1. Deep Learning Virtual Contrast-Enhanced T1 Mapping for Contrast-Free Myocardial Extracellular Volume Assessment.
- Author
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Nowak S, Bischoff LM, Pennig L, Kaya K, Isaak A, Theis M, Block W, Pieper CC, Kuetting D, Zimmer S, Nickenig G, Attenberger UI, Sprinkart AM, and Luetkens JA
- Subjects
- Humans, Retrospective Studies, Male, Female, Middle Aged, Adult, Amyloidosis diagnostic imaging, Amyloidosis pathology, Myocardium pathology, Magnetic Resonance Imaging, Cine methods, Image Interpretation, Computer-Assisted, Aged, Predictive Value of Tests, Deep Learning, Contrast Media, Myocarditis diagnostic imaging, Myocarditis pathology
- Abstract
Background: The acquisition of contrast-enhanced T1 maps to calculate extracellular volume (ECV) requires contrast agent administration and is time consuming. This study investigates generative adversarial networks for contrast-free, virtual extracellular volume (vECV) by generating virtual contrast-enhanced T1 maps., Methods and Results: This retrospective study includes 2518 registered native and contrast-enhanced T1 maps from 1000 patients who underwent cardiovascular magnetic resonance at 1.5 Tesla. Recent hematocrit values of 123 patients (hold-out test) and 96 patients from a different institution (external evaluation) allowed for calculation of conventional ECV. A generative adversarial network was trained to generate virtual contrast-enhanced T1 maps from native T1 maps for vECV creation. Mean and SD of the difference per patient (ΔECV) were calculated and compared by permutation of the 2-sided t test with 10 000 resamples. For ECV and vECV, differences in area under the receiver operating characteristic curve (AUC) for discriminating hold-out test patients with normal cardiovascular magnetic resonance versus myocarditis or amyloidosis were tested with Delong's test. ECV and vECV showed a high agreement in patients with myocarditis (ΔECV: hold-out test, 2.0%±1.5%; external evaluation, 1.9%±1.7%) and normal cardiovascular magnetic resonance (ΔECV: hold-out test, 1.9%±1.4%; external evaluation, 1.5%±1.2%), but variations in amyloidosis were higher (ΔECV: hold-out test, 6.2%±6.0%; external evaluation, 15.5%±6.4%). In the hold-out test, ECV and vECV had a comparable AUC for the diagnosis of myocarditis (ECV AUC, 0.77 versus vECV AUC, 0.76; P =0.76) and amyloidosis (ECV AUC, 0.99 versus vECV AUC, 0.96; P =0.52)., Conclusions: Generation of vECV on the basis of native T1 maps is feasible. Multicenter training data are required to further enhance generalizability of vECV in amyloidosis.
- Published
- 2024
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