Variability in quantitative cardiac magnetic resonance perfusion analysis

Area of Science:

• Cardiovascular Imaging
• Medical Physics
• Diagnostic Cardiology

Background:

• First-pass perfusion cardiovascular magnetic resonance (CMR) is a noninvasive tool for detecting reversible myocardial ischemia.
• CMR can quantitatively assess myocardial perfusion reserve using myocardial perfusion reserve index (MPRI) and absolute myocardial blood flow (MBF).

Purpose of the Study:

• To highlight the challenges and variability in perfusion CMR data acquisition and post-processing.
• To emphasize the need for a universal, reproducible, accurate, and easily applicable tool for perfusion CMR analysis.

Main Methods:

• Review of factors affecting perfusion CMR data acquisition, including imaging techniques, contrast agents, and physiological variables.
• Discussion of mechanisms underlying variability in perfusion CMR post-processing and their clinical significance.

Main Results:

• Perfusion CMR is highly accurate for cardiac function and volumes but faces challenges in perfusion assessment.
• Variability in data acquisition and post-processing affects the reliability of perfusion CMR measurements.
• The clinical significance of post-processing variability requires further elucidation.

Conclusions:

• Standardization of perfusion CMR techniques and analysis is crucial for improving its clinical utility.
• Further research is needed to develop robust and reproducible methods for perfusion CMR analysis.
• A universal tool for perfusion CMR analysis would significantly enhance its role in patient care.