Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2017 Feb 27;19(1):21.
doi: 10.1186/s12968-017-0337-7.

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

Matthew P M Graham-Brown  1   2   3 , Elaine Rutherford  4   5 , E Levelt  6 , Daniel S March  7   8 , Darren R Churchward  7   8 , David J Stensel  9 , Christie McComb  4   10 , Kenneth Mangion  4   11 , Samantha Cockburn  4 , Colin Berry  4   11 , James C Moon  12 , Patrick B Mark  4   5 , James O Burton  7   8   6 , Gerry P McCann  6
Affiliations
Multicenter Study

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

Matthew P M Graham-Brown et al. J Cardiovasc Magn Reson. .

Abstract

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.

Keywords: Cardiovascular magnetic resonance; Hemodialysis; Myocardial fibrosis; Native T1; Reproducibility.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
a: Native T1 map analysis of a mid-ventricular slice with software package CMR42 at centre 1. Endocardial (red line) and epicardial (green line) contouring on native T1 parametric map. Segments (1–6) are calculated from defining the RV insertion point (arrow). b: Typical segmentation of a basal native T1 map site from centre 2. 6 discrete regions of interest drawn within the myocardium for each segment
Fig. 2
Fig. 2
Bland-Altman plots for: a: Inter-study reproducibility left ventricular mass, b: Inter-study reproducibility left ventricular end-diastolic volume, c: Inter-study reproducibility left ventricular ejection fraction, d: Inter-study reproducibility mid-ventricular native T1, e: inter-observer variability of mid-ventricular native T1 and f: intra-observer variability of mid-ventricular native T1
Fig. 3
Fig. 3
Relationships between measures of fluid status between scans and LV mass. a: Significant correlation between Delta LVEDV and Delta weight. b: No relationship between Delta LVEDV and Delta LV Mass or c: between Delta Weight and Delta LV mass. LV, left ventricular; LVEDV, Left ventricular end-diastolic volume
Fig. 4
Fig. 4
Relationships between changes in native T1 and changes in measures of fluid status. a: No correlation between delta native T1 and delta LVEDV. b: No relationship between delta native T1 and delta weight
See this image and copyright information in PMC

References

    1. U.S. Renal Data System . USRDS 2006 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. 2006.
    1. Glassock RJ, Pecoits-Filho R, Barberato SH. Left ventricular mass in chronic kidney disease and ESRD. Clin J Am Soc Nephrol. 2009;4(Suppl 1):S79–S91. doi: 10.2215/CJN.04860709. - DOI - PubMed
    1. Pierdomenico SD, Cuccurullo F. Risk reduction after regression of echocardiographic left ventricular hypertrophy in hypertension: a meta-analysis. Am J Hypertens. 2010;23(8):876–881. doi: 10.1038/ajh.2010.80. - DOI - PubMed
    1. Mancini GB, Dahlof B, Diez J. Surrogate markers for cardiovascular disease: structural markers. Circulation. 2004;109(25 Suppl 1):IV22–IV30. - PubMed
    1. Badve SV, Palmer SC, Strippoli GF, Roberts MA, Teixeira-Pinto A, Boudville N, et al. The Validity of Left Ventricular Mass as a Surrogate End Point for All-Cause and Cardiovascular Mortality Outcomes in People With CKD: A Systematic Review and Meta-analysis. Am J Kidney Dis. 2016;68(4):554-63. - PubMed

Publication types

MeSH terms