Reference Ranges, Diagnostic and Prognostic Utility of Native T1 Mapping and Extracellular Volume for Cardiac Amyloidosis: A Meta-Analysis.

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  • Additional Information
    • Source:
      Publisher: Wiley-Liss Country of Publication: United States NLM ID: 9105850 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-2586 (Electronic) Linking ISSN: 10531807 NLM ISO Abbreviation: J Magn Reson Imaging Subsets: MEDLINE
    • Publication Information:
      Publication: <2005-> : Hoboken , N.J. : Wiley-Liss
      Original Publication: Chicago, IL : Society for Magnetic Resonance Imaging, c1991-
    • Subject Terms:
      Amyloidosis*/diagnostic imaging; Area Under Curve ; Contrast Media ; Humans ; Magnetic Resonance Imaging ; Myocardium ; Predictive Value of Tests ; Prognosis ; Reference Values ; Reproducibility of Results
    • Abstract:
      Background: Cardiac MRI is central to the evaluation of cardiac amyloidosis (CA). Native T 1 mapping and extracellular volume (ECV) are novel MR techniques with evolving utility in cardiovascular diseases, including CA.
      Purpose: To perform a meta-analysis of the diagnostic and prognostic data of native T 1 mapping and ECV techniques for assessing CA.
      Study Type: Systematic review and meta-analysis.
      Population: In all, 3520 patients including 1539 with CA from 22 studies retrieved following systematic search of Pubmed, Cochrane, and Embase.
      Field Strength/sequence: 1.5T or 3.0T/modified Look-Locker inversion recovery (MOLLI) or shortened MOLLI (shMOLLI) sequences.
      Assessment: Meta-analysis was performed for all CA and for light-chain (AL) and transthyretin (ATTR) subtypes. Thresholds were calculated to classify native T 1 and ECV values as not suggestive, indeterminate, or suggestive of CA.
      Statistical Analysis: Area under the receiver-operating characteristic curves (AUCs) and hazards ratios (HRs) with 95% confidence intervals (95% CI) were pooled using random-effects models and Open-Meta(Analyst) software.
      Results: Six studies were diagnostic, 16 studies reported T 1 and ECV values to determine reference range, and six were prognostic. Pooled AUCs (95% CI) for diagnosing CA were 0.92 (0.89-0.96) for native T 1 mapping and 0.96 (0.93-1.00) for ECV, with similarly high detection rates for AL- and ATTR-CA. Based on the pooled values of native T 1 and ECV in CA and control subjects, the thresholds that suggested the absence, indeterminate, or presence of CA were identified as <994 msec, 994-1073 msec, and >1073 msec, respectively, for native T 1 at 1.5T. Pooled HRs (95% CI) for predicting all-cause mortality were 1.15 (1.08-1.22) for native T 1 mapping as a continuous parameter, 1.19 (1.01-1.40) for ECV as a continuous parameter, and 4.93 (2.64-9.20) for ECV as a binary threshold.
      Data Conclusion: Native T 1 mapping and ECV had high diagnostic performance and predicted all-cause mortality in CA.
      Level of Evidence: 1 TECHNICAL EFFICACY STAGE: 2.
      (© 2020 International Society for Magnetic Resonance in Medicine.)
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    • Contributed Indexing:
      Keywords: T1-mapping; cardiac amyloidosis; extracellular volume; magnetic resonance imaging; meta-analysis
    • Accession Number:
      0 (Contrast Media)
    • Publication Date:
      Date Created: 20201204 Date Completed: 20210519 Latest Revision: 20210519
    • Publication Date:
      20221213
    • Accession Number:
      10.1002/jmri.27459
    • Accession Number:
      33274809