Quantitative cardiovascular magnetic resonance perfusion imaging: inter-study reproducibility

Morton, Geraint; Jogiya, Roy; Plein, Sven; Schuster, Andreas; Chiribiri, Amedeo; Nagel, Eike

doi:10.1093/ehjci/jes103

Cited by 31 publications

(23 citation statements)

References 32 publications

(30 reference statements)

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“…While MBFs and MPR from the Fermi model have been validated by microspheres, it is still not clear if these values reflect perfusion or if extraction or permeability also needs to be considered. Even if the MBFs reported here and previously more correctly reflect a flow index, measuring their repeatability is important.…”

Section: Discussionmentioning

confidence: 83%

“…Table summarizes the results from previously published results on repeatability of perfusion cardiovascular MRI . The studies listed in Table all made use of ECG‐gated, breath‐held acquisitions.…”

Section: Discussionmentioning

confidence: 99%

“…Table 3 summarizes the results from previously published results on repeatability of perfusion cardiovascular MRI. [8][9][10][11] The studies listed in Table 3 all made use of ECG-gated, breath-held acquisitions. Three of the four studies reported results from a single mid-ventricular slice.…”

Section: Discussionmentioning

confidence: 99%

“…4 There have been relatively few studies looking at the reproducibility of quantitative MBF or myocardial perfusion reserve (MPR). [7][8][9][10][11] While the main aim of this study was to analyze the interstudy repeatability of quantitative MPR and MBF using a quantitative self-gated MR approach, we also studied the interstudy repeatability of myocardial fibrosis assessment by extracellular volume fraction (ECV) derived from modified Look-Locker inversion recovery (MOLLI) T 1 mapping (see Supplemental File 1, online). Studies have reported good reproducibility of native and postcontrast T 1 derived from MOLLI T 1 mapping.…”

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confidence: 99%

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Interstudy repeatability of self‐gated quantitative myocardial perfusion MRI

Likhite

Suksaranjit

Adluru

et al. 2015

Magnetic Resonance Imaging

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Purpose To evaluate the inter-study repeatability of multi-slice quantitative cardiovascular magnetic resonance myocardial blood flow (MBF), myocardial perfusion reserve (MPR), and extracellular volume (ECV). A unique saturation recovery self-gated acquisition was used for the perfusion scans. Materials and Methods An ungated golden angle radial turboFLASH pulse sequence was used to scan 10 subjects on two separate days on a 3T scanner. A single saturation pulse was followed by a set of 4 slices. Rest and hyperemia scans were acquired during free breathing. The images were reconstructed using an iterative algorithm with spatiotemporal constraints. The ungated images were retrospectively binned (self-gated) into near-systole and near-diastole. Deformable registration was performed to adjust for respiratory and residual cardiac motion, and the data was fit with a Fermi model to estimate the inter-study repeatability of quantitative self-gated MBF and MPR. Results The coefficient of variation (CoV) of the territorial MPR using the self-gated near-systole data was 18.6%. The self-gated near-diastole data gave less good CoV of MPR, equal to 46.2%. For MBFs, and using smaller (segmental) regions, the CoVs were 20.1% and 22.7% for the estimation of myocardial blood flow at stress and rest respectively using the self-gated near-systole data. The self-gated near-diastole data gave CoV=48.6% and 44.9% for stress and rest. Conclusion The self-gated free breathing technique for quantification of myocardial blood flow showed good repeatability for near-systole, with results comparable to published studies on inter-study repeatability of quantitative myocardial perfusion MRI using ECG-gating and breath-holds. Self-gated near-diastole data results were less repeatable.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Interstudy repeatability of self‐gated quantitative myocardial perfusion MRI

Likhite

Suksaranjit

Adluru

et al. 2015

Magnetic Resonance Imaging

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“…[43][44][45][46][47] Direct comparison with the reproducibility of PET-based myocardial perfusion measurements is hampered by different measures of repeatability used in different studies and wide time ranges between the repeated measures in some studies. However, the repeatability coefficients reported in some MRI studies 44,47 are somewhat higher and the ICC somewhat lower 44,46 than in the previously mentioned PET-studies. 41,42 Morton et al 21 reported weak correlations for absolute perfusion values when comparing rest and stress perfusion values separately (r = 0.32 and r = 0.37, respectively).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of quantitative CMR perfusion imaging by comparison with simultaneous 15O-water-PET

Kero

Johansson

Engström³

et al. 2021

Journal of Nuclear Cardiology

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Background. We assessed the quantitative accuracy of cardiac perfusion measurements using dynamic contrast-enhanced MRI with simultaneous 15 O-water PET as reference with a fully integrated PET-MR scanner.Methods. 15 patients underwent simultaneous DCE MRI and 15 O-water PET scans at rest and adenosine-stress on an integrated PET-MR scanner. Correlation and agreement between MRI-and PET-based global and regional MBF values were assessed using correlation and Bland-Altman analysis.Results. Three subjects were excluded due to technical problems. Global mean (± SD) MBF values at rest and stress were 0.97 ± 0.27 and 3.19 ± 0.70 mL/g/min for MRI and 1.02 ± 0.28 and 3.13 ± 1.16 mL/g/min for PET (P = 0.66 and P = 0.81). The correlations between global and regional MRI-and PET-based MBF values were strong (r = 0.86 and r = 0.75). The biases were negligible for both global and regional MBF comparisons (0.01 and 0.00 mL/min/g for both), but the limits of agreement were wide for both global and regional MBF, with larger variability for high MBF-values.Conclusion. The correlation between simultaneous MBF measurements with DCE MRI and 15 O-water PET measured in an integrated PET-MRI was strong but the agreement was only moderate indicating that MRI-based quantitative MBF measurements is not ready for clinical introduction.

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Aortic valve calcification and myocardial fibrosis determine outcome following transcatheter aortic valve replacement

et al. 2023

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Aims There is evidence to suggest that the subtype of aortic stenosis (AS), the degree of myocardial fibrosis (MF), and level of aortic valve calcification (AVC) are associated with adverse cardiac outcome in AS. Because little is known about their respective contribution, we sought to investigate their relative importance and interplay as well as their association with adverse cardiac events following transcatheter aortic valve replacement (TAVR). Methods and resultsOne hundred consecutive patients with severe AS and indication for TAVR were prospectively enrolled between January 2017 and October 2018. Patients underwent transthoracic echocardiography, multidetector computed tomography, and left ventricular endomyocardial biopsies at the time of TAVR. The final study cohort consisted of 92 patients with a completed study protocol, 39 (42.4%) of whom showed a normal ejection fraction (EF) high-gradient (NEFHG) AS, 13 (14.1%) a low EF high-gradient (LEFHG) AS, 25 (27.2%) a low EF low-gradient (LEFLG) AS, and 15 (16.3%) a paradoxical low-flow, low-gradient (PLFLG) AS. The high-gradient phenotypes (NEFHG and LEFHG) showed the largest amount of AVC (807 ± 421 and 813 ± 281 mm 3 , respectively) as compared with the low-gradient phenotypes (LEFLG and PLFLG; 503 ± 326 and 555 ± 594 mm 3 , respectively, P < 0.05). Conversely, MF was most prevalent in low-output phenotypes (LEFLG > LEFHG > PLFLG > NEFHG, P < 0.05). This was paralleled by a greater cardiovascular (CV) mortality within 600 days after TAVR (LEFLG 28% > PLFLG 26.7% > LEFHG 15.4% > NEFHG 2.5%; P = 0.023). In patients with a high MF burden, a higher AVC was associated with a lower mortality following TAVR (P = 0.045, hazard ratio 0.261, 95% confidence interval 0.07-0.97). Conclusions MF is associated with adverse CV outcome following TAVR, which is most prevalent in low EF situations. In the presence of large MF burden, patients with large AVC have better outcome following TAVR. Conversely, worse outcome in large MF and relatively little AVC may be explained by a relative prominence of an underlying cardiomyopathy. The better survival rates in large AVC patients following TAVR indicate TAVR induced relief of severe AS-associated pressure overload with subsequently improved outcome.

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Quantitative cardiovascular magnetic resonance perfusion imaging: inter-study reproducibility

Cited by 31 publications

References 32 publications

Interstudy repeatability of self‐gated quantitative myocardial perfusion MRI

Interstudy repeatability of self‐gated quantitative myocardial perfusion MRI

Evaluation of quantitative CMR perfusion imaging by comparison with simultaneous 15O-water-PET

Aortic valve calcification and myocardial fibrosis determine outcome following transcatheter aortic valve replacement

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