Native T1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions

Avinash Kali, Eui Young Choi, Behzad Sharif, Young Jin Kim, Xiaoming Bi, Bruce Spottiswoode, Ivan Cokic, Hsin Jung Yang, Mourad Tighiouart, Antonio Hernandez Conte, Debiao Li, Daniel S. Berman, Byoung Wook Choi, Hyuk Jae Chang, Rohan Dharmakumar

Research output: Contribution to journalArticle

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Abstract

Objectives The purpose of this study was to investigate whether native T1 maps at 3-T can reliably characterize chronic myocardial infarctions (MIs) in patients with prior ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI). Background Late gadolinium enhancement (LGE) cardiac magnetic resonance is the gold standard for characterizing chronic MIs, but it is contraindicated in patients with end-stage chronic kidney disease. Methods Native T1 and LGE images were acquired at 3-T in patients with prior STEMI (n = 13) and NSTEMI (n = 12) at a median of 13.6 years post-MI. Infarct location, size, and transmurality were measured using mean ± 5 SDs thresholding criterion from LGE images and T1 maps and compared against one another. Independent reviewers assessed visual conspicuity of MIs on LGE images and T1 maps. Results Native T1 maps and LGE images were not different for measuring infarct size (STEMI: p = 0.46; NSTEMI: p = 0.27) and transmurality (STEMI: p = 0.13; NSTEMI: p = 0.21) using thresholding criterion. Using thresholding criterion, good agreement was observed between LGE images and T1 maps for measuring infarct size (STEMI: bias = 0.6 ± 3.1%; R2 = 0.93; NSTEMI: bias = -0.4 ± 4.4%; R2 = 0.85) and transmurality (STEMI: bias = 2.0 ± 4.2%; R2 = 0.89; NSTEMI: bias = -2.7 ± 7.9%; R2 = 0.68). Sensitivity and specificity of T1 maps for detecting chronic MIs based on thresholding criterion were 89% and 98%, respectively (STEMI), and 87% and 95%, respectively (NSTEMI). Relative to LGE images, the mean visual conspicuity score for detecting chronic MIs was significantly lower for T1 maps (p < 0.001 for both cases). Median infarct-to-remote myocardium contrast-to-noise ratio was 2.5-fold higher for LGE images relative to T1 maps (p < 0.001). Sensitivity and specificity of T1 maps for visual detection were 60% and 86%, respectively (STEMI), and 64% and 91% (NSTEMI), respectively. Conclusions Chronic MIs in STEMI and NSTEMI patients can be reliably characterized using threshold-based detection on native T1 maps at 3-T. Visual detection of chronic MIs on native T1 maps in both patient populations has high specificity, but modest sensitivity.

Original languageEnglish
Pages (from-to)1019-1030
Number of pages12
JournalJACC: Cardiovascular Imaging
Volume8
Issue number9
DOIs
Publication statusPublished - 2015 Sep 1

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Myocardial Infarction
Image Enhancement
Gadolinium
3-monoiodothyronine
Sensitivity and Specificity
Non-ST Elevated Myocardial Infarction
Chronic Renal Insufficiency
Chronic Kidney Failure
Noise
Myocardium
Magnetic Resonance Spectroscopy

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Kali, Avinash ; Choi, Eui Young ; Sharif, Behzad ; Kim, Young Jin ; Bi, Xiaoming ; Spottiswoode, Bruce ; Cokic, Ivan ; Yang, Hsin Jung ; Tighiouart, Mourad ; Conte, Antonio Hernandez ; Li, Debiao ; Berman, Daniel S. ; Choi, Byoung Wook ; Chang, Hyuk Jae ; Dharmakumar, Rohan. / Native T1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions. In: JACC: Cardiovascular Imaging. 2015 ; Vol. 8, No. 9. pp. 1019-1030.
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title = "Native T1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions",
abstract = "Objectives The purpose of this study was to investigate whether native T1 maps at 3-T can reliably characterize chronic myocardial infarctions (MIs) in patients with prior ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI). Background Late gadolinium enhancement (LGE) cardiac magnetic resonance is the gold standard for characterizing chronic MIs, but it is contraindicated in patients with end-stage chronic kidney disease. Methods Native T1 and LGE images were acquired at 3-T in patients with prior STEMI (n = 13) and NSTEMI (n = 12) at a median of 13.6 years post-MI. Infarct location, size, and transmurality were measured using mean ± 5 SDs thresholding criterion from LGE images and T1 maps and compared against one another. Independent reviewers assessed visual conspicuity of MIs on LGE images and T1 maps. Results Native T1 maps and LGE images were not different for measuring infarct size (STEMI: p = 0.46; NSTEMI: p = 0.27) and transmurality (STEMI: p = 0.13; NSTEMI: p = 0.21) using thresholding criterion. Using thresholding criterion, good agreement was observed between LGE images and T1 maps for measuring infarct size (STEMI: bias = 0.6 ± 3.1{\%}; R2 = 0.93; NSTEMI: bias = -0.4 ± 4.4{\%}; R2 = 0.85) and transmurality (STEMI: bias = 2.0 ± 4.2{\%}; R2 = 0.89; NSTEMI: bias = -2.7 ± 7.9{\%}; R2 = 0.68). Sensitivity and specificity of T1 maps for detecting chronic MIs based on thresholding criterion were 89{\%} and 98{\%}, respectively (STEMI), and 87{\%} and 95{\%}, respectively (NSTEMI). Relative to LGE images, the mean visual conspicuity score for detecting chronic MIs was significantly lower for T1 maps (p < 0.001 for both cases). Median infarct-to-remote myocardium contrast-to-noise ratio was 2.5-fold higher for LGE images relative to T1 maps (p < 0.001). Sensitivity and specificity of T1 maps for visual detection were 60{\%} and 86{\%}, respectively (STEMI), and 64{\%} and 91{\%} (NSTEMI), respectively. Conclusions Chronic MIs in STEMI and NSTEMI patients can be reliably characterized using threshold-based detection on native T1 maps at 3-T. Visual detection of chronic MIs on native T1 maps in both patient populations has high specificity, but modest sensitivity.",
author = "Avinash Kali and Choi, {Eui Young} and Behzad Sharif and Kim, {Young Jin} and Xiaoming Bi and Bruce Spottiswoode and Ivan Cokic and Yang, {Hsin Jung} and Mourad Tighiouart and Conte, {Antonio Hernandez} and Debiao Li and Berman, {Daniel S.} and Choi, {Byoung Wook} and Chang, {Hyuk Jae} and Rohan Dharmakumar",
year = "2015",
month = "9",
day = "1",
doi = "10.1016/j.jcmg.2015.04.018",
language = "English",
volume = "8",
pages = "1019--1030",
journal = "JACC: Cardiovascular Imaging",
issn = "1936-878X",
publisher = "Elsevier Inc.",
number = "9",

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Kali, A, Choi, EY, Sharif, B, Kim, YJ, Bi, X, Spottiswoode, B, Cokic, I, Yang, HJ, Tighiouart, M, Conte, AH, Li, D, Berman, DS, Choi, BW, Chang, HJ & Dharmakumar, R 2015, 'Native T1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions', JACC: Cardiovascular Imaging, vol. 8, no. 9, pp. 1019-1030. https://doi.org/10.1016/j.jcmg.2015.04.018

Native T1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions. / Kali, Avinash; Choi, Eui Young; Sharif, Behzad; Kim, Young Jin; Bi, Xiaoming; Spottiswoode, Bruce; Cokic, Ivan; Yang, Hsin Jung; Tighiouart, Mourad; Conte, Antonio Hernandez; Li, Debiao; Berman, Daniel S.; Choi, Byoung Wook; Chang, Hyuk Jae; Dharmakumar, Rohan.

In: JACC: Cardiovascular Imaging, Vol. 8, No. 9, 01.09.2015, p. 1019-1030.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Native T1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions

AU - Kali, Avinash

AU - Choi, Eui Young

AU - Sharif, Behzad

AU - Kim, Young Jin

AU - Bi, Xiaoming

AU - Spottiswoode, Bruce

AU - Cokic, Ivan

AU - Yang, Hsin Jung

AU - Tighiouart, Mourad

AU - Conte, Antonio Hernandez

AU - Li, Debiao

AU - Berman, Daniel S.

AU - Choi, Byoung Wook

AU - Chang, Hyuk Jae

AU - Dharmakumar, Rohan

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Objectives The purpose of this study was to investigate whether native T1 maps at 3-T can reliably characterize chronic myocardial infarctions (MIs) in patients with prior ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI). Background Late gadolinium enhancement (LGE) cardiac magnetic resonance is the gold standard for characterizing chronic MIs, but it is contraindicated in patients with end-stage chronic kidney disease. Methods Native T1 and LGE images were acquired at 3-T in patients with prior STEMI (n = 13) and NSTEMI (n = 12) at a median of 13.6 years post-MI. Infarct location, size, and transmurality were measured using mean ± 5 SDs thresholding criterion from LGE images and T1 maps and compared against one another. Independent reviewers assessed visual conspicuity of MIs on LGE images and T1 maps. Results Native T1 maps and LGE images were not different for measuring infarct size (STEMI: p = 0.46; NSTEMI: p = 0.27) and transmurality (STEMI: p = 0.13; NSTEMI: p = 0.21) using thresholding criterion. Using thresholding criterion, good agreement was observed between LGE images and T1 maps for measuring infarct size (STEMI: bias = 0.6 ± 3.1%; R2 = 0.93; NSTEMI: bias = -0.4 ± 4.4%; R2 = 0.85) and transmurality (STEMI: bias = 2.0 ± 4.2%; R2 = 0.89; NSTEMI: bias = -2.7 ± 7.9%; R2 = 0.68). Sensitivity and specificity of T1 maps for detecting chronic MIs based on thresholding criterion were 89% and 98%, respectively (STEMI), and 87% and 95%, respectively (NSTEMI). Relative to LGE images, the mean visual conspicuity score for detecting chronic MIs was significantly lower for T1 maps (p < 0.001 for both cases). Median infarct-to-remote myocardium contrast-to-noise ratio was 2.5-fold higher for LGE images relative to T1 maps (p < 0.001). Sensitivity and specificity of T1 maps for visual detection were 60% and 86%, respectively (STEMI), and 64% and 91% (NSTEMI), respectively. Conclusions Chronic MIs in STEMI and NSTEMI patients can be reliably characterized using threshold-based detection on native T1 maps at 3-T. Visual detection of chronic MIs on native T1 maps in both patient populations has high specificity, but modest sensitivity.

AB - Objectives The purpose of this study was to investigate whether native T1 maps at 3-T can reliably characterize chronic myocardial infarctions (MIs) in patients with prior ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI). Background Late gadolinium enhancement (LGE) cardiac magnetic resonance is the gold standard for characterizing chronic MIs, but it is contraindicated in patients with end-stage chronic kidney disease. Methods Native T1 and LGE images were acquired at 3-T in patients with prior STEMI (n = 13) and NSTEMI (n = 12) at a median of 13.6 years post-MI. Infarct location, size, and transmurality were measured using mean ± 5 SDs thresholding criterion from LGE images and T1 maps and compared against one another. Independent reviewers assessed visual conspicuity of MIs on LGE images and T1 maps. Results Native T1 maps and LGE images were not different for measuring infarct size (STEMI: p = 0.46; NSTEMI: p = 0.27) and transmurality (STEMI: p = 0.13; NSTEMI: p = 0.21) using thresholding criterion. Using thresholding criterion, good agreement was observed between LGE images and T1 maps for measuring infarct size (STEMI: bias = 0.6 ± 3.1%; R2 = 0.93; NSTEMI: bias = -0.4 ± 4.4%; R2 = 0.85) and transmurality (STEMI: bias = 2.0 ± 4.2%; R2 = 0.89; NSTEMI: bias = -2.7 ± 7.9%; R2 = 0.68). Sensitivity and specificity of T1 maps for detecting chronic MIs based on thresholding criterion were 89% and 98%, respectively (STEMI), and 87% and 95%, respectively (NSTEMI). Relative to LGE images, the mean visual conspicuity score for detecting chronic MIs was significantly lower for T1 maps (p < 0.001 for both cases). Median infarct-to-remote myocardium contrast-to-noise ratio was 2.5-fold higher for LGE images relative to T1 maps (p < 0.001). Sensitivity and specificity of T1 maps for visual detection were 60% and 86%, respectively (STEMI), and 64% and 91% (NSTEMI), respectively. Conclusions Chronic MIs in STEMI and NSTEMI patients can be reliably characterized using threshold-based detection on native T1 maps at 3-T. Visual detection of chronic MIs on native T1 maps in both patient populations has high specificity, but modest sensitivity.

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