Perfusion Abnormalities Research Articles

Fully automated Bayesian analysis for quantifying the extent and distribution of pulmonary perfusion changes on CT pulmonary angiography in CTEPH.

This work aimed to develop an automated method for quantifying the distribution and severity of perfusion changes on CT pulmonary angiography (CTPA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and to assess their associations with clinical parameters and expert annotations. Following automated segmentation of the chest, a machine-learning model assuming three distributions of attenuation in the pulmonary parenchyma (hyperemic, normal, and oligemic) was fitted to the attenuation histogram of CTPA images using Bayesian analysis. The proportion of each component, its spatial heterogeneity (entropy), and center-to-periphery distribution of the attenuation were calculated and correlated with the findings on CTPA semi-quantitatively evaluated by radiologists and with clinical function tests. CTPA scans from 52 patients (mean age, 65.2 ± 13.0 years; 27 men) diagnosed with CTEPH were analyzed. An inverse correlation was observed between the proportion of normal parenchyma and brain natriuretic propeptide (proBNP, ρ = -0.485, p = 0.001), mean pulmonary arterialpressure (ρ = -0.417, p = 0.002) and pulmonary vascular resistance (ρ = -0.556, p < 0.0001), mosaic attenuation (ρ = -0.527, p < 0.0001), perfusion centralization (ρ = -0.489, p = < 0.0001), and right ventricular diameter (ρ = -0.451, p = 0.001). The entropy of hyperemic parenchyma showed a positive correlation with the pulmonary wedge pressure (ρ = 0.402, p = 0.003). The slope of center-to-periphery attenuation distribution correlated with centralization (ρ = -0.477, p < 0.0001), and with proBNP (ρ = -0.463, p = 0.002). This study validates an automated system that leverages Bayesian analysis to quantify the severity and distribution of perfusion changes in CTPA. The results show the potential of this method to support clinical evaluations of CTEPH by providing reproducible and objective measures. Question This study introduces an automated method for quantifying the extent and spatial distribution of pulmonary perfusion abnormalities in CTEPH using variational Bayesian estimation. Findings Quantitative measures describing the extent, heterogeneity, and distribution of perfusion changes demonstrate strong correlations with key clinical hemodynamic indicators. Clinical relevance The automated quantification of perfusion changes aligns closely with radiologists' evaluations, delivering a standardized, reproducible measure with clinical relevance.

Associating electrocardiographic abnormalities with coronary artery disease: insights into microvascular dysfunction from dynamic CT perfusion.

Electrocardiographic (ECG) abnormalities serve as important predictors of future cardiovascular events. However, the specific cardiac abnormalities that bridge the gap between ECG abnormalities and subsequent events remain poorly understood. This study aimed to evaluate the relationship between ECG abnormalities and the prevalence of coronary artery disease (CAD) in propensity score-matched patients with suspected CAD who underwent comprehensive cardiac computed tomography (CT). A total of 357 patients suspected of CAD underwent ECG and cardiac CT assessments, including calcium scoring, stress dynamic CT perfusion (CTP), coronary CT angiography (CCTA), and CT late enhancement. Propensity score matching based on demographic parameters and CAD risk factors was performed, resulting in 286 matched patients (143 without ECG abnormalities and 143 with ECG abnormalities). In both unadjusted and propensity score-matched analyses, ECG abnormalities were significantly associated with microvascular dysfunction and myocardial scarring (p < 0.05 for both analyses). However, no significant associations were observed between ECG abnormalities and coronary calcification severity or obstructive CAD (≥ 50% luminal narrowing) in the propensity score-matched patients. Among matched patients without obstructive CAD on CCTA, those with ECG abnormalities exhibited a higher prevalence (30%) of microvascular dysfunction, particularly in the diffuse-transmural pattern, compared to that (14%) of patients without ECG abnormalities (p < 0.01). ECG abnormalities may not be reliable indicators of the presence of obstructive CAD. However, given their association with microvascular dysfunction, CAD evaluation with comprehensive cardiac CT, including dynamic CTP, is recommended for patients exhibiting ECG abnormalities, particularly to evaluate myocardial perfusion abnormalities. Question We investigated whether ECG abnormalities in patients suspected of having CAD are linked to epicardial stenosis, microvascular dysfunction, or myocardial scarring. Findings After adjusting for traditional risk factors using propensity-score matching, ECG abnormalities were associated with microvascular dysfunction and myocardial scarring, but not with epicardial coronary stenosis. Clinical relevance These results suggest that ECG abnormalities may offer important insights into tissue-level changes and microvascular pathology, rather than simply reflecting epicardial stenosis, thereby underlining the need for comprehensive cardiac assessment in patients with ECG changes.

Myocardial Perfusion Imaging with Cardiovascular Magnetic Resonance in Nonischemic Cardiomyopathies: An In-Depth Review of Techniques and Clinical Applications.

Background and Objectives: Nonischemic cardiomyopathies comprise a wide spectrum of heart muscle disorders characterized by different morphological, functional, and tissue abnormalities. Cardiovascular magnetic resonance (CMR) represents the gold standard imaging modality for assessing cardiac morphology, systolic function, and tissue characterization, thereby aiding in early diagnosis, precise phenotyping, and tailored treatment. The aim of this review is to provide an up-to-date overview of CMR techniques for studying myocardial perfusion and their applications to nonischemic cardiomyopathy, not only to rule out an underlying ischemic aetiology but also to investigate the pathophysiological characteristics of microcirculatory dysfunction in these patients. Materials and Methods: We performed a structured review of the literature focusing on first-pass gadolinium perfusion sequences, stress protocols, and emerging pixel-wise perfusion mapping approaches. Studies were selected to illustrate the methods for image acquisition, post-processing, and quantification of myocardial blood flow (MBF) and myocardial perfusion reserve (MPR), as well as to highlight associations with clinical endpoints. Results: First-pass CMR perfusion imaging reliably detects diffuse and regional microvascular dysfunction across cardiomyopathies. Semi-quantitative parameters (e.g., upslope, MPRI) and quantitative MBF mapping (mL/g/min) have demonstrated that impaired perfusion correlates with disease severity, extent of fibrosis, and adverse outcomes, including heart failure hospitalization, arrhythmias, and mortality. Novel automated pixel-wise mapping enhances reproducibility and diagnostic accuracy, distinguishing coronary microvascular dysfunction from balanced three-vessel disease. Microvascular dysfunction-present in approximately 50-60% of dilated cardiomyopathy (DCM), 40-80% of hypertrophic cardiomyopathy (HCM), and >95% of cardiac amyloidosis (CA) patients-has emerged as a key driver of adverse outcomes. Perfusion defects appear early, often preceding overt hypertrophy or fibrosis, and provide incremental prognostic value beyond conventional CMR metrics. Conclusions: CMR represents a powerful tool for detecting myocardial perfusion abnormalities in nonischemic cardiomyopathies, improving phenotyping, risk stratification, and personalized management. Further standardization of quantitative perfusion techniques will facilitate broader clinical adoption.

Observer variabilities for the diagnosis of coronary artery disease using anatomical and functional testing: the impact of certification.

To compare the reproducibility in reporting of coronary computed tomography angiography (CCTA) or cardiovascular magnetic resonance imaging (CMR) by certified readers for CCTA and CMR by the German Society of Cardiology (DGK) versus that by non-certified readers. The study included 40 randomly selected CCTA and vasodilator stress CMR patient datasets. For CCTA, the degree of lumen narrowing, plaque composition, and high-risk plaque features were assessed. For CMR, wall motion and perfusion abnormalities and late gadolinium enhancement (LGE) were rated. All measures were conducted by segments and for individual patients. Intraclass correlation coefficients (ICC) were calculated to assess agreement between non-certified (n = 4) vs. DGK-certified readers (n = 4). ICC for assessment of luminal narrowing, plaque composition, and high-risk features were, respectively, 0.65 (95% confidence intervals [CI] 0.59-0.69), 0.64 (95%CI 0.45-0.80), and 0.45 (95%CI 0.22-0.66) for non-certified versus 0.78 (95%CI 0.74-0.81), 0.88 (95%CI 0.79-0.93), and 0.89 (95%CI 0.81-0.95) for DGK-certified readers (p < 0.001 for all). ICC for the assessment of wall motion, perfusion, and LGE were, respectively, 0.41 (95%CI 0.35-0.48), 0.27 (95%CI 0.18-0.38), and 0.48 (95%CI 0.41-0.54) for non-certified versus 0.71 (95%CI 0.67-0.75), 0.71 (95%CI 0.67-0.75) and 0.67 (95%CI 0.62-0.71) for DGK-certified readers (p < 0.001 for all). The agreement was excellent among DGK-certified readers for obstructive CAD (≥ 70% lumen narrowing) assessed by CCTA and high for abnormal perfusion and for LGE by CMR in a per-patient analysis (0.88; 95%CI 0.79-0.94 and 0.84; 95%CI 0.71-0.92), respectively. Substantially better CCTA and CMR reporting was observed for DGK-certified cardiologists, who achieved high agreement for diagnosing the presence or absence of obstructive CAD by CCTA and abnormal perfusion by CMR. Since important clinical decisions may be based on these readings, our data support quality-controlled education programs for advanced cardiac imaging.

Dobutamine Stress Cardiac Magnetic Resonance role in patients with anomalous aortic origin of coronary arteries.

Anomalous Aortic Origin of Coronary Arteries (AAOCA) is associated with myocardial ischemia and sudden cardiac death, particularly in young athletes. Although inducible myocardial ischemia investigation is generally recommended, there is no clear indication of the most appropriate stress test, as the ECG exercise stress test presents low diagnostic accuracy. Dobutamine-stress cardiac magnetic resonance (dsCMR) has been proposed as a promising diagnostic tool, but its application has been limited to pediatric populations. This study aimed to evaluate the presence of inducible myocardial ischemia assessed by dsCMR in AAOCA patients, regardless of age, and to identify factors associated with inducible myocardial ischemia. In this single-center observational study, 100 AAOCA patients who underwent to dsCMR were enrolled from 2015 to 2024. dsCMR resulted positive in 14 cases, all showing perfusion abnormalities, with only one presenting segmental wall motion abnormalities. dsCMR was found to be safe without major adverse events. Factors significantly associated with inducible ischemia included intramural course, the presence of ischemic late gadolinium enhancement (LGE), and a history of acute coronary syndrome (ACS). Nine patients (9%) showed small areas of ischemic LGE within the AAOCA territory, and they were older with a higher incidence of arterial hypertension, smoking habits and previous ACS episodes. dsCMR is a reliable test for the evaluation of myocardial ischemia in AAOCA, especially for those with intramural course, ischemic LGE, and previous ACS episodes. Although rare, older patients may have a myocardial ischemic scar without alteration of ventricular function.

No brain MRI abnormalities after mild-to-moderate COVID-19: an observational study.

To assess COVID-19-related morphological brain changes in individuals who recovered from mild-to-moderate COVID-19. This prospective cohort study enrolled 112 consecutive individuals who recovered from mild-to-moderate COVID-19 and underwent an MRI of the brain between September 2020 and March 2022. MR exams were consistently obtained on a clinical 3T MR scanner in all study participants and 50 age-matched matched controls. The following clinical neuroradiological MR imaging findings were analyzed: post- and acute ischemic lesions, cortical signal alterations, microbleeds, perfusion abnormalities, cytotoxic lesions of the corpus callosum, and vascular abnormalities. Additionally, we manually quantified white matter lesion loads and the number of perivascular spaces and performed an automated brain volumetric analysis. In 112 consecutive individuals the mean age was 45 years, female: male = 70:42, mean days at MRI after SARS CoV-2 infection: 228 (sd: 140), and hospitalized: non-hospitalized ratio = 30:82. Using general linear regression models, adjusting for age and gender, the frequency of white matter hyperintensities was not significantly different between subjects who recovered from COVID-19 and matched controls: 9.8 (sd: 17.3) vs. 7.6 (sd: 12.7), p = 0.590. Similarly, the number of enlarged perivascular spaces was not significantly different between the two groups: 62.7 (sd: 43.5) vs. 61.3 (sd: 47.2), p = 0.902. A subgroup analysis between those who were hospitalized in the course of the disease, in which no one required intensive care, and those who remained outpatients, also did not reveal any differences in MRI measures. We did not find evidence for perfusion-/diffusion abnormalities, (micro-)hemorrhages, or cortical abnormalities. In the present cohort, there was currently no evidence of COVID-19-related morphological brain changes in individuals who recovered from mild-to-moderate COVID-19.

Assessment of cardiac masses by magnetic resonance imaging: prognostic value and agreement with histopathology.

Assessment of cardiac masses by magnetic resonance imaging: prognostic value and agreement with histopathology.

Tranexamic acid impact on platelet adhesion to the endothelium after shock conditions: A protective effect?

Trauma and hemorrhagic shock lead to microcirculatory disturbances related to endothelial injury and endothelial glycocalyx (EG) degradation. Improved outcomes following trauma and hemorrhagic shock have been linked to protection of the EG layer, which is a topic of increasing investigation. Early tranexamic acid (TXA) administration following trauma and hemorrhagic shock improves outcomes in clinic studies. Recent translational studies have also shown that early TXA administration protects the EG following shock insults; the impact on blood-endothelial cell interactions is unknown. Platelet adherence to vascular endothelium may contribute to microcirculatory disturbances; the effects of TXA on this phenomenon are uncertain. Microfluidic devices have been used to study the behavior of endothelial cells and platelets under flow conditions. We hypothesize that the protective effect of TXA against EG degradation would prevent shock-induced platelet adhesion to the microvasculature. This was studied in a microfluidic cell culture model under a controlled microenvironment. Microfluidic endothelial cell cultures were exposed to flow conditions under control or hypoxia-epinephrine exposure. Tranexamic acid was added to the perfusate at various times in control and experimental groups. Endothelial glycocalyx thickness, degradation products, and platelet adhesion to the endothelium were measured. Tranexamic acid protected the glycocalyx from degradation following hypoxia-reoxygenation-epinephrine exposure. Platelet adhesion to the endothelium was significantly reduced by TXA in a time sensitive manner. Tranexamic acid may protect the microvasculature from perfusion abnormalities following shock conditions. This is likely due to inhibition of platelet adhesion and mitigating thromboinflammation at the endothelium in the microvasculature.

Que peut nous apprendre l’étude du métabolisme cérébral en TEP au 18F-FDG du syndrome de Lance-Adams ?

Que peut nous apprendre l’étude du métabolisme cérébral en TEP au 18F-FDG du syndrome de Lance-Adams ?

Regional cerebral blood perfusion impairment in type 1 narcolepsy patients: An arterial spin labeling study.

Regional cerebral blood perfusion impairment in type 1 narcolepsy patients: An arterial spin labeling study.

Three-dimensional Pseudo-continuous Arterial Spin Labeling Technique to Assess Cerebral Perfusion Changes in End-stage Renal Disease Patients Undergoing Hemodialysis.

Three-dimensional Pseudo-continuous Arterial Spin Labeling Technique to Assess Cerebral Perfusion Changes in End-stage Renal Disease Patients Undergoing Hemodialysis.

Prevalence of Persistent Cardiovascular and Pulmonary Abnormalities on PET/MRI and DECT Imaging in Long COVID Patients.

The objective of this study is to describe the prevalence of inflammatory cardiopulmonary findings in a prospective cohort of long coronavirus disease (LC) patients. Methods: Subjects with a history of coronavirus disease 2019 infection, persistent cardiopulmonary symptoms 9-12 mo after initial infection, and a clinical assessment compatible with LC underwent cardiopulmonary 18F-FDG PET/MRI, dual-energy CT (DECT) of the lungs, and plasma protein analysis (subgroup). A control group that included subjects with a history of acute severe acute respiratory syndrome coronavirus 2 infection but without cardiopulmonary symptoms at recruitment was also characterized. Results: Ninety-eight patients (median age, 48.5 y; 47% men) were enrolled. The most common LC symptom was shortness of breath (80%), and 27% of participants were hospitalized. Of the subjects, 90% presented abnormalities in DECT, with 67% and 59% of participants demonstrating pulmonary infiltrates and abnormal perfusion, respectively. PET/MRI was abnormal for 57% of subjects: 24% showed cardiac involvement suggestive of myocarditis, 22% presented uptake reminiscent of pericarditis, 11% showed periannular uptake, and 30% showed vascular uptake (aortic or pulmonary). There was no myocardial, pericardial, periannular, or pulmonary uptake on the PET/MRI scans of the control group (n = 9). Analysis of plasma protein concentrations showed significant differences between the LC and the control groups. Lastly, the plasma protein profile was significantly different among LC patients with abnormal and normal PET/MRI. Conclusion: In LC subjects evaluated up to a year after coronavirus disease 2019 infection, our results indicate a high prevalence of abnormalities on PET/MRI and DECT, as well as significant differences in the peripheral biomarker profile, which might warrant further monitoring to exclude the development of complications such as pulmonary hypertension and valvular disease.

A Comparative Study of CT Perfusion Postprocessing Tools in Medium/Distal Vessel Occlusion Stroke.

CTP has been validated for stroke due to large vessel occlusion, but not for medium or distal vessel occlusions (MDVO). The aim of this study was to evaluate discrepancy of 2 widely used postprocessing tools for CTP in patients with medium/distal vessel occlusion (MDVO) stroke. This retrospective single-center cohort study comprised CTP data sets of patients with acute isolated MDVO and disabling stroke. CTP postprocessing included Syngo.via and RapidAI. Perfusion lesions were segmented and compared with regard to volume and spatial distribution of the perfusion abnormalities. For each patient, the results of the 2 postprocessing tools were deemed to represent agreement regarding volume and/or distribution according to a predefined classification scheme. Penumbra volumes were compared between postprocessing tools by using the t test for paired samples. Fifty CTP data sets from 49 patients (mean age 75.3 ± 10.7 years, 33 male patients) were included. In <30% of patients, the predefined criteria for agreement were met which indicate at least 50% congruence regarding lesion size and lesion location as well as a maximum distance between lesion margins <50 mm. Comparison of tissue at risk volumes revealed outliers, volume disagreement, and distribution disagreement in up to 79.6%. The 2 postprocessing tools disagreed on presence and volume of an infarct core in up to 86% of patients. Penumbra volumes differed significantly between postprocessing tools (P < .001; mean difference 50.5 mL/16.9 mL). Despite being in daily use, commercially available postprocessing tools for CTP provide discrepant results in patients with MDVO.

Factors Associated with Early-Childhood Ipsilateral Perfusion Abnormalities among Patients with Congenital Diaphragmatic Hernia.

Factors Associated with Early-Childhood Ipsilateral Perfusion Abnormalities among Patients with Congenital Diaphragmatic Hernia.

Patient Motion During Cardiac PET Imaging.

Cardiac PET imaging is increasingly used for myocardial perfusion studies because of its high diagnostic accuracy and low radiation exposure to the patient. However, patient motion can be challenging, affecting a large number of studies. Motion artifacts can lead to inconclusive or false-positive results, complicating clinical interpretation. This article explores the causes of motion artifacts and their characteristic appearance in cardiac PET imaging, highlighting their distinction from true perfusion abnormalities. Strategies for minimizing motion through effective patient positioning and communication are discussed. Understanding and addressing motion artifacts are crucial for optimizing diagnostic accuracy and ensuring the full benefit of cardiac PET imaging.

Quantitative MRI detects delayed perfusion and impact of bronchial artery dilatation on pulmonary circulation in patients with cystic fibrosis.

MRI detects abnormal lung perfusion in patients with cystic fibrosis (CF). However, little is known about the contribution of bronchial arteries to lung perfusion in CF. We hypothesized that delayed perfusion can be detected by dynamic contrast-enhanced (DCE-)MRI and thatbronchial artery dilatation (BAD) is associated with changes in lung perfusion. Morpho-functional MRI was prospectively acquired in 75 patients with CF (18.7 ± 7.6 years, range 6-39 years). Lungs and perfusion defects were segmented automatically to quantify perfusion defects in percent (QDP). Pulmonary blood flow (PBF), mean transit time (MTT), and perfusion delay were calculated for the whole lung, inside normally perfused and perfusion defect areas. Chest MRI score and BAD were assessed visually. QDP and PBF correlated with MRI global score (r = 0.58 and -0.53, p < 0.001). In normally perfused lung, PBF was higher (161.2 ± 77.9 mL/100 mL/min vs. 57.5 ± 26.4 mL/100 mL/min, p < 0.001), and MTT (5.4 ± 1.7 s vs. 6.9 ± 2.3 s, p < 0.001) and perfusion delay were shorter than in perfusion defect areas (4.6 ± 5.3 s vs.13.4 ± 16.2 s, p < 0.001). 48 (64.0%) patients showed BAD, had higher QDP (44.6 ± 20.8% vs. 17.3 ± 11.0%, p < 0.001) and lower PBF (91.9 ± 54.8 mL/100 mL/min vs. 178.3 ± 77.4 mL/100 mL/min, p < 0.001) than patients without BAD. MTT was shorter (6.3 ± 1.9 s vs. 8.0 ± 2.6 s, p < 0.001), and perfusion delay was longer (13.8 ± 10.1 s vs. 12.8 ± 23.7 s, p < 0.02) inside perfusion defects of patients with BAD compared to without BAD. Perfusion parameters correlate with lung disease severity, and perfusion defects showed delayed perfusion in patients with CF. BAD was associated with more extensive perfusion defects and reduced PBF. Question Dilated bronchial arteries are a common comorbidity in cystic fibrosis (CF), which can cause hemoptysis, but their quantitative contribution to lung perfusion is little researched. Findings Perfusion defects in percent (QDP) enabled objective assessment of perfusion abnormalities in CF patients, while perfusion delay and arterial correlation showed bronchial artery perfusion contribution. Clinical relevance The usage of quantitative perfusion metrics in CF may help tracking disease progression. By also including the proposed metrics perfusion delay and arterial correlation, bronchial artery inflow could be assessed and used to detect early onset of bronchial artery dilation.

Interfinger Differences in Pulse Oximetry Signal-Derived Peripheral Perfusion Index: A Single-Center Exploratory Study.

Peripheral perfusion monitoring is crucial for the management of critically ill patients because abnormal peripheral perfusion is associated with a poor prognosis. The peripheral perfusion index (PPI), derived from pulse oximetry, quantifies peripheral perfusion but varies across fingers. A pulse oximeter probe may cause burns when worn at the same site. Therefore, changing the site has been recommended. However, changes in PPI values owing to probe replacement reduce the reliability of clinical and research applications. No two fingers with equivalent PPI values have been identified yet. This study assessed the interfinger differences in PPI by measuring the five fingers simultaneously and identified the two fingers with the least fluctuation in values. A total of 30 healthy volunteers were included in this single-center prospective exploratory study. For PPI measurements, the pulse amplitude index (PAI) was measured using a pulse oximeter on a bedside monitor (Life Scope PT; Nihon Kohden Corp., Tokyo, Japan). The tape-type disposable pulse oximeter probes were attached to each of the five fingertips of the dominant hand, and measurements were conducted in three rooms with different temperatures (16°C, 22°C, and 28°C) to induce thermoregulatory responses and capture a wide range of PAI values. The primary endpoint was the PAI in pairs of two fingers each (a total of 10 pairs). Paired t-tests with Bonferroni correction were used to compare finger pairs, with statistical significance defined as p < 0.005. The combination with the least difference in PAI was the index-ring finger combination (0.07% ± 1.89%, p = 0.74), followed by the middle-ring finger (0.45% ± 1.93%, p = 0.03) and index-middle finger combinations (0.52% ± 2.05%, p = 0.02). All other finger combinations showed statistically significant differences (p < 0.001). PPI values measured using the pulse oximeter showed the smallest interfinger difference between the index and ring fingers. If changing the finger to which the probe is attached during clinical or research use is needed, it may be possible to consistently measure the PPI values by alternately attaching the probe to the index and ring fingers.

Left ventricular diastolic inflow and myocardial flow reserve in patients with coronary artery disease: simultaneous analysis of 4D-Flow and myocardial perfusion using hybrid PETMR.

This study aimed to simultaneously evaluate the association between diastolic left ventricular (LV) inflow and myocardial flow reserve (MFR) using a hybrid PET/MR system in patients with coronary artery disease (CAD). Sixty-seven patients (mean 66 ± 15 years, male 55) with CAD who underwent rest-pharmacological stress 13N-ammonia PET/MR were included. MFR, perfusion defect, and peak filling rate (PFR) were obtained through rest-stress PET. MR acquisition was performed simultaneously during the PET scan to obtain rest-stress 4D flow. Diastolic LV inflow volume (LVinf)(mL/s), peak velocity (peakV)(cm/s), and the change from the rest scan (Δvalue) were computed. Diastolic LV inflow parameters were compared based on the presence or absence of preserved MFR and perfusion defects. In all patients, diastolic LV inflow parameters significantly increased in the stress scan compared to the rest (53.7 ± 23.1 vs. 64.1 ± 32.9ml/s, p = 0.0002; 68.1 ± 15.1 vs. 76.4 ± 20.6cm/s, p = 0.0001 for LVinf and peakV, respectively). PeakV and PFR showed a significant correlation for rest and stress (r = 0.4, p = 0.01; r = 0.3, p = 0.03 for rest and stress, respectively).ΔpeakV significantly correlated to stress MBF, and MFR (r = 0.3, p = 0.007; r = 0.3, p = 0.04 for stress MBF, and MFR, respectively). Among patients with preserved LVEF (n = 47), when were divided into 4 subgroups based on the median myocardial flow reserve (MFR, 1.86) and the presence of perfusion defect, ΔpeakV was significantly higher in those with MFR above median and without abnormal perfusion compared to the other groups (21.8 ± 13.6 vs. 13.5 ± 17.0, 13.0 ± 13.5, and 4.6 ± 19.1; p = 0.04, 0.04, and 0.04 for MFR ≥ 1.86 or < 1.86 with or without abnormal perfusion, respectively). Non-invasive assessment of diastolic intra-LV hemodynamics derived from 4D flow MR demonstrated a significant association with coronary vasodilation.

Development of ICP-OES Method for Determination Copper Tetramibi Tetrafluoroborate Active Substance Content in a Kit for Radiopharmaceutical Preparation.

The aim of this study was to develop a fast, quantitative method for the determination of copper tetramibi tetrafluoroborate active substance content in the POLATOM’s PoltechMIBI kit before radiolabeling, using inductively coupled plasma optical emission spectrometry (ICP-OES). Copper tetramibi is a key complex that after radiolabeling with sodium pertechnetate [99mTc], forms technetium [99mTc] sestamibi used primarily for detection of myocardial perfusion abnormalities. Indirect method that determines Cu content was developed and validated according to ICH guidelines and European Pharmacopoeia validation requirements, showing good linearity, accuracy, precision and intermediate precision between two different ICP-OES systems, making it suitable and adequate for routine analysis.

Brain Perfusion Abnormalities using pCASL Imaging in Participants with Acute Post-Traumatic Headache due to Mild Traumatic Brain Injury (P4-12.005)

Brain Perfusion Abnormalities using pCASL Imaging in Participants with Acute Post-Traumatic Headache due to Mild Traumatic Brain Injury (P4-12.005)