Validation of cardiac diffusion tensor imaging sequences: A multicentre test–retest phantom study
Irvin Teh, William Romero, Jordan H. Boyle, Jaume Coll‐Font, Erica Dall’Armellina, Daniel B. Ennis, Pedro Ferreira, Prateek Kalra, Arunark Kolipaka, Sebastian Kozerke, David Lohr, François‐Pierre Mongeon, Kévin Moulin, Christopher Nguyen, Sònia Nielles‐Vallespin, Brian Raterman, Wolfgang Schreiber, Andrew D. Scott, David E. Sosnovik, Christian T. Stoeck, Cyril Tous, Elizabeth M. Tunnicliffe, Andreas Max Weng, Pierre Croisille, Magalie Viallon, Jürgen E. Schneider
Abstract
Cardiac diffusion tensor imaging (DTI) is an emerging technique for the in vivo characterisation of myocardial microstructure, and there is a growing need for its validation and standardisation. We sought to establish the accuracy, precision, repeatability and reproducibility of state‐of‐the‐art pulse sequences for cardiac DTI among 10 centres internationally. Phantoms comprising 0%–20% polyvinylpyrrolidone (PVP) were scanned with DTI using a product pulsed gradient spin echo (PGSE; N = 10 sites) sequence, and a custom motion‐compensated spin echo (SE; N = 5) or stimulated echo acquisition mode (STEAM; N = 5) sequence suitable for cardiac DTI in vivo. A second identical scan was performed 1–9 days later, and the data were analysed centrally. The average mean diffusivities (MDs) in 0% PVP were (1.124, 1.130, 1.113) x 10 −3 mm 2 /s for PGSE, SE and STEAM, respectively, and accurate to within 1.5% of reference data from the literature. The coefficients of variation in MDs across sites were 2.6%, 3.1% and 2.1% for PGSE, SE and STEAM, respectively, and were similar to previous studies using only PGSE. Reproducibility in MD was excellent, with mean differences in PGSE, SE and STEAM of (0.3 ± 2.3, 0.24 ± 0.95, 0.52 ± 0.58) x 10 −5 mm 2 /s (mean ± 1.96 SD). We show that custom sequences for cardiac DTI provide accurate, precise, repeatable and reproducible measurements. Further work in anisotropic and/or deforming phantoms is warranted.