Comparison between cardiac magnetic resonance stress T1 mapping and [15O]H2O positron emission tomography in patients with suspected obstructive coronary artery disease. (13th May 2021)

• Record Type: Journal Article
• Authors: Everaars, Henk; van Diemen, Pepijn A; Biesbroek, P Stefan; Hopman, Luuk H G A; Bom, Michiel J; Schumacher, Stefan P; de Winter, Ruben W; van de Ven, Peter M; Raijmakers, Pieter G; Lammertsma, Adriaan A; Hofman, Mark B M; Nijveldt, Robin; Götte, Marco J; van Rossum, Albert C; Danad, Ibrahim; Driessen, Roel S; Knaapen, Paul
• Is Part Of: European heart journal. Volume 23:Number 2(2022)
• Page Start: 229
• Page End: 237
• Publication Date: 2021-05-13
• Subjects: cardiac magnetic resonance -- positron emission tomography -- T1 mapping -- myocardial ischaemia -- coronary artery disease; Cardiovascular system -- Imaging -- Periodicals; Heart -- Imaging -- Periodicals; 616.10754
• DOI: 10.1093/ehjci/jeab073
• Languages: English
• ISSNs: 2047-2404

Abstract

Abstract: Aims: To compare cardiac magnetic resonance (CMR) measurement of T1 reactivity (ΔT1) with [ 15 O]H2 O positron emission tomography (PET) measurements of quantitative myocardial perfusion. Methods and results: Forty-three patients with suspected obstructed coronary artery disease underwent [ 15 O]H2 O PET and CMR at 1.5-T, including rest and adenosine stress T1 mapping (ShMOLLI) and late gadolinium enhancement to rule out presence of scar tissue. ΔT1 was determined for the three main vascular territories and compared with [ 15 O]H2 O PET-derived regional stress myocardial blood flow (MBF) and myocardial flow reserve (MFR). ΔT1 showed a significant but poor correlation with stress MBF ( R 2 = 0.04, P = 0.03) and MFR ( R 2 = 0.07, P = 0.004). Vascular territories with impaired stress MBF (i.e. ≤2.30 mL/min/g) demonstrated attenuated ΔT1 compared with vascular territories with preserved stress MBF (2.9 ± 2.2% vs. 4.1 ± 2.2%, P = 0.008). In contrast, ΔT1 did not differ between vascular territories with impaired (i.e. <2.50) and preserved MFR (3.2 ± 2.6% vs. 4.0 ± 2.1%, P = 0.25). Receiver operating curve analysis of ΔT1 resulted in an area under the curve of 0.66 [95% confidence interval (CI): 0.57–0.75, P = 0.009] for diagnosing impaired stress MBF and 0.62 (95% CI: 0.53–0.71, P = 0.07) for diagnosing impaired MFR. Conclusions: CMR stress T1 mapping has poor agreement with [ 15 O]H2 O PET measurements of absolute myocardial perfusion. Stress T1 and ΔT1 are lower in vascular territories with reduced stress MBF but have poor accuracy for detecting impaired myocardial perfusion.