PMID- 31971296 OWN - NLM STAT- MEDLINE DCOM- 20210514 LR - 20220716 IS - 1522-2586 (Electronic) IS - 1053-1807 (Print) IS - 1053-1807 (Linking) VI - 52 IP - 3 DP - 2020 Sep TI - Texture signatures of native myocardial T(1) as novel imaging markers for identification of hypertrophic cardiomyopathy patients without scar. PG - 906-919 LID - 10.1002/jmri.27048 [doi] AB - BACKGROUND: In patients with suspected or known hypertrophic cardiomyopathy (HCM), late gadolinium enhancement (LGE) provides diagnostic and prognostic value. However, contraindications and long-term retention of gadolinium have raised concern about repeated gadolinium administration in this population. Alternatively, native T(1) -mapping enables identification of focal fibrosis, the substrate of LGE. However HCM-specific heterogeneous fibrosis distribution leads to subtle T(1) -maps changes that are difficult to identify. PURPOSE: To apply radiomic texture analysis on native T(1) -maps to identify patients with a low likelihood of LGE(+), thereby reducing the number of patients exposed to gadolinium administration. STUDY TYPE: Retrospective interpretation of prospectively acquired data. SUBJECTS: In all, 188 (54.7 +/- 14.4 years, 71% men) with suspected or known HCM. FIELD STRENGTH/SEQUENCE: A 1.5T scanner; slice-interleaved native T(1) -mapping (STONE) sequence and 3D LGE after administration of 0.1 mmol/kg of gadobenate dimeglumine. ASSESSMENT: Left ventricular LGE images were location-matched with native T(1) -maps using anatomical landmarks. Using a split-sample validation approach, patients were randomly divided 3:1 (training/internal validation vs. test cohorts). To balance the data during training, 50% of LGE(-) slices were discarded. STATISTICAL TESTS: Four sets of texture descriptors were applied to the training dataset for capture of spatially dependent and independent pixel statistics. Five texture features were sequentially selected with the best discriminatory capacity between LGE(+) and LGE(-) T(1) -maps and tested using a decision tree ensemble (DTE) classifier. RESULTS: The selected texture features discriminated between LGE(+) and LGE(-) T(1) -maps with a c-statistic of 0.75 (95% confidence interval [CI]: 0.70-0.80) using 10-fold cross-validation during internal validation in the training dataset and 0.74 (95% CI: 0.65-0.83) in the independent test dataset. The DTE classifier provided adequate labeling of all (100%) LGE(+) patients and 37% of LGE(-) patients during testing. DATA CONCLUSION: Radiomic analysis of native T(1) -images can identify ~1/3 of LGE(-) patients for whom gadolinium administration can be safely avoided. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020. J. Magn. Reson. Imaging 2020;52:906-919. CI - (c) 2020 International Society for Magnetic Resonance in Medicine. FAU - Neisius, Ulf AU - Neisius U AUID- ORCID: 0000-0003-4744-9166 AD - Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. AD - Cardiology Section, Department of Medicine, VA Boston Healthcare System, Harvard Medical School, Boston, Massachusetts, USA. FAU - El-Rewaidy, Hossam AU - El-Rewaidy H AD - Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. AD - Department of Computer Science, Technical University of Munich, Munich, Germany. FAU - Kucukseymen, Selcuk AU - Kucukseymen S AD - Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. FAU - Tsao, Connie W AU - Tsao CW AD - Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. FAU - Mancio, Jennifer AU - Mancio J AD - Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. FAU - Nakamori, Shiro AU - Nakamori S AD - Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. FAU - Manning, Warren J AU - Manning WJ AD - Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. AD - Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. FAU - Nezafat, Reza AU - Nezafat R AUID- ORCID: 0000-0002-1963-7138 AD - Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. LA - eng GR - 1R01HL127015/NH/NIH HHS/United States GR - 1R01HL129157/NH/NIH HHS/United States GR - R01 HL154744/HL/NHLBI NIH HHS/United States GR - 1R01HL129185-01/NH/NIH HHS/United States GR - R01 HL129157/HL/NHLBI NIH HHS/United States GR - R01 HL129185/HL/NHLBI NIH HHS/United States GR - R01 HL127015/HL/NHLBI NIH HHS/United States PT - Clinical Study PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20200123 PL - United States TA - J Magn Reson Imaging JT - Journal of magnetic resonance imaging : JMRI JID - 9105850 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Adult MH - Aged MH - *Cardiomyopathy, Hypertrophic/diagnostic imaging/pathology MH - Cicatrix/pathology MH - Contrast Media MH - Female MH - Fibrosis MH - *Gadolinium MH - Humans MH - Magnetic Resonance Imaging, Cine MH - Male MH - Middle Aged MH - Myocardium/pathology MH - Predictive Value of Tests MH - Retrospective Studies PMC - PMC9190206 MID - NIHMS1708011 OTO - NOTNLM OT - T1 mapping OT - cardiac magnetic resonance imaging OT - hypertrophic cardiomyopathy OT - late gadolinium enhancement OT - radiomics EDAT- 2020/01/24 06:00 MHDA- 2021/05/15 06:00 PMCR- 2022/06/13 CRDT- 2020/01/24 06:00 PHST- 2019/10/14 00:00 [received] PHST- 2019/12/17 00:00 [revised] PHST- 2019/12/19 00:00 [accepted] PHST- 2020/01/24 06:00 [pubmed] PHST- 2021/05/15 06:00 [medline] PHST- 2020/01/24 06:00 [entrez] PHST- 2022/06/13 00:00 [pmc-release] AID - 10.1002/jmri.27048 [doi] PST - ppublish SO - J Magn Reson Imaging. 2020 Sep;52(3):906-919. doi: 10.1002/jmri.27048. Epub 2020 Jan 23.