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Discrete truncation method for measuring the cardiac t2* values in patients with thalassemia
Jixing Yi1, Fengming Xu1, Qing Feng1
1Department of Radiology, Liuzhou Worker's Hospital, Guangxi Zhuang Autonomous Region, Liuzhou, China.
Insights
A new discrete truncation method offers a stable and reliable way to measure cardiac T2* values in thalassemia patients, improving accuracy for dark-blood and bright-blood imaging. This enhances cardiac iron overload assessment.
Area of Science:
- Cardiology
- Medical Imaging
- Biophysics
Background:
- Cardiac iron overload is a significant complication in thalassemia patients.
- Accurate measurement of cardiac T2* values is crucial for monitoring iron levels.
- Current automatic truncation methods show discrepancies between dark-blood (DB) and bright-blood (BB) T2* measurements.
Purpose of the Study:
- To develop and validate a novel discrete truncation method for measuring cardiac T2* values.
- To compare the accuracy and reliability of the discrete truncation method against the automatic truncation method.
- To assess the agreement between DB-T2* and BB-T2* measurements using both methods in thalassemia patients.
Main Methods:
- Cardiac magnetic resonance (CMR) T2* values were measured in 349 thalassemia patients using CMRtools software.
- Two truncation methods were applied: the existing automatic method and a novel discrete method.
- Statistical analyses, including correlation and Bland-Altman analysis, were performed to compare DB-T2* and BB-T2* measurements.
Main Results:
- The discrete truncation method showed no significant difference and excellent agreement between DB-T2* and BB-T2* (p=0.249, r=0.997).
- The automatic truncation method demonstrated a significant difference and poor agreement between DB-T2* and BB-T2* (p<0.0001).
- The discrete method exhibited superior stability and reliability in cardiac T2* measurements.
Conclusions:
- The discrete truncation method provides a more stable and reliable measurement of cardiac T2* values in thalassemia patients.
- This novel method improves the accuracy of assessing cardiac iron overload compared to the automatic truncation method.
- The findings support the adoption of the discrete truncation method for routine clinical use in managing thalassemia patients.
Objective:
In clinical work, it has been found that there are differences between the dark-blood (DB) and bright-blood (BB) cardiac magnetic resonance (CMR) T2* values (DB-T2* and BB-T2*) measured by the current automatic truncation method in patients with cardiac iron overload. The paper aims to develop a novel discrete truncation method to measure cardiac T2* value in patients with thalassemia.
Methods:
The cardiac T2* values of 349 thalassemia (TM) patients (mean age, 13.41 years ±8.761, 173 males) from three hospitals during January 2011 to June 2023 were measured by CMRtools software. Different truncation methods were used to remove signal values that deviated from the fitting curve and the corresponding T2* values were recorded. The difference, correlation and consistency of DB-T2* and BB-T2* measured by different methods were compared.
Results:
There was no significant difference between DB-T2* and BB-T2* measured by discrete truncation method (DB-T2* vs.BB-T2*, p = 0.249), respectively; and there was a high positive correlation (rs = 0.997, p < 0.0001). In the Bland-Altman analysis, the two methods had a very good agreement (p = 0.2489). There was a high positive correlation between DB-T2* and BB-T2* measured by the automatic truncation method (rs = 0.974, p < 0.0001), but there was a significant difference between them (DB-T2* vs.BB-T2*, p < 0.0001), respectively. In the Bland-Altman analysis, there was no good agreement between the two methods (p < 0.0001).
Conclusion:
The discrete truncation method is more stable and reliable than the automatic truncation method in the measurement of cardiac T2* value in TM patients.
