title: Quantification of absolute myocardial perfusion in patients with coronary artery disease: comparison between cardiovascular magnetic resonance and positron emission tomography.
abstract: OBJECTIVE
  The aim of this study was to compare fully quantitative cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) myocardial perfusion and myocardial perfusion reserve (MPR) measurements in patients with coronary artery disease (CAD).
  
  
  BACKGROUND
  Absolute quantification of myocardial perfusion and MPR with PET have proven diagnostic and prognostic roles in patients with CAD. Quantitative CMR perfusion imaging has been established more recently and has been validated against PET in normal hearts. However, there are no studies comparing fully quantitative CMR against PET perfusion imaging in patients with CAD.
  
  
  METHODS
  Forty-one patients with known or suspected CAD prospectively underwent quantitative (13)N-ammonia PET and CMR perfusion imaging before coronary angiography.
  
  
  RESULTS
  The CMR-derived MPR (MPR(CMR)) correlated well with PET-derived measurements (MPR(PET)) (r = 0.75, p < 0.0001). MPR(CMR) and MPR(PET) for the 2 lowest scoring segments in each coronary territory also correlated strongly (r = 0.79, p < 0.0001). Absolute CMR perfusion values correlated significantly, but weakly, with PET values both at rest (r = 0.32; p = 0.002) and during stress (r = 0.37; p < 0.0001). Area under the receiver-operating characteristic curve for MPR(PET) to detect significant CAD was 0.83 (95% confidence interval: 0.73 to 0.94) and for MPR(CMR) was 0.83 (95% confidence interval: 0.74 to 0.92). An MPR(PET) ≤1.44 predicted significant CAD with 82% sensitivity and 87% specificity, and MPR(CMR) ≤1.45 predicted significant CAD with 82% sensitivity and 81% specificity.
  
  
  CONCLUSIONS
  There is good correlation between MPR(CMR) and MPR(PET.) For the detection of significant CAD, MPR(PET) and MPR(CMR) seem comparable and very accurate. However, absolute perfusion values from PET and CMR are only weakly correlated; therefore, although quantitative CMR is clinically useful, further refinements are still required.
authors.affiliation: King's College London British Heart Foundation Centre of Excellence, National Institute of Health Research Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council Medical Engineering Centre, Division of Imaging Sciences, The Rayne Institute, St. Thomas' Hospital, London, United Kingdom.
authors.forename: Geraint
authors.initials: G
authors.lastname: Morton
authors.forename: Amedeo
authors.initials: A
authors.lastname: Chiribiri
authors.forename: Masaki
authors.initials: M
authors.lastname: Ishida
authors.forename: Shazia T
authors.initials: ST
authors.lastname: Hussain
authors.forename: Andreas
authors.initials: A
authors.lastname: Schuster
authors.forename: Andreas
authors.initials: A
authors.lastname: Indermuehle
authors.forename: Divaka
authors.initials: D
authors.lastname: Perera
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
authors.forename: Stacey
authors.initials: S
authors.lastname: Baker
authors.forename: Erik
authors.initials: E
authors.lastname: Hedström
authors.forename: Paul
authors.initials: P
authors.lastname: Schleyer
authors.forename: Michael
authors.initials: M
authors.lastname: O'Doherty
authors.forename: Sally
authors.initials: S
authors.lastname: Barrington
authors.forename: Eike
authors.initials: E
authors.lastname: Nagel
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D049268:Positron-Emission Tomography; D015203:Reproducibility of Results