Reproducibility of three different cardiac T2-mapping sequences at 1.5T and impact of cofactors on T2-relaxation times

PURPOSE To elucidate the impact of technical and intraindividual reproducibility on the overall variability of myocardial T2 relaxation times. MATERIALS AND METHODS Thirty healthy volunteers were examined three times (day 1 morning/evening, evening after 2-3 weeks) at 1.5T. During each examination three different T2 -mapping sequences were acquired twice at three slices in short axis view: multi-echo-spin-echo (MESE), T2 -prepared balanced steady-state free precession (SSFP) (T2 prep), and gradient-spin-echo with and without fat saturation (GraSE/GraSEFS ). Repeated measurements were performed for T2 prep and GraSE. Segmented T2 -maps were generated for each slice according to the American Heart Association (AHA) 16-segment model. RESULTS The coefficients of variation and intraclass correlation coefficients for intraobserver variability were: 1.3% and 0.89 for T2 prep, 1.5% and 0.93 for GraSE, 3.1% and 0.83 for MESE; and for interobserver variability: 3.3% and 0.66 for T2 prep, 2.0% and 0.83 for GraSE, 3.6% and 0.77 for MESE. No systematic difference of T2 times was observed due to diurnal effects and on long-term analysis using one-way analysis of variance (ANOVA) with Tukey-type multiple comparisons (morning vs. evening scan for T2 prep: 52.5 ± 2.4 vs. 51.7 ± 2.7 msec, P = 0.119; for GraSE: 58.6 ± 4.0 vs. 58.5 ± 3.8 msec, P = 0.984; for GraSEFS 57.1 ± 3.2 vs. 57.2 ± 3.9 msec, P = 0.998, and for MESE: 53.8 ± 2.7 vs. 53.3 ± 3.3 msec, P = 0.541; scans between weeks for T2 prep: 51.7 ± 2.7 vs. 51.4 ± 2.4 msec, P = 0.873; for GraSE: 58.5 ± 3.8 vs. 58.1 ± 3.4 msec, P = 0.736; for GraSEFS : 57.2 ± 3.9 vs. 57.0 ± 4.6 msec, P = 0.964, and for MESE: 53.3 ± 3.3 vs. 53.4 ± 2.4 msec, P = 0.970). ANOVA components, however, demonstrated a greater variance of T2 times over multiple timepoints than for repeated measurements within the same scan (variance components of the model fit for intraday variance vs. repeated measurements: T2 prep 2.22 vs. 1.36, GraSE 3.76 vs. 2.09, GraSEFS 3.96 vs. 1.58, MESE 1.86; and for interweeks variance vs. repeated measurements: T2 prep 2.21 vs. 0.80, GraSE 3.20 vs. 2.10, GraSEFS 8.82 vs. 1.18, and MESE 4.49). CONCLUSION Technical reproducibility and intra- and interobserver agreement of myocardial T2 relaxation times are excellent and intraindividual variation over time is small. Therefore, we consider subject-related factors to explain most of the interindividual variability of myocardial T2 times reported in previous studies. The acknowledgment of this subject-related, biological variability may be important for the future diagnostic value of T2 -mapping. J. Magn. Reson. Imaging 2016;44:1168-1178.