Dataset Information

Optimized AIR and investigational MOLLI cardiac T1 mapping pulse sequences produce similar intra-scan repeatability in patients at 3T.

ABSTRACT: This study was conducted to improve the precision of arrhythmia-insensitive rapid (AIR) cardiac T1 mapping through pulse sequence optimization and then evaluate the intra-scan repeatability in patients at 3T against investigational modified Look-Locker inversion recovery (MOLLI) T1 mapping. In the first development phase (five human subjects), we implemented and tested centric-pair k-space ordering to suppress image artifacts associated with eddy currents. In the second development phase (15 human subjects), we determined optimal flip angles to reduce the measurement variation in T1 maps. In the validation phase (35 patients), we compared the intra-scan repeatability between investigational MOLLI and optimized AIR. In 23 cardiac planes, conventional centric k-space ordering (3.7%) produced significantly (p < 0.05) more outliers as a fraction of left ventricular cavity area than optimal centric k-space ordering (1.4%). In 15 human subjects, for each of four types of measurement (native myocardial T1 , native blood T1 , post-contrast myocardial T1 , post-contrast blood T1 ), flip angles of 55-65° produced lower measurement variation while producing results that are not significantly different from those produced with the previously used flip angle of 35° (p > 0.89, intra-class correlation coefficient ? 0.95 for all four measurement types). Compared with investigational MOLLI (coefficient of repeatability, CR = 40.0, 77.2, 26.5, and 25.9 ms for native myocardial, native blood, post-contrast myocardial, and post-contrast blood T1 , and 2.0% for extracellular volume (ECV) measurements, respectively), optimized AIR (CR = 54.3, 89.7, 30.5, and 14.7 ms for native myocardial, native blood, post-contrast myocardial, and post-contrast blood T1 , and 1.6% for ECV measurements, respectively) produced similar absolute intra-scan repeatability in all 35 patients in the validation phase. High repeatability is critically important for longitudinal studies, where the goal is to monitor physiologic/pathologic changes, not measurement variation. Optimized AIR cardiac T1 mapping is likely to yield high scan-retest repeatability for pre-clinical and clinical applications.

SUBMITTER: Hong K

PROVIDER: S-EPMC5065359 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

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Optimized AIR and investigational MOLLI cardiac T1 mapping pulse sequences produce similar intra-scan repeatability in patients at 3T.

Hong KyungPyo K Collins Jeremy J Lee Daniel C DC Wilcox Jane E JE Markl Michael M Carr James J Kim Daniel D

NMR in biomedicine 20160905 10

This study was conducted to improve the precision of arrhythmia-insensitive rapid (AIR) cardiac T1 mapping through pulse sequence optimization and then evaluate the intra-scan repeatability in patients at 3T against investigational modified Look-Locker inversion recovery (MOLLI) T1 mapping. In the first development phase (five human subjects), we implemented and tested centric-pair k-space ordering to suppress image artifacts associated with eddy currents. In the second development phase (15 hum ...[more]

PMID: 27593977

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Project description:Stress and rest T1-mapping may assess for myocardial ischemia and extracellular volume (ECV). However, the stress T1 response is method-dependent, and underestimation may lead to misdiagnosis. Further, ECV quantification may be affected by time, as well as the number and dosage of gadolinium (Gd) contrast administered. We compared two commonly available T1-mapping approaches in their stress T1 response and ECV measurement stability. Healthy subjects (n = 10, 50% female, 35 ± 8 years) underwent regadenoson stress CMR (1.5 T) on two separate days. Prototype ShMOLLI 5(1)1(1)1 sequence was used to acquire consecutive mid-ventricular T1-maps at rest, stress and post-Gd contrast to track the T1 time evolution. For comparison, standard MOLLI sequences were used: MOLLI 5(3)3 Low (256 matrix) & High (192 matrix) Heart Rate (HR) to acquire rest and stress T1-maps, and MOLLI 4(1)3(1)2 Low & High HR for post-contrast T1-maps. Stress and rest myocardial blood flow (MBF) maps were acquired after IV Gd contrast (0.05 mmol/kg each). Stress T1 reactivity (delta T1) was defined as the relative percentage increase in native T1 between rest and stress. Myocardial T1 values for delta T1 (dT1) and ECV were calculated. Residuals from the identified time dependencies were used to assess intra-method variability. ShMOLLI achieved a greater stress T1 response compared to MOLLI Low and High HR (peak dT1 = 6.4 ± 1.7% vs. 4.8 ± 1.3% vs. 3.8 ± 1.0%, respectively; both p < 0.0001). ShMOLLI dT1 correlated strongly with stress MBF (r = 0.77, p < 0.001), compared to MOLLI Low HR (r = 0.65, p < 0.01) and MOLLI High HR (r = 0.43, p = 0.07). ShMOLLI ECV was more stable to gadolinium dose with less time drift (0.006-0.04% per minute) than MOLLI variants. Overall, ShMOLLI demonstrated less intra-individual variability than MOLLI variants for stress T1 and ECV quantification. Power calculations indicate up to a fourfold (stress T1) and 7.5-fold (ECV) advantage in sample-size reduction using ShMOLLI. Our results indicate that ShMOLLI correlates strongly with increased MBF during regadenoson stress and achieves a significantly higher stress T1 response, greater effect size, and greater ECV measurement stability compared with the MOLLI variants tested.

Project description:BackgroundMyocardial T1-mapping recently emerged as a promising quantitative method for non-invasive tissue characterization in numerous cardiomyopathies. Commonly performed with an inversion-recovery (IR) magnetization preparation at 1.5T, the application at 3T has gained due to increased quantification precision. Alternatively, saturation-recovery (SR) T1-mapping has recently been introduced at 1.5T for improved accuracy. Thus, the purpose of this study is to investigate the robustness and precision of SR T1-mapping at 3T and to establish accurate reference values for native T1-times and extracellular volume fraction (ECV) of healthy myocardium.MethodsBalanced Steady-State Free-Precession (bSSFP) Saturation-Pulse Prepared Heart-rate independent Inversion-REcovery (SAPPHIRE) and Saturation-recovery Single-SHot Acquisition (SASHA) T1-mapping were compared with the Modified Look-Locker inversion recovery (MOLLI) sequence at 3T. Accuracy and precision were studied in phantom. Native and post-contrast T1-times and regional ECV were determined in 20 healthy subjects (10 men, 27 ± 5 years). Subjective image quality, susceptibility artifact rating, in-vivo precision and reproducibility were analyzed.ResultsSR T1-mapping showed <4 % deviation from the spin-echo reference in phantom in the range of T1 = 100-2300 ms. The average quality and artifact scores of the T1-mapping methods were: MOLLI:3.4/3.6, SAPPHIRE:3.1/3.4, SASHA:2.9/3.2; (1: poor - 4: excellent/1: strong - 4: none). SAPPHIRE and SASHA yielded significantly higher T1-times (SAPPHIRE: 1578 ± 42 ms, SASHA: 1523 ± 46 ms), in-vivo T1-time variation (SAPPHIRE: 60.1 ± 8.7 ms, SASHA: 70.0 ± 9.3 ms) and lower ECV-values (SAPPHIRE: 0.20 ± 0.02, SASHA: 0.21 ± 0.03) compared with MOLLI (T1: 1181 ± 47 ms, ECV: 0.26 ± 0.03, Precision: 53.7 ± 8.1 ms). No significant difference was found in the inter-subject variability of T1-times or ECV-values (T1: p = 0.90, ECV: p = 0.78), the observer agreement (inter: p > 0.19; intra: p > 0.09) or consistency (inter: p > 0.07; intra: p > 0.17) between the three methods.ConclusionsSaturation-recovery T1-mapping at 3T yields higher accuracy, comparable inter-subject, inter- and intra-observer variability and less than 30 % precision-loss compared to MOLLI.

Project description:BACKGROUND:The T1 Mapping and Extracellular volume (ECV) Standardization (T1MES) program explored T1 mapping quality assurance using a purpose-developed phantom with Food and Drug Administration (FDA) and Conformité Européenne (CE) regulatory clearance. We report T1 measurement repeatability across centers describing sequence, magnet, and vendor performance. METHODS:Phantoms batch-manufactured in August 2015 underwent 2?years of structural imaging, B0 and B1, and "reference" slow T1 testing. Temperature dependency was evaluated by the United States National Institute of Standards and Technology and by the German Physikalisch-Technische Bundesanstalt. Center-specific T1 mapping repeatability (maximum one scan per week to minimum one per quarter year) was assessed over mean 358 (maximum 1161) days on 34 1.5?T and 22 3?T magnets using multiple T1 mapping sequences. Image and temperature data were analyzed semi-automatically. Repeatability of serial T1 was evaluated in terms of coefficient of variation (CoV), and linear mixed models were constructed to study the interplay of some of the known sources of T1 variation. RESULTS:Over 2?years, phantom gel integrity remained intact (no rips/tears), B0 and B1 homogenous, and "reference" T1 stable compared to baseline (% change at 1.5?T, 1.95?±?1.39%; 3?T, 2.22?±?1.44%). Per degrees Celsius, 1.5?T, T1 (MOLLI 5s(3s)3s) increased by 11.4?ms in long native blood tubes and decreased by 1.2?ms in short post-contrast myocardium tubes. Agreement of estimated T1 times with "reference" T1 was similar across Siemens and Philips CMR systems at both field strengths (adjusted R2 ranges for both field strengths, 0.99-1.00). Over 1?year, many 1.5?T and 3?T sequences/magnets were repeatable with mean CoVs <?1 and 2% respectively. Repeatability was narrower for 1.5?T over 3?T. Within T1MES repeatability for native T1 was narrow for several sequences, for example, at 1.5?T, Siemens MOLLI 5s(3s)3s prototype number 448B (mean CoV?=?0.27%) and Philips modified Look-Locker inversion recovery (MOLLI) 3s(3s)5s (CoV 0.54%), and at 3?T, Philips MOLLI 3b(3s)5b (CoV 0.33%) and Siemens shortened MOLLI (ShMOLLI) prototype 780C (CoV 0.69%). After adjusting for temperature and field strength, it was found that the T1 mapping sequence and scanner software version (both P?<?0.001 at 1.5?T and 3?T), and to a lesser extent the scanner model (P?=?0.011, 1.5?T only), had the greatest influence on T1 across multiple centers. CONCLUSION:The T1MES CE/FDA approved phantom is a robust quality assurance device. In a multi-center setting, T1 mapping had performance differences between field strengths, sequences, scanner software versions, and manufacturers. However, several specific combinations of field strength, sequence, and scanner are highly repeatable, and thus, have potential to provide standardized assessment of T1 times for clinical use, although temperature correction is required for native T1 tubes at least.

Project description:PurposeTo determine the influence of preprocessing on the repeatability and redundancy of radiomics features extracted using a popular open-source radiomics software package in a scan-rescan glioblastoma MRI study.Materials and methodsIn this study, a secondary analysis of T2-weighted fluid-attenuated inversion recovery (FLAIR) and T1-weighted postcontrast images from 48 patients (mean age, 56 years [range, 22-77 years]) diagnosed with glioblastoma were included from two prospective studies (ClinicalTrials.gov NCT00662506 [2009-2011] and NCT00756106 [2008-2011]). All patients underwent two baseline scans 2-6 days apart using identical imaging protocols on 3-T MRI systems. No treatment occurred between scan and rescan, and tumors were essentially unchanged visually. Radiomic features were extracted by using PyRadiomics (https://pyradiomics.readthedocs.io/) under varying conditions, including normalization strategies and intensity quantization. Subsequently, intraclass correlation coefficients were determined between feature values of the scan and rescan.ResultsShape features showed a higher repeatability than intensity (adjusted P < .001) and texture features (adjusted P < .001) for both T2-weighted FLAIR and T1-weighted postcontrast images. Normalization improved the overlap between the region of interest intensity histograms of scan and rescan (adjusted P < .001 for both T2-weighted FLAIR and T1-weighted postcontrast images), except in scans where brain extraction fails. As such, normalization significantly improves the repeatability of intensity features from T2-weighted FLAIR scans (adjusted P = .003 [z score normalization] and adjusted P = .002 [histogram matching]). The use of a relative intensity binning strategy as opposed to default absolute intensity binning reduces correlation between gray-level co-occurrence matrix features after normalization.ConclusionBoth normalization and intensity quantization have an effect on the level of repeatability and redundancy of features, emphasizing the importance of both accurate reporting of methodology in radiomics articles and understanding the limitations of choices made in pipeline design. Supplemental material is available for this article. © RSNA, 2020See also the commentary by Tiwari and Verma in this issue.

Dataset Information

Optimized AIR and investigational MOLLI cardiac T1 mapping pulse sequences produce similar intra-scan repeatability in patients at 3T.

Publications

Optimized AIR and investigational MOLLI cardiac T1 mapping pulse sequences produce similar intra-scan repeatability in patients at 3T.

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