How accurate is MOLLI T1 mapping in vivo? Validation by spin echo methods.

T1 mapping is a promising quantitative tool for assessing diffuse cardiomyopathies. The purpose of this study is to quantify in vivo accuracy of the Modified Look-Locker Inversion Recovery (MOLLI) cardiac T1 mapping sequence against the spin echo gold standard, which has not been done previously. T1 accuracy of MOLLI was determined by comparing with the gold standard inversion recovery spin echo sequence in the calf muscle, and with a rapid inversion recovery fast spin echo sequence in the heart. T1 values were obtained with both conventional MOLLI fitting and MOLLI fitting with inversion efficiency correction. In the calf (n = 6), conventional MOLLI fitting produced inconsistent T1 values with error ranging from 8.0% at 90° to 17.3% at 30°. Modified MOLLI fitting with inversion efficiency correction improved error to under 7.4% at all flip angles. In the heart (n = 5), modified MOLLI fitting with inversion correction reduced T1 error to 5.5% from 14.0% by conventional MOLLI fitting. This study shows that conventional MOLLI fitting can lead to significant in vivo T1 errors when not accounting for the lower adiabatic inversion efficiency often experienced in vivo.