T1 mapping for myocardial extracellular volume measurement by CMR: Bolus only versus primed infusion technique
Objectives: The aim of this study was to determine the accuracy of the contrast "bolus only" T1 mapping cardiac magnetic resonance (CMR) technique for measuring myocardial extracellular volume fraction (ECV). Background: Myocardial ECV can be measured with T1 mapping before and after contr...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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2013
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| _version_ | 1797090762956996608 |
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| author | White, S Sado, D Fontana, M Banypersad, S Maestrini, V Flett, A Piechnik, S Robson, M Hausenloy, D Sheikh, A Hawkins, P Moon, J |
| author_facet | White, S Sado, D Fontana, M Banypersad, S Maestrini, V Flett, A Piechnik, S Robson, M Hausenloy, D Sheikh, A Hawkins, P Moon, J |
| author_sort | White, S |
| collection | OXFORD |
| description | Objectives: The aim of this study was to determine the accuracy of the contrast "bolus only" T1 mapping cardiac magnetic resonance (CMR) technique for measuring myocardial extracellular volume fraction (ECV). Background: Myocardial ECV can be measured with T1 mapping before and after contrast agent if the contrast agent distribution between blood/myocardium is at equilibrium. Equilibrium distribution can be achieved with a primed contrast infusion (equilibrium contrast-CMR [EQ-CMR]) or might be approximated by the dynamic equilibration achieved by delayed post-bolus measurement. This bolus only approach is highly attractive, but currently limited data support its use. We compared the bolus only technique with 2 independent standards: collagen volume fraction (CVF) from myocardial biopsy in aortic stenosis (AS); and the infusion technique in 5 representative conditions. Methods: One hundred forty-seven subjects were studied: healthy volunteers (n = 50); hypertrophic cardiomyopathy (n = 25); severe AS (n = 22); amyloid (n = 20); and chronic myocardial infarction (n = 30). Bolus only (at 15 min) and infusion ECV measurements were performed and compared. In 18 subjects with severe AS the results were compared with histological CVF. Results: The ECV by both techniques correlated with histological CVF (n = 18, r2 = 0.69, p < 0.01 vs. r2 = 0.71, p < 0.01, p = 0.42 for comparison). Across health and disease, there was strong correlation between the techniques (r2 = 0.97). However, in diseases of high ECV (amyloid, hypertrophic cardiomyopathy late gadolinium enhancement, and infarction), Bland-Altman analysis indicates the bolus only technique has a consistent and increasing offset, giving a higher value for ECVs above 0.4 (mean difference ± limit of agreement for ECV <0.4 = -0.004 ± 0.037 vs. ECV >0.4 = 0.040 ± 0.075, p < 0.001). Conclusions: Bolus only, T1 mapping-derived ECV measurement is sufficient for ECV measurement across a range of cardiac diseases, and this approach is histologically validated in AS. However, when ECV is >0.4, the bolus only technique consistently measures ECV higher compared with infusion. © 2013 American College of Cardiology Foundation. © 2013 By Theamerican College of Cardiology Foundation. |
| first_indexed | 2024-03-07T03:23:22Z |
| format | Journal article |
| id | oxford-uuid:b8336c11-9a68-400e-8289-3d3612dc1b86 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:23:22Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:b8336c11-9a68-400e-8289-3d3612dc1b862022-03-27T04:54:13ZT1 mapping for myocardial extracellular volume measurement by CMR: Bolus only versus primed infusion techniqueJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b8336c11-9a68-400e-8289-3d3612dc1b86EnglishSymplectic Elements at Oxford2013White, SSado, DFontana, MBanypersad, SMaestrini, VFlett, APiechnik, SRobson, MHausenloy, DSheikh, AHawkins, PMoon, JObjectives: The aim of this study was to determine the accuracy of the contrast "bolus only" T1 mapping cardiac magnetic resonance (CMR) technique for measuring myocardial extracellular volume fraction (ECV). Background: Myocardial ECV can be measured with T1 mapping before and after contrast agent if the contrast agent distribution between blood/myocardium is at equilibrium. Equilibrium distribution can be achieved with a primed contrast infusion (equilibrium contrast-CMR [EQ-CMR]) or might be approximated by the dynamic equilibration achieved by delayed post-bolus measurement. This bolus only approach is highly attractive, but currently limited data support its use. We compared the bolus only technique with 2 independent standards: collagen volume fraction (CVF) from myocardial biopsy in aortic stenosis (AS); and the infusion technique in 5 representative conditions. Methods: One hundred forty-seven subjects were studied: healthy volunteers (n = 50); hypertrophic cardiomyopathy (n = 25); severe AS (n = 22); amyloid (n = 20); and chronic myocardial infarction (n = 30). Bolus only (at 15 min) and infusion ECV measurements were performed and compared. In 18 subjects with severe AS the results were compared with histological CVF. Results: The ECV by both techniques correlated with histological CVF (n = 18, r2 = 0.69, p < 0.01 vs. r2 = 0.71, p < 0.01, p = 0.42 for comparison). Across health and disease, there was strong correlation between the techniques (r2 = 0.97). However, in diseases of high ECV (amyloid, hypertrophic cardiomyopathy late gadolinium enhancement, and infarction), Bland-Altman analysis indicates the bolus only technique has a consistent and increasing offset, giving a higher value for ECVs above 0.4 (mean difference ± limit of agreement for ECV <0.4 = -0.004 ± 0.037 vs. ECV >0.4 = 0.040 ± 0.075, p < 0.001). Conclusions: Bolus only, T1 mapping-derived ECV measurement is sufficient for ECV measurement across a range of cardiac diseases, and this approach is histologically validated in AS. However, when ECV is >0.4, the bolus only technique consistently measures ECV higher compared with infusion. © 2013 American College of Cardiology Foundation. © 2013 By Theamerican College of Cardiology Foundation. |
| spellingShingle | White, S Sado, D Fontana, M Banypersad, S Maestrini, V Flett, A Piechnik, S Robson, M Hausenloy, D Sheikh, A Hawkins, P Moon, J T1 mapping for myocardial extracellular volume measurement by CMR: Bolus only versus primed infusion technique |
| title | T1 mapping for myocardial extracellular volume measurement by CMR: Bolus only versus primed infusion technique |
| title_full | T1 mapping for myocardial extracellular volume measurement by CMR: Bolus only versus primed infusion technique |
| title_fullStr | T1 mapping for myocardial extracellular volume measurement by CMR: Bolus only versus primed infusion technique |
| title_full_unstemmed | T1 mapping for myocardial extracellular volume measurement by CMR: Bolus only versus primed infusion technique |
| title_short | T1 mapping for myocardial extracellular volume measurement by CMR: Bolus only versus primed infusion technique |
| title_sort | t1 mapping for myocardial extracellular volume measurement by cmr bolus only versus primed infusion technique |
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