Key result
Cine Dixon MRI quantified epicardial fat with excellent intra-observer variability (ICC = 0.96) and good inter-observer variability (ICC = 0.76), outperforming standard single-phase Dixon.
Why the study?
Epicardial fat is linked to cardiovascular diseases, but the merits of a new high-resolution cine 3D Dixon technique compared to single-phase 3D Dixon for epicardial adipose tissue quantification were unknown.
Does 3D cine Dixon MRI improve the reproducibility of epicardial fat quantification compared to standard single-phase 3D Dixon MRI in patients with cardiovascular disease?
Cross-Sectional (n=15)
Single-blind
No
Does 3D cine Dixon MRI improve the reproducibility of epicardial fat quantification compared to standard single-phase 3D Dixon MRI in patients with cardiovascular disease?
Absolute Event Rate: 0.96% vs 0.92%
3D cine Dixon MRI provides lower intra- and inter-observer variability for quantifying epicardial fat compared to standard single-phase Dixon, likely due to better delineation of fat borders across the cardiac cycle.
May support refined epicardial fat imaging protocols in research; leaves open clinical outcome impact in cardiovascular disease.
BACKGROUND: There is an increased interest in quantifying and characterizing epicardial fat which has been linked to various cardiovascular diseases such as coronary artery disease and atrial fibrillation. Recently, three-dimensional single-phase Dixon techniques have been used to depict the heart and to quantify the surrounding fat. The purpose of this study was to investigate the merits of a new high-resolution cine 3D Dixon technique for quantification of epicardial adipose tissue and compare it to single-phase 3D Dixon in patients with cardiovascular disease. METHODS: Fifteen patients referred for clinical CMR examination of known or suspected heart disease were scanned on a 1.5 T scanner using single-phase Dixon and cine Dixon. Epicardial fat was segmented by three readers and intra- and inter-observer variability was calculated per slice. Cine Dixon segmentation was performed in the same cardiac phase as single-phase Dixon. Subjective image quality assessment of water and fat images were performed by three readers using a 4-point Likert scale (1 = severe; 2 = significant; 3 = mild; 4 = no blurring of cardiac structures). RESULTS: Intra-observer variability was excellent for cine Dixon images (ICC = 0.96), and higher than single-phase Dixon (ICC = 0.92). Inter-observer variability was good for cine Dixon (ICC = 0.76) and moderate for single-phase Dixon (ICC = 0.63). The intra-observer measurement error (mean ± standard deviation) per slice for cine was - 0.02 ± 0.51 ml (- 0.08 ± 0.4%), and for single-phase 0.39 ± 0.72 ml (0.18 ± 0.41%). Inter-observer measurement error for cine was 0.46 ± 0.98 ml (0.11 ± 0.46%) and for single-phase 0.42 ± 1.53 ml (0.17 ± 0.47%). Visual scoring of the water image yielded median of 2 (interquartile range = [Q3-Q1] 2-2) for cine and median of 3 (interquartile range = 3-2) for single-phase (P < 0.05) while no significant difference was found for the fat images, both techniques yielding a median of 3 and interquartile range of 3-2. CONCLUSION: Cine Dixon can be used to quantify epicardial fat with lower intra- and inter-observer variability compared to standard single-phase Dixon. The time-resolved information provided by the cine acquisition appears to support the delineation of the epicardial adipose tissue depot.
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Henningsson et al. (2020) conducted a cross-sectional in Known or suspected heart disease (n=15). 3D cine Dixon MRI vs. Single-phase 3D Dixon MRI was evaluated on Intra-observer variability (ICC) for epicardial fat quantification. Cine Dixon MRI quantified epicardial fat with excellent intra-observer variability (ICC = 0.96) and good inter-observer variability (ICC = 0.76), outperforming standard single-phase Dixon.
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