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Published on: February 16, 2016
Comparison of different quantification methods of late gadolinium enhancement in patients with hypertrophic
Mateusz Spiewak1, Lukasz A Malek, Jolanta Misko
1First Department of Coronary Artery Disease, Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland. mspiewak@ikard.pl
Insights
Quantifying late gadolinium enhancement (LGE) in hypertrophic cardiomyopathy (HCM) using a 6SD threshold best matches visual assessment. This method offers reliable LGE mass estimation in HCM patients.
Area of Science:
- Cardiovascular Imaging
- Cardiac MRI
- Quantitative Analysis
Background:
- Quantification of late gadolinium enhancement (LGE) in hypertrophic cardiomyopathy (HCM) lacks a standardized approach.
- Accurate LGE assessment is crucial for understanding disease severity and patient outcomes.
Purpose of the Study:
- To compare various quantification techniques for LGE in patients diagnosed with HCM.
- To identify the most reliable method for LGE mass measurement in this population.
Main Methods:
- Cardiac MRI was performed on 33 HCM patients.
- LGE was quantified using visual assessment and multiple thresholding techniques (1SD to 6SD, FWHM).
- Signal intensity (SI) of remote myocardium and maximal SI were used for threshold calculations.
Main Results:
- LGE was detected in 78% of patients.
- Median LGE mass varied significantly across methods, with 1SD yielding the highest and FWHM the lowest values.
- The 6SD threshold demonstrated the strongest correlation with visual assessment (rho=0.956, p<0.0001), showing no significant difference.
Conclusions:
- A threshold of 6SD above the mean SI of remote myocardium provides the best agreement with visual assessment for LGE quantification in HCM.
- This method offers a reliable approach for LGE mass estimation in clinical practice.
Aim:
There is no consensus regarding the technique of quantification of late gadolinium enhancement (LGE). The aim of the study was to compare different methods of LGE quantification in patients with hypertrophic cardiomyopathy (HCM).
Methods:
Cardiac magnetic resonance was performed in 33 patients with HCM. First, LGE was quantified by visual assessment by the team of experienced readers and compared with different thresholding techniques: from 1SD to 6SD above mean signal intensity (SI) of remote myocardium, above 50% of maximal SI of the enhanced area (full-width at half maximum, FWHM) and above peak SI of remote myocardium.
Results:
LGE was present in 25 (78%) of patients. The median mass of LGE varied greatly depending on the quantification method used and was highest with the utilization of 1SD threshold [75.5 g, interquartile range (IQR): 63.3-112.3g] and lowest for FWHM method (8.4 g, IQR: 4.3-13.3g). There was no difference in mass of LGE as assessed with 6SD threshold and FWHM when compared to visual assessment (p=0.19 and p=0.1, respectively); all other thresholding techniques provided significant differences in the median LGE size when compared to visual analysis. Results for all thresholds, except FWHM were significantly correlated with visual assessment with the strongest correlation for 6SD (rho=0.956, p<0.0001).
Conclusions:
LGE quantification with the use of a threshold of 6SD above the mean SI of the remote myocardium provided the best agreement with visual assessment in patients with HCM.
