A Siemens Single-Shot T1 Mapping Sequence as an Alternative to MOLLI
DOI:
https://doi.org/10.62438/tunismed.v104i05.6107Keywords:
Cardiac Magnetic Resonance, T1 mapping, Single-Shot, MOLLI alternative, myocardial tissue characterizationAbstract
Background: Native T1 mapping has become an essential tool for quantitative myocardial tissue characterization in cardiac magnetic resonance(CMR). However, widely used techniques such as Modified Look-Locker Inversion Recovery (MOLLI) remain limited by their proprietary nature and
limited accessibility, particularly in resource-constrained settings.
Aim: This study aimed to develop and validate a more accessible Single-Shot T1 mapping technique as a practical alternative to MOLLI, and to assess its agreement and diagnostic performance against a reference standard (Circle Cardiovascular Imaging, CVI⁴²).
Methods: A retrospective study was conducted on 40 subjects (25 healthy controls and 15 patients with cardiac pathologies) who underwent 3T CMR imaging. Native T1 values were acquired using a modified Single-Shot inversion recovery scheme (3(3)3(3)5). Quantitative analysis was
performed using custom MATLAB-based post-processing and compared with reference measurements obtained using CVI⁴² software. Agreement was assessed using Bland–Altman analysis, while group differences were evaluated using independent t-tests.
Results: Pathological subjects demonstrated significantly elevated native T1 values compared to healthy controls (1566 ± 65 ms vs. 1079 ± 80 ms, p <0.001). The proposed method showed strong agreement with the reference standard, with a mean difference of 5.7 ms and no statistically significant
bias. Additionally, the Single-Shot approach exhibited significantly reduced inter-subject variability compared to CVI⁴²-based measurements.
Conclusion: The proposed Single-Shot T1 mapping technique provides a reliable, reproducible, and accessible alternative to MOLLI, with comparable accuracy and improved numerical stability. This approach may expand access to advanced myocardial tissue characterization, particularly in low-
resource settings.
Downloads
References
Berraih SA, Baakek YNE, Debbal SMEA. Preliminary study in the analysis of the severity of cardiac pathologies using the higher-
order spectra on the heart-beats signals. Pol J Med Phys Eng. 2021;27(1):73–85. doi:10.2478/pjmpe-2021-0010
Friedrich MG, Sechtem U, Schulz-Menger J, Holmvang G, Alakija P, Cooper LT, et al. Cardiovascular magnetic resonance in myocarditis:
a JACC White Paper. J Am Coll Cardiol. 2009;53(17):1475–87. doi:10.1016/j.jacc.2009.02.007
van der Graaf AW, Bhagirath P, Ghoerbien S, Götte MJW. Cardiac magnetic resonance imaging: artefacts for clinicians. Neth Heart J.
;22(12):542–9. doi:10.1007/s12471-014-0623-z
Dali M, Benameur N, Labidi S. A new approach for native myocardial T1 mapping using a standard single-shot MRI pulse sequence
technique. Procedia Comput Sci. 2023;219:1216–23. doi:10.1016/j. procs.2023.01.404
Moon JC, Messroghli DR, Kellman P, Piechnik SK, Robson MD, Ugander M, et al. Myocardial T1 mapping and extracellular
volume quantification: a SCMR and CMR Working Group consensus statement. J Cardiovasc Magn Reson. 2013;15:92.
doi:10.1186/1532-429X-15-92
Ugander M, Oki AJ, Hsu L-Y, Kellman P, Greiser A, Aletras AH, et al. Extracellular volume imaging by MRI provides insight into overt and
subclinical myocardial pathology. Eur Heart J. 2012;33(10):1268– 78. doi:10.1093/eurheartj/ehr481
Xue H, Shah S, Greiser A, Guetter C, Littmann A, Jolly MP, et al. Motion correction for myocardial T1 mapping using image
registration with synthetic image estimation. Magn Reson Med. 2012;67(6):1644–55. doi:10.1002/mrm.23153
Schelbert EB, Testa SM, Meier CG, Ceyrolles WJ, Levenson JE, Blair AJ, et al. Myocardial extracellular volume fraction measurement
by gadolinium cardiovascular magnetic resonance in humans: slow infusion versus bolus. J Cardiovasc Magn Reson. 2011;13:16.
doi:10.1186/1532-429X-13-16
Kellman P, Wilson JR, Xue H, Ugander M, Arai AE. Extracellular volume fraction mapping in the myocardium, part 1: evaluation
of an automated method. J Cardiovasc Magn Reson. 2012;14:63. doi:10.1186/1532-429X-14-63
Kellman P, Arai AE, Xue H. T1 and extracellular volume mapping in the heart: estimation of error maps and the influence of noise on
precision. J Cardiovasc Magn Reson. 2013;15:56. doi:10.1186/1532-429X-15-56
Kellman P, Herzka DA, Arai AE, Hansen MS. Influence of off-resonance in myocardial T1-mapping using SSFP based MOLLI method. J Cardiovasc Magn Reson. 2013;15:63. doi:10.1186/1532-429X-15-63
Kellman P, Hansen MS. T1-mapping in the heart: accuracy and precision. J Cardiovasc Magn Reson. 2014;16:2. doi:10.1186/1532-
X-16-2
Krumm P, Martirosian P, Brendel A, Braun A, Nickel MD, Schick F, et al. T1 Mapping MOLLI 5(3)3 Acquisition Scheme Yields High
Accuracy in 1.5 T Cardiac Magnetic Resonance. Diagnostics (Basel). 2022;12(11):2729. doi:10.3390/diagnostics12112729
Piechnik SK, Ferreira VM, Dall’Armellina E, Cochlin LE, Greiser A, Neubauer S, et al. Shortened modified look-locker inversion
recovery (ShMOLLI) for clinical myocardial T1-mapping at 1.5 and 3 T within a 9 heartbeat breathhold. J Cardiovasc Magn Reson.
;12:69. doi:10.1186/1532-429X-12-69
Rogers T, Dabir D, Mahmoud I, Voigt T, Schaeffter T, Nagel E, et al. Standardization of T1 measurements with MOLLI in differentiation
between health and disease: the ConSept study. J Cardiovasc Magn Reson. 2013;15:78. doi:10.1186/1532-429X-15-78
Puntmann VO, Voigt T, Chen Z, Mayr M, Karim R, Rhode K, et al. Native T1 mapping in differentiation of normal myocardium from
diffuse disease in hypertrophic and dilated cardiomyopathy. JACC Cardiovasc Imaging. 2013;6(4):475–84. doi:10.1016/j.
jcmg.2012.08.019
Singh A, Horsfield MA, Bekele S, Khan JN, Greiser A, McCann GP. Myocardial T1 and extracellular volume fraction measurement in
asymptomatic patients with aortic stenosis: reproducibility and comparison with age-matched controls. Eur Heart J Cardiovasc
Imaging. 2015;16:763–70. doi:10.1093/ehjci/jev007
Roy C, Slimani A, de Meester C, Amzulescu M, Pasquet A, Vancraeynest D. Age and sex corrected normal reference values of
T1, T2, T2* and ECV in healthy subjects at 3T CMR. J Cardiovasc Magn Reson. 2017;19:72. doi:10.1186/s12968-017-0371-5
Nacif MS, Turkbey EB, Gai N, Nazarian S, van der Geest RJ, Noureldin RA, et al. Myocardial T1 mapping with MRI: comparison
of look-locker and MOLLI sequences. J Magn Reson Imaging. 2011;34(6):1367–73. doi:10.1002/jmri.22753
Chow K, Flewitt JA, Pagano JJ, Green JD, Friedrich MG, Thompson RB. MOLLI T1 values have systematic T2 and inversion efficiency
dependent errors. Proc Intl Soc Magn Reson Med. 2012;20. doi:10.1002/mrm.24878
Kellman P, Arai AE, Xue H. T1 and extracellular volume mapping in the heart: estimation of error maps and the influence of noise on
precision. J Cardiovasc Magn Reson. 2013;15:56. doi:10.1186/1532-429X-15-56.
Chin CW, Semple S, Malley T, White AC, Mirsadraee S, Weale PJ, et al. Optimization and comparison of myocardial T1 techniques at
T in patients with aortic stenosis. Eur Heart J Cardiovasc Imaging.2014;15:556–65. doi:10.1093/ehjci/jet245.
Hinojar R, Varma N, Child N, et al. T1 mapping in discrimination of hypertrophic phenotypes: hypertensive heart disease and
hypertrophic cardiomyopathy: findings from the International T1 Multicenter Cardiovascular Magnetic Resonance Study.
Circ Cardiovasc Imaging. 2015;8:e003285. doi:10.1161/CIRCIMAGING.115.003285.
Terrier B, Gouya H, Berezne A, Régent A, Cohen P, Guillevin L, et al. Apport de l’IRM cardiaque avec séquences T1 mapping et
de diffusion multi-b au cours de la sclérodermie systémique. Rev Med Interne. 2015;36 Suppl 1:49–50. doi:10.1016/j.
revmed.2015.03.282.
Lee SP, Lee W, Lee JM, Park EA, Kim HK, Kim YJ, et al. Assessment of diffuse myocardial fibrosis by using MR imaging in asymptomatic
patients with aortic stenosis. Radiology. 2015;274:359–69. doi:10.1148/radiol.14141120.
Teixeira T, Hafyane T, Stikov N, Akdeniz C, Greiser A, Friedrich MG. Comparison of different cardiovascular magnetic resonance
sequences for native myocardial T1 mapping at 3T. J Cardiovasc Magn Reson. 2016;18:65. doi:10.1186/s12968-016-0286-6.
Tribuna L, Oliveira PB, Iruela A, Marques J, Santos P, Teixeira T. Reference values of native T1 at 3T cardiac magnetic
resonance—standardization considerations between different vendors. Diagnostics (Basel). 2021;11(12):2334. doi:10.3390/ diagnostics11122334.
Lavall D, Vosshage NH, Geßner R, et al. Native T1 mapping for the diagnosis of cardiac amyloidosis in patients with left ventricular
hypertrophy. Clin Res Cardiol. 2022. doi:10.1007/s00392-022-02005-2.
Guo R, El-Rewaidy H, Assana S, et al. Accelerated cardiac T1 mapping in four heartbeats with inline MyoMapNet: a deep
learning-based T1 estimation approach. J Cardiovasc Magn Reson. 2022;24:6. doi:10.1186/s12968-021-00834-0.
Von Knobelsdorff-Brenkenhoff F, Prothmann M, Dieringer MA, Wassmuth R, Greiser A, Schwenke C, et al. Myocardial T1
and T2 mapping at 3 T: reference values, influencing factors and implications. J Cardiovasc Magn Reson. 2013;15:53.
doi:10.1186/1532-429X-15-53.
Heidenreich JF, Weng AM, Donhauser J, Greiser A, Chow K,Nordbeck P, et al. T1- and ECV-mapping in clinical routine at 3 T:
differences between MOLLI, ShMOLLI and SASHA. BMC Med Imaging. 2019;19:59. doi:10.1186/s12880-019-0362-0.
Ferreira VM, Piechnik SK, Dall’Armellina E, Karamitsos TD, Francis JM, Ntusi N, et al. Native T1-mapping detects the localisation,
extent and patterns of acute myocarditis without the need for gadolinium contrast agents. J Cardiovasc Magn Reson. 2014;16:36.
doi:10.1186/1532-429X-16-36.
Ntusi NA, Piechnik SK, Francis JM, Ferreira VM, Matthews PM, Robson MD, et al. Diffuse myocardial fibrosis and inflammation
in rheumatoid arthritis: insights from CMR T1 mapping. JACC Cardiovasc Imaging. 2015;8:526–36. doi:10.1016/j.
jcmg.2014.12.025.
Ntusi NA, Piechnik SK, Francis JM, Ferreira VM, Rai AB, Matthews PM, et al. Subclinical myocardial inflammation and diffuse fibrosis
are common in systemic sclerosis: a clinical study using myocardial T1-mapping and extracellular volume quantification. J Cardiovasc
Magn Reson. 2014;16:21. doi:10.1186/1532-429X-16-21.
Holloway CJ, Ntusi N, Suttie J, Mahmod M, Wainwright E, Clutton G, et al. Comprehensive cardiac magnetic resonance imaging and
spectroscopy reveal a high burden of myocardial disease in HIV patients. Circulation. 2013;128:814–22
Tham EB, Haykowsky MJ, Chow K, Spavor M, Kaneko S, Khoo NS, et al. Diffuse myocardial fibrosis by T1-mapping in children with
subclinical anthracycline cardiotoxicity: relationship to exercise capacity, cumulative dose and remodeling. J Cardiovasc Magn
Reson. 2013;15:48. doi:10.1186/1532-429X-15-48.
Luetkens JA, Homsi R, Sprinkart AM, Doerner J, Dabir D, Kuetting DL, et al. Incremental value of quantitative CMR including parametric
mapping for the diagnosis of acute myocarditis. Eur Heart J Cardiovasc Imaging. 2016;17:154–61. doi:10.1093/ehjci/jev246.
Hinojar R, Foote L, Arroyo Ucar E, Jackson T, Jabbour A, Yu CY, et al. Native T1 in discrimination of acute and convalescent stages
in patients with clinical diagnosis of myocarditis: a proposed diagnostic algorithm using CMR. JACC Cardiovasc Imaging.
;8:37–46. doi:10.1016/j.jcmg.2014.07.016.
Chow K, Flewitt J, Pagano JJ, Green JD, Friedrich MG, Thompson RB. T2-dependent errors in MOLLI T1 values: simulations, phantoms,
and in vivo studies. J Cardiovasc Magn Reson. 2012;14(Suppl1):P281. doi:10.1186/1532-429X-14-S1-P281.
Dabir D, Child N, Kalra A, et al. Reference values for healthy human myocardium using a T1 mapping methodology: results from the
International T1 Multicenter cardiovascular magnetic resonance study. J Cardiovasc Magn Reson. 2014;16:69. doi:10.1186/s12968-
-0069-x.
Dali M, Kachouri R, Benameur N, Arous Y, Laabidi S. Enhancing myocardial disease prediction with DOC-NET+ architecture: a
custom data analysis approach for the EMIDEC challenge. Procedia Comput. Sci. 235, 3217–3225 (2024). https://doi.org/10.1016/j.
procs.2024.04.304.
Dali M, Kachouri R, Benameur N, Boukriba S, Arous Y, Labidi S. MyoClass: a modular multimodal auto-classification system for
myocardial tissue characterization. Int. J. Cardiovasc. Imaging(2026). https://doi.org/10.1007/s10554-026-03684-y.
Additional Files
Published
Issue
Section
Categories
License
Copyright (c) 2026 La Tunisie Médicale

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.