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T1 mapping performance and measurement repeatability: results from the multi-national T1 mapping standardization phantom program (T1MES)

  • Captur, Gabriella1, 2, 3
  • Bhandari, Abhiyan4
  • Brühl, Rüdiger5
  • Ittermann, Bernd5
  • Keenan, Kathryn E.6
  • Yang, Ye7
  • Eames, Richard J.8
  • Benedetti, Giulia9
  • Torlasco, Camilla10
  • Ricketts, Lewis4
  • Boubertakh, Redha11
  • Fatih, Nasri1, 2
  • Greenwood, John P.12
  • Paulis, Leonie E. M.13
  • Lawton, Chris B.14
  • Bucciarelli-Ducci, Chiara14
  • Lamb, Hildo J.15
  • Steeds, Richard16
  • Leung, Steve W.17
  • Berry, Colin18
  • And 29 more
  • 1 University College London, Gower Street, London, WC1E 6BT, UK , London (United Kingdom)
  • 2 University College London, 1-19 Torrington Place, London, WC1E 7BH, UK , London (United Kingdom)
  • 3 The Royal Free Hospital, Centre for Inherited Heart Muscle Conditions, Pond Street, Hampstead, London, NW3 2QG, UK , London (United Kingdom)
  • 4 University College London, Bloomsbury Campus, Gower Street, London, WC1E 6BT, UK , London (United Kingdom)
  • 5 Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2–12, Berlin, D-10587, Germany , Berlin (Germany)
  • 6 National Institute of Standards and Technology (NIST), Boulder, MS 818.03, 325 Broadway, Boulder, CO, USA , Boulder (United States)
  • 7 Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, 310016, People’s Republic of China , Hangzhou (China)
  • 8 Imperial College London, Prince Consort Rd, London, SW7 2BB, UK , London (United Kingdom)
  • 9 Guys and St Thomas NHS Foundation Trust, London, UK , London (United Kingdom)
  • 10 University of Milan-Bicocca, Piazza dell’Ateneo Nuovo 1, Milan, 20100, Italy , Milan (Italy)
  • 11 Queen Mary University of London, London, E1 4NS, UK , London (United Kingdom)
  • 12 University of Leeds, Leeds, UK , Leeds (United Kingdom)
  • 13 Maastricht University Medical Centre, Maastricht, 6202 AZ, The Netherlands , Maastricht (Netherlands)
  • 14 University Hospitals Bristol NHS Foundation Trust and University of Bristol, Upper Maudlin St, Bristol, BS2 8HW, UK , Bristol (United Kingdom)
  • 15 Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands , Leiden (Netherlands)
  • 16 University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, B15 2TH, UK , Birmingham (United Kingdom)
  • 17 Gill Heart & Vascular Institute, Lexington, KY, 40536, USA , Lexington (United States)
  • 18 Institute of Cardiovascular and Medical Sciences, RC309 Level C3, Bhf Gcrc, Glasgow, Scotland, G12 8TA, UK , Glasgow (United Kingdom)
  • 19 Lomonosov Moscow State University, Moscow, Russia , Moscow (Russia)
  • 20 University Hospital Southampton Foundation Trust, Tremona Road, Southampton, Hampshire, SO16 6YD, UK , Southampton (United Kingdom)
  • 21 Oslo University Hospital, Sognsvannsveien 20, Oslo, 0372, Norway , Oslo (Norway)
  • 22 San Raffaele Hospital, Via Olgettina 60, Milan, 20132, Italy , Milan (Italy)
  • 23 University of Lyon, UJM-Saint-Etienne, CREATIS, Saint-Etienne, F-42023, France , Saint-Etienne (France)
  • 24 University Hospital Saint-Etienne, Saint-Etienne, France , Saint-Etienne (France)
  • 25 Philips, Philips Centre, Unit 3, Guildford Business Park, Guildford, Surrey, GU2 8XG, UK , Guildford (United Kingdom)
  • 26 SiemensHealthcare GmbH, Erlangen, Germany , Erlangen (Germany)
  • 27 Resonance Health, 278 Stirling Highway, Claremont, WA, 6010, Australia , Claremont (Australia)
  • 28 Griffith University and University of Queensland, Brisbane, Australia , Brisbane (Australia)
  • 29 Universitair Ziekenhuis Leuven, Leuven, UZ, Belgium , Leuven (Belgium)
  • 30 Fondazione Toscana Gabriele Monasterio, Pisa, Italy , Pisa (Italy)
  • 31 University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland, UK , Aberdeen (United Kingdom)
  • 32 Alfred Hospital, Melbourne, Australia , Melbourne (Australia)
  • 33 Baker Heart and Diabetes Institute, Melbourne, Australia , Melbourne (Australia)
  • 34 Monash University, Melbourne, Australia , Melbourne (Australia)
  • 35 Montreal Heart Institute and Université de Montréal, 5000 Bélanger Street, Montreal, QC, H1T 1C8, Canada , Montreal (Canada)
  • 36 Deutsches Herzzentrum Berlin, Berlin, Germany , Berlin (Germany)
  • 37 Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany , Berlin (Germany)
  • 38 National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia , Riyadh (Saudi Arabia)
  • 39 The University of Sydney School of Medicine, Camperdown, NSW, 2006, Australia , Camperdown (Australia)
  • 40 I.R.C.C.S., Policlinico San Donato, Piazza Edmondo Malan, 2, San Donato Milanese, MI, 20097, Italy , San Donato Milanese (Italy)
  • 41 Beth Israel Deaconess Medical Center, Harvard Medical School, Cardiology East Campus, Room E/SH455, 330 Brookline Ave, Boston, MA, 02215, USA , Boston (United States)
  • 42 University of Virginia Health System, 1215 Lee St, Charlottesville, VA, 22908, USA , Charlottesville (United States)
  • 43 National Institutes of Health, Bethesda, MD, 20892-1061, USA , Bethesda (United States)
  • 44 University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792-3252, USA , Madison (United States)
  • 45 Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK , London (United Kingdom)
  • 46 St Bartholomew’s Hospital, West Smithfield, London, EC1A 7BE, UK , London (United Kingdom)
Published Article
Journal of Cardiovascular Magnetic Resonance
Springer (Biomed Central Ltd.)
Publication Date
May 07, 2020
DOI: 10.1186/s12968-020-00613-3
Springer Nature


BackgroundThe T1 Mapping and Extracellular volume (ECV) Standardization (T1MES) program explored T1 mapping quality assurance using a purpose-developed phantom with Food and Drug Administration (FDA) and Conformité Européenne (CE) regulatory clearance. We report T1 measurement repeatability across centers describing sequence, magnet, and vendor performance.MethodsPhantoms batch-manufactured in August 2015 underwent 2 years of structural imaging, B0 and B1, and “reference” slow T1 testing. Temperature dependency was evaluated by the United States National Institute of Standards and Technology and by the German Physikalisch-Technische Bundesanstalt. Center-specific T1 mapping repeatability (maximum one scan per week to minimum one per quarter year) was assessed over mean 358 (maximum 1161) days on 34 1.5 T and 22 3 T magnets using multiple T1 mapping sequences. Image and temperature data were analyzed semi-automatically. Repeatability of serial T1 was evaluated in terms of coefficient of variation (CoV), and linear mixed models were constructed to study the interplay of some of the known sources of T1 variation.ResultsOver 2 years, phantom gel integrity remained intact (no rips/tears), B0 and B1 homogenous, and “reference” T1 stable compared to baseline (% change at 1.5 T, 1.95 ± 1.39%; 3 T, 2.22 ± 1.44%). Per degrees Celsius, 1.5 T, T1 (MOLLI 5s(3s)3s) increased by 11.4 ms in long native blood tubes and decreased by 1.2 ms in short post-contrast myocardium tubes. Agreement of estimated T1 times with “reference” T1 was similar across Siemens and Philips CMR systems at both field strengths (adjusted R2 ranges for both field strengths, 0.99–1.00). Over 1 year, many 1.5 T and 3 T sequences/magnets were repeatable with mean CoVs < 1 and 2% respectively. Repeatability was narrower for 1.5 T over 3 T. Within T1MES repeatability for native T1 was narrow for several sequences, for example, at 1.5 T, Siemens MOLLI 5s(3s)3s prototype number 448B (mean CoV = 0.27%) and Philips modified Look-Locker inversion recovery (MOLLI) 3s(3s)5s (CoV 0.54%), and at 3 T, Philips MOLLI 3b(3s)5b (CoV 0.33%) and Siemens shortened MOLLI (ShMOLLI) prototype 780C (CoV 0.69%). After adjusting for temperature and field strength, it was found that the T1 mapping sequence and scanner software version (both P < 0.001 at 1.5 T and 3 T), and to a lesser extent the scanner model (P = 0.011, 1.5 T only), had the greatest influence on T1 across multiple centers.ConclusionThe T1MES CE/FDA approved phantom is a robust quality assurance device. In a multi-center setting, T1 mapping had performance differences between field strengths, sequences, scanner software versions, and manufacturers. However, several specific combinations of field strength, sequence, and scanner are highly repeatable, and thus, have potential to provide standardized assessment of T1 times for clinical use, although temperature correction is required for native T1 tubes at least.

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