Validation of fully automated myocardial T1 and synthetic hematocrit-based extracellular volume quantification on 3T cardiac MRI: a retrospective cross-sectional study.
8 affiliations
- 1Department of Physiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- 2Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- 3Division of General Internal Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- 4Division of Internal Medicine, Faculty of Medicine, Burapha University, Chonburi, Thailand.
- 5Division of Hospital and Ambulatory Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- 6Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- 7Department of Radiology, Research Institute of Radiological Science, Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea.
- 8Phantomics, Inc., Seoul, Korea.
Abstract
Automated post-processing software has been developed to quantify various cardiac magnetic resonance (CMR) parameters, including native T1 and extracellular volume (ECV) using synthetic hematocrit (Hct). However, validation studies of these automated measurements remain limited. We aimed to validate a fully automated workflow integrating myocardial T1 analysis and synthetic Hct for ECV quantification on 3T CMR, using manual ECV calculation based on venous Hct as the reference method. This retrospective, cross-sectional study included 65 adults with low-to-intermediate risk of atherosclerotic cardiovascular disease who underwent stress 3T CMR. Manual ECV was calculated using manually contoured myocardial T1 values and venous Hct obtained within 7 days of CMR. Automated analysis used Myomics-T1 software (Phantomics, Korea) to automatically generate myocardial and blood-pool T1 values and contours, with synthetic Hct derived from a regression model developed in an independent cohort of 450 participants. Correlation and agreement were assessed using Pearson correlation, intraclass correlation coefficients (ICC), and Bland-Altman analysis. The mean age was 65.2±11.5 years, and 60% of participants were female. Automated myocardial native T1 and ECV showed excellent correlation with manual measurements (r=0.96 and 0.91, respectively) and excellent agreement (ICC =0.96 and 0.93, respectively). Automated myocardial native T1 was slightly higher than manual measurements (1,246±52 vs. 1,233±47 ms), whereas automated ECV was higher by 1.2 percentage points (29.0%±4.9% vs. 27.8%±4.6%). Synthetic Hct correlated with venous Hct (r=0.78; ICC =0.76) but demonstrated proportional bias. Agreement between synthetic Hct-derived and manual ECV was better within the normal Hct range (35-45%) but substantially reduced at Hct >45% (ICC =0.04). Fully automated ECV quantification demonstrated strong correlation and agreement with the manual method within the normal Hct range. However, synthetic Hct-derived ECV was less reliable at abnormal Hct levels, particularly at Hct >45%. Further external validation and refinement of the synthetic Hct model are warranted to support broader clinical application.
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BibTeX
@article{kositanurit2026validation,
title = {{Validation of fully automated myocardial T1 and synthetic hematocrit-based extracellular volume quantification on 3T cardiac MRI: a retrospective cross-sectional study.}},
author = {Weerapat Kositanurit and Nonthikorn Theerasuwipakorn and Tanawin Suksiriworaboot and Sopida Thammongkolchai and Maethas Panyawongkhanti and Yongkasem Vorasettakarnkit and Chonthicha Lerdkhonsan and Monravee Tumkosit and Byoung Wook Choi and Jinho Park and Pairoj Chattranukulchai},
journal = {Quantitative imaging in medicine and surgery},
year = {2026},
month = sep,
doi = {10.21037/qims-2026-0883},
url = {https://europepmc.org/article/MED/42997942},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Validation of fully automated myocardial T1 and synthetic hematocrit-based extracellular volume quantification on 3T cardiac MRI: a retrospective cross-sectional study.
AU - Weerapat Kositanurit
AU - Nonthikorn Theerasuwipakorn
AU - Tanawin Suksiriworaboot
AU - Sopida Thammongkolchai
AU - Maethas Panyawongkhanti
AU - Yongkasem Vorasettakarnkit
AU - Chonthicha Lerdkhonsan
AU - Monravee Tumkosit
AU - Byoung Wook Choi
AU - Jinho Park
AU - Pairoj Chattranukulchai
PY - 2026
DA - 2026/09/29
JO - Quantitative imaging in medicine and surgery
DO - 10.21037/qims-2026-0883
UR - https://europepmc.org/article/MED/42997942
AB - Automated post-processing software has been developed to quantify various cardiac magnetic resonance (CMR) parameters, including native T1 and extracellular volume (ECV) using synthetic hematocrit (Hct). However, validation studies of these automated measurements remain limited. We aimed to validate a fully automated workflow integrating myocardial T1 analysis and synthetic Hct for ECV quantification on 3T CMR, using manual ECV calculation based on venous Hct as the reference method. This retrospective, cross-sectional study included 65 adults with low-to-intermediate risk of atherosclerotic cardiovascular disease who underwent stress 3T CMR. Manual ECV was calculated using manually contoured myocardial T1 values and venous Hct obtained within 7 days of CMR. Automated analysis used Myomics-T1 software (Phantomics, Korea) to automatically generate myocardial and blood-pool T1 values and contours, with synthetic Hct derived from a regression model developed in an independent cohort of 450 participants. Correlation and agreement were assessed using Pearson correlation, intraclass correlation coefficients (ICC), and Bland-Altman analysis. The mean age was 65.2±11.5 years, and 60% of participants were female. Automated myocardial native T1 and ECV showed excellent correlation with manual measurements (r=0.96 and 0.91, respectively) and excellent agreement (ICC =0.96 and 0.93, respectively). Automated myocardial native T1 was slightly higher than manual measurements (1,246±52 vs. 1,233±47 ms), whereas automated ECV was higher by 1.2 percentage points (29.0%±4.9% vs. 27.8%±4.6%). Synthetic Hct correlated with venous Hct (r=0.78; ICC =0.76) but demonstrated proportional bias. Agreement between synthetic Hct-derived and manual ECV was better within the normal Hct range (35-45%) but substantially reduced at Hct >45% (ICC =0.04). Fully automated ECV quantification demonstrated strong correlation and agreement with the manual method within the normal Hct range. However, synthetic Hct-derived ECV was less reliable at abnormal Hct levels, particularly at Hct >45%. Further external validation and refinement of the synthetic Hct model are warranted to support broader clinical application.
SN - 2223-4292
SN - 2223-4306
ER -