PMID- 28856412 OWN - NLM STAT- MEDLINE DCOM- 20180620 LR - 20200330 IS - 1432-1084 (Electronic) IS - 0938-7994 (Print) IS - 0938-7994 (Linking) VI - 28 IP - 2 DP - 2018 Feb TI - Accurate late gadolinium enhancement prediction by early T1- based quantitative synthetic mapping. PG - 844-850 LID - 10.1007/s00330-017-5018-2 [doi] AB - OBJECTIVES: Early synthetic gadolinium enhancement (ESGE) imaging from post-contrast T1 mapping after adenosine stress-perfusion cardiac magnetic resonance (CMR) was compared to conventional late gadolinium enhancement (LGE) imaging for assessing myocardial scar. METHODS: Two hundred fourteen consecutive patients suspected of myocardial ischaemia were referred for stress-perfusion CMR. Myocardial infarct volume was quantified on a per-subsegment basis in both synthetic (2-3 min post-gadolinium) and conventional (9 min post-gadolinium) images by two independent observers. Sensitivity, specificity, PPV and NPV were calculated on a per-patient and per-subsegment basis. RESULTS: Both techniques detected 39 gadolinium enhancement areas in 23 patients. The median amount of scar was 2.0 (1.0-3.1) g in ESGE imaging and 2.2 (1.1-3.1) g in LGE imaging (p=0.39). Excellent correlation (r=0.997) and agreement (mean absolute difference: -0.028+/-0.289 ml) were found between ESGE and LGE images. Sensitivity, specificity, PPV and NPV of ESGE imaging were 96 (78.9-99.9), 99 (97.1-100.0)%, 96 (76.5-99.4) and 99.5 (96.6-99.9) in patient-based and 99 (94.5-100.0), 100 (99.9-100.0)%, 97.0 (91.3-99.0) and 100.0 (99.8-100.0) in subsegment-based analysis. CONCLUSION: ESGE based on post-contrast T1 mapping after adenosine stress-perfusion CMR imaging shows excellent agreement with conventional LGE imaging for assessing myocardial scar, and can substantially shorten clinical acquisition time. KEY POINTS: * Synthetic gadolinium enhancement images can be used for detection of myocardial scar. * Early synthetic gadolinium enhancement images can substantially shorten clinical acquisition time. * ESGE has high diagnostic accuracy as compared to conventional late gadolinium enhancement. * Quantification of myocardial scar with ESGE closely correlates with conventional LGE. * ESGE after stress perfusion CMR avoids need for additional gadolinium administration. FAU - van Dijk, Randy AU - van Dijk R AD - University of Groningen, University Medical Centre Groningen, Centre for Medical Imaging, Groningen, The Netherlands. AD - Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. FAU - Kuijpers, Dirkjan AU - Kuijpers D AD - University of Groningen, University Medical Centre Groningen, Centre for Medical Imaging, Groningen, The Netherlands. AD - Department of Cardiovascular Imaging HMC-Bronovo, The Hague, The Netherlands. FAU - Kaandorp, Theodorus A M AU - Kaandorp TAM AD - Department of Cardiovascular Imaging HMC-Bronovo, The Hague, The Netherlands. FAU - van Dijkman, Paul R M AU - van Dijkman PRM AD - Department of Cardiovascular Imaging HMC-Bronovo, The Hague, The Netherlands. FAU - Vliegenthart, Rozemarijn AU - Vliegenthart R AD - Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. FAU - van der Harst, Pim AU - van der Harst P AD - University of Groningen, University Medical Centre Groningen, Centre for Medical Imaging, Groningen, The Netherlands. AD - Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. FAU - Oudkerk, Matthijs AU - Oudkerk M AD - University of Groningen, University Medical Centre Groningen, Centre for Medical Imaging, Groningen, The Netherlands. m.oudkerk@umcg.nl. AD - Center for Medical Imaging, University Medical Center Groningen, Hanzeplein 1 EB 45, Groningen, The Netherlands. m.oudkerk@umcg.nl. LA - eng GR - 10-10400-98-14017/Zon-MW (Innovative Medical Devices Initiative LSH)/ GR - CVON2015-17/Hartstichting/ PT - Journal Article DEP - 20170830 PL - Germany TA - Eur Radiol JT - European radiology JID - 9114774 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) RN - K72T3FS567 (Adenosine) SB - IM MH - Adenosine/administration & dosage MH - Aged MH - Cicatrix/*diagnostic imaging/*pathology MH - *Contrast Media MH - Female MH - *Gadolinium MH - Humans MH - Image Enhancement MH - Magnetic Resonance Angiography/*methods MH - Male MH - Middle Aged MH - Myocardial Infarction/*diagnostic imaging/*pathology MH - Myocardium/pathology MH - Prospective Studies MH - Sensitivity and Specificity PMC - PMC5740207 OTO - NOTNLM OT - Adenosine OT - Coronary artery disease OT - Fibrosis OT - Gadolinium OT - Magnetic resonance imaging COIS- GUARANTOR: The scientific guarantor of this publication is professor M. Oudkerk. CONFLICT OF INTEREST: The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. FUNDING: This study was supported by a grant from Zon-MW (Innovative Medical Devices Initiative LSH 2014 (10-10400-98-14017) and a grant from the Dutch Heart Foundation (CVON2015-17). STATISTICS AND BIOMETRY: No complex statistical methods were necessary for this paper. INFORMED CONSENT: Written informed consent was obtained from all subjects (patients) in this study. ETHICAL APPROVAL: Institutional Review Board approval was obtained. METHODOLOGY: * prospective * diagnostic or prognostic/observational study * performed at one institution EDAT- 2017/09/01 06:00 MHDA- 2018/06/21 06:00 PMCR- 2017/08/30 CRDT- 2017/09/01 06:00 PHST- 2017/03/21 00:00 [received] PHST- 2017/08/02 00:00 [accepted] PHST- 2017/07/26 00:00 [revised] PHST- 2017/09/01 06:00 [pubmed] PHST- 2018/06/21 06:00 [medline] PHST- 2017/09/01 06:00 [entrez] PHST- 2017/08/30 00:00 [pmc-release] AID - 10.1007/s00330-017-5018-2 [pii] AID - 5018 [pii] AID - 10.1007/s00330-017-5018-2 [doi] PST - ppublish SO - Eur Radiol. 2018 Feb;28(2):844-850. doi: 10.1007/s00330-017-5018-2. Epub 2017 Aug 30.