title: Contrast-optimized composite image derived from multigradient echo cardiac magnetic resonance imaging improves reproducibility of myocardial contours and T2* measurement.
abstract: OBJECTIVE
  Reproducibility of myocardial contour determination in cardiac magnetic resonance imaging is important, especially when determining T2* values per myocardial segment as a prognostic factor of heart failure or thalassemia. A method creating a composite image with contrasts optimized for drawing myocardial contours is introduced and compared with the standard method on a single image.
  
  
  METHODS
  A total of 36 short-axis slices from bright-blood multigradient echo (MGE) T2* scans of 21 patients were acquired at eight echo times. Four observers drew free-hand myocardial contours on one manually selected T2* image (method 1) and on one image composed by blending three images acquired at TEs providing optimum contrast-to-noise ratio between the myocardium and its surrounding regions (method 2).
  
  
  RESULTS
  Myocardial contouring by method 2 met higher interobserver reproducibility than method 1 (P < 0.001) with smaller Coefficient of variance (CoV) of T2* values in the presence of myocardial iron accumulation (9.79 vs. 15.91%) and in both global myocardial and mid-ventricular septum regions (12.29 vs. 16.88 and 5.76 vs. 8.16%, respectively).
  
  
  CONCLUSIONS
  The use of contrast-optimized composite images in MGE data analysis improves reproducibility of myocardial contour determination, leading to increased consistency in the calculated T2* values enhancing the diagnostic impact of this measure of iron overload.
authors.affiliation: Center for Medical Imaging-North East Netherlands, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands. p.triadyaksa@umcg.nl.|Department of Physics, Diponegoro University, Prof. Soedarto street, Semarang, 50275, Indonesia. p.triadyaksa@umcg.nl.
authors.forename: Pandji
authors.initials: P
authors.lastname: Triadyaksa
authors.affiliation: Center for Medical Imaging-North East Netherlands, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
authors.forename: Astri
authors.initials: A
authors.lastname: Handayani
authors.affiliation: Center for Medical Imaging-North East Netherlands, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.|Department of Radiology, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
authors.forename: Hildebrand
authors.initials: H
authors.lastname: Dijkstra
authors.affiliation: Center for Medical Imaging-North East Netherlands, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
authors.forename: Kadek Y E
authors.initials: KY
authors.lastname: Aryanto
authors.affiliation: Center for Medical Imaging-North East Netherlands, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
authors.forename: Gert Jan
authors.initials: GJ
authors.lastname: Pelgrim
authors.affiliation: Center for Medical Imaging-North East Netherlands, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
authors.forename: Xueqian
authors.initials: X
authors.lastname: Xie
authors.affiliation: Department of Radiology, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
authors.forename: Tineke P
authors.initials: TP
authors.lastname: Willems
authors.affiliation: Center for Medical Imaging-North East Netherlands, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.|Department of Radiology, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
authors.forename: Niek H J
authors.initials: NH
authors.lastname: Prakken
authors.affiliation: Center for Medical Imaging-North East Netherlands, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
authors.forename: Matthijs
authors.initials: M
authors.lastname: Oudkerk
authors.affiliation: Center for Medical Imaging-North East Netherlands, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.|Department of Radiology, EB45, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Sijens
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D003287:Contrast Media / Q000737:chemistry*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007501:Iron; D019190:Iron Overload / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007501:Iron
keywords: Contrast-optimized composite image; Iron overload; Magnetic resonance imaging; Myocardium; T2* quantification