Tissue Characterization
Michael P. DiLorenzo, MD MSCE
Assitant Professor of Pediatrics
Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian
New York, New York, United States
Michael P. DiLorenzo, MD MSCE
Assitant Professor of Pediatrics
Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian
New York, New York, United States
.jpg "Anjali Chelliah, MD photo")
Anjali Chelliah, MD
Division Chief, Pediatric Cardiology
Goryeb Children's Hospital, Morristown Medical Center/Atlantic Health System
Morristown, New Jersey, United States
.jpg "Christopher Z. Lam, MD photo")
Christopher Z. Lam, MD
Division Head, Body and Cardiac Imaging
The Hospital for Sick Children
Toronto, Ontario, Canada
Francesca Raimondi, MD
Staff Physician
University of Florence
Paris, Toscana, Italy
Jimmy C. Lu, MD
Associate Professor
University of Michigan
Ann Arbor, Michigan, United States
Edythe Tham, MD
Faculty
Stollery Children's Hospital, Canada
Daniel A. Castellanos, MD
Instructor of Pediatrics
Boston Children's Hospital
Boston, Massachusetts, United States
.png "Laura Olivieri, MD photo")
Laura Olivieri, MD
Director, Noninvasive Cardiac Imaging
Children's Hospital of Pittsburgh of UPMC, United States
Jyoti K. Patel, MD
Assistant Professor of Pediatrics
Riley Children's Health
Indianapolis, Indiana, United States
Marc Lee, MD
Physician
Nationwide Children's Hospital
Columbus, Ohio, United States
Matthew Cornicelli, MD
Assistant Professor of Pediatrics
Ann & Robert H. Lurie Children's Hospital of Chicago, United States
Sujatha Buddhe, MD, MSc
Director, Noninvasive Cardiac Imaging Research
Seattle Children's Hospital
Seattle, Washington, United States
Uyen Truong, MD
Director, Advanced Imaging
Children's National Medical Center, United States
David M. Biko, MD
Assistant Professor
The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Brian Fonseca, MD
Associate Professor of Cardiology
Children's Hospital Colorado
Aurora, Colorado, United States
Shafkat Anwar, MD, FSCMR
Associate Professor of Pediatrics and Radiology
University of California, San Francisco
San Francisco, California, United States
Anh Thi Ngoc Chau, MD
Radiologist, Division of Cardiac Imaging
Tam Anh Hospital, Vietnam
Ho Chi Minh City, Vietnam
Rami Kharouf, MD
Assistant Professor of Pediatrics
UT Health McGovern, United States
Maria Boutsikou, MD, PhD, MSc, FSCMR
Director
Mediterraneo Hospital
Athens, Attiki, Greece
Markus S. Renno, MD
Faculty
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States
Jyothsna Akam-Venkata, MD
Assistant Professor
University of Mississippi Medical Center
Madison, Mississippi, United States
Barbara E. Burkhardt, MD
Pediatric Cardiologist
University of Zurich Children's Hospital
Zurich, Zurich, Switzerland
.jpg "Olga H. Toro-Salazar, MD photo")
Olga H. Toro-Salazar, MD
Head of Non-Invasive Imaging and Cardio-Oncology
Connecticut Children's Medical Center
Glastonbury, Connecticut, United States
Margaret M. Samyn, MD, MBA, FSCMR
Professor of Pediatrics
Medical College of Wisconsin/ Herma Heart Institute at Children's Wisconsin
Milwaukee, Wisconsin, United States
Katrina Golub, MPH
Research Manager
Columbia University Irving Medical Center, United States
Lars Grosse-Wortmann, M.D., FRCPC, MD
Dr.
Oregon Health & Science University
Portland, Oregon, United States
Jonathan H. Soslow, MD, MSc
Associate Professor of Pediatrics, and Director, Pediatric Cardiac Imaging Research Center
Vanderbilt University Medical Center
Nashville, United States
Parametric mapping has become a clinically useful tool to assess for myocardial edema and diffuse fibrosis by cardiac MRI (CMR). While published adult normative parametric mapping data are available, normative data among children and adolescents are limited to smaller, single center studies. We sought to establish normal values in a pediatric population.
Methods:
In this retrospective international study, individual centers submitted parametric mapping data for children and adolescents ≤21 years of age. Indications for CMR included ECG abnormalities, arrhythmias, cardiomyopathy rule out, asymptomatic COVID, evaluation of anatomic questions, or as “healthy controls.” Exclusion criteria included congenital heart disease (other than simple shunts), suspected cardiomyopathies or aortopathies, genetic abnormalities, abnormal ventricular size or function, or presence of late gadolinium enhancement. Data were submitted through REDCap. Parametric mapping values were measured and reported by individual centers as per local protocol. Student’s t-test and one-way ANOVA were used to assess differences in continuous variables.
Results:
Studies in 349 patients were submitted from 10 centers. 179 (52%) were female; the median age at CMR was 16.8 years (range 6, 21). Most studies had been performed on 1.5 T magnets (n=343, 99%) and a majority of studies were performed on Siemens scanners (n=202, 59%). T1 and ECV calculations at 1.5 T were reported on 279 and 170 studies. All studies were performed using modified Look-Locker inversion recovery (MOLLI) with a 5(x)3 acquisition method. The median basal and mid-ventricular native T1 values were 1007±56 ms and 992±34 ms, respectively. Mid-ventricular native T1 values were higher in females (999±33 ms vs 985±33 ms, p< 0.001) although basal native T1 values were not significantly different (1010 ± 53 ms vs 1004±60 ms, p=0.46). There was no difference in T1 values based on vendor (base: p=0.9, mid: p=0.13), but values varied by center (base and mid: p< 0.001). The mean basal (n=76) and mid-ventricular (n=170) ECV was 23.1±3.0% and 24.3±3.1%, respectively. ECV was higher among females (base: 24.9±2.5% vs 21.8±2.6%, p < 0.001; mid: 25.7±2.8% vs 22.8±2.6%, p< 0.001, Figure 1). Mid-ventricular ECV varied significantly based on MRI vendor, driven by a difference between Siemens and Philips (Siemens 23.1±2.9; Philips 25.7±2.4; GE 20.5±3.9, p< 0.001) (Figure 2).
Conclusion: Native T1 and ECV values in this cohort of healthy children were higher among females. While there was no overall difference in native T1 values based on vendor, values varied by center, emphasizing the need for locally derived values. In this small subset, ECV varied by vendor, necessitating further investigation. Ultimately, this large, multicenter initiative with centralized image processing will help elucidate gender, vendor, and age-related differences in ECV to help guide pediatric centers in interpreting pediatric values.