title: Color-encoded semiautomatic analysis of multi-slice first-pass magnetic resonance perfusion: comparison to tetrofosmin single photon emission computed tomography perfusion and X-ray angiography.
abstract: OBJECTIVE
  Cardiovascular magnetic resonance (CMR) perfusion can accurately detect coronary artery disease (CAD). However, the absence of efficient, easy-to-use and reliable image analysis software is an obstacle to its introduction into clinical practice. The aim of this study was to evaluate new color-encoded semiautomatic software for analysis of first-pass CMR perfusion in comparison to tetrofosmin myocardial single photon emission computed tomography (SPECT), using X-ray angiography as the standard of truth for the detection of CAD.
  
  
  METHODS
  Thirty-two patients underwent both SPECT and CMR perfusion at rest and adenosine stress. Twenty of these patients also underwent X-ray angiography. Off-line CMR image analysis consisted of six steps to generate a color display of the myocardial perfusion reserve index (MPRI). The MPRI color-maps were analyzed visually and compared to SPECT.
  
  
  RESULTS
  In comparison to X-ray angiography overall accuracy was 87% for CMR and 77% for SPECT perfusion to detect significant CAD (stenosis > or =70%). In comparison with SPECT sensitivity was 80%, specificity 91%, and the overall agreement 89% for CMR.
  
  
  CONCLUSIONS
  Post-processing of CMR perfusion data using new semiautomatic software to generate and display the MPRI visually as color-encoded images is feasible and fast. In this study it yielded higher accuracy than SPECT to detect significant CAD on X-ray angiography. Correlation between SPECT and CMR accuracy for detection of perfusion defects was high. This method may accelerate the time-consuming analysis of CMR perfusion data, thus enabling a more widespread clinical utility.
authors.affiliation: Department of Cardiology, University of Leipzig-Heart Center, Leipzig, Germany. thielh@medizin.uni-leipzig.de
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
authors.forename: Sven
authors.initials: S
authors.lastname: Plein
authors.forename: Marcel
authors.initials: M
authors.lastname: Breeuwer
authors.forename: John P
authors.initials: JP
authors.lastname: Ridgway
authors.forename: David
authors.initials: D
authors.lastname: Higgins
authors.forename: Penelope J
authors.initials: PJ
authors.lastname: Thorley
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.forename: Mohan U
authors.initials: MU
authors.lastname: Sivananthan
mesh_terms: D000241:Adenosine; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D012984:Software; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents; D014965:X-Rays
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; C078700:technetium tc-99m tetrofosmin; D000241:Adenosine