Clinical applications of co-registered myocardial T2 mapping and dual bright- and black-blood late gadolinium enhancement magnetic resonance imaging

Cardiovascular magnetic resonance imaging has become pivotal in the non-invasive assessment of the heart. Bright-blood sequences are used to retrieve information about cardiac anatomy and function. Concurrently, novel black-blood late gadolinium enhancement sequences have showcased potential for scar detection by uncovering scar patterns that may be confounded with blood. In the acute setting, T2 mapping allows for quantitative characterization of oedematous tissue. Nowadays, these images are acquired sequentially through multiple breath-holds, adding to the workload of medical professionals, reducing patient comfort, and hampering image analysis.

Here, we assess the clinical value of SPOT-MAPPING, a sequence combining co-registered T2 mapping and joint black- and bright-blood imaging.

Twenty-six patients (27% women, age 64 ± 12yo) with acute, chronic, ischaemic, non-ischaemic, and overlapping cardiomyopathies, prospectively underwent SPOT-MAPPING at 1.5T. Conventional PSIR images and T2 maps served as the reference standard. Left ventricular (LV) mass, scar mass, burden, and transmurality and T2 values were retrieved and compared between sequences. Acquisition times were recorded. Acquisition time for SPOT-MAPPING was in average twice shorter than combined reference sequences (5 min 55 s [5 min 14 s–6 min 30 s] vs. 11 min 56 s [10 min 39s–12 min 12 s]). High reproducibility was obtained with reference sequences for LV mass (ICC ≥ 0.93). Strong agreement was observed with PSIR in scar extraction (mean bias: mass +2.3 g, burden +1.1%LV mass, transmurality +1.4%). No significant difference with reference T2 mapping was observed in remote (P = 1.000) and oedematous myocardium (P = 0.883).

SPOT-MAPPING demonstrated its efficacy in a wide range of patients, proving itself as a time-efficient and reproducible CMR method for the assessment of various cardiac diseases.