title: Noncontrast myocardial T1 mapping using cardiovascular magnetic resonance for iron overload.
abstract: OBJECTIVE
  To explore the use and reproducibility of magnetic resonance-derived myocardial T1 mapping in patients with iron overload.
  
  
  METHODS
  The research received ethics committee approval and all patients provided written informed consent. This was a prospective study of 88 patients and 67 healthy volunteers. Thirty-five patients underwent repeat scanning for reproducibility. T1 mapping used the shortened modified Look-Locker inversion recovery sequence (ShMOLLI) with a second, confirmatory MOLLI sequence in the reproducibility group. T2 * was performed using a commercially available sequence. The analysis of the T2 * interstudy reproducibility data was performed by two different research groups using two different methods.
  
  
  RESULTS
  Myocardial T1 was lower in patients than healthy volunteers (836 ± 138 msec vs. 968 ± 32 msec, P < 0.0001). Myocardial T1 correlated with T2 * (R = 0.79, P < 0.0001). No patient with low T2 * had normal T1 , but 32% (n = 28) of cases characterized by a normal T2 * had low myocardial T1 . Interstudy reproducibility of either T1 sequence was significantly better than T2 *, with the results suggesting that the use of T1 in clinical trials could decrease potential sample sizes by 7-fold.
  
  
  CONCLUSIONS
  Myocardial T1 mapping is an alternative method for cardiac iron quantification. T1 mapping shows the potential for improved detection of mild iron loading. The superior reproducibility of T1 has potential implications for clinical trial design and therapeutic monitoring.
authors.affiliation: The Heart Hospital, London, UK.|Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Sado
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrology and Geriatrics Sciences, La Sapienza, University of Rome, Rome, Italy.
authors.forename: Viviana
authors.initials: V
authors.lastname: Maestrini
authors.affiliation: Oxford Centre for Clinical Magnetic Resonance Research, Department of Cardiovascular Medicine, University of Oxford, Oxford, UK.
authors.forename: Stefan K
authors.initials: SK
authors.lastname: Piechnik
authors.affiliation: The Heart Hospital, London, UK.|Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: Sanjay M
authors.initials: SM
authors.lastname: Banypersad
authors.affiliation: The Heart Hospital, London, UK.|Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: Steven K
authors.initials: SK
authors.lastname: White
authors.affiliation: The Heart Hospital, London, UK.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Flett
authors.affiliation: Oxford Centre for Clinical Magnetic Resonance Research, Department of Cardiovascular Medicine, University of Oxford, Oxford, UK.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Robson
authors.affiliation: Oxford Centre for Clinical Magnetic Resonance Research, Department of Cardiovascular Medicine, University of Oxford, Oxford, UK.
authors.forename: Stefan
authors.initials: S
authors.lastname: Neubauer
authors.affiliation: Department of Statistics, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Cono
authors.initials: C
authors.lastname: Ariti
authors.affiliation: National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Arai
authors.affiliation: National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Kellman
authors.affiliation: University Medical Centre Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg, Germany.
authors.forename: Jin
authors.initials: J
authors.lastname: Yamamura
authors.affiliation: University Medical Centre Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg, Germany.
authors.forename: Bjoern P
authors.initials: BP
authors.lastname: Schoennagel
authors.affiliation: The Whittington Hospital, London, UK.
authors.forename: Farrukh
authors.initials: F
authors.lastname: Shah
authors.affiliation: The Whittington Hospital, London, UK.
authors.forename: Bernard
authors.initials: B
authors.lastname: Davis
authors.affiliation: University College Hospital, London, UK.
authors.forename: Sara
authors.initials: S
authors.lastname: Trompeter
authors.affiliation: The Heart Hospital, London, UK.|Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Walker
authors.affiliation: University College Hospital, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Porter
authors.affiliation: The Heart Hospital, London, UK.|Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: James C
authors.initials: JC
authors.lastname: Moon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019190:Iron Overload / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D015203:Reproducibility of Results
keywords: MRI; T1; iron