Reference values for healthy human myocardium using a T1 mapping methodology: results from the International T1 Multicenter cardiovascular magnetic resonance study.
BACKGROUND
T1 mapping is a robust and highly reproducible application to quantify myocardial relaxation of longitudinal magnetisation. Available T1 mapping methods are presently site and vendor specific, with variable accuracy and precision of T1 values between the systems and sequences. We assessed the transferability of a T1 mapping method and determined the reference values of healthy human myocardium in a multicenter setting.


METHODS
Healthy subjects (n=102; mean age 41 years (range 17-83), male, n=53 (52%)), with no previous medical history, and normotensive low risk subjects (n=113) referred for clinical cardiovascular magnetic resonance (CMR) were examined. Further inclusion criteria for all were absence of regular medication and subsequently normal findings of routine CMR. All subjects underwent T1 mapping using a uniform imaging set-up (modified Look- Locker inversion recovery, MOLLI, using scheme 3(3)3(3)5)) on 1.5 Tesla (T) and 3 T Philips scanners. Native T1-maps were acquired in a single midventricular short axis slice and repeated 20 minutes following gadobutrol. Reference values were obtained for native T1 and gadolinium-based partition coefficients, λ and extracellular volume fraction (ECV) in a core lab using standardized postprocessing.


RESULTS
In healthy controls, mean native T1 values were 950±21 msec at 1.5 T and 1052±23 at 3 T. λ and ECV values were 0.44±0.06 and 0.25±0.04 at 1.5 T, and 0.44±0.07 and 0.26±0.04 at 3 T, respectively. There were no significant differences between healthy controls and low risk subjects in routine CMR parameters and T1 values. The entire cohort showed no correlation between age, gender and native T1. Cross-center comparisons of mean values showed no significant difference for any of the T1 indices at any field strength. There were considerable regional differences in segmental T1 values. λ and ECV were found to be dose dependent. There was excellent inter- and intraobserver reproducibility for measurement of native septal T1.


CONCLUSIONS
We show transferability for a unifying T1 mapping methodology in a multicenter setting. We provide reference ranges for T1 values in healthy human myocardium, which can be applied across participating sites.
Darius
D
Dabir
Nicholas
N
Child
Ashwin
A
Kalra
Toby
T
Rogers
Rolf
R
Gebker
Andrew
A
Jabbour
Sven
S
Plein
Chung-Yao
CY
Yu
James
J
Otton
Ananth
A
Kidambi
Adam
A
McDiarmid
David
D
Broadbent
David M
DM
Higgins
Bernhard
B
Schnackenburg
Lucy
L
Foote
Ciara
C
Cummins
Eike
E
Nagel
Valentina O
VO
Puntmann
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005060:Europe; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009517:New South Wales; D015588:Observer Variation; D011237:Predictive Value of Tests; D012016:Reference Values; D015203:Reproducibility of Results; D012737:Sex Factors; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D055815:Young Adult
D003287:Contrast Media