title: A quantitative high resolution voxel-wise assessment of myocardial blood flow from contrast-enhanced first-pass magnetic resonance perfusion imaging: microsphere validation in a magnetic resonance compatible free beating explanted pig heart model.
abstract: OBJECTIVE
  To assess the feasibility of high-resolution quantitative cardiovascular magnetic resonance (CMR) voxel-wise perfusion imaging using clinical 1.5 and 3 T sequences and to validate it using fluorescently labelled microspheres in combination with a state of the art imaging cryomicrotome in a novel, isolated blood-perfused MR-compatible free beating pig heart model without respiratory motion.
  
  
  RESULTS
  MR perfusion imaging was performed in pig hearts at 1.5 (n = 4) and 3 T (n = 4). Images were acquired at physiological flow ('rest'), reduced flow ('ischaemia'), and during adenosine-induced hyperaemia ('stress') in control and coronary occlusion conditions. Fluorescently labelled microspheres and known coronary myocardial blood flow represented the reference standards for quantitative perfusion validation. For the comparison with microspheres, the LV was divided into 48 segments based on a subdivision of the 16 AHA segments into subendocardial, midmyocardial, and subepicardial subsegments. Perfusion quantification of the time-signal intensity curves was performed using a Fermi function deconvolution. High-resolution quantitative voxel-wise perfusion assessment was able to distinguish between occluded and remote myocardium (P < 0.001) and between rest, ischaemia, and stress perfusion conditions at 1.5 T (P < 0.001) and at 3 T (P < 0.001). CMR-MBF estimates correlated well with the microspheres at the AHA segmental level at 1.5 T (r = 0.94, P < 0.001) and at 3 T (r = 0.96, P < 0.001) and at the subendocardial, midmyocardial, and subepicardial level at 1.5 T (r = 0.93, r = 0.9, r = 0.88, P < 0.001, respectively) and at 3 T (r = 0.91, r = 0.95, r = 0.84, P < 0.001, respectively).
  
  
  CONCLUSIONS
  CMR-derived voxel-wise quantitative blood flow assessment is feasible and very accurate compared with microspheres. This technique is suitable for both clinically used field strengths and may provide the tools to assess extent and severity of myocardial ischaemia.
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London British Heart Foundation (BHF) Centre of Excellence, National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas' Hospital, Lambeth Palace Road, London, UK Department of Cardiology and Pneumology and German Centre for Cardiovascular Research (DZHK, Partner Site Göttingen), Georg-August-University, Göttingen, Germany andreas_schuster@gmx.net.
authors: Andreas
authors: A
authors: Schuster
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London British Heart Foundation (BHF) Centre of Excellence, National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas' Hospital, Lambeth Palace Road, London, UK.
authors: Matthew
authors: M
authors: Sinclair
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London British Heart Foundation (BHF) Centre of Excellence, National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas' Hospital, Lambeth Palace Road, London, UK.
authors: Niloufar
authors: N
authors: Zarinabad
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London British Heart Foundation (BHF) Centre of Excellence, National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas' Hospital, Lambeth Palace Road, London, UK.
authors: Masaki
authors: M
authors: Ishida
authors: Department of Biomedical Engineering and Physics, Academic Medical Centre, Amsterdam, The Netherlands.
authors: Jeroen P H M
authors: JP
authors: van den Wijngaard
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London British Heart Foundation (BHF) Centre of Excellence, National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas' Hospital, Lambeth Palace Road, London, UK.
authors: Matthias
authors: M
authors: Paul
authors: Department of Biomedical Engineering and Physics, Academic Medical Centre, Amsterdam, The Netherlands.
authors: Pepijn
authors: P
authors: van Horssen
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London British Heart Foundation (BHF) Centre of Excellence, National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas' Hospital, Lambeth Palace Road, London, UK.
authors: Shazia T
authors: ST
authors: Hussain
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London British Heart Foundation (BHF) Centre of Excellence, National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas' Hospital, Lambeth Palace Road, London, UK King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
authors: Divaka
authors: D
authors: Perera
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London British Heart Foundation (BHF) Centre of Excellence, National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas' Hospital, Lambeth Palace Road, London, UK.
authors: Tobias
authors: T
authors: Schaeffter
authors: Department of Biomedical Engineering and Physics, Academic Medical Centre, Amsterdam, The Netherlands.
authors: Jos A E
authors: JA
authors: Spaan
authors: Department of Biomedical Engineering and Physics, Academic Medical Centre, Amsterdam, The Netherlands.
authors: Maria
authors: M
authors: Siebes
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London British Heart Foundation (BHF) Centre of Excellence, National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas' Hospital, Lambeth Palace Road, London, UK Division of Cardiovascular Imaging, Goethe University Frankfurt and German Centre for Cardiovascular Research (DZHK, Partner Site Rhine-Main), Frankfurt, Germany.
authors: Eike
authors: E
authors: Nagel
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London British Heart Foundation (BHF) Centre of Excellence, National Institute of Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre, The Rayne Institute, St. Thomas' Hospital, Lambeth Palace Road, London, UK.
authors: Amedeo
authors: A
authors: Chiribiri
mesh_terms: D000465:Algorithms; D000818:Animals; D001783:Blood Flow Velocity; D003287:Contrast Media; D003326:Coronary Circulation / Q000502:physiology*; D005240:Feasibility Studies; D006940:Hyperemia / Q000503:physiopathology; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008863:Microspheres; D023421:Models, Animal; D009942:Organometallic Compounds; D059629:Signal-To-Noise Ratio; D013552:Swine
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol
keywords: Isolated heart perfusion; cardiovascular magnetic resonance imaging; fermi deconvolution; microspheres; myocardial perfusion imaging; voxel-wise quantification