Key result
3D water-fat separated LGE imaging demonstrated satisfactory diagnostic image quality, with fat suppression scoring highest (2.54 ± 0.72 on a 4-point scale), though quality was significantly affected by obesity, myocardial mass, and cardiac function.
Why the study?
Three-dimensional water-fat separated LGE allows simultaneous assessment of cardiac fibrosis and fatty infiltration, but systematic analysis of its image quality and confounding factors was needed.
Cross-Sectional (n=138)
No
3D water-fat separated LGE imaging provides satisfactory image quality, particularly for fat suppression, though it can be confounded by patient obesity, high myocardial mass, and cardiac function.
3D water-fat LGE enables concurrent fibrosis and fat assessment; leaves open its added diagnostic value in clinical practice.
BACKGROUND: Three-dimensional (3D) water-fat separated late gadolinium enhancement (LGE) imaging is a cardiovascular magnetic resonance imaging technique allowing simultaneous assessment of and discrimination between cardiac fibrosis and myocardial fatty infiltration. The aim of this study is to systematically analyze the image quality of a 3D water-fat separated LGE research sequence and identify confounders of image quality METHODS: In total, 126 patients and 12 healthy volunteers were included. Patients were included with inflammatory bowel disease (n=35), muscular dystrophy (n=38), hypertrophic cardiomyopathy (n=23) and paroxysmal atrial fibrillation (n=30). 3D water-fat separated LGE images were acquired at 1.5T (n=122) or 3T (n=16). Image quality was subjectively rated (4-point Likert scale) in six categories (overall image quality [OV], blood-myocardium border sharpness, LGE-remote/healthy myocardium border sharpness, fat suppression, myocardial nulling [MN], anatomical structures [AS]), additionally, the contrast ratio was calculated. Cardiac function, acquisition conditions, and demographic data were investigated as potential confounders for image quality and contrast ratio. RESULTS: Fat suppression had the highest quality score (2.54±0.72), followed by AS (2.11±0.94) and MN (2.01±0.78). In total, 18 parameters showed a significant correlation with multiple image quality categories, most of which related to cardiac function, such as the cardiac index, which significantly correlated with OV (Wald Chi-squared=4.35; p<0.05), LGE-remote/healthy myocardium border sharpness (Wald Chi-squared=5.03; p<0.05), and AS (Wald Chi-square=16.00; p<0.001). Left ventricular mass index to height showed significant correlation with OV (Wald Chi-squared=7.57; p<0.01), blood-myocardium border sharpness (Wald Chi-squared=7.35; p<0.01), and contrast ratio (Wald Chi-squared=5.50; p<0.05). Furthermore, demographic parameters, such as body mass index (BMI), were identified as significant confounders, showing a notable correlation between BMI and the depiction of AS. (Wald Chi-square=11.14; p<0.01). CONCLUSION: In this study, 3D water-fat separated LGE imaging shows satifactory image quality, especially for water-fat separation. However, image quality may be affected by several other parameters such as patient obesity, high myocardial mass, and cardiac function. Trial Registration: 3000339.
No takes yet. Share an insight, caveat, or question.
Kuhnt et al. (2025) conducted a cross-sectional in Cardiovascular disease (Inflammatory bowel disease, muscular dystrophy, hypertrophic cardiomyopathy, paroxysmal atrial fibrillation) (n=138). 3D water-fat separated late gadolinium enhancement (LGE) imaging was evaluated on Subjective image quality (4-point Likert scale) and contrast ratio. 3D water-fat separated LGE imaging demonstrated satisfactory diagnostic image quality, with fat suppression scoring highest (2.54 ± 0.72 on a 4-point scale), though quality was significantly affected by obesity, myocardial mass, and cardiac function.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: