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Updated: Jul 20, 2026
Registered Bioimaging of Nanomaterials for Diagnostic and Therapeutic Monitoring
Published on: December 9, 2010
Quantitative magnetic resonance first-pass perfusion analysis: inter- and intraobserver agreement
O M Mühling1, M E Dickson, A Zenovich
1Department of Radiology, MR-Core Laboratory, Center of Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, USA.
Abstract:
Magnetic resonance first-pass (MRFP) imaging awaits longitudinal clinical trials for quantification of myocardial perfusion. The purpose of this study was to assess inter- and intraobserver agreement of this method. Seventeen MRFP studies (14 rest and 3 under adenosine-induced hyperemia) from 14 patients were acquired. Two observers visually graded study quality. Each study was subdivided into eight regions. Both observers analyzed all 17 studies (8 x 17 = 136 regions) for interobserver agreement. Each observer then analyzed 10 of the 17 studies a second time (2 x 8 x 10 = 160 regions) for intraobserver agreement. Signal intensity curves were obtained with Argus software (Siemens, Iselin, NJ). The maximum amplitude of the impulse response function (Rmax) and the change of signal intensity (deltaSImax) of the contrast bolus were determined. Intraclass correlation coefficient was used to determine intra- and interobserver agreement. The quality was good or excellent in 14 studies. Intraobserver agreement of Rmax and deltaSImax were good (0.85 and 0.80, n = 160). Interobserver agreement of Rmax was fair (0.55, n = 136) but improved after exclusion of poor-quality studies (0.88, n = 112). Interobserver agreement of deltaSImax was good (0.73) and improved less than Rmax with study quality (0.83). Interobserver agreement for Rmax in individual myocardial regions before and after exclusion of studies with poor quality changed most markedly in lateral and posterior regions (0.69 and 0.65 vs. 0.97 and 0.94), where signal-to-noise ratios were reduced compared with anteroseptal regions (p < 0.01). Analysis of MRFP images provides good intraobserver agreement. Interobserver agreement of the quantitative perfusion analysis is good under the premise of good image quality.
Insights
Magnetic resonance first-pass (MRFP) imaging shows good intraobserver agreement for myocardial perfusion quantification. Interobserver agreement is fair but improves significantly with good image quality, especially in anteroseptal regions.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
- Radiology
Background:
- Magnetic resonance first-pass (MRFP) imaging is a promising technique for quantifying myocardial perfusion.
- Longitudinal clinical trials are needed to establish MRFP's role in patient management.
- Assessing the reliability of MRFP analysis is crucial before widespread clinical adoption.
Purpose of the Study:
- To evaluate the inter- and intraobserver agreement of quantitative myocardial perfusion analysis using MRFP imaging.
- To determine the impact of image quality on the reliability of MRFP measurements.
- To identify specific myocardial regions where agreement is most affected by image quality.
Main Methods:
- Seventeen MRFP studies (14 rest, 3 hyperemia) from 14 patients were analyzed.
- Two independent observers assessed image quality and analyzed signal intensity curves.
- Quantitative parameters, maximum amplitude of the impulse response function (Rmax) and change of signal intensity (deltaSImax), were measured.
- Intraclass correlation coefficients (ICC) were calculated to assess agreement.
Main Results:
- Good intraobserver agreement was observed for both Rmax (ICC=0.85) and deltaSImax (ICC=0.80).
- Initial interobserver agreement for Rmax was fair (ICC=0.55), but improved to good (ICC=0.88) after excluding poor-quality studies.
- Interobserver agreement for deltaSImax was good (ICC=0.73) and improved to (ICC=0.83) with better image quality.
- Agreement was most variable in lateral and posterior regions, correlating with lower signal-to-noise ratios.
Conclusions:
- MRFP imaging demonstrates reliable intraobserver agreement for myocardial perfusion quantification.
- Interobserver agreement is acceptable, particularly when focusing on studies with good image quality.
- Image quality significantly influences interobserver agreement, with lower signal-to-noise ratios in certain regions impacting results.
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