Characterization of cardiac amyloidosis using cardiac magnetic resonance fingerprinting. (15th March 2022)

• Record Type: Journal Article
• Authors: Eck, Brendan L.; Seiberlich, Nicole; Flamm, Scott D.; Hamilton, Jesse I.; Suresh, Abhilash; Kumar, Yash; Hanna, Mazen; Houston, Angel; Tew, Derrek; Tang, W.H. Wilson; Kwon, Deborah H.
• Is Part Of: International journal of cardiology. Volume 351(2022)
• Page Start: 107
• Page End: 110
• Publication Date: 2022-03-15
• Subjects: Magnetic resonance imaging -- Cardiac amyloidosis -- Tissue characterization -- Magnetic resonance fingerprinting -- T1 mapping -- T2 mapping; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2021.12.038
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Cardiac amyloidosis (CA) is an infiltrative cardiomyopathy with poor prognosis absent appropriate treatment. Elevated native myocardial T1 and T2 have been reported for CA, and tissue characterization by cardiac MRI may expedite diagnosis and treatment. Cardiac Magnetic Resonance Fingerprinting (cMRF) has the potential to enable tissue characterization for CA through rapid, simultaneous T1 and T2 mapping. Furthermore, cMRF signal timecourses may provide additional information beyond myocardial T1 and T2 . Methods: Nine CA patients and five controls were scanned at 3 T using a prospectively gated cMRF acquisition. Two cMRF-based analysis approaches were examined: (1) relaxometric-based linear discriminant analysis (LDA) using native T1 and T2, and (2) signal timecourse-based LDA. The Fisher coefficient was used to compare the separability of patient and control groups from both approaches. Leave-two-out cross-validation was employed to evaluate the classification error rates of both approaches. Results: Elevated myocardial T1 and T2 was observed in patients vs controls (T1 : 1395 ± 121 vs 1240 ± 36.4 ms, p < 0.05; T2 : 36.8 ± 3.3 vs 31.8 ± 2.6 ms, p < 0.05). LDA scores were elevated in patients for relaxometric-based LDA (0.56 ± 0.28 vs 0.18 ± 0.13, p < 0.05) and timecourse-based LDA (0.97 ± 0.02 vs 0.02 ± 0.02, p < 0.05). The Fisher coefficient was greater for timecourse-based LDA (60.8) vs relaxometric-based LDA (1.6). Classification error rates were lower for timecourse-based LDA vs relaxometric-based LDA (12.6 ± 24.3 vs 22.5 ± 30.1%, p < 0.05). Conclusions: These findings suggest that cMRF may be a valuable technique for the detection and characterization of CA. Analysis of cMRF signal timecourse data may improve tissue characterization as compared to analysis of native T1 and T2 alone. Highlights: Cardiac amyloidosis (CA) is an infiltrative cardiomyopathy Myocardial T1 and T2 mapping can support CA tissue characterization, aid diagnosis Cardiac Magnetic Resonance Fingerprinting (cMRF) may enhance CA characterization cMRF-derived T1 and T2 were elevated in CA patients vs controls cMRF signal timecourse data showed improved CA discrimination vs T1 and T2 alone