Comparison between quantitative cardiac magnetic resonance perfusion imaging and [15O]H2O positron emission tomography

Figures

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  Fig. 1. Case example of concordance between CMR and [15O]H2O PET in a 71-year-old female patient who presented with typical angina. Short-axis slices at the basal, mid, and apical levels have been selected from the PET study in order to match CMR and PET images. Both CMR and [15O]H2O PET demonstrate a perfusion defect in the inferior wall stretching from base to apex. With both techniques, the measured stress MBF and MFR in the vascular territory of the RCA are well below the ischemic thresholds. CMR = cardiac magnetic resonance imaging; LAD = left anterior descending artery; LCx = left circumflex artery; MBF = myocardial blood flow; MFR = myocardial flow reserve; PET = positron emission tomography; RCA = right coronary artery

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  Fig. 2. Global perfusion. Scatter (left) and Bland-Altman (right) plots demonstrating the relationship between CMR and [15O]H2O PET measurements of global rest MBF (top) and stress MBF (middle) and MFR (bottom). In the Bland-Altman plots, the solid red line indicates the mean bias, and the dashed black lines indicate the limits of agreement. Abbreviations as in Fig. 1

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  Fig. 3. Regional perfusion. Scatter (left) and Bland-Altman (right) plots comparing CMR and [15O]H2O PET measurements of rest MBF (top) and stress MBF (middle) and MFR (bottom) on a per-vessel basis. In the scatter plots of stress MBF and MFR, the dashed black lines indicate the thresholds for abnormal myocardial perfusion. Stress MBF and MFR correlate significantly between CMR and [15O]H2O PET (r = 0.39; P < 0.001 for stress MBF and r = 0.36; P < 0.001 for MFR). In the Bland-Altman plots, the solid red line indicates the mean bias, and the dashed black lines indicate the limits of agreement. Abbreviations as in Fig. 1

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  Fig. 4. ROC curves for detecting abnormal regional perfusion. ROC curves of CMR derived stress MBF (left) and MFR (right) for detecting abnormal regional perfusion defined as [15O]H2O PET-derived stress MBF ≤2.30 and MFR ≤2.50. AUC = area under the curve; ROC = receiver operating characteristic; other abbreviations as in Fig. 1