Baessler, Bettina ORCID: 0000-0002-3244-3864, Luecke, Christian, Lurz, Julia, Klingel, Karin, Das, Arijit, von Roeder, Maximilian, de Waha-Thiele, Suzanne, Besler, Christian, Rommel, Karl-Philipp, Maintz, David, Gutberlet, Matthias, Thiele, Hoker and Lurz, Philipp (2019). Cardiac MRI and Texture Analysis of Myocardial T1 and T2 Maps in Myocarditis with Acute versus Chronic Symptoms of Heart Failure. Radiology, 292 (3). S. 608 - 618. OAK BROOK: RADIOLOGICAL SOC NORTH AMERICA. ISSN 0033-8419

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Abstract

Background: The establishment of a timely and correct diagnosis in heart failure-like myocarditis remains one of the most challenging in clinical cardiology. Purpose: To assess the diagnostic potential of texture analysis in heart failure-like myocarditis with comparison to endomyocardial biopsy (EMB) as the reference standard. Materials and Methods: Seventy-one study participants from the Magnetic Resonance Imaging in Myocarditis (MyoRacer) trial(ClinicalTrials.gov registration no. NCT02177630) with clinical suspicion for myocarditis and symptoms of heart failure were prospectively included (from August 2012 to May 2015) in the study. Participants underwent biventricular EMB and cardiac MRI at 1.5 T, including native T1 and T2 mapping and standard Lake Louise criteria. Texture analysis was applied on T1 andT2 maps by using an open-source software. Stepwise dimension reduction was performed for selecting features enabling the diagnosis of myocarditis. Diagnostic performance was assessed from the area under the curve (AUC) from receiver operating characteristic analyses with 10-fold cross validation. Results: In participants with acute heart failure-like myocarditis (n = 31; mean age, 47 years +/- 17; 10 women), the texture feature GrayLevelNonUniformity from T2 maps (T2_GLNU) showed diagnostic performance similar to that of mean myocardial T2 time(AUC, 0.69 for both). The combination of mean T2 time and T2_GLNU had the highest AUC (0.76; 95% confidence interval[CI]: 0.43, 0.95), with sensitivity of 81% (25 of 31) and specificity of 71% (22 of 31). In patients with chronic heart failure-like myocarditis (n = 40; mean age, 48 years +/- 13; 12 women), the histogram feature T2_kurtosis demonstrated superior diagnostic performance compared to that of all other single parameters (AUC, 0.81; 95% CI: 0.66, 0.96). The combination of the two texture features, T2_kurtosis and the GrayLevelNonUniformity from T1, had the highest diagnostic performance (AUC, 0.85; 95% CI:0.57, 0.90; sensitivity, 90% [36 of 40]; and specificity, 72% [29 of 40]). Conclusion: In this proof-of-concept study, texture analysis applied on cardiac MRI T1 and T2 mapping delivers quantitative imaging parameters for the diagnosis of acute or chronic heart failure-like myocarditis and might be superior to Lake Louise criteria or averaged myocardial T1 or T2 values. (C) RSNA, 2019

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Baessler, BettinaUNSPECIFIEDorcid.org/0000-0002-3244-3864UNSPECIFIED
Luecke, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lurz, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klingel, KarinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Das, ArijitUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Roeder, MaximilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Waha-Thiele, SuzanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Besler, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rommel, Karl-PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maintz, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gutberlet, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thiele, HokerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lurz, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-143467
DOI: 10.1148/radiol.2019190101
Journal or Publication Title: Radiology
Volume: 292
Number: 3
Page Range: S. 608 - 618
Date: 2019
Publisher: RADIOLOGICAL SOC NORTH AMERICA
Place of Publication: OAK BROOK
ISSN: 0033-8419
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MAGNETIC-RESONANCE; DIAGNOSIS; ACCURACYMultiple languages
Radiology, Nuclear Medicine & Medical ImagingMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/14346

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