T1 mapping of the gadolinium-enhanced myocardium: adjustment for factors affecting interpatient comparison - PubMed (original) (raw)

. 2011 May;65(5):1407-15.

doi: 10.1002/mrm.22716. Epub 2010 Dec 16.

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T1 mapping of the gadolinium-enhanced myocardium: adjustment for factors affecting interpatient comparison

Neville Gai et al. Magn Reson Med. 2011 May.

Abstract

Quantitative T(1) mapping of delayed gadolinium-enhanced cardiac magnetic resonance imaging has shown promise in identifying diffuse myocardial fibrosis. Despite careful control of magnetic resonance imaging parameters, comparison of T(1) times between different patients may be problematic because of patient specific factors such as gadolinium dose, differing glomerular filtration rates, and patient specific delay times. In this work, a model driven approach to account for variations between patients to allow for comparison of T(1) data is provided. Kinetic model parameter values were derived from healthy volunteer time-contrast curves. Correction values for the factors described above were used to normalize T(1) values to a matched state. Examples of pre- and postcorrected values for a pool of normal subjects and in a patient cohort of type 1 diabetic patients shows tighter clustering and improved discrimination of disease state.

Trial registration: ClinicalTrials.gov NCT00360815 NCT00360893.

Copyright © 2010 Wiley-Liss, Inc.

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Figures

FIG. 1

FIG. 1

Example of multiphase images obtained from a volunteer. a: Source images obtained using an inversion recovery True FISP Look Locker sequence in the four chamber view with FOV = 380 × 297 mm, matrix size = 192 × 75, slice thickness = 8 mm, TR/TE = 2.5/1.1 msec, phase interval = 23 msec, flip angle = 50°. b: Myocardial wall contouring. c: _T_1 fitting over the entire myocardium.

FIG. 2

FIG. 2

Precontrast _T_1 values of the myocardium showed a strong negative linear correlation to heart rate (Pearson r = −0.89).

FIG. 3

FIG. 3

Correction curves for changing dose (dose = 0.1 to 0.28 mmol/kg) and for different delay times after the injection of gadolinium. The correction factor on the _y_-axis is in reference to a gadolinium dose of 0.15 mmol/kg.

FIG. 4

FIG. 4

Correction curves for varying time and as a function of different doses of gadolinium. The correction factor on the _y_-axis is in reference to a standardized delay time of 15 min after gadolinium injection.

FIG. 5

FIG. 5

Correction for varying GFR at different time values. The correction factor on the _y_-axis is in reference to _m_2 = 0.0064 min−1 (corresponding to GFR = 90 mL/min/1.73 m2 for weight = 70 kg and height =175 cm).

FIG. 6

FIG. 6

Correction for hematocrit fraction variation for different time values. The correction factor on the _y_-axis is in reference to a hematocrit level of 0.40.

FIG. 7

FIG. 7

_T_1 values for low- and high-cardiovascular risk diabetic patients before and after normalization. (*p < 0.05 for difference after normalization). Before normalization, gadolinium dose ranged from 0.1 mmol/kg to 0.22 mmol/kg, delay time from 8 to 16 min, and GFR from 64.8 to 114.1 mL/min/1.73 m2. Data were normalized to a dose of 0.15 mmol/kg, delay time of 15 min, and _m_2 = 0.0064 min−1 (GFR = 90 mL/min/1.73 m2 for weight = 70 kg and height = 175 cm).

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