T1-Mapping by Cardiac Magnetic Resonance Imaging: From Histological Validation to Clinical Implication

Kammerlander, Andreas A.; Marzluf, Beatrice A.; Zotter-Tufaro, Caroline; Duca, Franz; Bachmann, Alina; Knechtelsdorfer, Klaus; Wiesinger, Matthias; Pfaffenberger, Stefan; Greiser, Andreas; Lang, Irene; Bonderman, Diana; Mascherbauer, Julia

doi:10.1016/s0735-1097(16)31697-7

Cited by 51 publications

(82 citation statements)

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“…73 These studies were pivotal in showing the markedly reduced postcontrast T1 in remote myocardium in patients with systolic and diastolic HF, respectively. 41,43 These studies also indicated an unfavorable relationship of ECV with outcome, 34,35,110 as well as the relationship of diabetes mellitus with ECV. 111 These studies cumulatively revealed a predictive value for ECV in terms of survival, cardiac mortality, and development of HF.…”

Section: T1 Mapping In Chronic Ischemic Cardiomyopathymentioning

confidence: 83%

“…The use of different sequences for native and postcontrast T1 acquisition, however, renders it debatable whether subtraction of the pre-from the postcontrast signal results in a true representation of the gadolinium effect. [34][35][36] As the majority of these clinically relevant effects cannot be reproduced in phantoms, sequence characterization in human Figure 4. T1 mapping in a nutshell.…”

Section: Basic Concepts Of T1 Mapping: From Acquisition To Postprocesmentioning

confidence: 99%

“…In some studies, areas of replacement fibrosis (seen as LGE) were included in histological collagen volume fraction, showing stronger relationships, [44][45][46]49 compared with those studies that focused primarily on the diffuse interstitial component. 35,41,42,47,50 The majority of studies relied on minute amounts of tissue from endomyocardial biopsy; explanted hearts were analyzed in only 2 studies. 44,51 Interestingly, the most recently reported association between CMR and histologically derived ECV (using a tissue-FAXS software analysis) 35 yielded an association of r=0.493 (P=0.002), demonstrating the influence of technical and myocardial elements on the measurement (Table 2).…”

Section: T1-mapping Indices: Initial Experience and Histological Corrmentioning

confidence: 99%

“…35,41,42,47,50 The majority of studies relied on minute amounts of tissue from endomyocardial biopsy; explanted hearts were analyzed in only 2 studies. 44,51 Interestingly, the most recently reported association between CMR and histologically derived ECV (using a tissue-FAXS software analysis) 35 yielded an association of r=0.493 (P=0.002), demonstrating the influence of technical and myocardial elements on the measurement (Table 2). Histological evidence on other tissue correlates remains scarce.…”

Section: T1-mapping Indices: Initial Experience and Histological Corrmentioning

confidence: 99%

“…First, native T1 provides excellent positive and negative predictive values Types of sequences and a staining method used, as well as several patients included, are also reported. Discriminative focus on replacement versus interstitial fibrosis is a paramount factor influencing the diversity of observed relationships; whereas some authors steered away from the inclusion of replacement fibrosis/LGE affected areas in histological CVF (or accounted for them separately), 35,41,47,51 or all-inclusive. 44,45,49 CVF indicates collagen volume fraction; DCM, dilative cardiomyopathy; ECV, extracellular volume fraction; FLASH-IR, fast low angle shot-inversion recovery; GCA, gadolinium contrast agents; IHD, ischemic heart disease; MOLLI, modified LookLocker imaging; NICM, nonischemic cardiomyopathies; and VAST, variable temporal sampling of k-space.…”

Section: T1 Mapping In Myocardial Inflammationmentioning

confidence: 99%

See 4 more Smart Citations

T1 Mapping in Characterizing Myocardial Disease

Püntmann

Peker

Chandrashekhar

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Cardiovascular magnetic resonance provides insights into myocardial structure and function noninvasively, with high diagnostic accuracy and without ionizing radiation. Myocardial tissue characterization in particular gives cardiovascular magnetic resonance a prime role among all the noninvasive cardiovascular investigations. Late gadolinium enhancement imaging is an established method for visualizing replacement scar, providing diagnostic and prognostic information in a variety of cardiac conditions. Late gadolinium enhancement, however, relies on the regional segregation of tissue characteristics to generate the imaging contrast. Thus, myocardial pathology that is diffuse in nature and affecting the myocardium in a rather uniform and global distribution is not well visualized with late gadolinium enhancement. Examples include diffuse myocardial inflammation, fibrosis, hypertrophy, and infiltration. T1 mapping is a novel technique allowing to diagnose these diffuse conditions by measurement of T1 values, which directly correspond to variation in intrinsic myocardial tissue properties. In addition to providing clinically meaningful indices, T1-mapping measurements also allow for an estimation of extracellular space by calculation of extracellular volume fraction. Multiple lines of evidence suggest a central role for T1 mapping in detection of diffuse myocardial disease in early disease stages and complements late gadolinium enhancement in visualization of the regional changes in common advanced myocardial disease. As a quantifiable measure, it may allow grading of disease activity, monitoring progress, and guiding treatment, potentially as a fast contrast-free clinical application. We present an overview of clinically relevant technical aspects of acquisition and processing, and the current state of art and evidence, supporting its clinical use.

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