Quantitative Myocardial Perfusion with Dynamic Contrast-Enhanced Imaging in MRI and CT: Theoretical Models and...

Area of Science:

• Cardiovascular imaging
• Medical physics
• Radiology

Background:

• Technological advancements in MRI and CT offer higher resolution, enabling absolute myocardial perfusion quantification.
• Currently, only PET provides this capability, but it is limited by cost and cyclotron requirements.
• Wider availability of MRI and CT could integrate perfusion biomarkers into coronary artery disease (CAD) workup.

Purpose of the Study:

• To provide insight into tracer kinetic models for quantitative myocardial perfusion analysis.
• To address implementation issues of these models in MRI and CT.
• To compare models based on theoretical derivations and their impact on acquisition parameters.

Main Methods:

• Review of tracer kinetic models for myocardial perfusion quantification.
• Analysis of model implementation challenges in MRI and CT.
• Comparison of different models regarding theoretical basis and acquisition requirements.

Main Results:

• Higher spatial and temporal resolution in MRI and CT now allow for absolute myocardial perfusion quantification.
• Standardization issues in protocols and model selection complicate cross-modality comparisons.
• Understanding the interplay between tracer kinetic modeling and acquisition settings is crucial for MRI and CT.

Conclusions:

• MRI and CT show promise for absolute myocardial perfusion quantification, potentially rivaling PET.
• Further research and standardization are needed to validate MRI and CT accuracy for CAD assessment.
• This overview highlights critical considerations for implementing quantitative myocardial perfusion analysis with MRI and CT.