Stress perfusion cardiac MRI with regadenoson and gadofoveset trisodium

Abstract

Background Stress perfusion cardiac MRI (CMR) with a high relaxivity blood-pool contrast agent should allow for improved quantification of myocardial perfusion and myocardium blood volume in patients with coronary artery disease (CAD). In the current study, we sought to evaluate the diagnostic performance and image quality of stress perfusion CMR using the intravascular contrast agent gadofoveset trisodium and regadenoson stress agent in patients with suspected CAD. Methods Patients with suspected CAD were identified based on referral for cardiac catheterization and/or stress testing and recruited to undergo CMR at 1.5T (MAGNETOM Avanto, Siemens, Erlangen, Germany). The CMR protocol included stress perfusion imaging using 5 ml intravenous (IV) regadenoson (Lexiscan, Astellas US LLC) as the stress agent, and the effects of regadenoson were reversed with 50 mg IV aminophylline following the completion of stress imaging. Left ventricular (LV) base, mid, and apex short axis cine images were acquired in identical slice positions during first pass using 5 ml IV gadofoveset trisodium contrast (Ablavar, Lantheus) at both stress and rest. Perfusion images were reviewed and sensitivity and specificity for CAD diagnosis were calculated. Overall image quality, image noise, and presence of artifact for each patient scan were graded on a scale of 1 - poor to 5 - excellent.In addition to the perfusion scan, the MRI protocol included pre- and postcontrast 2D Modified Look-Locker (MOLLI) measurement of T1 which were used to calculate the myocardial blood volume (in ml/100g of tissue). Results