Key result
Free-breathing, non-ECG CMR multitasking strongly correlated with MOLLI for native T1 mapping (R2=0.69-0.81, P<0.001) and showed superior diagnostic accuracy in patients with breath-holding issues.
Why the study?
To evaluate the image quality of free-breathing, non-ECG multitasking T1 mapping and compare its T1 values, lesion area, and diagnostic performance with the traditional MOLLI sequence in ischaemic and non-ischaemic cardiomyopathy.
Does free-breathing, non-ECG CMR multitasking provide accurate T1 mapping compared to traditional MOLLI in patients with ischaemic and non-ischaemic cardiomyopathy?
Cross-Sectional (n=139)
Does free-breathing, non-ECG CMR multitasking provide accurate T1 mapping compared to traditional MOLLI in patients with ischaemic and non-ischaemic cardiomyopathy?
Effect estimate: R2 = 0.69 to 0.81
p-value: p=<.001
Free-breathing, non-ECG CMR multitasking achieves accurate T1 mapping comparable to MOLLI, with superior performance in patients with breath-holding difficulties or arrhythmias.
May facilitate T1 mapping in breath-hold-limited patients; leaves open prospective outcome validation.
OBJECTIVE: To evaluate the image quality of the free-breathing, non-ECG-multitasking T1 mapping and to compare T1 values, lesion area, and ROC curve with those derived from the traditional MOLLI sequence in ischaemic and non-ischaemic cardiomyopathy. METHODS: In vitro, T1 values from CMR multitasking and MOLLI images were compared in 4 phantoms. In vivo studies included 108 patients (38 ischaemic cardiomyopathy, 70 non-ischaemic cardiomyopathy) and 31 healthy volunteers. All underwent mid-ventricular short-axis CMR Multitasking (free-breathing) and MOLLI (breath-held). Image quality was scored (4-point scale). T1 values and lesion areas were compared via linear regression, Bland-Altman analysis, and ROC curves (LGE as reference). RESULTS: Phantom T1 values showed excellent agreement (Multitasking versus reference: R2 = 0.99, P < .001). In vivo, multitasking strongly correlated with MOLLI for native T1 in healthy subjects (R2 = 0.69), ischaemic (R2 = 0.71), and non-ischaemic groups (R2 = 0.81, all P < .001). Multitasking demonstrated superior image quality in patients with breath-holding difficulties and adverse heart rates (P < .001). MOLLI image quality declined with breath-holding difficulties, arrhythmia, and high BMI (P < .05); multitasking was less affected but still impacted by BMI (P < .05). Lesion areas showed no inter-sequence differences (P > .05). ROC analysis revealed comparable diagnostic accuracy between sequences in stable patients (P > .05), but superior multitasking performance in breath-holding difficulties and arrhythmia subgroups (P < .05). CONCLUSION: Multitasking provides accurate T1 quantification and lesion delineation in cardiomyopathy, with enhanced robustness for patients with poor breath-holding or arrhythmia. BMI-related limitations warrant technical refinement. ADVANCES IN KNOWLEDGE: Free-breathing, non-ECG CMR multitasking achieves accurate T1 mapping in ischaemic/non-ischaemic cardiomyopathy, overcoming ECG/respiratory limitation.
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Wang et al. (2025) conducted a cross-sectional in Ischaemic and non-ischaemic cardiomyopathy (n=139). Free-breathing, non-ECG-triggered CMR multitasking T1 mapping vs. Traditional MOLLI sequence (breath-held) was evaluated on Native T1 values correlation (R2 = 0.69 to 0.81, p=<.001). Free-breathing, non-ECG CMR multitasking strongly correlated with MOLLI for native T1 mapping (R2=0.69-0.81, P<0.001) and showed superior diagnostic accuracy in patients with breath-holding issues.
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