Key result
T2 map texture analysis shows high diagnostic accuracy for acute infarctlike myocarditis with 0.88 AUC.
Why the study?
Does texture analysis of T1 and T2 maps improve the diagnosis of acute infarctlike myocarditis compared to standard mapping and Lake Louise criteria?
Observational (n=39)
Does texture analysis of T1 and T2 maps improve the diagnosis of acute infarctlike myocarditis compared to standard mapping and Lake Louise criteria?
Effect estimate: AUC 0.88 (95% CI 0.73, 1.00)
p-value: p=< .001
Texture analysis of T2 maps shows high sensitivity and specificity for the diagnosis of acute infarctlike myocarditis, outperforming standard mapping and Lake Louise criteria.
Texture analysis of T2 maps may aid noninvasive diagnosis of acute infarctlike myocarditis; leaves open prospective validation against standard mapping and Lake Louise criteria.
Purpose To assess the diagnostic potential of texture analysis applied to T1 and T2 maps obtained with cardiac MRI for the diagnosis of acute infarctlike myocarditis. Materials and Methods This prospective study from August 2012 to May 2015 included 39 participants (overall mean age ± standard deviation, 34.7 years ± 12.2 [range, 18-63 years]; mean age of women, 46.1 years ± 10.8 [range, 24-63 years]; mean age of men, 29.8 years ± 9.2 [range, 18-56 years]) from the Magnetic Resonance Imaging in Myocarditis (MyoRacer) trial with clinical suspicion of acute myocarditis and infarctlike presentation. Participants underwent biventricular endomyocardial biopsy, cardiac catheterization, and cardiac MRI at 1.5 T, in which native T1 and T2 mapping as well as Lake Louise criteria (LLC) were assessed. Texture analysis was applied on T1 and T2 maps by using a freely available software package. Stepwise dimension reduction and texture feature selection was performed for selecting features enabling the diagnosis of myocarditis by using endomyocardial biopsy as the reference standard. Results Endomyocardial biopsy confirmed the diagnosis of acute myocarditis in 26 patients, whereas 13 participants had no signs of acute inflammation. Mean T1 and T2 values and LLC showed a low diagnostic performance, with area under the curve in receiver operating curve analyses as follows: 0.65 (95% confidence interval [CI]: 0.45, 0.85) for T1, 0.67 (95% CI: 0.49, 0.85) for T2, and 0.62 (95% CI: 0.42, 0.79) for LLC. Combining the texture features T2 run-length nonuniformity and gray-level nonuniformity resulted in higher diagnostic performance with an area under the curve of 0.88 (95% CI: 0.73, 1.00) (P < .001) and a sensitivity and specificity of 89% [95% CI: 81%, 93%] and 92% [95% CI: 77%, 93%], respectively. Conclusion Texture analysis of T2 maps shows high sensitivity and specificity for the diagnosis of acute infarctlike myocarditis.
No takes yet. Share an insight, caveat, or question.
Baeßler et al. (2018) conducted an observational in acute infarctlike myocarditis (n=39). Texture analysis of T1 and T2 maps vs. Mean T1 and T2 values and Lake Louise criteria was evaluated on Diagnosis of acute myocarditis using endomyocardial biopsy as reference (AUC 0.88, 95% CI 0.73, 1.00, p=< .001). Texture analysis of T2 maps combining run-length and gray-level nonuniformity showed high diagnostic performance for acute infarctlike myocarditis (AUC 0.88; 95% CI 0.73-1.00; P<0.001).