Background
Methods
Patients and study design
Cardiovascular magnetic resonance image acquisition
Positron emission tomography image acquisition
Data analysis
CMR myocardial blood flow quantification
Calculation of contrast agent concentration
Deconvolution methods
Fermi function parameterization
Truncated singular valued decomposition
Tikhonov regularization with b-splines
PET myocardial blood flow quantification
LV volumetric analysis
Interobserver variability
Statistical analysis
Results
Study population
CAD patients | Healthy volunteers | p value | |
---|---|---|---|
n = 9 | n = 9 | ||
Male | 8 (89%) | 7 (78%) | 0.527 |
Age | 68 ± 5 | 48 ± 9 | <0.001 |
BMI (kg/m2) | 26.6 ± 2.7 | 27.0 ± 3.4 | 0.783 |
eGFR (mL/min/m2) | 78 ± 22 | 86 ± 13 | 0.375 |
Hypertension | 5 (56%) | 0 | |
Diabetes | 2 (22%) | 0 | |
Current/previous smoker | 1 (11%) / 4 (44%) | 0 | |
Previous MI | 4 (44%) | 0 | |
Previous PCI | 4 (44%) | 0 | |
Previous CABG | 1 (11%) | 0 | |
Coronary disease | |||
Left anterior descending | 4 (44%) | - | |
Circumflex | 2 (22%) | - | |
Right | 6 (67%) | - | |
Angina (CCS) | |||
Class 1 | 1 (11%) | - | |
Class 2 | 4 (44%) | - | |
Class 3 | 4 (44%) | - | |
LVEDVI (mL/m2) | 87 ± 19 | 86 ± 8 | 0.871 |
LVESVI (mL/m2) | 36 ± 19 | 28 ± 4 | 0.223 |
LVEF (%) | 61 ± 11 | 68 ± 4 | 0.086 |
LV Mass I (g/m2) | 46 ± 9 | 48 ± 8 | 0.694 |
Contrast agent concentration versus signal intensity
Overall MBF (mL/min/g) | Stress MBF (mL/min/g) | Rest MBF (mL/min/g) | |
---|---|---|---|
A. Saturation correction
| |||
Contrast agent concentration | 1.10 ± 0.64 | 1.55 ± 0.63 | 0.66 ± 0.20 |
Signal intensity | 1.80 ± 1.03 | 2.51 ± 1.00 | 1.09 ± 0.33 |
p value | <0.001 | <0.001 | <0.001 |
95% limits of agreement | −0.20 to 1.60 | 0.01 to 1.92 | 0.02 to 0.85 |
B. AIF location
| |||
Basal ventricular | 1.10 ± 0.64 | 1.55 ± 0.63 | 0.66 ± 0.20 |
Mid ventricular | 1.22 ± 0.80 | 1.79 ± 0.75 | 0.64 ± 0.23 |
p value | 0.002 | <0.001 | 0.392 |
95% limits of agreement | −0.40 to 0.64 | −0.36 to 0.85 | −0.23 to 0.21 |
AIF location
Method of deconvolution
A. Mean values | ||||
---|---|---|---|---|
Fermi | Tikhonov | TSVD | p value | |
Overall MBF (mL/min/g) | 1.10 ± 0.64 | 1.15 ± 0.57 | 1.09 ± 0.56 | 0.023 |
Stress MBF (mL/min/g) | 1.55 ± 0.63 | 1.55 ± 0.53 | 1.48 ± 0.54 | 0.105 |
Rest MBF (mL/min/g) | 0.66 ± 0.20 | 0.76 ± 0.24 | 0.70 ± 0.20 | <0.001 |
B. Mean differences and limits of agreement
| ||||
Mean difference
|
p-value
|
95% limits of agreement
| ||
Overall MBF (mL/min/g)
| ||||
Fermi – Tikhonov | −0.05 | 0.160 | −0.58 to 0.48 | |
Fermi – TSVD | 0.01 | 1.000 | −0.41 to 0.44 | |
Tikhonov – TSVD | 0.06 | 0.025 | −0.37 to 0.51 | |
Stress MBF (mL/min/g)
| ||||
Fermi – Tikhonov | 0.00 | 1.00 | −0.62 to 0.61 | |
Fermi – TSVD | 0.07 | 0.345 | −0.44 to 0.59 | |
Tikhonov – TSVD | 0.08 | 0.148 | −0.42 to 0.57 | |
Rest MBF (mL/min/g)
| ||||
Fermi – Tikhonov | −0.10 | <0.001 | −0.52 to 0.32 | |
Fermi – TSVD | −0.04 | 0.021 | −0.32 to 0.24 | |
Tikhonov – TSVD | 0.06 | 0.119 | −0.32 to 0.45 |
Interobserver repeatability
Comparison with PET
A. Mean values | ||||
---|---|---|---|---|
PET | Fermi | Tikhonov | TSVD | |
Overall MBF (mL/min/g) | 1.23 ± 0.72 | 0.90 ± 0.44 | 1.05 ± 0.51 | 0.94 ± 0.47 |
Stress MBF (mL/min/g) | 1.62 ± 0.81 | 1.16 ± 0.47 | 1.29 ± 0.51 | 1.21 ± 0.50 |
Rest MBF (mL/min/g) | 0.84 ± 0.27 | 0.64 ± 0.20 | 0.80 ± 0.35 | 0.67 ± 0.17 |
MPR | 1.97 ± 0.87 | 1.97 ± 1.13 | 1.73 ± 0.73 | 1.87 ± 0.79 |
B. Mean differences and limits of agreement
| ||||
Mean difference
|
p-value
|
95% limits of agreement
| ||
Overall MBF (mL/min/g)
| ||||
PET – Fermi | 0.35 | <0.001 | −0.56 to 1.26 | |
PET – Tikhonov | 0.19 | 0.014 | −0.90 to 1.29 | |
PET – TSVD | 0.30 | <0.001 | −0.73 to 1.32 | |
Stress MBF (mL/min/g)
| ||||
PET – Fermi | 0.48 | <0.001 | −0.65 to 1.61 | |
PET – Tikhonov | 0.34 | 0.004 | −0.95 to 1.63 | |
PET – TSVD | 0.43 | 0.001 | −0.89 to 1.75 | |
Rest MBF (mL/min/g)
| ||||
PET – Fermi | 0.22 | <0.001 | −0.28 to 0.72 | |
PET – Tikhonov | 0.05 | 0.531 | −0.72 to 0.82 | |
PET – TSVD | 0.17 | <0.001 | −0.32 to 0.66 | |
MPR
| ||||
PET – Fermi | 0.02 | 0.869 | −1.41 to 1.38 | |
PET – Tikhonov | 0.25 | 0.028 | −0.99 to 1.50 | |
PET – TSVD | 0.14 | 0.200 | −1.06 to 1.34 |
Stenotic territory | Remote territory | p value | |
---|---|---|---|
Stress MBF (mL/min/g)
| |||
PET | 1.20 ± 0.66 | 1.89 ± 0.78 | <0.001 |
Fermi | 0.81 ± 0.29 | 1.36 ± 0.47 | <0.001 |
Tikhonov | 0.99 ± 0.36 | 1.47 ± 0.55 | <0.001 |
TSVD | 0.90 ± 0.33 | 1.38 ± 0.54 | <0.001 |
Rest MBF (mL/min/g)
| |||
PET | 0.80 ± 0.26 | 0.86 ± 0.28 | 0.034 |
Fermi | 0.62 ± 0.18 | 0.62 ± 0.17 | 0.917 |
Tikhonov | 0.79 ± 0.46 | 0.79 ± 0.24 | 0.926 |
TSVD | 0.66 ± 0.20 | 0.68 ± 0.17 | 0.618 |
MPR
| |||
PET | 1.53 ± 0.68 | 2.25 ± 0.88 | <0.001 |
Fermi | 1.35 ± 0.47 | 2.40 ± 1.31 | <0.001 |
Tikhonov | 1.35 ± 0.47 | 1.95 ± 0.79 | 0.004 |
TSVD | 1.41 ± 0.49 | 2.10 ± 0.86 | <0.001 |