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Effect of inversion time on the precision of myocardial late gadolinium enhancement quantification evaluated with synthetic inversion recovery MR imaging

  • Cardiac
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Abstract

Objectives

To evaluate the influence of inversion time (TI) on the precision of myocardial late gadolinium enhancement (LGE) quantification using synthetic inversion recovery (IR) imaging in patients with myocardial infarction (MI).

Methods

Fifty-three patients with suspected prior MI underwent 1.5-T cardiac MRI with conventional magnitude (MagIR) and phase-sensitive IR (PSIR) LGE imaging and T1 mapping at 15 min post-contrast. T1-based synthetic MagIR and PSIR images were calculated with a TI ranging from −100 to +150 ms at 5-ms intervals relative to the optimal TI (TI0). LGE was quantified using a five standard deviation (5SD) and full width at half-maximum (FWHM) thresholds. Measurements were compared using one-way analysis of variance.

Results

The MagIRsy technique provided precise assessment of LGE area at TIs ≥ TI0, while precision was decreased below TI0. The LGE area showed significant differences at ≤ −25 ms compared to TI0 using 5SD (P < 0.001) and at ≤ −65 ms using the FWHM approach (P < 0.001). LGE measurements did not show significant difference over the analysed TI range in the PSIRsy images using either of the quantification methods.

Conclusions

T1 map-based PSIRsy images provide precise quantification of MI independent of TI at the investigated time point post-contrast. MagIRsy-based MI quantification is precise at TI0 and at longer TIs while showing decreased precision at TI values below TI0.

Key Points

• Synthetic IR imaging retrospectively generates LGE images at any theoretical TI

• Synthetic IR imaging can simulate the effect of TI on LGE quantification

• Fifteen minutes post-contrast MagIR sy accurately quantifies infarcts from TI 0 to TI 0   + 150 ms

• Fifteen minutes post-contrast PSIR sy provides precise infarct size independent of TI

• Synthetic IR imaging has further advantages in reducing operator dependence

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Acknowledgements

The scientific guarantor of this publication is U. Joseph Schoepf. The authors of this manuscript declare relationships with the following companies: U.J.S. is a consultant for and/or receives research support from Bayer (Wayne/NJ, USA), Bracco (Princeton/NJ, USA), GE Healthcare (Little Chalfont, UK), Guerbet (Bloomington/IN, USA), Medrad (Warrendale/PA, USA) and Siemens Healthineers (Malvern/PA, USA). A.V.S. and C.N.D.C. are consultants for and/or receive research support from Guerbet (Bloomington/IN, USA) and Siemens Healthineers (Malvern/PA, USA). B.S.S. is an employee of Siemens. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, experimental, performed at one institution.

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Authors and Affiliations

  1. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA

    Akos Varga-Szemes, U. Joseph Schoepf, Carlo N. De Cecco, Giuseppe Muscogiuri, Julian L. Wichmann, Stefanie Mangold, Stephen R. Fuller, Rozemarijn Vliegenthart & Pal Suranyi

  2. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

    Rob J. van der Geest

  3. Siemens Medical Solutions, Chicago, IL, USA

    Bruce S. Spottiswoode

  4. Department of Imaging, Bambino Gesu Children’s Hospital IRCCS, Rome, Italy

    Giuseppe Muscogiuri

  5. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany

    Julian L. Wichmann

  6. Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen, Germany

    Stefanie Mangold

  7. MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary

    Pal Maurovich-Horvat & Bela Merkely

  8. Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Sheldon E. Litwin

  9. Center for Medical Imaging-North East Netherlands, Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Rozemarijn Vliegenthart

Authors
  1. Akos Varga-Szemes
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  2. Rob J. van der Geest
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  3. U. Joseph Schoepf
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  4. Bruce S. Spottiswoode
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  5. Carlo N. De Cecco
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  6. Giuseppe Muscogiuri
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  7. Julian L. Wichmann
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  8. Stefanie Mangold
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  9. Stephen R. Fuller
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  10. Pal Maurovich-Horvat
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  11. Bela Merkely
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  12. Sheldon E. Litwin
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  13. Rozemarijn Vliegenthart
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  14. Pal Suranyi
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Correspondence to U. Joseph Schoepf.

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Varga-Szemes, A., van der Geest, R.J., Schoepf, U.J. et al. Effect of inversion time on the precision of myocardial late gadolinium enhancement quantification evaluated with synthetic inversion recovery MR imaging. Eur Radiol 27, 3235–3243 (2017). https://doi.org/10.1007/s00330-016-4665-z

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  • DOI: https://doi.org/10.1007/s00330-016-4665-z

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