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

Zsofia Lenkey, Akos Varga-Szemes, Tamas Simor, Rob J. Van Der Geest, Robert Kirschner, Levente Toth, Tamas Bodnar, Brigitta C. Brott, Ada Elgavish, Gabriel A. Elgavish

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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 0.2 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.

Original languageEnglish
Pages (from-to)911-920
Number of pages10
JournalJournal of Magnetic Resonance Imaging
Volume43
Issue number4
DOIs
Publication statusPublished - Apr 1 2016

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

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    Lenkey, Z., Varga-Szemes, A., Simor, T., Van Der Geest, R. J., Kirschner, R., Toth, L., Bodnar, T., Brott, B. C., Elgavish, A., & Elgavish, G. A. (2016). Age-independent myocardial infarct quantification by signal intensity percent infarct mapping in swine. Journal of Magnetic Resonance Imaging, 43(4), 911-920. https://doi.org/10.1002/jmri.25046