A Siemens Single-Shot T1 Mapping Sequence as an Alternative to MOLLI
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Abstract
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.
Keywords:
Cardiac Magnetic Resonance, T1 mapping, Single-Shot, MOLLI alternative, myocardial tissue characterization##plugins.themes.academic_pro.article.details##

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