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Quality assurance of quantitative cardiac T1-mapping.pdf (2.66 MB)

Quality assurance of quantitative cardiac T1-mapping in multicenter clinical trials – A T1 phantom program from the hypertrophic cardiomyopathy registry (HCMR) study

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posted on 2021-04-14, 10:05 authored by Q Zhang, K Werys, IA Popescu, L Biasiolli, NAB Ntusi, M Desai, SL Zimmerman, DJ Shah, K Autry, B Kim, HW Kim, ER Jenista, S Huber, JA White, GP McCann, SA Mohiddin, R Boubertakh, A Chiribiri, D Newby, S Prasad, A Radjenovic, D Dawson, J Schulz-Menger, H Mahrholdt, I Carbone, O Rimoldi, S Colagrande, L Calistri, M Michels, MBM Hofman, L Anderson, C Broberg, F Andrew, J Sanz, C Bucciarelli-Ducci, K Chow, D Higgins, DA Broadbent, S Semple, T Hafyane, J Wormleighton, M Salerno, T He, S Plein, RY Kwong, M Jerosch-Herold, CM Kramer, S Neubauer, VM Ferreira, SK Piechnik
Background: Quantitative cardiovascular magnetic resonance T1-mapping is increasingly used for myocardial tissue characterization. However, the lack of standardization limits direct comparability between centers and wider roll-out for clinical use or trials. Purpose: To develop a quality assurance (QA) program assuring standardized T1 measurements for clinical use. Methods: MR phantoms manufactured in 2013 were distributed, including ShMOLLI T1-mapping and reference T1 and T2 protocols. We first studied the T1 and T2 dependency on temperature and phantom aging using phantom datasets from a single site over 4 years. Based on this, we developed a multiparametric QA model, which was then applied to 78 scans from 28 other multi-national sites. Results: T1 temperature sensitivity followed a second-order polynomial to baseline T1 values (R2 > 0.996). Some phantoms showed aging effects, where T1 drifted up to 49% over 40 months. The correlation model based on reference T1 and T2, developed on 1004 dedicated phantom scans, predicted ShMOLLI-T1 with high consistency (coefficient of variation 1.54%), and was robust to temperature variations and phantom aging. Using the 95% confidence interval of the correlation model residuals as the tolerance range, we analyzed 390 ShMOLLI T1-maps and confirmed accurate sequence deployment in 90%(70/78) of QA scans across 28 multiple centers, and categorized the rest with specific remedial actions. Conclusions: The proposed phantom QA for T1-mapping can assure correct method implementation and protocol adherence, and is robust to temperature variation and phantom aging. This QA program circumvents the need of frequent phantom replacements, and can be readily deployed in multicenter trials.

Funding

This work is funded by British Heart Foundation (BHF) project grant PG/15/71/31731 (QZ, KW, SKP) and National Institute for Health Research (NIHR) Oxford Biomedical Research Centre at The Oxford University Hospitals (IAP, SKP, VMF and SN).

History

Citation

International Journal of Cardiology, Volume 330, 1 May 2021, Pages 251-258

Author affiliation

Department of Cardiovascular Sciences

Version

  • VoR (Version of Record)

Published in

International Journal of Cardiology

Volume

330

Issue

.

Pagination

251 - 258

Publisher

Elsevier

issn

0167-5273

eissn

1874-1754

Acceptance date

2021-01-07

Copyright date

2021

Available date

2021-04-14

Spatial coverage

Netherlands

Language

English

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