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Native T1 mapping: inter-study, inter-observer and inter-center reproducibility in hemodialysis patients

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posted on 24.03.2017 by Matthew P.M. Graham-Brown, Elaine Rutherford, E. Levelt, Daniel S. March, Darren R. Churchward, David Stensel, Christie McComb, Kenneth Mangion, Samantha Cockburn, Colin Berry, James C. Moon, Patrick B. Mark, James O. Burton, Gerry P. McCann
Background Native T1 mapping is a cardiovascular magnetic resonance (CMR) technique that associates with markers of fibrosis and strain in hemodialysis patients. The reproducibility of T1 mapping in hemodialysis patients, prone to changes in fluid status, is unknown. Accurate quantification of myocardial fibrosis in this population has prognostic potential. Methods Using 3 Tesla CMR, we report the results of 1) the inter-study, inter-observer and intra-observer reproducibility of native T1 mapping in 10 hemodialysis patients; 2) inter-study reproducibility of left ventricular (LV) structure and function in 10 hemodialysis patients; 3) the agreement of native T1 map and native T1 phantom analyses between two centres in 20 hemodialysis patients; 4) the effect of changes in markers of fluid status on native T1 values in 10 hemodialysis patients. Results Inter-study, inter-observer and intra-observer variability of native T1 mapping were excellent with co-efficients of variation (CoV) of 0.7, 0.3 and 0.4% respectively. Inter-study CoV for LV structure and function were: LV mass = 1%; ejection fraction = 1.1%; LV end-diastolic volume = 5.2%; LV end-systolic volume = 5.6%. Inter-centre variability of analysis techniques were excellent with CoV for basal and mid-native T1 slices between 0.8–1.2%. Phantom analyses showed comparable native T1 times between centres, despite different scanners and acquisition sequences (centre 1: 1192.7 ± 7.5 ms, centre 2: 1205.5 ± 5 ms). For the 10 patients who underwent inter-study testing, change in body weight (Δweight) between scans correlated with change in LV end-diastolic volume (ΔLVEDV) (r = 0.682;P = 0.03) representing altered fluid status between scans. There were no correlations between change in native T1 between scans (ΔT1) and ΔLVEDV or Δweight (P > 0.6). Linear regression confirmed ΔT1 was unaffected by ΔLVEDV or Δweight (P > 0.59). Conclusions Myocardial native T1 is reproducible in HD patients and unaffected by changes in fluid status at the levels we observed. Native T1 mapping is a potential imaging biomarker for myocardial fibrosis in patients with end-stage renal disease.

Funding

This study is independent research arising from a Clinician Scientist Award (Dr James Burton, CS-2013-13-014) supported by the NIHR, and a grant from Kidney Research UK (Research Innovation Grant IN02/2013). This work is also supported by the NIHR Leicester Cardiovascular Biomedical Research Unit based at University Hospitals of Leicester and the University of Leicester and the NIHR Diet, Lifestyle & Physical Activity Biomedical Research Unit based at University Hospitals of Leicester and Loughborough University.

History

School

  • Sport, Exercise and Health Sciences

Published in

Journal of Cardiovascular Magnetic Resonance

Volume

19

Issue

1

Citation

GRAHAM-BROWN, M.P.M. ... et al, 2017. Native T1 mapping: inter-study, inter-observer and inter-center reproducibility in hemodialysis patients. Journal of Cardiovascular Magnetic Resonance, 19 (21), doi: 10.1186/s12968-017-0337-7.

Publisher

© The Authors. Published by BioMed Central

Version

VoR (Version of Record)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution 4.0 International (CC BY 4.0) licence. Full details of this licence are available at: http://creativecommons.org/licenses/ by/4.0/

Acceptance date

26/01/2017

Publication date

2017-02-27

Copyright date

2017

Notes

This is an Open Access Article. It is published by BioMed Central under the Creative Commons Attribution 4.0 International License (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/

ISSN

1532-429X

Language

en

Licence

Exports