Zsofia Lenkey1,2,3, Akos Varga-Szemes1,2, Tamas Simor1,2,3, Rob J van der Geest4, Robert Kirschner1,2, Levente Toth1,2, Tamas Bodnar1,2, Brigitta C Brott5, Ada Elgavish2,6, Gabriel A Elgavish1,2. 1. Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA. 2. Elgavish Paramagnetics Inc, Birmingham, Alabama, USA. 3. Medical School, University of Pecs, Hungary. 4. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. 5. Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA. 6. Department of Medicine, Division of Clinical Immunology & Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Abstract
PURPOSE: To test whether signal intensity percent infarct mapping (SI-PIM) accurately determines the size of myocardial infarct (MI) regardless of infarct age. MATERIALS AND METHODS: Forty-five swine with reperfused MI underwent 1.5T late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) after bolus injection of 0.2 mmol/kg Gd(DTPA) on days 2-62 following MI. Animals were classified into acute, healing, and healed groups by pathology. Infarct volume (IV) and infarct fraction (IF) were determined by two readers, using binary techniques (including 2-5 standard deviations [SD] above the remote, and full-width at half-maximum) and the SI-PIM method. Triphenyl-tetrazolium-chloride staining (TTC) was performed as reference. Bias (percent under/overestimation of IV relative to TTC) of each quantification method was calculated. Bland-Altman analysis was done to test the accuracy of the quantification methods, while intraclass correlation coefficient (ICC) analysis was done to assess intra- and interobserver agreement. RESULTS: Bias of the MRI quantification methods do not depend on the age of the MI. Full-width at half-maximum (FWHM) and SI-PIM gave the best estimate of MI volume determined by the reference TTC (P-values for the FWHM and SI-PIM methods were 0.183, 0.26, 0.95, and 0.073, 0.091, 0.73 in Group 1, Group 2, and Group 3, respectively), while using any of the binary thresholds of 2-4 SDs above the remote myocardium showed significant overestimation. The 5 SD method, however, provided similar IV compared to TTC and was shown to be independent of the size and age of MI. ICC analysis showed excellent inter- and intraobserver agreement between the readers. CONCLUSION: Our results indicate that the SI-PIM method can accurately determine MI volume regardless of the pathological stage of MI. Once tested, it may prove to be useful for the clinic.
PURPOSE: To test whether signal intensity percent infarct mapping (SI-PIM) accurately determines the size of myocardial infarct (MI) regardless of infarct age. MATERIALS AND METHODS: Forty-five swine with reperfused MI underwent 1.5T late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) after bolus injection of 0.2 mmol/kg Gd(DTPA) on days 2-62 following MI. Animals were classified into acute, healing, and healed groups by pathology. Infarct volume (IV) and infarct fraction (IF) were determined by two readers, using binary techniques (including 2-5 standard deviations [SD] above the remote, and full-width at half-maximum) and the SI-PIM method. Triphenyl-tetrazolium-chloride staining (TTC) was performed as reference. Bias (percent under/overestimation of IV relative to TTC) of each quantification method was calculated. Bland-Altman analysis was done to test the accuracy of the quantification methods, while intraclass correlation coefficient (ICC) analysis was done to assess intra- and interobserver agreement. RESULTS: Bias of the MRI quantification methods do not depend on the age of the MI. Full-width at half-maximum (FWHM) and SI-PIM gave the best estimate of MI volume determined by the reference TTC (P-values for the FWHM and SI-PIM methods were 0.183, 0.26, 0.95, and 0.073, 0.091, 0.73 in Group 1, Group 2, and Group 3, respectively), while using any of the binary thresholds of 2-4 SDs above the remote myocardium showed significant overestimation. The 5 SD method, however, provided similar IV compared to TTC and was shown to be independent of the size and age of MI. ICC analysis showed excellent inter- and intraobserver agreement between the readers. CONCLUSION: Our results indicate that the SI-PIM method can accurately determine MI volume regardless of the pathological stage of MI. Once tested, it may prove to be useful for the clinic.
Authors: Pál Surányi; Pál Kiss; Brigitta C Brott; Tamás Simor; Ada Elgavish; Balázs Ruzsics; Nada H Saab-Ismail; Gabriel A Elgavish Journal: Magn Reson Med Date: 2006-09 Impact factor: 4.668
Authors: Olga Bondarenko; Aernout M Beek; Mark B M Hofman; Harald P Kühl; Jos W R Twisk; Willem G van Dockum; Cees A Visser; Albert C van Rossum Journal: J Cardiovasc Magn Reson Date: 2005 Impact factor: 5.364
Authors: K C Wu; E A Zerhouni; R M Judd; C H Lugo-Olivieri; L A Barouch; S P Schulman; R S Blumenthal; J A Lima Journal: Circulation Date: 1998-03-03 Impact factor: 29.690
Authors: Luciano C Amado; Bernhard L Gerber; Sandeep N Gupta; Dan W Rettmann; Gilberto Szarf; Robert Schock; Khurram Nasir; Dara L Kraitchman; João A C Lima Journal: J Am Coll Cardiol Date: 2004-12-21 Impact factor: 24.094
Authors: J M de Bakker; R Coronel; S Tasseron; A A Wilde; T Opthof; M J Janse; F J van Capelle; A E Becker; G Jambroes Journal: J Am Coll Cardiol Date: 1990-06 Impact factor: 24.094
Authors: Akos Varga-Szemes; Rob J van der Geest; U Joseph Schoepf; Bruce S Spottiswoode; Carlo N De Cecco; Giuseppe Muscogiuri; Julian L Wichmann; Stefanie Mangold; Stephen R Fuller; Pal Maurovich-Horvat; Bela Merkely; Sheldon E Litwin; Rozemarijn Vliegenthart; Pal Suranyi Journal: Eur Radiol Date: 2017-01-03 Impact factor: 5.315