Re-evaluation of a novel approach for quantitative myocardial oedema detection by analysing tissue inhomogeneity in acute myocarditis using T2-mapping

verfasst von: Bettina Baeßler, Frank Schaarschmidt, Melanie Treutlein, Christian Stehning, Bernhard Schnackenburg, Guido Michels, David Maintz, Alexander C. Bunck
Abstract: Objectives: To re-evaluate a recently suggested approach of quantifying myocardial oedema and increased tissue inhomogeneity in myocarditis by T2-mapping. Methods: Cardiac magnetic resonance data of 99 patients with myocarditis were retrospectively analysed. Thirthy healthy volunteers served as controls. T2-mapping data were acquired at 1.5 T using a gradient-spin-echo T2-mapping sequence. T2-maps were segmented according to the 16-segments AHA-model. Segmental T2-values, segmental pixel-standard deviation (SD) and the derived parameters maxT2, maxSD and madSD were analysed and compared to the established Lake Louise criteria (LLC). Results: A re-estimation of logistic regression models revealed that all models containing an SD-parameter were superior to any model containing global myocardial T2. Using a combined cut-off of 1.8 ms for madSD + 68 ms for maxT2 resulted in a diagnostic sensitivity of 75% and specificity of 80% and showed a similar diagnostic performance compared to LLC in receiver-operating-curve analyses. Combining madSD, maxT2 and late gadolinium enhancement (LGE) in a model resulted in a superior diagnostic performance compared to LLC (sensitivity 93%, specificity 83%). Conclusions: The results show that the novel T2-mapping-derived parameters exhibit an additional diagnostic value over LGE with the inherent potential to overcome the current limitations of T2-mapping. Key Points: • A novel quantitative approach to myocardial oedema imaging in myocarditis was re-evaluated. • The T2-mapping-derived parameters maxT2 and madSD were compared to traditional Lake-Louise criteria. • Using maxT2 and madSD with dedicated cut-offs performs similarly to Lake-Louise criteria. • Adding maxT2 and madSD to LGE results in further increased diagnostic performance. • This novel approach has the potential to overcome the limitations of T2-mapping.
Organisationseinheit(en): Abteilung Biostatistik
Externe Organisation(en): Universität zu Köln
Philips HealthTech
Typ: Artikel
Journal: European radiology
Band: 27
Seiten: 5169-5178
Anzahl der Seiten: 10
ISSN: 0938-7994
Publikationsdatum: 27.06.2017
Publikationsstatus: Veröffentlicht
Peer-reviewed: Ja
ASJC Scopus Sachgebiete: Radiologie, Nuklearmedizin und Bildgebung
Elektronische Version(en): https://doi.org/10.1007/s00330-017-4894-9 (Zugang: Geschlossen)

BibTeX

@article{7c452cab3d9b4d1ba79239af7a262ede,
title = "Re-evaluation of a novel approach for quantitative myocardial oedema detection by analysing tissue inhomogeneity in acute myocarditis using T2-mapping",
abstract = "Objectives: To re-evaluate a recently suggested approach of quantifying myocardial oedema and increased tissue inhomogeneity in myocarditis by T2-mapping. Methods: Cardiac magnetic resonance data of 99 patients with myocarditis were retrospectively analysed. Thirthy healthy volunteers served as controls. T2-mapping data were acquired at 1.5 T using a gradient-spin-echo T2-mapping sequence. T2-maps were segmented according to the 16-segments AHA-model. Segmental T2-values, segmental pixel-standard deviation (SD) and the derived parameters maxT2, maxSD and madSD were analysed and compared to the established Lake Louise criteria (LLC). Results: A re-estimation of logistic regression models revealed that all models containing an SD-parameter were superior to any model containing global myocardial T2. Using a combined cut-off of 1.8 ms for madSD + 68 ms for maxT2 resulted in a diagnostic sensitivity of 75% and specificity of 80% and showed a similar diagnostic performance compared to LLC in receiver-operating-curve analyses. Combining madSD, maxT2 and late gadolinium enhancement (LGE) in a model resulted in a superior diagnostic performance compared to LLC (sensitivity 93%, specificity 83%). Conclusions: The results show that the novel T2-mapping-derived parameters exhibit an additional diagnostic value over LGE with the inherent potential to overcome the current limitations of T2-mapping. Key Points: • A novel quantitative approach to myocardial oedema imaging in myocarditis was re-evaluated. • The T2-mapping-derived parameters maxT2 and madSD were compared to traditional Lake-Louise criteria. • Using maxT2 and madSD with dedicated cut-offs performs similarly to Lake-Louise criteria. • Adding maxT2 and madSD to LGE results in further increased diagnostic performance. • This novel approach has the potential to overcome the limitations of T2-mapping.",
keywords = "Lake Louise criteria, Myocarditis, Oedema imaging, T2 mapping, Tissue inhomogeneity",
author = "Bettina Bae{\ss}ler and Frank Schaarschmidt and Melanie Treutlein and Christian Stehning and Bernhard Schnackenburg and Guido Michels and David Maintz and Bunck, {Alexander C.}",
note = "Publisher Copyright: {\textcopyright} 2017, European Society of Radiology. Copyright: Copyright 2018 Elsevier B.V., All rights reserved.",
year = "2017",
month = jun,
day = "27",
doi = "10.1007/s00330-017-4894-9",
language = "English",
volume = "27",
pages = "5169--5178",
journal = "European radiology",
issn = "0938-7994",
publisher = "Springer Verlag",
number = "12",
}