Late Gadolinium Enhancement of Nonischemic Cardiomyopathy at 5.0 T versus 3.0 T: A Crossover Design Study

Purpose To compare the acquisition time, image quality, and late gadolinium enhancement (LGE) visualization and quantification on phase-sensitive inversion recovery (PSIR) images using 5.0-T versus 3.0-T cardiac MRI. Materials and Methods In this prospective crossover study, 49 participants (mean ± SD age, 43.7 years ± 13.1; 39 men) suspected or diagnosed with nonischemic cardiomyopathy were enrolled from April 2023 to March 2024 and randomly assigned to group 1 (5.0-T followed by 3.0-T LGE cardiac MRI) or group 2 (3.0-T followed by 5.0-T LGE cardiac MRI). PSIR images were acquired at spatial resolutions of 1.2, 0.9, and 1.6 mm. Image quality and LGE were qualitatively evaluated using a five-point Likert scale by two readers, and signal-to-noise ratio, contrast-to-noise ratio, and LGE mass were quantitatively assessed. Bland-Altman plots were used to evaluate interreader agreement. Results There was no evidence of a difference in the acquisition time for obtaining a single-layer PSIR image at 5.0 T compared with 3.0 T (<i>P</i> > .05 for all), irrespective of resolutions at 1.2, 0.9, and 1.6 mm. The 5.0-T PSIR images demonstrated better image quality and LGE visualization compared with 3.0-T images, particularly at 1.2 mm (image quality: median 5 [IQR, 5-5] vs median 5 [IQR, 4-5]; <i>P</i> = .004; LGE score: median 5 [IQR, 5-5] vs median 4.25 [IQR, 4-5]; <i>P</i> < .001). No evidence of differences in image quality or LGE scores was found between 5.0-T and 3.0-T cardiac MRI at 1.6-mm resolution. Signal-to-noise ratio and contrast-to-noise ratio were higher on 5.0-T PSIR images across all resolutions compared with 3.0-T images (<i>P</i> < .001 for all), but no evidence of a difference was found in LGE mass measurements. Conclusion The study demonstrates that 5.0-T PSIR imaging offers better image quality and LGE visualization than 3.0-T PSIR, particularly at a 1.2-mm resolution, in individuals with nonischemic cardiomyopathy. <b>Keywords:</b> MRI, Cardiac, Heart, Comparative Studies, Nonischemic Cardiomyopathy, Late Gadolinium Enhancement, Phase-Sensitive Inversion Recovery <i>Supplemental material is available for this article.</i> ©RSNA, 2024.