A Quantitative Pixel-Wise Measurement of Myocardial Blood Flow by Contrast-Enhanced First-Pass CMR Perfusion Imaging

Hsu, Li‐Yueh; Groves, Daniel W.; Aletras, Anthony H.; Kellman, Peter; Arai, Andrew E.

doi:10.1016/j.jcmg.2011.07.013

Cited by 127 publications

(118 citation statements)

References 48 publications

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“…Perfusion imaging is one of the many areas where CMR is becoming quantitative, and although it is by no means perfect and the required imaging and postprocessing methods are not widely available, first results show excellent correlation with microspheres in the experimental animal 14 and demonstrate similar results to perfusion quantification by PET. 15 CMR increasingly demonstrates its potential to assess microvascular disease.…”

Section: See Article By Heydari Et Almentioning

confidence: 90%

Cardiovascular Magnetic Resonance in Diabetic Patients

Nagel

2016

Circ: Cardiovascular Imaging

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Section: See Article By Heydari Et Almentioning

confidence: 90%

Cardiovascular Magnetic Resonance in Diabetic Patients

Nagel

2016

Circ: Cardiovascular Imaging

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“…Others have used just one of these indices while yet others have derived quantitative MPI values from advanced analyses of the MPI time-intensity curves (8,9). Similarly, SPECT has its own set of quantitative criteria (10).…”

Section: Mpi Measures Of Ischemiamentioning

confidence: 99%

Use of bio-informatics assessment schema (BIAS) to improve diagnosis and prognosis of myocardial perfusion data: results from the NHLBI-sponsored women’s ischemia syndrome evaluation (WISE)

Doyle

Pohost

Merz

et al. 2016

Cardiovasc. Diagn. Ther.

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Background:We introduce an algorithmic approach to optimize diagnostic and prognostic value of gated cardiac single photon emission computed tomography (SPECT) and magnetic resonance (MR) myocardial perfusion imaging (MPI) modalities in women with suspected myocardial ischemia. The novel approach: bioinformatics assessment schema (BIAS) forms a mathematical model utilizing MPI data and cardiac metrics generated by one modality to predict the MPI status of another modality. The model identifies cardiac features that either enhance or mask the image-based evidence of ischemia. For each patient, the BIAS model value is used to set an appropriate threshold for the detection of ischemia.Methods: Women (n=130), with symptoms and signs of suspected myocardial ischemia, underwent MPI assessment for regional perfusion defects using two different modalities: gated SPECT and MR. To determine perfusion status, MR data were evaluated qualitatively (MRI QL ) and semi-quantitatively (MRI SQ ) while SPECT data were evaluated using conventional clinical criteria. Evaluators were masked to results of the alternate modality. These MPI status readings were designated "original". Two regression models designated "BIAS" models were generated to model MPI status obtained with one modality (e.g., MRI) compared with a second modality (e.g., SPECT), but importantly, the BIAS models did not include the primary Original MPI reading of the predicting modality. Instead, the BIAS models included auxiliary measurements like left ventricular chamber volumes and myocardial wall thickness. For each modality, the BIAS model was used to set a progressive threshold for interpretation of MPI status. Women were then followed for 38±14 months for the development of a first major adverse cardiovascular event [MACE:CV death, nonfatal myocardial infarction (MI) or hospitalization for heart failure]. Original and BIASaugmented perfusion status were compared in their ability to detect coronary artery disease (CAD) and for prediction of MACE.Results: Adverse events occurred in 14 (11%) women and CAD was present in 13 (10%). There was a positive correlation of maximum coronary artery stenosis and BIAS score for MRI and SPECT (P<0.001).Receiver operator characteristic (ROC) analysis was conducted and showed an increase in the area IntroductionPreviously we showed that the initial (i.e., "original") interpretation of myocardial perfusion imaging (MPI) was improved by modeling the results of one modality, such as magnetic resonance imaging (MRI), against the results of another modality, such as single photon emission computed tomography (SPECT) for diagnosis and prognosis in women with signs and symptoms of ischemia (1). This approach, termed Decisions Informed by Combining Entities (DICE) better identified women likely to experience a major adverse cardiovascular event (MACE) versus the original reading. However, since the DICE formula incorporated the Original MPI reading it was constrained to convert false negatives to true positives, but did not convert fal...

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“…Hyperemia to measure maximal MBF 16 can be evaluated using exercise or pharmacological (dobutamine or vasodilator) stress CMR. Exercise is achieved through the use of a supine bicycle or non-ferromagnetic treadmill.…”

Section: Increased Myocardial Workloadmentioning

confidence: 99%

“…16 Clinical validation studies in humans have also been reported using invasive FFR techniques, 31 and non-invasively with positron emission tomography (PET) imaging. 32 44 Jogiya and colleagues also reported an overall diagnostic accuracy of 91% (per patient) and 88% (per coronary territory) in 53 patients using FFR<0.75 (anatomic coronary stenosis >50%) as gold standard for qualitative 3D CMR perfusion.…”

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confidence: 99%