Sena Bozer ULUDAĞ, Sena ÜNAL, Elif PEKER, Çağlar UZUN
The Anatolian Journal of Cardiology - 2026;30(6):386-400
Background: This study aimed to identify the optimal measurement location and technique for native T1 mapping to establish a standardized approach. The diagnostic performance of various T1 mapping measurement approaches was evaluated by comparing nonischemic dilated cardiomyopathy (NIDCM) and hypertrophic cardiomyopathy (HCM) cohorts with a control group. Methods: Patients who underwent 1.5 T cardiac magnetic resonance (CMR) were retrospectively reviewed with standardized protocol [functional sequences, T1 mapping, and late gadolinium enhancement] between November 2016 and January 2023. A total of 143 subjects (61 NIDCM, 60 HCM, and 22 controls) were grouped based on CMR findings. Native T1 mapping images were acquired in basal, midventricular, and apical short-axis (SAX) slices. Regions of interest were drawn in both the whole left ventricular (LV) myocardium SAX and the interventricular septum. Diagnostic yield and optimal cut-off values for native T1 were investigated. Results: Native T1 values were significantly higher than the control group for 6 different measurement approaches (P < .05). Basal SAX and basal septal measurements provided the highest diagnostic accuracy values for both groups. Statistical analysis revealed that T1 values could differentiate between healthy and diseased myocardium, with a diagnostic accuracy of 86% for NIDCM and 73.4% for HCM. Furthermore, T1 values correlated with measures of global systolic function and LV remodeling. Conclusions: The study shows that native T1 mapping using a streamlined single-slice acquisition with a septal measurement technique achieves diagnostic performance comparable to multi-slice protocols while reducing measurement heterogeneity. This optimization facilitates a time-efficient workflow and improves patient comfort without compromising diagnostic accuracy.
