Marcelo Souto Nacif, Songtao Liu, Evrim B. Turkbey, James Mudd, Rob J. Van Der Geest, João A C Lima, Marc K. Halushka, David A. Bluemke

    Research output: Contribution to journalArticle

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    Abstract

    Purpose: To determine the utility of cardiac magnetic resonance (MR) T1 mapping for quantification of diffuse myocardial fibrosis compared with the standard of endomyocardial biopsy. Materials and Methods: This HIPAA-compliant study was approved by the institutional review board. Cardiomyopathy patients were retrospectively identified who had undergone endomyocardial biopsy and cardiac MR at one institution during a 5-year period. Forty-seven patients (53% male; mean age, 46.8 years) had undergone diagnostic cardiac MR and endomyocardial biopsy. Thirteen healthy volunteers (54% male; mean age, 38.1 years) underwent cardiac MR as a reference. Myocardial T1 mapping was performed 10.7 minutes ± 2.7 (standard deviation) after bolus injection of 0.2 mmol/kg gadolinium chelate by using an inversion-recovery Look-Locker sequence on a 1.5-T MR imager. Late gadolinium enhancement was assessed by using gradientecho inversion-recovery sequences. Cardiac MR results were the consensus of two radiologists who were blinded to histopathologic findings. Endomyocardial biopsy fibrosis was quantitatively measured by using automated image analysis software with digital images of specimens stained with Masson trichrome. Histopathologic findings were reported by two pathologists blinded to cardiac MR findings. Statistical analyses included Mann-Whitney U test, analysis of variance, and linear regression. Results: Median myocardial fibrosis was 8.5% (interquartile range, 5.7-14.4). T1 times were greater in control subjects than in patients without and in patients with evident late gadolinium enhancement (466 msec ± 14, 406 msec ± 59, and 303 msec ± 53, respectively; P <.001). T1 time and histologic fibrosis were inversely correlated (r = -0.57; 95% confidence interval: -0.74, -0.34; P <.0001). The area under the curve for myocardial T1 time to detect fibrosis of greater than 5% was 0.84 at a cutoff of 383 msec. Conclusion: Cardiac MR with T1 mapping can provide noninvasive evidence of diffuse myocardial fibrosis in patients referred for evaluation of cardiomyopathy.

    Original languageEnglish (US)
    Pages (from-to)724-732
    Number of pages9
    JournalRadiology
    Volume265
    Issue number3
    DOIs
    StatePublished - 2012

    Fingerprint

    Cardiomyopathies
    Magnetic Resonance Spectroscopy
    Biopsy
    Fibrosis
    Gadolinium
    Endomyocardial Fibrosis
    Sequence Inversion
    Health Insurance Portability and Accountability Act
    Research Ethics Committees
    Nonparametric Statistics
    Area Under Curve
    Linear Models
    Analysis of Variance
    Healthy Volunteers
    Software
    Confidence Intervals
    Injections

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging

    Cite this

    Sibley, C., Noureldin, R. A., Gai, N., Nacif, M. S., Liu, S., Turkbey, E. B., ... Bluemke, D. A. (2012). T1 mapping in cardiomyopathy at cardiac MR: Comparison with endomyocardial biopsy. Radiology, 265(3), 724-732. https://doi.org/10.1148/radiol.12112721

    T1 mapping in cardiomyopathy at cardiac MR : Comparison with endomyocardial biopsy. / Sibley, Christopher; Noureldin, Radwa A.; Gai, Neville; Nacif, Marcelo Souto; Liu, Songtao; Turkbey, Evrim B.; Mudd, James; Van Der Geest, Rob J.; Lima, João A C; Halushka, Marc K.; Bluemke, David A.

    In: Radiology, Vol. 265, No. 3, 2012, p. 724-732.

    Research output: Contribution to journalArticle

    Sibley, C, Noureldin, RA, Gai, N, Nacif, MS, Liu, S, Turkbey, EB, Mudd, J, Van Der Geest, RJ, Lima, JAC, Halushka, MK & Bluemke, DA 2012, 'T1 mapping in cardiomyopathy at cardiac MR: Comparison with endomyocardial biopsy', Radiology, vol. 265, no. 3, pp. 724-732. https://doi.org/10.1148/radiol.12112721
    Sibley C, Noureldin RA, Gai N, Nacif MS, Liu S, Turkbey EB et al. T1 mapping in cardiomyopathy at cardiac MR: Comparison with endomyocardial biopsy. Radiology. 2012;265(3):724-732. https://doi.org/10.1148/radiol.12112721
    Sibley, Christopher ; Noureldin, Radwa A. ; Gai, Neville ; Nacif, Marcelo Souto ; Liu, Songtao ; Turkbey, Evrim B. ; Mudd, James ; Van Der Geest, Rob J. ; Lima, João A C ; Halushka, Marc K. ; Bluemke, David A. / T1 mapping in cardiomyopathy at cardiac MR : Comparison with endomyocardial biopsy. In: Radiology. 2012 ; Vol. 265, No. 3. pp. 724-732.
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    abstract = "Purpose: To determine the utility of cardiac magnetic resonance (MR) T1 mapping for quantification of diffuse myocardial fibrosis compared with the standard of endomyocardial biopsy. Materials and Methods: This HIPAA-compliant study was approved by the institutional review board. Cardiomyopathy patients were retrospectively identified who had undergone endomyocardial biopsy and cardiac MR at one institution during a 5-year period. Forty-seven patients (53{\%} male; mean age, 46.8 years) had undergone diagnostic cardiac MR and endomyocardial biopsy. Thirteen healthy volunteers (54{\%} male; mean age, 38.1 years) underwent cardiac MR as a reference. Myocardial T1 mapping was performed 10.7 minutes ± 2.7 (standard deviation) after bolus injection of 0.2 mmol/kg gadolinium chelate by using an inversion-recovery Look-Locker sequence on a 1.5-T MR imager. Late gadolinium enhancement was assessed by using gradientecho inversion-recovery sequences. Cardiac MR results were the consensus of two radiologists who were blinded to histopathologic findings. Endomyocardial biopsy fibrosis was quantitatively measured by using automated image analysis software with digital images of specimens stained with Masson trichrome. Histopathologic findings were reported by two pathologists blinded to cardiac MR findings. Statistical analyses included Mann-Whitney U test, analysis of variance, and linear regression. Results: Median myocardial fibrosis was 8.5{\%} (interquartile range, 5.7-14.4). T1 times were greater in control subjects than in patients without and in patients with evident late gadolinium enhancement (466 msec ± 14, 406 msec ± 59, and 303 msec ± 53, respectively; P <.001). T1 time and histologic fibrosis were inversely correlated (r = -0.57; 95{\%} confidence interval: -0.74, -0.34; P <.0001). The area under the curve for myocardial T1 time to detect fibrosis of greater than 5{\%} was 0.84 at a cutoff of 383 msec. Conclusion: Cardiac MR with T1 mapping can provide noninvasive evidence of diffuse myocardial fibrosis in patients referred for evaluation of cardiomyopathy.",
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    T1 - T1 mapping in cardiomyopathy at cardiac MR

    T2 - Comparison with endomyocardial biopsy

    AU - Sibley, Christopher

    AU - Noureldin, Radwa A.

    AU - Gai, Neville

    AU - Nacif, Marcelo Souto

    AU - Liu, Songtao

    AU - Turkbey, Evrim B.

    AU - Mudd, James

    AU - Van Der Geest, Rob J.

    AU - Lima, João A C

    AU - Halushka, Marc K.

    AU - Bluemke, David A.

    PY - 2012

    Y1 - 2012

    N2 - Purpose: To determine the utility of cardiac magnetic resonance (MR) T1 mapping for quantification of diffuse myocardial fibrosis compared with the standard of endomyocardial biopsy. Materials and Methods: This HIPAA-compliant study was approved by the institutional review board. Cardiomyopathy patients were retrospectively identified who had undergone endomyocardial biopsy and cardiac MR at one institution during a 5-year period. Forty-seven patients (53% male; mean age, 46.8 years) had undergone diagnostic cardiac MR and endomyocardial biopsy. Thirteen healthy volunteers (54% male; mean age, 38.1 years) underwent cardiac MR as a reference. Myocardial T1 mapping was performed 10.7 minutes ± 2.7 (standard deviation) after bolus injection of 0.2 mmol/kg gadolinium chelate by using an inversion-recovery Look-Locker sequence on a 1.5-T MR imager. Late gadolinium enhancement was assessed by using gradientecho inversion-recovery sequences. Cardiac MR results were the consensus of two radiologists who were blinded to histopathologic findings. Endomyocardial biopsy fibrosis was quantitatively measured by using automated image analysis software with digital images of specimens stained with Masson trichrome. Histopathologic findings were reported by two pathologists blinded to cardiac MR findings. Statistical analyses included Mann-Whitney U test, analysis of variance, and linear regression. Results: Median myocardial fibrosis was 8.5% (interquartile range, 5.7-14.4). T1 times were greater in control subjects than in patients without and in patients with evident late gadolinium enhancement (466 msec ± 14, 406 msec ± 59, and 303 msec ± 53, respectively; P <.001). T1 time and histologic fibrosis were inversely correlated (r = -0.57; 95% confidence interval: -0.74, -0.34; P <.0001). The area under the curve for myocardial T1 time to detect fibrosis of greater than 5% was 0.84 at a cutoff of 383 msec. Conclusion: Cardiac MR with T1 mapping can provide noninvasive evidence of diffuse myocardial fibrosis in patients referred for evaluation of cardiomyopathy.

    AB - Purpose: To determine the utility of cardiac magnetic resonance (MR) T1 mapping for quantification of diffuse myocardial fibrosis compared with the standard of endomyocardial biopsy. Materials and Methods: This HIPAA-compliant study was approved by the institutional review board. Cardiomyopathy patients were retrospectively identified who had undergone endomyocardial biopsy and cardiac MR at one institution during a 5-year period. Forty-seven patients (53% male; mean age, 46.8 years) had undergone diagnostic cardiac MR and endomyocardial biopsy. Thirteen healthy volunteers (54% male; mean age, 38.1 years) underwent cardiac MR as a reference. Myocardial T1 mapping was performed 10.7 minutes ± 2.7 (standard deviation) after bolus injection of 0.2 mmol/kg gadolinium chelate by using an inversion-recovery Look-Locker sequence on a 1.5-T MR imager. Late gadolinium enhancement was assessed by using gradientecho inversion-recovery sequences. Cardiac MR results were the consensus of two radiologists who were blinded to histopathologic findings. Endomyocardial biopsy fibrosis was quantitatively measured by using automated image analysis software with digital images of specimens stained with Masson trichrome. Histopathologic findings were reported by two pathologists blinded to cardiac MR findings. Statistical analyses included Mann-Whitney U test, analysis of variance, and linear regression. Results: Median myocardial fibrosis was 8.5% (interquartile range, 5.7-14.4). T1 times were greater in control subjects than in patients without and in patients with evident late gadolinium enhancement (466 msec ± 14, 406 msec ± 59, and 303 msec ± 53, respectively; P <.001). T1 time and histologic fibrosis were inversely correlated (r = -0.57; 95% confidence interval: -0.74, -0.34; P <.0001). The area under the curve for myocardial T1 time to detect fibrosis of greater than 5% was 0.84 at a cutoff of 383 msec. Conclusion: Cardiac MR with T1 mapping can provide noninvasive evidence of diffuse myocardial fibrosis in patients referred for evaluation of cardiomyopathy.

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