TY - JOUR
T1 - Accurate late gadolinium enhancement prediction by early T1- based quantitative synthetic mapping
AU - van Dijk, Randy
AU - Kuijpers, Dirkjan
AU - Kaandorp, Theodorus A M
AU - van Dijkman, Paul R M
AU - Vliegenthart, Rozemarijn
AU - van der Harst, Pim
AU - Oudkerk, Matthijs
N1 - Funding Information:
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study was supported by a grant from Zon-MW (Innovative Medical Devices Initiative LSH 2014 (10-10400-98-14017) and a grant from the Dutch Heart Foundation (CVON2015-17).
Publisher Copyright:
© 2017, The Author(s).
PY - 2018/2/1
Y1 - 2018/2/1
N2 - OBJECTIVES: Early synthetic gadolinium enhancement (ESGE) imaging from post-contrast T1 mapping after adenosine stress-perfusion cardiac magnetic resonance (CMR) was compared to conventional late gadolinium enhancement (LGE) imaging for assessing myocardial scar.METHODS: Two hundred fourteen consecutive patients suspected of myocardial ischaemia were referred for stress-perfusion CMR. Myocardial infarct volume was quantified on a per-subsegment basis in both synthetic (2-3 min post-gadolinium) and conventional (9 min post-gadolinium) images by two independent observers. Sensitivity, specificity, PPV and NPV were calculated on a per-patient and per-subsegment basis.RESULTS: Both techniques detected 39 gadolinium enhancement areas in 23 patients. The median amount of scar was 2.0 (1.0-3.1) g in ESGE imaging and 2.2 (1.1-3.1) g in LGE imaging (p=0.39). Excellent correlation (r=0.997) and agreement (mean absolute difference: -0.028±0.289 ml) were found between ESGE and LGE images. Sensitivity, specificity, PPV and NPV of ESGE imaging were 96 (78.9-99.9), 99 (97.1-100.0)%, 96 (76.5-99.4) and 99.5 (96.6-99.9) in patient-based and 99 (94.5-100.0), 100 (99.9-100.0)%, 97.0 (91.3-99.0) and 100.0 (99.8-100.0) in subsegment-based analysis.CONCLUSION: ESGE based on post-contrast T1 mapping after adenosine stress-perfusion CMR imaging shows excellent agreement with conventional LGE imaging for assessing myocardial scar, and can substantially shorten clinical acquisition time.KEY POINTS: • Synthetic gadolinium enhancement images can be used for detection of myocardial scar. • Early synthetic gadolinium enhancement images can substantially shorten clinical acquisition time. • ESGE has high diagnostic accuracy as compared to conventional late gadolinium enhancement. • Quantification of myocardial scar with ESGE closely correlates with conventional LGE. • ESGE after stress perfusion CMR avoids need for additional gadolinium administration.
AB - OBJECTIVES: Early synthetic gadolinium enhancement (ESGE) imaging from post-contrast T1 mapping after adenosine stress-perfusion cardiac magnetic resonance (CMR) was compared to conventional late gadolinium enhancement (LGE) imaging for assessing myocardial scar.METHODS: Two hundred fourteen consecutive patients suspected of myocardial ischaemia were referred for stress-perfusion CMR. Myocardial infarct volume was quantified on a per-subsegment basis in both synthetic (2-3 min post-gadolinium) and conventional (9 min post-gadolinium) images by two independent observers. Sensitivity, specificity, PPV and NPV were calculated on a per-patient and per-subsegment basis.RESULTS: Both techniques detected 39 gadolinium enhancement areas in 23 patients. The median amount of scar was 2.0 (1.0-3.1) g in ESGE imaging and 2.2 (1.1-3.1) g in LGE imaging (p=0.39). Excellent correlation (r=0.997) and agreement (mean absolute difference: -0.028±0.289 ml) were found between ESGE and LGE images. Sensitivity, specificity, PPV and NPV of ESGE imaging were 96 (78.9-99.9), 99 (97.1-100.0)%, 96 (76.5-99.4) and 99.5 (96.6-99.9) in patient-based and 99 (94.5-100.0), 100 (99.9-100.0)%, 97.0 (91.3-99.0) and 100.0 (99.8-100.0) in subsegment-based analysis.CONCLUSION: ESGE based on post-contrast T1 mapping after adenosine stress-perfusion CMR imaging shows excellent agreement with conventional LGE imaging for assessing myocardial scar, and can substantially shorten clinical acquisition time.KEY POINTS: • Synthetic gadolinium enhancement images can be used for detection of myocardial scar. • Early synthetic gadolinium enhancement images can substantially shorten clinical acquisition time. • ESGE has high diagnostic accuracy as compared to conventional late gadolinium enhancement. • Quantification of myocardial scar with ESGE closely correlates with conventional LGE. • ESGE after stress perfusion CMR avoids need for additional gadolinium administration.
KW - Adenosine/administration & dosage
KW - Aged
KW - Cicatrix/diagnostic imaging
KW - Contrast Media
KW - Female
KW - Gadolinium
KW - Humans
KW - Image Enhancement
KW - Magnetic Resonance Angiography/methods
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/diagnostic imaging
KW - Myocardium/pathology
KW - Prospective Studies
KW - Sensitivity and Specificity
KW - Adenosine
KW - Coronary artery disease
KW - Magnetic resonance imaging
KW - Fibrosis
UR - http://www.scopus.com/inward/record.url?scp=85028584652&partnerID=8YFLogxK
U2 - 10.1007/s00330-017-5018-2
DO - 10.1007/s00330-017-5018-2
M3 - Article
C2 - 28856412
SN - 0938-7994
VL - 28
SP - 844
EP - 850
JO - European Radiology
JF - European Radiology
IS - 2
ER -