title: Comparison of dual to single contrast bolus magnetic resonance myocardial perfusion imaging for detection of significant coronary artery disease.
abstract: OBJECTIVE
  To investigate the incremental diagnostic value of dual-bolus over single-contrast-bolus first pass magnetic resonance myocardial perfusion imaging (MR-MPI) for detection of significant coronary artery disease (CAD).
  
  
  METHODS
  Patients (n = 49) with suspected CAD underwent first pass adenosine stress and rest MR-MPI and invasive coronary angiography (CA). Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) was injected with a prebolus (1 mL) and a large bolus (0.1 mmol/kg). For the single-bolus technique, the arterial input function (AIF) was obtained from the large-contrast bolus. For the dual-bolus technique, the AIF was reconstructed from the prebolus. Absolute myocardial perfusion was calculated by Fermi-model constrained deconvolution. Receiver operating characteristic (ROC) analysis was used to investigate diagnostic accuracy of MR myocardial perfusion imaging for detection of significant CAD on CA at vessel-based analysis.
  
  
  RESULTS
  The area under the curve (AUC) of the minimal stress perfusion value for the detection of significant CAD using the single-bolus and dual-bolus technique was 0.85 +/- 0.04 (95% confidence interval [CI], 0.77-0.93) and 0.77 +/- 0.05 (95% CI, 0.67-0.86), respectively.
  
  
  CONCLUSIONS
  In this study the dual-bolus technique had no incremental diagnostic value over single-bolus technique for detection of significant CAD with the used contrast concentrations.
authors.affiliation: Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands. j.groothuis@vumc.nl
authors.forename: Jan G J
authors.initials: JG
authors.lastname: Groothuis
authors.forename: Frans P P J
authors.initials: FP
authors.lastname: Kremers
authors.forename: Aernout M
authors.initials: AM
authors.lastname: Beek
authors.forename: Stijn L
authors.initials: SL
authors.lastname: Brinckman
authors.forename: Alvin C
authors.initials: AC
authors.lastname: Tuinenburg
authors.forename: Michael
authors.initials: M
authors.lastname: Jerosch-Herold
authors.forename: Albert C
authors.initials: AC
authors.lastname: van Rossum
authors.forename: Mark B M
authors.initials: MB
authors.lastname: Hofman
mesh_terms: D019540:Area Under Curve; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000175:diagnosis*; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA