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Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model
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Excellent Reproducibility of Synthetic Extracellular Volume Without Blood Extraction Across Different

Jeong W Choi1, Sylvia Biso1, Jonathan Weber1

  • 1Division of Cardiovascular Imaging, St. Francis Hospital & Heart Center, Roslyn, NY 11576, USA.

Journal of Cardiovascular Development and Disease
|January 27, 2026
PubMed
Summary
This summary is machine-generated.

Synthetic extracellular volume (ECV) calculations in cardiac MRI show excellent reproducibility, potentially eliminating the need for same-day blood draws. This advance could improve early fibrosis detection in various heart conditions.

Keywords:
extracellular volumeinfiltrative cardiomyopathysynthetic ECVsynthetic hematocrit

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Area of Science:

  • Cardiovascular Imaging
  • Medical Physics
  • Biomarkers

Background:

  • Cardiac magnetic resonance (CMR) T1 mapping and extracellular volume (ECV) calculations can detect early myocardial fibrosis.
  • Current ECV calculation requires same-day hematocrit (Hct) measurements due to temporal variations, limiting its clinical utility.
  • Reproducibility of synthetic ECV using different models needs evaluation.

Purpose of the Study:

  • To assess the reproducibility of synthetic hematocrit (Hct) and ECV using various published models.
  • To compare synthetic ECV reproducibility with measured ECV across different cardiac conditions.
  • To determine the accuracy of synthetic ECV models in predicting abnormal measured ECV.

Main Methods:

  • Retrospective analysis of 148 subjects (healthy, cardiac amyloidosis, sarcoidosis, hypertrophic cardiomyopathy) using 1.5T CMR.
  • Acquisition of native and post-contrast T1 maps with same-day Hct measurements.
  • Calculation and comparison of synthetic and measured ECV using six different published formulas.

Main Results:

  • Excellent reproducibility (ICCs ~0.98) was observed between synthetic and measured ECV across all six formulas.
  • Synthetic and measured Hct showed only modest reproducibility (ICCs 0.52-0.66).
  • Synthetic ECV models demonstrated consistently excellent accuracy in predicting abnormal measured ECV, irrespective of CMR vendor used for model generation.

Conclusions:

  • Synthetic ECV offers excellent reproducibility compared to ECV calculated with measured Hct.
  • Synthetic ECV may obviate the need for blood draws in cardiac MRI settings lacking point-of-care Hct.
  • This approach could enhance the clinical application of ECV for early fibrosis detection in CMR.