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Principles and Applications
Phillip C. Yang
Editor
T1-Mapping in
Myocardial Disease
T1-Mapping in Myocardial Disease
Phillip C. Yang
Editor
T1-Mapping in
Myocardial Disease
Principles and Applications
ISBN 978-3-319-91109-0 ISBN 978-3-319-91110-6 (eBook)
https://doi.org/10.1007/978-3-319-91110-6
Library of Congress Control Number: 2018954764
© Springer International Publishing AG, part of Springer Nature 2018
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or
part of the material is concerned, specically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way,
and transmission or information storage and retrieval, electronic adaptation, computer software,
or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specic statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher nor
the authors or the editors give a warranty, express or implied, with respect to the material
contained herein or for any errors or omissions that may have been made. The publisher remains
neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by Springer Nature, under the registered company Springer
International Publishing AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Editor
Phillip C. Yang
School of Medicine
Stanford University School of Medicine
Stanford, CA
USA
v
Cardiovascular disease is the leading cause of death and hospitalization in the
United States. Early and precise diagnosis of the cardiomyopathy will reduce
the resultant morbidity and mortality from heart failure (HF). More than ve
million people suffer from HF with an annual incidence of 500,000 patients
in our country alone. Despite signicant therapeutic advances over the last
three decades, the 5-year survival remains at a dismal 50%. Clinical studies
have conrmed that the major sequela of HF is left ventricular (LV) arrhyth-
mia, dilatation, and dysfunction. Patients with a history of coronary artery
disease and HF have a 6-month mortality of greater than 10%, one-third of
which is attributed to sudden cardiac death.
This book provides a comprehensive description of the advances in car-
diac MRI to quantitate the tissue characteristics of the diseased myocardium,
using myocardial and blood T1 measurements. This novel approach detects
both the regional and diffuse pathological processes in the complex and con-
tractile myocardium, the only moving organ in the human body, consisting of
cardiac, interstitial, brotic, smooth muscle and endothelial cells. Evaluation
of the native myocardial brosis, disarray, injury, remodeling, apoptosis and
necrosis and measurement of their extracellular niche have allowed an
unprecedented opportunity to elucidate the underlying pathology, provide
accurate early- and late-diagnoses, and determine the prognosis of these
patients aficted with severe cardiovascular diseases.
T1-Mapping in Myocardial Disease: Principles and Applications aims to
cover the broad spectrum of cardiomyopathic processes to provide a practical
and meaningful guidance on how to apply this novel technique in daily clini-
cal practice. The main objective of this book is not only to convey the innova-
tion in T1-mapping but also to emphasize the relevance of this technique in
managing cardiomyopathy patients. The specic topics include the funda-
mental principles of T1-mapping technique and their application in a variety
of disease entities. These unique properties of T1-mapping are illustrated spe-
cically through their ability to analyze and measure the pathology in hyper-
trophic cardiomyopathy, cancer chemotherapy induced cardiomyopathy,
cardiac brosis, aortic stenosis, ischemic cardiomyopathy, uncommon non-
ischemic cardiomyopathy, and cell therapy for myocardial restoration. This
comprehensive application of T1-mapping in cardiovascular diseases will
appeal to the entire cardiovascular medicine and imaging communities.
In conclusion, I would like to express my gratitude to the tremendous
effort of all the authors and the support of their family members in complet-
Preface
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vi
ing this book. I am truly honored to have experienced this opportunity to
collaborate with the experts and leaders of their respective eld. If I may, I
would like to acknowledge my wife, Mariko, for her kind and genuine sup-
port throughout the entire duration. Her patience and unconditional support
often provided the necessary emotional strength and intellectual fortitude to
move forward. I also appreciate our three children, Risako, Seiji, and Masako,
who challenged me to think harder, persevere and appreciate multiple per-
spectives, which enabled me to carry this project to completion. Finally, our
pet dog, Rocky, provided sanity, calm, and many moments of self-reection.
I am forever grateful to all. Thank you.
Stanford, CA PhillipC.Yang
Preface
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vii
Contents
1 Fundamentals ofCardiac T1 Mapping . . . . . . . . . . . . . . . . . . . . . . . 1
Joëlle K. Barral, Matthias G. Friedrich, and Nikola Stikov
2 T1 Mapping inCardiac Hypertrophy � � � � � � � � � � � � � � � � � � � � � � � 15
Michael Salerno and Christopher M. Kramer
3 T1 Mapping inCardiomyopathy fromCancer Treatment . . . . . . 27
Jennifer H. Jordan and W. Gregory Hundley
4 Comparison ofT1 Mapping byCardiac
MRI toNon-cardiac MRI Methods toEvaluate
Cardiac Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Róisín B. Morgan, Michael Jerosch-Herold,
and Raymond Y. Kwong
5 T1 Mapping inAortic Stenosis � � � � � � � � � � � � � � � � � � � � � � � � � � � � 61
Russell J. Everett, David E. Newby, and Marc R. Dweck
6 T1 Mapping inPeri-infarct Injury
inIschemic Cardiomyopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Yuko Tada and Rajesh Dash
7 T1 Mapping inStem Cell Therapy � � � � � � � � � � � � � � � � � � � � � � � � � 87
Yoko Kato, Mohammad R. Ostovaneh,
Bharath Ambale-Venkatesh, and Joao Lima
8 T1 Mapping inUncommon Non- ischemic Cardiomyopathies . . 101
Kate Hanneman
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Bharath Ambale-Venkatesh Department of Radiology, Johns Hopkins
University School of Medicine, Baltimore, MD, USA
JoëlleK�Barral Verily Life Sciences, South San Francisco, CA, USA
RajeshDash, MD, PhD Division of Cardiovascular Medicine, Department
of Medicine, Stanford University Medical Center, Stanford, CA, USA
Marc R� Dweck British Heart Foundation Centre for Cardiovascular
Science, University of Edinburgh, Edinburgh, UK
Russell J� Everett British Heart Foundation Centre for Cardiovascular
Science, University of Edinburgh, Edinburgh, UK
Matthias G� Friedrich Departments of Cardiology and Diagnostic
Radiology, McGill University Health Centre, McGill University, Montreal,
QC, Canada
Kate Hanneman, MD, MPH, FRCPC Department of Medical Imaging,
Toronto General Hospital, University of Toronto, Toronto, ON, Canada
W� Gregory Hundley Department of Internal Medicine, Section on
Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem,
NC, USA
MichaelJerosch-Herold Department of Radiology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, USA
Jennifer H� Jordan Department of Internal Medicine, Section on
Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem,
NC, USA
YokoKato Department of Cardiology, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
ChristopherM�Kramer Department of Medicine, University of Virginia
Health System, Charlottesville, VA, USA
Department of Radiology, University of Virginia Health System,
Charlottesville, VA, USA
Cardiovascular Imaging Center, University of Virginia Health System,
Charlottesville, VA, USA
Contributors
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RaymondY�Kwong Non-invasive Cardiovascular Imaging, Cardiovascular
Division, Department of Medicine, Brigham and Women’s Hospital, Harvard
Medical School, Boston, MA, USA
JoaoLima Department of Cardiology, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
Department of Radiology, Johns Hopkins University School of Medicine,
Baltimore, MD, USA
Róisín B� Morgan Non-invasive Cardiovascular Imaging, Cardiovascular
Division, Department of Medicine, Brigham and Women’s Hospital, Harvard
Medical School, Boston, MA, USA
David E� Newby British Heart Foundation Centre for Cardiovascular
Science, University of Edinburgh, Edinburgh, UK
Mohammad R� Ostovaneh Department of Cardiology, Johns Hopkins
University School of Medicine, Baltimore, MD, USA
Michael Salerno Department of Medicine, University of Virginia Health
System, Charlottesville, VA, USA
Department of Radiology, University of Virginia Health System,
Charlottesville, VA, USA
Department of Biomedical Engineering, University of Virginia Health
System, Charlottesville, VA, USA
Cardiovascular Imaging Center, University of Virginia Health System,
Charlottesville, VA, USA
Cardiovascular Division, University of Virginia Health System,
Charlottesville, VA, USA
Nikola Stikov NeuroPoly Lab, Institute of Biomedical Engineering,
Polytechnique Montreal, Montreal, QC, Canada
Montreal Heart Institute, University of Montreal, Montreal, QC, Canada
YukoTada, MD, PhD Division of Cardiovascular Medicine, Department of
Medicine, Stanford University, Stanford, CA, USA
Contributors
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1
© Springer International Publishing AG, part of Springer Nature 2018
P. C. Yang (ed.), T1-Mapping in Myocardial Disease, https://doi.org/10.1007/978-3-319-91110-6_1
Fundamentals ofCardiac
T1 Mapping
JoëlleK.Barral, MatthiasG.Friedrich,
andNikolaStikov
Magnetic resonance imaging (MRI) has revolu-
tionized the way we visualize and understand the
human body. MR image acquisition enables cli-
nicians and scientists to tweak a number of
parameters (e.g., repetition time, echo time, ip
angle) to generate unique tissue contrast. Each
combination of parameters leads to a wealth of
information about the tissue microstructure, yet
reverse engineering the tissue makeup from MR
images is not an easy task.
The fundamental contrast mechanisms that
produce MR images are the longitudinal and the
transverse relaxations, characterized by the T1
and T2 parameters, respectively. The MR signal
is the product of the interaction between billions
of spins (atoms with a magnetic moment) over a
macroscopic volume (on the order of millimeters
cubed). T1 and T2 share a complex relationship,
making it difcult to isolate their individual con-
tributions to the MR signal and understand
exactly how many different spin populations are
being imaged, as well as what their relative con-
tributions are.
Quantitative MRI attempts to make sense of
this wealth of information using biophysical
models that relate the MR signal to the tissue
makeup. In this chapter we will focus on the fun-
damentals of T1 mapping.
T1
Hydrogen atoms (H) exhibit nuclear magnetic
resonance, and water molecules (H
2
O) are the
source of most of the signal in MRI.We distin-
guish between free water, where motion is unhin-
dered, structured water, where water is bound to
a macromolecule by a single hydrogen atom, and
bound water, where water is bound to a macro-
molecule by both hydrogen atoms [1].
In the absence of an external magnetic eld,
spins are randomly oriented and the net magneti-
zation is zero. In an applied magnetic eld (1.5T
or 3T for clinical scanners), spins align with the
applied eld, contributing to a non-zero magneti-
zation. From a classical physics perspective,
spins precess around the applied eld at the
Larmor frequency, which is proportional to the
eld strength. If an ensemble of spins is now
excited by a radiofrequency (RF) pulse at the
Larmor frequency, the magnetization is per-
turbed. In a classical representation, the RF pulse
J. K. Barral
Verily Life Sciences, South San Francisco, CA, USA
M. G. Friedrich
Departments of Cardiology and Diagnostic
Radiology, McGill University Health Centre, McGill
University, Montreal, QC, Canada
N. Stikov (*)
NeuroPoly Lab, Institute of Biomedical Engineering,
Polytechnique Montreal, Montreal, QC, Canada
Montreal Heart Institute, University of Montreal,
Montreal, QC, Canada
e-mail: nikola.stikov@polymtl.ca
1
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