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Pixel‐wise assessment of cardiovascular magnetic resonance first‐pass perfusion using a cardiac phantom mimicking transmural myocardial perfusion gradients
Author(s) -
Milidonis Xenios,
Nazir Muhummad Sohaib,
Schneider Torben,
Capstick Myles,
Drost Sita,
Kok Gertjan,
Pelevic Nikola,
Poelma Christian,
Schaeffter Tobias,
Chiribiri Amedeo
Publication year - 2020
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.28296
Subject(s) - perfusion , imaging phantom , magnetic resonance imaging , perfusion scanning , reproducibility , first pass , pixel , biomedical engineering , coronary circulation , medicine , nuclear medicine , blood flow , radiology , computer science , mathematics , artificial intelligence , statistics , arithmetic
Purpose Cardiovascular magnetic resonance first‐pass perfusion for the pixel‐wise detection of coronary artery disease is rapidly becoming the clinical standard, yet no widely available method exists for its assessment and validation. This study introduces a novel phantom capable of generating spatially dependent flow values to enable assessment of new perfusion imaging methods at the pixel level. Methods A synthetic multicapillary myocardial phantom mimicking transmural myocardial perfusion gradients was designed and manufactured with high‐precision 3D printing. The phantom was used in a stationary flow setup providing reference myocardial perfusion rates and was scanned on a 3T system. Repeated first‐pass perfusion MRI for physiological perfusion rates between 1 and 4 mL/g/min was performed using a clinical dual‐sequence technique. Fermi function‐constrained deconvolution was used to estimate pixel‐wise perfusion rate maps. Phase contrast (PC)‐MRI was used to obtain velocity measurements that were converted to perfusion rates for validation of reference values and cross‐method comparison. The accuracy of pixel‐wise maps was assessed against simulated reference maps. Results PC‐MRI indicated excellent reproducibility in perfusion rate (coefficient of variation [CoV] 2.4‐3.5%) and correlation with reference values (R 2 = 0.985) across the full physiological range. Similar results were found for first‐pass perfusion MRI (CoV 3.7‐6.2%, R 2 = 0.987). Pixel‐wise maps indicated a transmural perfusion difference of 28.8‐33.7% for PC‐MRI and 23.8‐37.7% for first‐pass perfusion, matching the reference values (30.2‐31.4%). Conclusion The unique transmural perfusion pattern in the phantom allows effective pixel‐wise assessment of first‐pass perfusion acquisition protocols and quantification algorithms before their introduction into routine clinical use.