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Background Native T1-maping at 3T has been shown to reliably characterize chronic myocardial infarctions (MIs). In this study, we evaluated the accuracy and precision of different thresholding techniques and visual delineation for characterizing chronic MIs on native T1 maps at 3T. Results Relative to LGE images, mean infarct size and transmur- ality measured from native T1 maps were significantly over-estimated by Mean+2SD, Mean+3SD, and Mean+ 4SD techniques (p<0.001, for all cases). Mean+6SD cri- terion and visual delineation significantly underesti- mated infarct size (p<0.001 for both cases) and transmurality (p=0.01 for Mean+6SD; p<0.001 for visual) on native T1 maps. Otsu's technique showed no differ- ence for measuring infarct size on native T1 maps com- pared to LGE images (p=0.27), but it over-estimated the infarct transmurality (p<0.001). Mean+5SD criterion showed no difference for measuring either infarct size (p=0.61) or transmurality (p=0.81) on T1 maps relative to LGE images. Mean CNR of LGE images was nearly 4-fold higher than that of native T1 maps (p<0.001). Mean+5SD criterion for detecting chronic MIs on native T1 maps at 3T showed the strongest diagnostic perfor- mance (area-under-curve=0.99, p<0.001), while visual delineation showed the weakest diagnostic performance (area-under-curve=0.84, p<0.001). Conclusions Threshold-based analysis using Mean+5SD criterion can accurately and precisely estimate the size, location and transmurality of chronic MIs on native T1 maps as reli- ably as LGE at 3T.

Accuracy and precision of chronic myocardial infarct characterization with native T1 mapping at 3T