Splenic T1-Mapping for Predicting Adenosine Stress Adequacy in Cardiac Magnetic Resonance Myocardial Perfusion Imaging: A Validation and Reproducibility Study

• Published in: Cardiovascular Imaging Asia Vol. 6; no. 3; pp. 88 - 95
• Main Authors: Wan, Fiona Fong-ying, Yeung, Catherine Ming-mun, Yam, Pak-ki, Ng, Pan-pan, Chow, Boris Chun-kei, Chiang, Jeanie Betsy, Lee, Jonan Chun-yin, Cheung, Kenneth Kai-yat, Ng, Ming-yen
• Format: Journal Article
• Language: English
• Published: 아시아심장혈관영상의학회 01.07.2022
• Subjects: 의학일반
• ISSN: 2508-707X; 2508-7088
• DOI: 10.22468/cvia.2022.00024

Objective:Splenic switch-off (SSO) sign has been utilized as a surrogate marker of adequate stress but can only be assessed after first-pass perfusion imaging. A study previously reported that drop in T1spleen ≥30 ms during adenosine infusion predicts presence of SSO, but this finding has not been externally validated. This study aimed to prospectively validate whether drop in T1spleen ≥30 ms is a reliable marker of SSO and hence adequate stress, and to assess reproducibility of T1spleen measurements. Materials and Methods: Data of fifty consecutive patients undergoing stress cardiac magnetic resonance were prospectively collected. Native T1-maps were acquired at rest and at 2.5 min after adenosine infusion in short axis slices, followed by perfusion images at 3 min. To measure T1spleen pre- and post-adenosine infusion, regions of interest were manually placed to include most splenic tissue. Adenosine stress adequacy was evaluated by visual SSO assessment and semi-quantitative splenic perfusion analysis. Results:A significant association was found between a drop in T1spleen of ≥30 ms and SSO response (p<0.001). There was excellent correlation between SSO response and semiquantitative perfusion change in spleen (rho=0.847, p<0.001). Inter-observer and intra-observer agreement for measurement of ΔT1spleen values were excellent, with intra-class correlation coefficients of 0.987 and 0.995, respectively. By receiver-operating characteristic analysis, the optimal cut-off value of ΔT1spleen for predicting presence of SSO was -28 ms, with area under the curve=0.76 (p=0.002). Conclusion:Splenic T1-mapping is accurate and reproducible for predicting SSO, potentially allowing optimization of adenosine dosage for adequate stress. KCI Citation Count: 0