Comparative analysis of pre-existing fibrosis assessment methods in a healthy subject. The MRI image was processed with the addition of 2, 3, or 4 SD above the mean of the normal myocardium14 and also with the IIR techniques using the validated cut-offs (0.97–1.61)40: the burden of fibrosis varied from the 0.4% detected with the 4 SD method (A) to 3.8% with the 3 SD method (B), reaching 17.95% at just 2 SD above the mean of the defined ‘normal’ tissue (C). With the IIR method, the total burden of fibrosis is very high (39.3%) but contained within the border-zone area (0.97 < IIR < 1.61), while the fibrosis labelled as ‘dense scar’ is completely absent (D). Figures generated with ADAS-AF software (Galgo Medical S.L., Barcelona, Catalonia, Spain).
