Age-independent myocardial infarct quantification by signal intensity percent infarct mapping in swine

Zsofia Lenkey, Akos Varga-Szemes, T. Símor, Rob J. van der Geest, Robert Kirschner, Levente Toth, Tamas Bodnar, Brigitta C. Brott, Ada Elgavish, Gabriel A. Elgavish

Research output: Contribution to journalArticle

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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 0.2mmol/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.

Original languageEnglish
JournalJournal of Magnetic Resonance Imaging
DOIs
Publication statusAccepted/In press - 2015

Fingerprint

Swine
Myocardial Infarction
Chlorides
Staining and Labeling
Magnetic Resonance Imaging
Gadolinium DTPA
Gadolinium
Myocardium
Pathology
Injections

Keywords

  • Infarct quantification
  • Late gadolinium enhancement
  • Myocardial infarct
  • Partial volume effect
  • Signal intensity percent infarct mapping

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Age-independent myocardial infarct quantification by signal intensity percent infarct mapping in swine. / Lenkey, Zsofia; Varga-Szemes, Akos; Símor, T.; van der Geest, Rob J.; Kirschner, Robert; Toth, Levente; Bodnar, Tamas; Brott, Brigitta C.; Elgavish, Ada; Elgavish, Gabriel A.

In: Journal of Magnetic Resonance Imaging, 2015.

Research output: Contribution to journalArticle

Lenkey, Z, Varga-Szemes, A, Símor, T, van der Geest, RJ, Kirschner, R, Toth, L, Bodnar, T, Brott, BC, Elgavish, A & Elgavish, GA 2015, 'Age-independent myocardial infarct quantification by signal intensity percent infarct mapping in swine', Journal of Magnetic Resonance Imaging. https://doi.org/10.1002/jmri.25046
Lenkey, Zsofia ; Varga-Szemes, Akos ; Símor, T. ; van der Geest, Rob J. ; Kirschner, Robert ; Toth, Levente ; Bodnar, Tamas ; Brott, Brigitta C. ; Elgavish, Ada ; Elgavish, Gabriel A. / Age-independent myocardial infarct quantification by signal intensity percent infarct mapping in swine. In: Journal of Magnetic Resonance Imaging. 2015.
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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 0.2mmol/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.",
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author = "Zsofia Lenkey and Akos Varga-Szemes and T. S{\'i}mor and {van der Geest}, {Rob J.} and Robert Kirschner and Levente Toth and Tamas Bodnar and Brott, {Brigitta C.} and Ada Elgavish and Elgavish, {Gabriel A.}",
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AU - Lenkey, Zsofia

AU - Varga-Szemes, Akos

AU - Símor, T.

AU - van der Geest, Rob J.

AU - Kirschner, Robert

AU - Toth, Levente

AU - Bodnar, Tamas

AU - Brott, Brigitta C.

AU - Elgavish, Ada

AU - Elgavish, Gabriel A.

PY - 2015

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N2 - 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 0.2mmol/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.

AB - 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 0.2mmol/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.

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KW - Late gadolinium enhancement

KW - Myocardial infarct

KW - Partial volume effect

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