Novel segmentation technique of T1 mapping in Pulmonary Hypertension
Research type
Research Study
Full title
Non-invasive measurement of myocardial damage in Pulmonary Hypertension using Native T1 mapping from Cardiac MRI : a novel segmentation technique and association with haemodynamic variables.
IRAS ID
231095
Contact name
Geeshath Jayasekera
Contact email
Sponsor organisation
Golden Jubilee National Hospital
Duration of Study in the UK
0 years, 3 months, 0 days
Research summary
Pulmonary hypertension (PH) is a disease process affecting the pulmonary circulation characterised by an increase in pulmonary artery pressure, leading to right ventricular (RV) failure and death. Although pulmonary hypertension is a disease of the pulmonary vessels, the subsequent RV failure is the main cause of morbidity and mortality in patients. Many Cardiac Magnetic Resonance (CMR) measures of RV and LV function have shown to be strongly predictive of mortality and survival thus offering potential for monitoring and determining response to treatment in PH.
Myocardial T1 mapping during CMR is a novel method of myocardial tissue characterisation without the need for contrast. Native T1 mapping has the potential to identify both focal and diffuse myocardial scarring without the need for contrast administration and reflects myocardial disease involving the myocyte and interstitium. Although identification of raised native T1 times has been used to identify myocardial histological changes in PH, success has been limited due to
1. The need for visual assessment of the insertion points or,
2. The existing AHA technique of segmentation of the LV fails to isolate the regions of Right ventricular insertion for analysis
The aims of our retrospective study was to develop a novel method of myocardial segmentation during T1 mapping, which isolated the regions of RV insertion points without requiring visual assessment. We hypothesised that the regional T1 values would identify myocardial abnormalities which related to markers of disease severity and prognosis. Because this technique is non-invasive we would then be able to use it in longitudinal studies. We used retrospective cohort of patients who had diagnostic MRI imaging as part of their diagnostic clinical assessment. As a secondary objective we also looked at cardiac strain measurements ( which a measure of myocardial deformation ) in the segments to try and identify mechanics behind the tissue changes.REC name
East of England - Cambridge East Research Ethics Committee
REC reference
18/EE/0010
Date of REC Opinion
5 Feb 2018
REC opinion
Further Information Favourable Opinion