Abstract
Background Quantitative cardiovascular magnetic resonance (CMR) myocardial perfusion imaging has the potential to evolve into a routine clinical method allowing for the assessment of myocardial blood flow (MBF). Multiple quantification pathways are available based on different algorithms. These algorithms involve complex modeling and quantitative results may not necessarily be the same. At present it remains unclear which algorithm is the most accurate. An isolated perfused, magnetic resonance (MR) compatible pig heart model allows very accurate titration of MBF and in combination with high-resolution assessment of fluorescently-labeled microspheres represents a near optimal platform for validation. We sought to investigate which algorithm is most suited to quantify myocardial perfusion by CMR imaging at 1.5 and 3 Tesla using state of the art CMR perfusion techniques and quantification algorithms. Methods First-pass CMR perfusion was performed in a MR compatible blood perfused pig heart model. We acquired perfusion images at resting flow (100%), 50% flow and during adenosine induced hyperemia in control and coronary occlusion conditions. MR myocardial perfusion imaging was performed at 1.5 Tesla (n=4) and at 3 Tesla (n=4). Fluorescently-labeled microspheres and externally controlled coronary blood flow served as reference standards for comparison of different quantification strategies, namely Fermi function constrained deconvolution, autoregressive moving average modeling, deconvolution using an exponential basis and deconvolution using a B-spline basis. Results All CMR derived MBF estimates agreed well with microsphere results. The best correlation was achieved with Fermi function constrained deconvolution both at 1.5 Tesla (r=0.93, p 0.05).The weakest correlation at 1.5 Tesla was found using B-spline deconvolution (r=0.74, p<0.001) and at 3 Tesla using exponential deconvolution (r=0.49, p<0.001). Conclusions
Highlights
Quantitative cardiovascular magnetic resonance (CMR) myocardial perfusion imaging has the potential to evolve into a routine clinical method allowing for the assessment of myocardial blood flow (MBF)
First-pass CMR perfusion was performed in a MR compatible blood perfused pig heart model
The best correlation was achieved with Fermi function constrained deconvolution both at 1.5 Tesla (r=0.93, p
Summary
Quantitative assessment of magnetic resonance derived perfusion measurements using advanced techniques: comparison with microspheres in an explanted pig heart system. Andreas Schuster1,2*, Niloufar Zarinabad, Masaki Ishida, Matthew Sinclair, Jeroen P van den Wijngaard, Geraint Morton, Gilion Hautvast, Boris Bigalke, Pepijn van Horssen, Nic Smith, Jos A Spaan, Maria Siebes, Amedeo Chiribiri, Eike Nagel. From 16th Annual SCMR Scientific Sessions San Francisco, CA, USA. From 16th Annual SCMR Scientific Sessions San Francisco, CA, USA. 31 January - 3 February 2013
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