Cardiac stress T1-mapping response and extracellular volume stability of MOLLI-based T1-mapping methods

Abstract 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 gadoliniu...

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Autores principales:	Matthew K. Burrage, Mayooran Shanmuganathan, Qiang Zhang, Evan Hann, Iulia A. Popescu, Rajkumar Soundarajan, Kelvin Chow, Stefan Neubauer, Vanessa M. Ferreira, Stefan K. Piechnik
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Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/63df588468834de68dabec6ac6791577
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spelling	oai:doaj.org-article:63df588468834de68dabec6ac67915772021-12-02T16:31:42ZCardiac stress T1-mapping response and extracellular volume stability of MOLLI-based T1-mapping methods10.1038/s41598-021-92923-42045-2322https://doaj.org/article/63df588468834de68dabec6ac67915772021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92923-4https://doaj.org/toc/2045-2322Abstract 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.Matthew K. BurrageMayooran ShanmuganathanQiang ZhangEvan HannIulia A. PopescuRajkumar SoundarajanKelvin ChowStefan NeubauerVanessa M. FerreiraStefan K. PiechnikNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Matthew K. Burrage Mayooran Shanmuganathan Qiang Zhang Evan Hann Iulia A. Popescu Rajkumar Soundarajan Kelvin Chow Stefan Neubauer Vanessa M. Ferreira Stefan K. Piechnik Cardiac stress T1-mapping response and extracellular volume stability of MOLLI-based T1-mapping methods
description	Abstract 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.
format	article
author	Matthew K. Burrage Mayooran Shanmuganathan Qiang Zhang Evan Hann Iulia A. Popescu Rajkumar Soundarajan Kelvin Chow Stefan Neubauer Vanessa M. Ferreira Stefan K. Piechnik
author_facet	Matthew K. Burrage Mayooran Shanmuganathan Qiang Zhang Evan Hann Iulia A. Popescu Rajkumar Soundarajan Kelvin Chow Stefan Neubauer Vanessa M. Ferreira Stefan K. Piechnik
author_sort	Matthew K. Burrage
title	Cardiac stress T1-mapping response and extracellular volume stability of MOLLI-based T1-mapping methods
title_short	Cardiac stress T1-mapping response and extracellular volume stability of MOLLI-based T1-mapping methods
title_full	Cardiac stress T1-mapping response and extracellular volume stability of MOLLI-based T1-mapping methods
title_fullStr	Cardiac stress T1-mapping response and extracellular volume stability of MOLLI-based T1-mapping methods
title_full_unstemmed	Cardiac stress T1-mapping response and extracellular volume stability of MOLLI-based T1-mapping methods
title_sort	cardiac stress t1-mapping response and extracellular volume stability of molli-based t1-mapping methods
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/63df588468834de68dabec6ac6791577
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Cardiac stress T1-mapping response and extracellular volume stability of MOLLI-based T1-mapping methods

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