title: Myocardial Late Gadolinium Enhancement: Accuracy of T1 Mapping-based Synthetic Inversion-Recovery Imaging.
abstract: OBJECTIVE
  To compare the accuracy of detection and quantification of myocardial late gadolinium enhancement (LGE) with a synthetic inversion-recovery (IR) approach with that of conventional IR techniques.
  
  
  METHODS
  This prospective study was approved by the institutional review board and compliant with HIPAA. All patients gave written informed consent. Between June and November 2014, 43 patients (25 men; mean age, 54 years ± 16) suspected of having previous myocardial infarction underwent magnetic resonance (MR) imaging, including contrast material-enhanced LGE imaging and T1 mapping. Synthetic magnitude and phase-sensitive IR images were generated on the basis of T1 maps. Images were assessed by two readers. Differences in the per-patient and per-segment LGE detection rates between the synthetic and conventional techniques were analyzed with the McNemar test, and the accuracy of LGE quantification was calculated with the paired t test and Bland-Altman statistics. Interreader agreement for the detection and quantification of LGE was analyzed with κ and Bland-Altman statistics, respectively.
  
  
  RESULTS
  Seventeen of the 43 patients (39%) had LGE patterns consistent with myocardial infarction. The sensitivity and specificity of synthetic magnitude and phase-sensitive IR techniques in the detection of LGE were 90% and 95%, respectively, with patient-based analysis and 94% and 99%, respectively, with segment-based analysis. The area of LGE measured with synthetic IR techniques showed excellent agreement with that of conventional techniques (4.35 cm(2) ± 1.88 and 4.14 cm(2)± 1.62 for synthetic magnitude and phase-sensitive IR, respectively, compared with 4.25 cm(2) ± 1.92 and 4.22 cm(2) ± 1.86 for conventional magnitude and phase-sensitive IR, respectively; P > .05). Interreader agreement was excellent for the detection (κ > 0.81) and quantification (bias range, -0.34 to 0.40; P > .05) of LGE.
  
  
  CONCLUSIONS
  The accuracy of the T1 map-based synthetic IR approach in the detection and quantification of myocardial LGE in patients with previous myocardial infarction was similar to that of conventional IR techniques. The use of T1 mapping to derive synthetic LGE images may reduce imaging times and operator dependence in future T1 mapping protocols with full left ventricular coverage.
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Akos
authors.initials: A
authors.lastname: Varga-Szemes
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van der Geest
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Spottiswoode
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Pal
authors.initials: P
authors.lastname: Suranyi
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Balazs
authors.initials: B
authors.lastname: Ruzsics
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Carlo N
authors.initials: CN
authors.lastname: De Cecco
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Muscogiuri
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Paola M
authors.initials: PM
authors.lastname: Cannaò
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Mary A
authors.initials: MA
authors.lastname: Fox
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Julian L
authors.initials: JL
authors.lastname: Wichmann
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: Rozemarijn
authors.initials: R
authors.lastname: Vliegenthart
authors.affiliation: From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (A.V.S., P.S., C.N.D.C., G.M., P.M.C., M.A.F., J.L.W., R.V., U.J.S.), and Division of Cardiology, Department of Medicine (U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29245-2260; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (R.J.v.d.G.); Siemens Medical Solutions, Chicago, Ill (B.S.S.); and Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom (B.R.).
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*; D009942:Organometallic Compounds / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine