Quality of MRI tests varies widely
Measurements in cardiac function by magnetic resonance imaging conceal a high potential for error / International Science team reports in the journal of Magnetic Resonance Imaging
Cardiac magnetic resonance imaging (MRI) is one of the most important investigative methods for gaining an image of the performance of the heart in patients with congenital heart defects, and in identifying the ideal time for treatment. A study by the Competence Network for Congenital Heart Defects in the Journal of Magnetic Resonance Imaging came to the conclusion that there are in some cases extreme variations between measurements by different specialized heart clinics. Experienced investigators from the three centers produced MRI images of 32 patients with tetralogy of Fallot and of a further 23 test persons in accordance with the standard cardiac MRI imaging protocol; these images were sent submitted to the MRI Core Lab of the Competence Network for evaluation. “Measurements can can vary by up to 30 or 40 percent, even with very qualified investigators”, reports Project Manager Dr. Philipp Beerbaum from King’s College London.
MRI influences therapy decisions
MRI is an excellent method for producing measurements about the performance of the heart and the effect of the heart defect on the body. Ideally, each change in the heart can be captured in quantitative terms over a certain time period, and it can be established at an early stage when the next procedure will be necessary.
The challenge, however, lies in the very diverse anatomy of the congenital heart defect. The problem lies more in the interpretation of the data than in the imaging procedure. In the case of a congenital heart defect, the heart does not have a normal anatomical shape and presents big challenges to MRI investigators. Many patients lack whole valves or chambers and the bloodstream is sometimes different from that of a person with a healthy heart.
Cooperation of scientific teams reduces the proportion of errors
- Scientific team: Andrea Kelter-Kloepping, Dr. Samir Sarikouch, Dr. Philipp Beerbaum, Irina Wahnsiedler
The solution, however, lies in a central evaluation of the data in a MRI Core Lab. Here, an experienced interdisciplinary assessor team can evaluate the image data and the proportion of errors in the tests can be significantly reduced.A MRI Core Lab was successfully established as part of the Competence Network for Congenital Heart Defects. “We have established that consensus training considerably improves image evaluation,” sums up Dr. Beerbaum. “It is only when the results are discussed amongst the doctors who are evaluating the results that more reliable therapy decisions for the treatment of patients with congenital heart defects can be made.”
Beerbaum P, Barth P, Kropf S, Sarikouch S, Kelter-Kloepping A, Franke D, Gutberlet M, Kühne T. Cardiac function by MRI in Congenital Heart Disease: Impact of consensus training on inter-institutional variance. Published in the Journal of Magnetic Resonance Imaging, Number 5, November 2009
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