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Tong MS, Slivnick JA, Sharif B, Kim HW, Young AA, Sierra-Galan LM, Mukai K, Farzaneh-Far A, Al-Kindi S, Chan AT, Dibu G, Elliott MD, Ferreira VM, Grizzard J, Kelle S, Lee S, Malahfji M, Petersen SE, Polsani V, Toro-Salazar OH, Shaikh KA, Shenoy C, Srichai MB, Stojanovska J, Tao Q, Wei J, Weinsaft JW, Wince WB, Chudgar PD, Judd M, Judd RM, Shah DJ, Simonetti OP. The Society for Cardiovascular Magnetic Resonance Registry at 150,000. J Cardiovasc Magn Reson 2024; 26:101055. [PMID: 38971501 PMCID: PMC11314894 DOI: 10.1016/j.jocmr.2024.101055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) is increasingly utilized to evaluate expanding cardiovascular conditions. The Society for Cardiovascular Magnetic Resonance (SCMR) Registry is a central repository for real-world clinical data to support cardiovascular research, including those relating to outcomes, quality improvement, and machine learning. The SCMR Registry is built on a regulatory-compliant, cloud-based infrastructure that houses searchable content and Digital Imaging and Communications in Medicine images. The goal of this study is to summarize the status of the SCMR Registry at 150,000 exams. METHODS The processes for data security, data submission, and research access are outlined. We interrogated the Registry and presented a summary of its contents. RESULTS Data were compiled from 154,458 CMR scans across 20 United States sites, containing 299,622,066 total images (∼100 terabytes of storage). Across reported values, the human subjects had an average age of 58 years (range 1 month to >90 years old), were 44% (63,070/145,275) female, 72% (69,766/98,008) Caucasian, and had a mortality rate of 8% (9,962/132,979). The most common indication was cardiomyopathy (35,369/131,581, 27%), and most frequently used current procedural terminology code was 75561 (57,195/162,901, 35%). Macrocyclic gadolinium-based contrast agents represented 89% (83,089/93,884) of contrast utilization after 2015. Short-axis cines were performed in 99% (76,859/77,871) of tagged scans, short-axis late gadolinium enhancement (LGE) in 66% (51,591/77,871), and stress perfusion sequences in 30% (23,241/77,871). Mortality data demonstrated increased mortality in patients with left ventricular ejection fraction <35%, the presence of wall motion abnormalities, stress perfusion defects, and infarct LGE, compared to those without these markers. There were 456,678 patient-years of all-cause mortality follow-up, with a median follow-up time of 3.6 years. CONCLUSION The vision of the SCMR Registry is to promote evidence-based utilization of CMR through a collaborative effort by providing a web mechanism for centers to securely upload de-identified data and images for research, education, and quality control. The Registry quantifies changing practice over time and supports large-scale real-world multicenter observational studies of prognostic utility.
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Affiliation(s)
- Matthew S Tong
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA.
| | - Jeremy A Slivnick
- Division of Cardiovascular Medicine, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Behzad Sharif
- Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Han W Kim
- Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA
| | - Alistair A Young
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand; School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Lilia M Sierra-Galan
- Cardiology Department of the Cardiovascular Division of The American British Cowdray Medical Center, Mexico City, Mexico
| | - Kanae Mukai
- Ryan Ranch Center for Advanced Diagnostic Imaging, Salinas Valley Health, Salinas, California, USA
| | - Afshin Farzaneh-Far
- Division of Cardiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Sadeer Al-Kindi
- Harrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University, Cleveland, Ohio, USA
| | - Angel T Chan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - George Dibu
- Ascension St. Vincent's Medical Center, Jacksonville, Florida, USA
| | - Michael D Elliott
- Sanger Heart & Vascular Institute, Atrium Health, Charlotte, North Carolina, USA
| | - Vanessa M Ferreira
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - John Grizzard
- Department of Radiology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sebastian Kelle
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Clinic, Berlin, Germany; German Centre for Cardiovascular Research, Berlin, Germany
| | - Simon Lee
- Heart Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Maan Malahfji
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Steffen E Petersen
- William Harvey Research Centre, Queen Mary University London, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service Trust, London, United Kingdom
| | | | - Olga H Toro-Salazar
- Pediatric Cardiology, Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford, Connecticut, USA
| | - Kamran A Shaikh
- Seton Heart Institute, Seton Medical Center, Kyle, Texas, USA
| | - Chetan Shenoy
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Monvadi B Srichai
- Departments of Cardiology and Radiology, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Jadranka Stojanovska
- Department of Radiology, Langone Health, New York University, New York, New York, USA
| | - Qian Tao
- Department of Imaging Physics, Delft University of Technology, Delft, the Netherlands
| | - Janet Wei
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jonathan W Weinsaft
- Division of Cardiology, Department of Medicine, Weill Cornell Medicine - New York Presbyterian Hospital, New York, New York, USA
| | | | - Priya D Chudgar
- Department of Radiology, Jupiter Hospital, Mumbai, Maharashtra, India
| | - Matthew Judd
- Heart Imaging Technologies, LLC, Durham, North Carolina, USA
| | - Robert M Judd
- Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA
| | - Dipan J Shah
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Orlando P Simonetti
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA; Department of Radiology, The Ohio State University, Columbus, Ohio, USA
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Hamel C, Avard B, Isaac N, Jassal D, Kirkpatrick I, Leipsic J, Michaud A, Worrall J, Nguyen ET. Canadian Association of Radiologists Cardiovascular Imaging Referral Guideline. Can Assoc Radiol J 2024:8465371241246425. [PMID: 38733286 DOI: 10.1177/08465371241246425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
The Canadian Association of Radiologists (CAR) Cardiovascular Expert Panel is made up of physicians from the disciplines of radiology, cardiology, and emergency medicine, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 30 clinical/diagnostic scenarios, a rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 48 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 125 recommendation statements across the 30 scenarios (27 unique scenarios as 2 scenarios point to the CAR Thoracic Diagnostic Imaging Referral Guideline and the acute pericarditis subscenario is included under 2 main scenarios). This guideline presents the methods of development and the referral recommendations for acute chest pain syndromes, chronic chest pain, cardiovascular screening and risk stratification, pericardial syndromes, intracardiac/pericardial mass, suspected valvular disease cardiomyopathy, aorta, venous thrombosis, and peripheral vascular disease.
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Affiliation(s)
- Candyce Hamel
- Canadian Association of Radiologists, Ottawa, ON, Canada
| | - Barb Avard
- North York General Hospital, Toronto, ON, Canada
| | - Neil Isaac
- Department of Medical Imaging, North York General Hospital, Toronto, ON, Canada
| | - Davinder Jassal
- Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba, Bergen Cardiac Care Centre St. Boniface Hospital, Winnipeg, MB, Canada
| | - Iain Kirkpatrick
- Max Rady College of Medicine, University of Manitoba, St. Boniface Hospital, Winnipeg, MB, Canada
| | - Jonathon Leipsic
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - James Worrall
- Department of Emergency Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Elsie T Nguyen
- University Medical Imaging Toronto, University of Toronto, Toronto General Hospital, Peter Munk Cardiac Centre, Toronto, ON, Canada
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3
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Steffner KR, Christensen M, Gill G, Bowdish M, Rhee J, Kumaresan A, He B, Zou J, Ouyang D. Deep learning for transesophageal echocardiography view classification. Sci Rep 2024; 14:11. [PMID: 38167849 PMCID: PMC10761863 DOI: 10.1038/s41598-023-50735-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/24/2023] [Indexed: 01/05/2024] Open
Abstract
Transesophageal echocardiography (TEE) imaging is a vital tool used in the evaluation of complex cardiac pathology and the management of cardiac surgery patients. A key limitation to the application of deep learning strategies to intraoperative and intraprocedural TEE data is the complexity and unstructured nature of these images. In the present study, we developed a deep learning-based, multi-category TEE view classification model that can be used to add structure to intraoperative and intraprocedural TEE imaging data. More specifically, we trained a convolutional neural network (CNN) to predict standardized TEE views using labeled intraoperative and intraprocedural TEE videos from Cedars-Sinai Medical Center (CSMC). We externally validated our model on intraoperative TEE videos from Stanford University Medical Center (SUMC). Accuracy of our model was high across all labeled views. The highest performance was achieved for the Trans-Gastric Left Ventricular Short Axis View (area under the receiver operating curve [AUC] = 0.971 at CSMC, 0.957 at SUMC), the Mid-Esophageal Long Axis View (AUC = 0.954 at CSMC, 0.905 at SUMC), the Mid-Esophageal Aortic Valve Short Axis View (AUC = 0.946 at CSMC, 0.898 at SUMC), and the Mid-Esophageal 4-Chamber View (AUC = 0.939 at CSMC, 0.902 at SUMC). Ultimately, we demonstrate that our deep learning model can accurately classify standardized TEE views, which will facilitate further downstream deep learning analyses for intraoperative and intraprocedural TEE imaging.
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Affiliation(s)
- Kirsten R Steffner
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.
| | - Matthew Christensen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - George Gill
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Michael Bowdish
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Justin Rhee
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Abirami Kumaresan
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA
- Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Bryan He
- Department of Computer Science, Stanford University, Stanford, USA
| | - James Zou
- Department of Biomedical Data Science, Stanford University, Stanford, USA
| | - David Ouyang
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA
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Slivnick JA, Alvi N, Singulane CC, Scheetz S, Goyal A, Patel H, Sarswat N, Addetia K, Fernandes F, Vieira MLC, Cafezeiro CRF, Carvalhal SF, Simonetti OP, Singh J, Lang RM, Zareba KM, Patel AR. Non-invasive diagnosis of transthyretin cardiac amyloidosis utilizing typical late gadolinium enhancement pattern on cardiac magnetic resonance and light chains. Eur Heart J Cardiovasc Imaging 2023; 24:829-837. [PMID: 36624559 DOI: 10.1093/ehjci/jeac249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/19/2022] [Indexed: 01/11/2023] Open
Abstract
AIMS While cardiac magnetic resonance (CMR) is often obtained early in the evaluation of suspected cardiac amyloidosis (CA), it currently cannot be utilized to differentiate immunoglobulin (AL) and transthyretin (ATTR) CA. We aimed to determine whether a novel CMR and light-chain biomarker-based algorithm could accurately diagnose ATTR-CA. METHODS AND RESULTS Patients with confirmed AL or ATTR-CA with typical late gadolinium enhancement (LGE) and Look-Locker pattern for CA on CMR were retrospectively identified at three academic medical centres. Comprehensive light-chain analysis including free light chains, serum, and urine electrophoresis/immunofixation was performed. The diagnostic accuracy of the typical CMR pattern for CA in combination with negative light chains for the diagnosis of ATTR-CA was determined both in the entire cohort and in the subset of patients with invasive tissue biopsy as the gold standard. A total of 147 patients (age 70 ± 11, 76% male, 51% black) were identified: 89 ATTR-CA and 58 AL-CA. Light-chain biomarkers were abnormal in 81 (55%) patients. Within the entire cohort, the sensitivity and specificity of a typical LGE and Look-Locker CMR pattern and negative light chains for ATTR-CA was 73 and 98%, respectively. Within the subset with biopsy-confirmed subtype, the CMR and light-chain algorithm were 69% sensitive and 98% specific. CONCLUSION The combination of a typical LGE and Look-Locker pattern on CMR with negative light chains is highly specific for ATTR-CA. The successful non-invasive diagnosis of ATTR-CA using CMR has the potential to reduce diagnostic and therapeutic delays and healthcare costs for many patients.
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Affiliation(s)
- Jeremy A Slivnick
- Division of Cardiovascular Medicine, The University of Chicago Medicine, Chicago, IL, USA
| | - Nazia Alvi
- Division of Cardiology, AMITA Health Adventist Medical Center, Hinsdale, IL, USA
| | - Cristiane C Singulane
- Division of Cardiovascular Medicine, The University of Chicago Medicine, Chicago, IL, USA
| | - Seth Scheetz
- Division of Cardiovascular Medicine, The University of Chicago Medicine, Chicago, IL, USA
| | - Akash Goyal
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Hena Patel
- Division of Cardiovascular Medicine, The University of Chicago Medicine, Chicago, IL, USA
| | - Nitasha Sarswat
- Division of Cardiovascular Medicine, The University of Chicago Medicine, Chicago, IL, USA
| | - Karima Addetia
- Division of Cardiovascular Medicine, The University of Chicago Medicine, Chicago, IL, USA
| | - Fabio Fernandes
- Division of Cardiology, Heart Institute (InCor), São Paulo University Medical School, São Paulo, Brazil
| | | | | | - Suênia Freitas Carvalhal
- Division of Cardiology, Heart Institute (InCor), São Paulo University Medical School, São Paulo, Brazil
| | - Orlando P Simonetti
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Jai Singh
- Division of Cardiovascular Medicine, Atrium Health, Charlotte, NC, USA
| | - Roberto M Lang
- Division of Cardiovascular Medicine, The University of Chicago Medicine, Chicago, IL, USA
| | - Karolina M Zareba
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Amit R Patel
- Division of Cardiovascular Medicine, The University of Virginia Health System, Charlottesville, VA, USA
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Menacho KD, Ramirez S, Perez A, Dragonetti L, Perez de Arenaza D, Katekaru D, Illatopa V, Munive S, Rodriguez B, Shimabukuro A, Cupe K, Bansal R, Bhargava V, Rodriguez I, Seraphim A, Knott K, Abdel-Gadir A, Guerrero S, Lazo M, Uscamaita D, Rivero M, Amaya N, Sharma S, Peix A, Treibel T, Manisty C, Mohiddin S, Litt H, Han Y, Fernandes J, Jacob R, Westwood M, Ntusi N, Herrey A, Walker JM, Moon J. Improving cardiovascular magnetic resonance access in low- and middle-income countries for cardiomyopathy assessment: rapid cardiovascular magnetic resonance. Eur Heart J 2022; 43:2496-2507. [PMID: 35139531 PMCID: PMC9259377 DOI: 10.1093/eurheartj/ehac035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/30/2021] [Accepted: 01/18/2022] [Indexed: 02/01/2023] Open
Abstract
AIMS To evaluate the impact of a simplified, rapid cardiovascular magnetic resonance (CMR) protocol embedded in care and supported by a partner education programme on the management of cardiomyopathy (CMP) in low- and middle-income countries (LMICs). METHODS AND RESULTS Rapid CMR focused particularly on CMP was implemented in 11 centres, 7 cities, 5 countries, and 3 continents linked to training courses for local professionals. Patients were followed up for 24 months to assess impact. The rate of subsequent adoption was tracked. Five CMR conferences were delivered (920 attendees-potential referrers, radiographers, reporting cardiologists, or radiologists) and five new centres starting CMR. Six hundred and one patients were scanned. Cardiovascular magnetic resonance indications were 24% non-contrast T2* scans [myocardial iron overload (MIO)] and 72% suspected/known cardiomyopathies (including ischaemic and viability). Ninety-eighty per cent of studies were of diagnostic quality. The average scan time was 22 ± 6 min (contrast) and 12 ± 4 min (non-contrast), a potential cost/throughput reduction of between 30 and 60%. Cardiovascular magnetic resonance findings impacted management in 62%, including a new diagnosis in 22% and MIO detected in 30% of non-contrast scans. Nine centres continued using rapid CMR 2 years later (typically 1-2 days per week, 30 min slots). CONCLUSIONS Rapid CMR of diagnostic quality can be delivered using available technology in LMICs. When embedded in care and a training programme, costs are lower, care is improved, and services can be sustained over time.
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Affiliation(s)
- Katia Devorha Menacho
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | | | - Aylen Perez
- Cardiology and Cardiovascular Surgery National Institute, La Havana, Cuba
| | | | | | - Diana Katekaru
- Military National Hospital, Cardiac Imaging Department, Lima, Peru
| | | | - Sara Munive
- National Cardiovascular Institute—INCOR, Lima, Peru
| | | | - Ana Shimabukuro
- Guillermo Almenara Irigoyen Hospital, National Hospital, Lima, Peru
| | - Kelly Cupe
- Guillermo Almenara Irigoyen Hospital, National Hospital, Lima, Peru
| | - Rajiv Bansal
- Santokba Durlabhji Memorial Hospital Cum Medical Research Institute, Jaipur, India
| | | | | | - Andreas Seraphim
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Kris Knott
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Amna Abdel-Gadir
- Institute of Cardiovascular Science, University College London, London, UK
| | | | - Marco Lazo
- Ramiro Priale National Hospital, Huancayo, Peru
| | - David Uscamaita
- Edgardo Rebagliati Hospital, MRI and CT Department, Lima, Peru
| | | | - Neil Amaya
- Edgardo Rebagliati Hospital, MRI and CT Department, Lima, Peru
| | - Sanjiv Sharma
- AlI India Institute of Medical Sciences, New Delhi, India
| | - Amelia Peix
- Cardiology and Cardiovascular Surgery National Institute, La Havana, Cuba
| | - Thomas Treibel
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Charlotte Manisty
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Sam Mohiddin
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Harold Litt
- Department of Medicine (Cardiovascular Division), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yuchi Han
- Department of Medicine (Cardiovascular Division), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Ron Jacob
- Lancaster General Health Hospital, Lancaster, USA
| | - Mark Westwood
- St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - Ntobeko Ntusi
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Anna Herrey
- Institute of Cardiovascular Science, University College London, London, UK,St Bartholomew’s Hospital, Barts Heart Centre, London EC1A 7BE, UK
| | - John Malcolm Walker
- Institute of Cardiovascular Science, University College London, London, UK,The Hatter Cardiovascular Institute, University College London Hospital, London, UK
| | - James Moon
- Corresponding author. Tel: +44 203 8870566,
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Böttcher B, Lorbeer R, Stöcklein S, Beller E, Lang CI, Weber MA, Meinel FG. Global and Regional Test-Retest Reproducibility of Native T1 and T2 Mapping in Cardiac Magnetic Resonance Imaging. J Magn Reson Imaging 2021; 54:1763-1772. [PMID: 34075646 DOI: 10.1002/jmri.27755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Mapping of T1 and T2 relaxation times in cardiac MRI is an invaluable tool for the diagnosis and risk stratification of a wide spectrum of cardiac diseases. PURPOSE To investigate the global and regional reproducibility of native T1 and T2 mapping and to analyze the influence of demographic factors, physiological parameters, slice position, and myocardial regions on reproducibility. STUDY TYPE Prospective single-center cohort-study. POPULATION Fifty healthy volunteers (29 female, 21 male) with a mean age of 39.4 ± 13.7 years. FIELD STRENGTH/SEQUENCE Each volunteer was investigated twice at 1.5 T using a modified look-locker inversion-recovery (MOLLI) sequence (T1 mapping) and a T2-prepared steady-state free precession (SSFP) sequence (T2 mapping). ASSESSMENT Global T1 and T2 values were quantified for the entire left ventricle in three short-axis slices. Regional T1 and T2 values were measured for each myocardial segment and for myocardial segments grouped by slice position and anatomical region. STATISTICAL TESTS Test-retest reproducibility was assessed using intraclass correlation coefficient (ICC) and Bland-Altman statistics. A P value < 0.05 was considered statistically significant. RESULTS Reproducibility was good for global T1 values (ICC 0.88) and excellent for global T2 values (ICC 0.91). Reproducibility of T1 values was excellent (ICC 0.91) for midventricular slice and good for apical (ICC 0.86) and basal slice (ICC 0.81). Reproducibility of T1 mapping values was highest in the septum (ICC 0.90) compared to the anterior (0.81), lateral (0.86), and inferior (0.86) wall. For T2 mapping, reproducibility was good for all slice positions (ICC 0.86 for midventricular, 0.83 for basal, and 0.80 for apical slice). Reproducibility of T2 mapping was significantly lower for the inferior wall (ICC 0.58) than for septum (0.89), anterior (0.85), and lateral (0.87) wall. DATA CONCLUSION Native T1 and T2 mapping has good to excellent reproducibility with significant regional differences. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Benjamin Böttcher
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilian University, Munich, Germany
| | - Sophia Stöcklein
- Department of Radiology, Ludwig-Maximilian University, Munich, Germany
| | - Ebba Beller
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Cajetan I Lang
- Department of Internal Medicine, Division of Cardiology, University Medical Center Rostock, Rostock, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Felix G Meinel
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
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7
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Reece TB. Commentary: Beyond appropriate use, excluding the useless. J Thorac Cardiovasc Surg 2019; 157:1465. [PMID: 30901791 DOI: 10.1016/j.jtcvs.2019.01.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 01/28/2019] [Indexed: 11/28/2022]
Affiliation(s)
- T Brett Reece
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, Aurora, Colo.
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