Key result
Z-score mapping of MOLLI T1 data differentiated patients with cardiac amyloidosis from healthy subjects with 96-100% sensitivity and 100% specificity, matching standard T1 analysis regardless of field strength.
Why the study?
MOLLI T1 mapping results differ across sites due to variations in hardware and software, limiting comparability across cardiovascular magnetic resonance platforms.
Does Z-score mapping of MOLLI T1 data improve comparability across different CMR platforms while maintaining diagnostic accuracy for cardiac amyloidosis?
Observational (n=83)
Yes
Does Z-score mapping of MOLLI T1 data improve comparability across different CMR platforms while maintaining diagnostic accuracy for cardiac amyloidosis?
Absolute Event Rate: 96% vs 96%
p-value: p=<0.001
Z-score mapping standardizes native T1 results across different CMR platforms and field strengths without losing diagnostic accuracy for detecting cardiac amyloidosis.
Supports T1 standardization across CMR platforms; leaves open prospective validation for cardiac amyloidosis.
BACKGROUND: T1 mapping using modified Look-Locker inversion recovery (MOLLI) provides quantitative information on myocardial tissue composition. T1 results differ between sites due to variations in hardware and software equipment, limiting the comparability of results. The aim was to test if Z-scores can be used to compare the results of MOLLI T1 mapping from different cardiovascular magnetic resonance (CMR) platforms. METHODS: First, healthy subjects (n = 15) underwent 11 combinations of native short-axis T1 mapping (four CMR systems from two manufacturers at 1.5 T and 3 T, three MOLLI schemes). Mean and standard deviation (SD) of septal myocardial T1 were derived for each combination. T1 maps were transformed into Z-score maps based on mean and SD values using a prototype post-processing module. Second, Z-score mapping was applied to a validation sample of patients with cardiac amyloidosis at 1.5 T (n = 25) or 3 T (n = 13). RESULTS: In conventional T1 analysis, results were confounded by variations in field strength, MOLLI scheme, and manufacturer-specific system characteristics. Z-score-based analysis yielded consistent results without significant differences between any two of the combinations in part 1 of the study. In the validation sample, Z-score mapping differentiated between patients with cardiac amyloidosis and healthy subjects with the same diagnostic accuracy as standard T1 analysis regardless of field strength. CONCLUSIONS: T1 analysis based on Z-score mapping provides consistent results without significant differences due to field strengths, CMR systems, or MOLLI variants, and detects cardiac amyloidosis with the same diagnostic accuracy as conventional T1 analysis. Z-score mapping provides a means to compare native T1 results acquired with MOLLI across different CMR platforms.
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Kranzusch et al. (2020) conducted an observational in Cardiac amyloidosis (n=83). Z-score mapping of MOLLI T1 data vs. Conventional T1 mapping was evaluated on Detection of cardiac amyloidosis (sensitivity at 1.5 T) (p=<0.001). Z-score mapping of MOLLI T1 data differentiated patients with cardiac amyloidosis from healthy subjects with 96-100% sensitivity and 100% specificity, matching standard T1 analysis regardless of field strength.
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