Myocardial first-pass perfusion magnetic resonance imaging: a multicenter dose-ranging study

Area of Science:

• Cardiovascular Imaging
• Radiology
• Medical Diagnostics

Background:

• Magnetic Resonance Imaging (MRI) can detect obstructive coronary artery disease.
• First-pass contrast bolus imaging during pharmacologically induced myocardial hyperemia is utilized.
• This study aimed to find the minimum effective dose of gadopentetate dimeglumine for this purpose.

Purpose of the Study:

• Determine the minimally efficacious dose of gadopentetate dimeglumine.
• Evaluate the efficacy for detecting obstructive coronary artery disease using MRI.

Main Methods:

• A multicenter, dose-ranging study involving 99 patients.
• Patients received 0.05, 0.10, or 0.15 mmol/kg of gadopentetate dimeglumine.
• First-pass perfusion MRI was performed with and without adenosine-induced hyperemia; results compared to coronary angiography.

Main Results:

• The low dose (0.05 mmol/kg) showed an area under the receiver-operating curve of 0.90.
• Mean sensitivity, specificity, and accuracy for the low dose were 93%, 75%, and 85%, respectively.
• The low dose was found to be at least as efficacious as higher doses.

Conclusions:

• First-pass perfusion MRI is a safe and accurate method for identifying obstructive coronary artery disease.
• A gadopentetate dimeglumine dose of 0.05 mmol/kg is sufficient for effective diagnosis.
• This finding supports the use of lower contrast agent doses in cardiac MRI.