title: Multicenter evaluation of dynamic three-dimensional magnetic resonance myocardial perfusion imaging for the detection of coronary artery disease defined by fractional flow reserve.
abstract: BACKGROUND
  First-pass myocardial perfusion cardiovascular magnetic resonance (CMR) imaging yields high diagnostic accuracy for the detection of coronary artery disease (CAD). However, standard 2D multislice CMR perfusion techniques provide only limited cardiac coverage, and hence considerable assumptions are required to assess myocardial ischemic burden. The aim of this prospective study was to assess the diagnostic performance of 3D myocardial perfusion CMR to detect functionally relevant CAD with fractional flow reserve (FFR) as a reference standard in a multicenter setting.
  
  
  RESULTS
  A total of 155 patients with suspected CAD listed for coronary angiography with FFR were prospectively enrolled from 5 European centers. 3D perfusion CMR was acquired on 3T MR systems from a single vendor under adenosine stress and at rest. All CMR perfusion analyses were performed in a central laboratory and blinded to all clinical data. One hundred fifty patients were successfully examined (mean age 62.9±10 years, 45 female). The prevalence of CAD defined by FFR (<0.8) was 56.7% (85 of 150 patients). The sensitivity and specificity of 3D perfusion CMR were 84.7% and 90.8% relative to the FFR reference. Comparison to quantitative coronary angiography (≥50%) yielded a prevalence of 65.3%, sensitivity and specificity of 76.5% and 94.2%, respectively.
  
  
  CONCLUSIONS
  In this multicenter study, 3D myocardial perfusion CMR proved highly diagnostic for the detection of significant CAD as defined by FFR.
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Robert
authors.initials: R
authors.lastname: Manka
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Lukas
authors.initials: L
authors.lastname: Wissmann
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Rolf
authors.initials: R
authors.lastname: Gebker
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Roy
authors.initials: R
authors.lastname: Jogiya
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Manish
authors.initials: M
authors.lastname: Motwani
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Michael
authors.initials: M
authors.lastname: Frick
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Sebastian
authors.initials: S
authors.lastname: Reinartz
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schnackenburg
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Markus
authors.initials: M
authors.lastname: Niemann
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Alexander
authors.initials: A
authors.lastname: Gotschy
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Christiane
authors.initials: C
authors.lastname: Kuhl
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Eike
authors.initials: E
authors.lastname: Nagel
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Eckart
authors.initials: E
authors.lastname: Fleck
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Marx
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Luescher
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.).
authors.forename: Sven
authors.initials: S
authors.lastname: Plein
authors.affiliation: From the University and ETH Zurich, Zurich, Switzerland (R.M., L.W., S.K.); University Heart Center, University Hospital Zurich, Zurich, Switzerland (R.M., M.N., A.G., T.F.L.); German Heart Institute, Berlin, Germany (R.G., B.S., E.F.); King's College London, London, United Kingdom (R.J., E.N.); University of Leeds, Leeds, United Kingdom (M.M., S.P.); and University Hospital RWTH Aachen, Germany (M.F., S.R., C.K., N.M.). kozerke@biomed.ee.ethz.ch.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kozerke
mesh_terms: D000241:Adenosine; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology; D003326:Coronary Circulation; D005060:Europe; D005080:Exercise Test; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000241:Adenosine
keywords: coronary artery disease; fractional flow reserve; magnetic resonance imaging; multicenter study; myocardial perfusion