What is the clinical evidence from this study?

Study design: Observational. Population: Cardiomyopathy (n=60). Intervention: Cardiac MR T1 mapping vs. Endomyocardial biopsy. Primary outcome: Correlation between myocardial T1 time and histologic fibrosis (r = -0.57, 95% CI -0.74, -0.34, p=<0.0001).

October 23, 2012Radiology

T1 Mapping in Cardiomyopathy at Cardiac MR: Comparison with Endomyocardial Biopsy

Q: What are the key findings of this study?

Postcontrast myocardial T1 time was significantly inversely correlated with histologic fibrosis (r = -0.57) and detected fibrosis greater than 5% with an area under the curve of 0.84.

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Key result

Postcontrast myocardial T1 time was significantly inversely correlated with histologic fibrosis (r = -0.57) and detected fibrosis greater than 5% with an area under the curve of 0.84.

Why the study?

Does cardiac MR T1 mapping accurately quantify diffuse myocardial fibrosis compared to endomyocardial biopsy in patients with cardiomyopathy?

Population

47 cardiomyopathy patients and 13 healthy volunteers

Comparison

Cardiac MR T1 mapping vs Endomyocardial biopsy with quantitative…

Design

Cohort, Radiologists blinded to histopathologic findings; pathologists blinded…

Authors

CSChristopher T. SibleyCardiac Imaging RNRadwa NoureldinSuez Canal University NGNeville GaiNational Institute of Biomedical Imaging and Bioengineering

Discussion

Member takes

Implication

May support noninvasive fibrosis assessment by T1 mapping; hypothesis-generating and requires prospective validation before clinical adoption.

Study Design

Type

Observational (n=60)

Blinding

Blinded readers

Multicenter

Structured PICO

Does cardiac MR T1 mapping accurately quantify diffuse myocardial fibrosis compared to endomyocardial biopsy in patients with cardiomyopathy?

Population

47 cardiomyopathy patients (53% male; mean age, 46.8 years) and 13 healthy volunteers (54% male; mean age, 38.1 years)

Intervention

Cardiac MR T1 mapping (inversion-recovery Look-Locker sequence on a 1.5-T MR imager after 0.2 mmol/kg gadolinium chelate)

Comparator

Endomyocardial biopsy with quantitative measurement of fibrosis (Masson trichrome staining)

Outcome

Correlation between myocardial T1 time and histologic fibrosissurrogate

Main Result

Effect estimate: r = -0.57 (95% CI -0.74, -0.34)

p-value: p=<0.0001

Cardiac MR T1 mapping provides a noninvasive method to detect and quantify diffuse myocardial fibrosis, correlating well with endomyocardial biopsy in cardiomyopathy patients.

Limitations

Referral bias based on the single institution's population
Time gaps between cardiac MR and biopsy for some patients may have resulted in histologic fibrosis leading or lagging noninvasive measures
Results may not be generalizable to patients with cardiomyopathies that result in rapid progression of myocardial injury, such as fulminant myocarditis
Retrospective, cross-sectional nature precludes assessment of test-retest reproducibility and measurement calibration
Inter- and intrareader reproducibility was not assessed
T1 shortening can also be due to the presence of fat, amyloid protein, or iron, not just fibrosis
A modified Look-Locker (MOLLI) sequence was not available over the duration of the study

Cite This Study

Sibley et al. (2012) conducted an observational in Cardiomyopathy (n=60). Cardiac MR T1 mapping vs. Endomyocardial biopsy was evaluated on Correlation between myocardial T1 time and histologic fibrosis (r = -0.57, 95% CI -0.74, -0.34, p=<0.0001). Postcontrast myocardial T1 time was significantly inversely correlated with histologic fibrosis (r = -0.57) and detected fibrosis greater than 5% with an area under the curve of 0.84.

synapsesocial.com/papers/6a121bbc45487b7639a5e5bf https://doi.org/10.1148/radiol.12112721

Topics

Cardiomyopathy

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October 23, 2012Radiology

T1 Mapping in Cardiomyopathy at Cardiac MR: Comparison with Endomyocardial Biopsy

View Full Paper

Ask AI

Bookmark

Key result

Postcontrast myocardial T1 time was significantly inversely correlated with histologic fibrosis (r = -0.57) and detected fibrosis greater than 5% with an area under the curve of 0.84.

Why the study?

Does cardiac MR T1 mapping accurately quantify diffuse myocardial fibrosis compared to endomyocardial biopsy in patients with cardiomyopathy?

Population

47 cardiomyopathy patients and 13 healthy volunteers

Comparison

Cardiac MR T1 mapping vs Endomyocardial biopsy with quantitative…

Design

Cohort, Radiologists blinded to histopathologic findings; pathologists blinded…

Authors

CSChristopher T. SibleyCardiac Imaging RNRadwa NoureldinSuez Canal University NGNeville GaiNational Institute of Biomedical Imaging and Bioengineering

Discussion

Member takes

Implication

May support noninvasive fibrosis assessment by T1 mapping; hypothesis-generating and requires prospective validation before clinical adoption.

Study Design

Type

Observational (n=60)

Blinding

Blinded readers

Multicenter

Structured PICO

Does cardiac MR T1 mapping accurately quantify diffuse myocardial fibrosis compared to endomyocardial biopsy in patients with cardiomyopathy?

Population

47 cardiomyopathy patients (53% male; mean age, 46.8 years) and 13 healthy volunteers (54% male; mean age, 38.1 years)

Intervention

Cardiac MR T1 mapping (inversion-recovery Look-Locker sequence on a 1.5-T MR imager after 0.2 mmol/kg gadolinium chelate)

Comparator

Endomyocardial biopsy with quantitative measurement of fibrosis (Masson trichrome staining)

Outcome

Correlation between myocardial T1 time and histologic fibrosissurrogate

Main Result

Effect estimate: r = -0.57 (95% CI -0.74, -0.34)

p-value: p=<0.0001

Cardiac MR T1 mapping provides a noninvasive method to detect and quantify diffuse myocardial fibrosis, correlating well with endomyocardial biopsy in cardiomyopathy patients.

Limitations

Referral bias based on the single institution's population
Time gaps between cardiac MR and biopsy for some patients may have resulted in histologic fibrosis leading or lagging noninvasive measures
Results may not be generalizable to patients with cardiomyopathies that result in rapid progression of myocardial injury, such as fulminant myocarditis
Retrospective, cross-sectional nature precludes assessment of test-retest reproducibility and measurement calibration
Inter- and intrareader reproducibility was not assessed
T1 shortening can also be due to the presence of fat, amyloid protein, or iron, not just fibrosis
A modified Look-Locker (MOLLI) sequence was not available over the duration of the study

Cite This Study

synapsesocial.com/papers/6a121bbc45487b7639a5e5bf https://doi.org/10.1148/radiol.12112721

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

Cardiomyopathy

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