The diagnostic performance of non-contrast T1-mapping in patients with acute myocarditis on cardiovascular magnetic resonance imaging
Bibliographic record
Abstract
The accurate diagnosis of acute myocarditis on cardiovascular magnetic resonance imaging (CMR) often requires multiple modalities, including T2-weighted (T2w), early and late gadolinium imaging. T1-mapping is an emerging technique which is also sensitive to acute changes in free water content. We hypothesized that non-contrast T1-mapping using the novel Shortened Modified Look-Locker Inversion Recovery (ShMOLLI) sequence can serve as a new diagnostic criterion for acute myocarditis. We studied 23 patients with suspected acute myocarditis and 17 healthy controls. All patients presented with chest pain and troponin I > 0.04 ug/L. CMR within 7 days included (1) T2w short-TI inversion recovery (STIR);(2) ShMOLLI T1-mapping; and (3) phase-sensitive late gadolinium enhancement (LGE) (Fig 1 ). T2 signal intensity (SI) relative to skeletal muscle (T2 SI ratio) and absolute T1 values per-subject were analyzed. ROC curves for ShMOLLI T1-mapping and T2-STIR in acute myocarditis. All patients had a CMR diagnosis of acute myocarditis based on both positive T2-STIR and typical LGE pattern. Compared to controls, both mean T1 and T2 SI ratio in patients were significantly higher (T1=1036±71ms vs. T1=938±19; T2 SI ratio=1.77±0.24 vs. 1.52±0.10, p<0.0002 for both). Receiver operator characteristics analysis showed excellent diagnostic performance for both methods: the area-under-the-curve for ShMOLLI T1-mapping=0.96 and STIR=0.93 (p=0.3, Fig 2 ). The equal sensitivity and specificity points were T1=87% (T1=958ms) and T2=83% (T2 SI ratio=1.63). Acute myocarditis. (Top) STIR demonstrating increased signal intensity in the mid lateral wall. (Middle) ShMOLLI T1-map demonstrating increased T1 values (1100-1200 ms) in the lateral wall. (Bottom) LGE imaging demonstrating mid-wall enhancement in the lateral wall. Non-contrast T1-mapping using ShMOLLI has a high diagnostic performance for acute myocarditis and may be used as a novel additional CMR diagnostic criterion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".