Imaging Techniques for Characterization of Myocardial Fibrosis
| Technique | Advantage | Disadvantage |
|---|---|---|
| Echocardiography, general (B-mode, 3D, contrast…) | Bedside standard, longitudinal studies; identifies remodeling | Not specific for fibrosis, observer-dependent |
| Echocardiography, strain rate imaging | Multiparametric measures of deformation and function | Observer-dependent |
| CMR, cine | Clinical reference standard for ventricular function and geometry and remodeling | Not specific for fibrosis |
| CMR, LGE | Robust, well established | Identifies only larger areas of replacement fibrosis |
| CMR, native tissue mapping (T1, T2, T2*…) | Very sensitive for changes in extracellular tissue composition | Fibrosis is one of several factors underlying signal changes; more information on precision, repeatability, standardization across centers needed |
| CMR, ECV | More sensitive than native mapping; parametric maps | Fibrosis is one of several factors underlying signal changes; more information on precision, repeatability, standardization across centers needed |
| PET, FAP ligands | Identifies cellular substrate of profibrotic activity; high target signal to low background; molecular specificity; broad availability due to success in oncology | Very early stage (clinical proof of feasibility); requires more information on precision, repeatability, optimal protocol; requires information on predictive value, value for therapy guidance |
| PET, other tracers | Molecular specificity | Not yet clinically feasible |
3D = 3-dimensional; ECV = extracellular volume.