Cardiac magnetic resonance T1 mapping. Part 2: Diagnostic potential and applications

Reiter, Ursula; Reiter, Christoph; Kräuter, Corina; Fuchsjäger, Michael; Reiter, Gert

doi:10.1016/j.ejrad.2018.10.013

Cited by 33 publications

(35 citation statements)

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“…The detection of chemotherapy cardiotoxicity has already been proposed among the possible clinical uses of ECV (35). Indeed, Jordan et al (36) and Neilan et al (37), have assessed ECV as a biomarker of anthracycline cardiotoxicity using CMR T1-mapping before/after the administration of gadolinium-based contrast agent.…”

Section: Discussionmentioning

confidence: 99%

Assessment of myocardial extracellular volume on body computed tomography in breast cancer patients treated with anthracyclines

Monti¹,

Zanardo²,

Bosetti³

et al. 2020

Quant Imaging Med Surg

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Background: Cancer treatment with anthracyclines may lead to an increased incidence of cardiac disease due to cardiotoxicity, as they may cause irreversible myocardial fibrosis. So far, the proposed methods for screening patients for cardiotoxicity have led to only limited success, while the analysis of myocardial extracellular volume (mECV) at cardiac magnetic resonance (CMR) has shown promising results, albeit requiring a dedicated exam. Recent studies have found strong correlations between mECV values obtained through computed tomography (CT), and those derived from CMR. Thus, our purpose was to evaluate the feasibility of estimating mECV on thoracic contrast-enhanced CT performed for staging or follow-up in breast cancer patients treated with anthracyclines, and, if feasible, to assess if a rise in mECV is associated with chemotherapy, and persistent over time.Methods: After ethics committee approval, female patients with breast cancer who had undergone at least 2 staging or follow-up CT examinations at our institution, one before and one shortly after the end of chemotherapy including anthracyclines were retrospectively evaluated. Patients without available haematocrit, with artefacts in CT images, or who had undergone radiation therapy of the left breast were excluded. Follow-up CT examinations at longer time intervals were also analysed, when available. mECV was calculated on scans obtained at 1, and 7 min after contrast injection.Results: Thirty-two female patients (aged 57±13 years) with pre-treatment haematocrit 38%±4%, and ejection fraction 64%±6% were analysed. Pre-treatment mECV was 27.0%±2.9% at 1 min, and 26.4%±3.8% at 7 min, similar to values reported for normal subjects in the literature. Post-treatment mECV (median interval: 89 days after treatment) was 31.1%±4.9%, and 30.0%±5.1%, respectively, values significantly higher than pre-treatment values at all times (P<0.005). mECV at follow-up (median interval: 135 days after post-treatment CT) was 31.0%±4.5%, and 27.7%±3.7%, respectively, without significant differences (P>0.548) when compared to post-treatment values.Conclusions: mECV values from contrast-enhanced CT scans could play a role in the assessment of myocardial condition in breast cancer patients undergoing anthracycline-based chemotherapy. CT-derived ECV could be an imaging biomarker for the monitoring of therapy-related cardiotoxicity, allowing for potential secondary prevention of cardiac damage, using data derived from an examination that could be already part of patients' clinical workflow.

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Section: Discussionmentioning

confidence: 99%

Assessment of myocardial extracellular volume on body computed tomography in breast cancer patients treated with anthracyclines

Monti¹,

Zanardo²,

Bosetti³

et al. 2020

Quant Imaging Med Surg

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“…In the present study, native T1 mapping was found to be an effective test for differentiating between controls and DCM with good diagnostic accuracy, specificity, and NPV, but not for sensitivity and PPV. The possible reason for limited sensitivity and PPV may be related to the accuracy of co-registration of thin-wall myocardium in DCM cases that is subjected to a potential measurement errors [ 29 ]. For differentiating HCM from controls, the average native T1 was found to have good diagnostic accuracy, specificity, and NPV, but it has limited sensitivity and PPV.…”

Section: Discussionmentioning

confidence: 99%

Native T1 mapping and extracellular volume fraction for differentiation of myocardial diseases from normal CMR controls in routine clinical practice

Thongsongsang

Songsangjinda

Tanapibunpon

et al. 2021

BMC Cardiovasc Disord

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Background This study aimed to determine native T1 and extracellular volume fraction (ECV) in distinct types of myocardial disease, including amyloidosis, dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), myocarditis and coronary artery disease (CAD), compared to controls. Methods We retrospectively enrolled patients with distinct types of myocardial disease, CAD patients, and control group (no known heart disease and negative CMR study) who underwent 3.0 Tesla CMR with routine T1 mapping. The region of interest (ROI) was drawn in the myocardium of the mid left ventricular (LV) short axis slice and at the interventricular septum of mid LV slice. ECV was calculated by actual hematocrit (Hct) and synthetic Hct. T1 mapping and ECV was compared between myocardial disease and controls, and between CAD and controls. Diagnostic yield and cut-off values were assessed. Results A total of 1188 patients were enrolled. The average T1 values in the control group were 1304 ± 42 ms at septum, and 1294 ± 37 ms at mid LV slice. The average T1 values in patients with myocardial disease and CAD were significantly higher than in controls (1441 ± 72, 1349 ± 59, 1345 ± 59, 1355 ± 56, and 1328 ± 54 ms for septum of amyloidosis, DCM, HCM, myocarditis, and CAD). Native T1 of the mid LV level and ECV at septum and mid LV with actual and synthetic Hct of patients with myocardial disease or CAD were significantly higher than in controls. Conclusions Although native T1 and ECV of patients with cardiomyopathy and CAD were significantly higher than controls, the values overlapped. The greatest clinical utilization was found for the amyloidosis group.

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“… 58‐60 Image quality was visually good. For the patient with suspected HHD, increased

T_{1}

and

T_{2}^{*}

was observed in the septal region and patchy structures in the

T_{1}

map as typically observed in HHD 61 . No reference methods were acquired in patients, which will be evaluated in future work.…”

Section: Discussionmentioning

confidence: 99%

Free‐breathing simultaneous T₁, T₂, and T₂^∗ quantification in the myocardium

Hermann

Kellman

Demirel

et al. 2021

Magnetic Resonance in Med

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Purpose To implement a free‐breathing sequence for simultaneous quantification of T1, T2, and T2∗ for comprehensive tissue characterization of the myocardium in a single scan using a multi‐gradient‐echo readout with saturation and T2 preparation pulses. Methods In the proposed Saturation And T2‐prepared Relaxometry with Navigator‐gating (SATURN) technique, a series of multi‐gradient‐echo (GRE) images with different magnetization preparations was acquired during free breathing. A total of 35 images were acquired in 26.5 ± 14.9 seconds using multiple saturation times and T2 preparation durations and with imaging at 5 echo times. Bloch simulations and phantom experiments were used to validate a 5‐parameter fit model for accurate relaxometry. Free‐breathing simultaneous T1, T2, and T2∗ measurements were performed in 10 healthy volunteers and 2 patients using SATURN at 3T and quantitatively compared to conventional single‐parameter methods such as SASHA for T1, T2‐prepared bSSFP, and multi‐GRE for T2∗. Results Simulations confirmed accurate fitting with the 5‐parameter model. Phantom measurements showed good agreement with the reference methods in the relevant range for in vivo measurements. Compared to single‐parameter methods comparable accuracy was achieved. SATURN produced in vivo parameter maps that were visually comparable to single‐parameter methods. No significant difference between T1, T2, and T2∗ times acquired with SATURN and single‐parameter methods was shown in quantitative measurements (SATURN T1=1573±86ms, T2=33.2±3.6ms, T2∗=25.3±6.1ms; conventional methods: T1=1544±107ms, T2=33.2±3.6ms, T2∗=23.8±5.5ms; P>.2) Conclusion SATURN enables simultaneous quantification of T1, T2, and T2∗ in the myocardium for comprehensive tissue characterization with co‐registered maps, in a single scan with good agreement to single‐parameter methods.

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Cardiac magnetic resonance T1 mapping. Part 2: Diagnostic potential and applications

Cited by 33 publications

References 100 publications

Assessment of myocardial extracellular volume on body computed tomography in breast cancer patients treated with anthracyclines

Assessment of myocardial extracellular volume on body computed tomography in breast cancer patients treated with anthracyclines

Native T1 mapping and extracellular volume fraction for differentiation of myocardial diseases from normal CMR controls in routine clinical practice

Free‐breathing simultaneous T₁, T₂, and T₂^∗ quantification in the myocardium

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Cardiac magnetic resonance T1 mapping. Part 2: Diagnostic potential and applications

Cited by 33 publications

References 100 publications

Assessment of myocardial extracellular volume on body computed tomography in breast cancer patients treated with anthracyclines

Assessment of myocardial extracellular volume on body computed tomography in breast cancer patients treated with anthracyclines

Native T1 mapping and extracellular volume fraction for differentiation of myocardial diseases from normal CMR controls in routine clinical practice

Free‐breathing simultaneous T1, T2, and T2∗ quantification in the myocardium

Contact Info

Product

Resources

About

Free‐breathing simultaneous T₁, T₂, and T₂^∗ quantification in the myocardium