- Oral presentation
- Open Access
Quantification of myocardial scar assessed by late gadolinium enhancement CMR in the multi-ethnics study of atherosclerosis: comparisons of 7 different methods
© Rizzi et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Cardiac Magnetic Resonance
- Late Gadolinium Enhancement
- Myocardial Scar
- Concordance Correlation Coefficient
- Scar Assessment
Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) is the non-invasive reference standard for myocardial scar assessment and has prognostic value for ischemic and non-ischemic cardiomyopathies. However, actual standard methods for determining scar quantification compromise its reproducibility. This study evaluates reliability of seven techniques on scar quantification in a large multi-center study.
1666 participants of the Multi-Ethnic Study of Atherosclerosis, age range 55-94 yrs, underwent a LGE-CMR study using 1.5T Tesla Siemens or GE scanners at six centers. Myocardial scar was visually detected in 137 studies (48% ischemic scar). The reference standard for quantitative analysis was semi-automated, based on choosing by visual inspection the best computed assisted planimetry, delineated using different automatic thresholds, with subsequent manual correction of partial volume and artifacts. This was compared to 6 different automatic methods including thresholding by 2, 4, 6 or 8 standard deviations (SD) above mean remote myocardial signal intensity (SI), full with half maximum (FWHM) and background correction (BCT) techniques. The BCT computes the threshold for each slice individually based on the sum of the mean SI of the entire myocardium, 2SD of the remote myocardium and 2SD of a ROI placed in the air. Inter/intraobserver agreement and reproducibility in studies of different scanners were assessed by paired t-test, concordance correlation coefficient (CCC) and Bland-Altman analysis.
Reproducibility according to type of MRI scanner
Siemens (n = 109)
GE (n = 23)
Method of Quantification by Scar Pattern
In the setting of a multi-center trial, BCT and FHWM methods are the preferred methods for automated quantification for ischemic scar, while only BCT is recommended for non-ischemic scar.
This study was supported by the National Heart, Lung, and Blood Institute grant (RO1-HL66075-01) and the MESA study contracts NO1-HC-9808, NO1-HC-95168, and NO1-HC-95169.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.