title: Quantification of myocardial perfusion with self-gated cardiovascular magnetic resonance.
abstract: BACKGROUND
  Current myocardial perfusion measurements make use of an ECG-gated pulse sequence to track the uptake and washout of a gadolinium-based contrast agent. The use of a gated acquisition is a problem in situations with a poor ECG signal. Recently, an ungated perfusion acquisition was proposed but it is not known how accurately quantitative perfusion estimates can be made from such datasets that are acquired without any triggering signal.
  
  
  METHODS
  An undersampled saturation recovery radial turboFLASH pulse sequence was used in 7 subjects to acquire dynamic contrast-enhanced images during free-breathing. A single saturation pulse was followed by acquisition of 4-5 slices after a delay of ~40 msec. This was repeated without pause and without any type of gating. The same pulse sequence, with ECG-gating, was used to acquire gated data as a ground truth. An iterative spatio-temporal constrained reconstruction was used to reconstruct the undersampled images. After reconstruction, the ungated images were retrospectively binned ("self-gated") into two cardiac phases using a region of interest based technique and deformably registered into near-systole and near-diastole. The gated and the self-gated datasets were then quantified with standard methods.
  
  
  RESULTS
  Regional myocardial blood flow estimates (MBFs) obtained using self-gated systole (0.64 ± 0.26 ml/min/g), self-gated diastole (0.64 ± 0.26 ml/min/g), and ECG-gated scans (0.65 ± 0.28 ml/min/g) were similar. Based on the criteria for interchangeable methods listed in the statistical analysis section, the MBF values estimated from self-gated and gated methods were not significantly different.
  
  
  CONCLUSIONS
  The self-gated technique for quantification of regional myocardial perfusion matched ECG-gated perfusion measurements well in normal subjects at rest. Self-gated systolic perfusion values matched ECG-gated perfusion values better than did diastolic values.
authors.forename: Devavrat
authors.initials: D
authors.lastname: Likhite
authors.forename: Ganesh
authors.initials: G
authors.lastname: Adluru
authors.forename: Nan
authors.initials: N
authors.lastname: Hu
authors.forename: Chris
authors.initials: C
authors.lastname: McGann
authors.forename: Edward
authors.initials: E
authors.lastname: DiBella
mesh_terms: D001783:Blood Flow Velocity; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media; D003326:Coronary Circulation; D004562:Electrocardiography; D005682:Gadolinium; D064368:Healthy Volunteers; D006571:Heterocyclic Compounds; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D009200:Myocardial Contraction; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D012119:Respiration
chemical_list: D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C062402:gadoteridol; D005682:Gadolinium
references.citation: J Magn Reson Imaging. 2006 Nov;24(5):1062-70
references.pmid: 17031818
references.citation: Magn Reson Med. 2006 Oct;56(4):844-9
references.pmid: 16941620
references.citation: J Biopharm Stat. 2007;17(4):571-82
references.pmid: 17613642
references.citation: Med Image Anal. 2008 Feb;12(1):26-41
references.pmid: 17659998
references.citation: J Magn Reson Imaging. 2008 Apr;27(4):793-801
references.pmid: 18302205
references.citation: J Magn Reson Imaging. 2008 Apr;27(4):818-24
references.pmid: 18383259
references.citation: J Magn Reson Imaging. 2008 Jun;27(6):1271-7
references.pmid: 18421683
references.citation: Magn Reson Med. 2008 Jun;59(6):1373-7
references.pmid: 18506802
references.citation: Magn Reson Med. 2008 Sep;60(3):683-90
references.pmid: 18727084
references.citation: J Biopharm Stat. 2009;19(1):150-73
references.pmid: 19127473
references.citation: J Magn Reson Imaging. 2009 Feb;29(2):466-73
references.pmid: 19161204
references.citation: Magn Reson Med. 2010 May;63(5):1230-7
references.pmid: 20432294
references.citation: Magn Reson Med. 2010 Jul;64(1):125-37
references.pmid: 20577976
references.citation: Magn Reson Med. 2010 Dec;64(6):1696-703
references.pmid: 20928890
references.citation: Magn Reson Imaging. 2011 Feb;29(2):160-6
references.pmid: 21129878
references.citation: J Cardiovasc Magn Reson. 2011;13:28
references.pmid: 21609423
references.citation: Radiology. 2012 Mar;262(3):816-23
references.pmid: 22357884
references.citation: Magn Reson Med. 2013 Jan;69(1):158-62
references.pmid: 22392645
references.citation: Phys Med Biol. 2013 Oct 21;58(20):7309-27
references.pmid: 24077063
references.citation: J Cardiovasc Magn Reson. 2013;15:26
references.pmid: 23537093
references.citation: Magn Reson Med. 2015 May;73(5):1764-74
references.pmid: 24806049
references.citation: Magn Reson Med. 2015 Sep;74(3):765-71
references.pmid: 25227935
references.citation: Med Phys. 2002 May;29(5):886-97
references.pmid: 12033585
references.citation: Magn Reson Med. 2004 Jan;51(1):93-102
references.pmid: 14705049
references.citation: J Magn Reson Imaging. 2004 Jul;20(1):39-45
references.pmid: 15221807
references.citation: Magn Reson Med. 2004 Oct;52(4):782-8
references.pmid: 15389958
references.citation: Invest Radiol. 1987 Jan;22(1):17-22
references.pmid: 3818232
references.citation: Magn Reson Med. 1988 Feb;6(2):240-5
references.pmid: 3367781
references.citation: Magn Reson Med. 1988 Sep;8(1):84-8
references.pmid: 3173072
references.citation: J Magn Reson Imaging. 1997 Jan-Feb;7(1):91-101
references.pmid: 9039598
references.citation: J Magn Reson Imaging. 1997 Jan-Feb;7(1):102-10
references.pmid: 9039599
references.citation: Magn Reson Med. 1997 Dec;38(6):981-9
references.pmid: 9402200
references.citation: Med Phys. 1998 Jan;25(1):73-84
references.pmid: 9472829
references.citation: IEEE Trans Biomed Eng. 1998 Feb;45(2):160-4
references.pmid: 9473839
references.citation: Magn Reson Med. 1999 Aug;42(2):361-70
references.pmid: 10440961
references.citation: Circulation. 2005 Nov 22;112(21):3289-96
references.pmid: 16286587
references.citation: J Am Coll Cardiol. 2006 Feb 7;47(3):565-72
references.pmid: 16458137
references.citation: J Magn Reson Imaging. 2006 Mar;23(3):323-30
references.pmid: 16456820
references.citation: J Magn Reson Imaging. 2006 Mar;23(3):315-22
references.pmid: 16463299
references.citation: J Cardiovasc Magn Reson. 2007;9(3):525-37
references.pmid: 17365232