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

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.

Electronic supplementary material

The online version of this article (doi:10.1186/s12968-017-0337-7) contains supplementary material, which is available to authorized users.

Contributors

Matthew P. M. Graham-Brown: [phone] , [e-mail]

Journal

Journal ID (nlm-ta): J Cardiovasc Magn Reson

Journal ID (iso-abbrev): J Cardiovasc Magn Reson

Title: Journal of Cardiovascular Magnetic Resonance

Publisher: BioMed Central (London )

ISSN (Print): 1097-6647

ISSN (Electronic): 1532-429X

Publication date (Electronic): 27 February 2017

Publication date PMC-release: 27 February 2017

Publication date Collection: 2017

Volume: 19

Affiliations

[1 ]ISNI 0000 0001 0435 9078, GRID grid.269014.8, John Walls Renal Unit, , University Hospitals Leicester NHS Trust, ; Leicester, UK

[2 ]ISNI 0000 0004 1936 8411, GRID grid.9918.9, Department of Infection Immunity and Inflammation, School of Medicine and Biological Sciences, , University of Leicester, ; Leicester, LE1 9HN UK

[3 ]ISNI 0000 0004 1936 8542, GRID grid.6571.5, National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, , Loughborough University, ; Loughborough, UK

[4 ]ISNI 0000 0001 2193 314X, GRID grid.8756.c, BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, , University of Glasgow, ; 126 University Place, Glasgow, UK

[5 ]ISNI 0000 0001 2177 007X, GRID grid.415490.d, The Glasgow Renal & Transplant Unit, , Queen Elizabeth University Hospital, ; 1345 Govan Road, Glasgow, UK

[6 ]ISNI 0000 0004 1936 8411, GRID grid.9918.9, Department of Cardiovascular Sciences, , University of Leicester and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital Leicester, ; Leicester, UK

[7 ]ISNI 0000 0001 0523 9342, GRID grid.413301.4, , Clinical Physics, NHS Greater Glasgow and Clyde, ; Glasgow, UK

[8 ]ISNI 0000 0004 0590 2070, GRID grid.413157.5, West of Scotland Heart and Lung Centre, , Golden Jubilee National Hospital, ; Clydebank, UK

[9 ]ISNI 0000000121901201, GRID grid.83440.3b, UCL Institute of Cardiovascular Science, , University College London, ; London, UK

Article

Publisher ID: 337

DOI: 10.1186/s12968-017-0337-7

PMC ID: 5327541

PubMed ID: 28238284

Copyright statement: © The Author(s). 2017

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Funding

Funded by: National Institue for Health Research

Award ID: CS-2013-13-014

Award Recipient : Matthew P. M. Graham-Brown

Funded by: FundRef http://dx.doi.org/10.13039/501100000291, Kidney Research UK;

Categories

Subject: Research

Custom metadata

issue-copyright-statement © The Author(s) 2017