Optimizing ventricular scar characterization in late-gadolinium enhancement cardiac MRI Impact of thresholding techniques in magnitude and phase-sensitive reconstructed images.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Heart rhythm Pub Date : 2025-03-13 DOI:10.1016/j.hrthm.2025.03.1943

Janneke C Burger, Luuk H G A Hopman, Fernando Campos, Cornelis P Allaart, Pieter G Postema, Michiel J B Kemme, Marco J W Götte, Martin J Bishop, Vokko van Halm, Pranav Bhagirath

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引用次数: 0

Abstract

Background: Late gadolinium enhancement (LGE) images, reconstructed using magnitude (MAG) or phase-sensitive inversion recovery (PSIR), differ in signal intensities due to their handling of longitudinal magnetization. These differences influence LGE quantification, which typically uses Full Width at Half Maximum (FWHM) or standard deviation (n-SD) thresholding when predicting cardiac events.

Objective: This study assessed the impact of FWHM and n-SD on MAG- and PSIR-derived scar characteristics.

Methods: Ischemic cardiomyopathy (ICM) patients undergoing LGE imaging were retrospectively studied. Two reconstruction techniques (MAG vs. PSIR) and two thresholding methods (FWHM vs. n-SD) were evaluated. LGE images were post-processed with commercially available software, using scar thresholds of 40-60% maximum signal intensity (FWHM) and 2-5 standard deviations above the mean (n-SD). Scar quantification was compared between primary and secondary prevention implantable cardioverter defibrillator (ICD) patients.

Results: Among 80 patients, 32 (40%) had an ICD for primary prevention. PSIR imaging showed significantly larger scar metrics than MAG using FWHM and n-SD thresholding, including greater border zone (BZ) (16.43 ± 8.15g vs. 21.42 ± 10.72g, p<0.001) and conduction corridor (CC) characteristics. MAG analysis revealed significant differences in scar and CC metrics. For PSIR, scar metrics were consistent across FWHM and n-SD. MAG-based analysis showed larger BZ and CC length in primary prevention patients, with similar trends for PSIR.

Conclusion: This study demonstrates significant differences in myocardial scar metrics based on reconstruction and thresholding techniques. PSIR consistently provided robust scar characterization across methods, emphasizing its clinical potential to standardize LGE-CMR workflows and improve ventricular arrhythmia risk stratification.

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.