Comparison of GRE versus SSFP-based cardiac T1-mapping in device patients

Area of Science:

• Cardiovascular Magnetic Resonance Imaging
• Medical Device Technology
• Quantitative Imaging

Background:

• Cardiac magnetic resonance (CMR) is limited in patients with metallic cardiac devices due to susceptibility artifacts.
• T1-mapping assesses interstitial fibrosis but is often performed with balanced steady-state free precession (SSFP) sequences susceptible to artifacts.
• Gradient echo (GRE) sequences offer potential for reduced artifact in CMR.

Purpose of the Study:

• To evaluate the comparability of T1-mapping using GRE versus SSFP in patients with cardiac devices.
• To assess the impact of GRE versus SSFP on T1 measurements and artifact prevalence in this cohort.

Main Methods:

• T1-mapping was performed using MOLLI with both SSFP and GRE sequences on 16 patients with cardiac devices and 10 controls at 1.5 T.
• Pre- and post-contrast T1 times were analyzed, comparing SSFP and GRE strategies.
• The percentage of artifactual segments and the parameter lambda (λ) were calculated for both sequences.

Main Results:

• GRE T1 measurements were consistently shorter than SSFP measurements (74 ms and 27 ms difference pre/post-contrast).
• No significant difference was found in lambda (λ) values between GRE and SSFP (p=0.91).
• GRE sequences showed significantly less visual artifact (24% vs. 45% artifactual segments) compared to SSFP.

Conclusions:

• T1-mapping using GRE is comparable to SSFP in patients with cardiac devices, yielding shorter T1 values but equivalent lambda.
• GRE sequences demonstrate reduced artifact burden, suggesting improved utility for T1-mapping in this patient group.
• GRE T1-mapping offers a promising alternative for accurate interstitial fibrosis assessment in patients with metallic cardiac implants.