Key result
In-bore 12-lead ECGs strongly correlate with reference ECGs and detect reduced stress flow with high NPV.
Why the study?
Standard MR scanner ECG devices suffer from signal distortion and narrow bandwidth, preventing QRS/QT measurement or ischaemic ST/T-wave detection.
Does in-bore 12-lead ECG reconstruction using novel post-processing software accurately replicate reference ECGs and detect ischaemia during adenosine stress perfusion in a 3T MR scanner?
Observational (n=26)
No
Does in-bore 12-lead ECG reconstruction using novel post-processing software accurately replicate reference ECGs and detect ischaemia during adenosine stress perfusion in a 3T MR scanner?
In-bore 12-lead ECG reconstruction during 3T CMR is feasible, correlates strongly with reference ECGs, and provides high negative predictive value for detecting inducible ischaemia.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for in-bore ECG monitoring in stress CMR; prospective validation needed before clinical adoption.
Background Electrocardiographic (ECG) devices in magnetic resonance (MR) scanners have a narrow bandwidth and suffer from signal distortion, preventing measurement of QRS/ QT durations, or detection of ST/ T-wave changes during ischaemia. We integrated an external device with novel post-processing software into a 3 Tesla (T) scanner to assess feasibility and accuracy for reconstructing 12-lead ECGs prior to and during adenosine infusion. Methods Reference 12-lead ECGs were first recorded outside the MR-environment. Using three MR-safe electrode patches, in-bore ECGs were then recorded prior to and during adenosine infusion. Post-processing removed artefacts and 12-lead ECGs were reconstructed from the raw signal using a subject-specific matrix. In-bore and reference ECGs were compared using Pearson's correlation coefficient on the PQRST waveform and by manual measurements of QRS and QT durations. Adenosine-induced ischaemic changes were compared with corresponding territories on stress perfusion maps. Results In 26 participants (70.8 ± 13.0 years; 34.6% female), in-bore ECGs were recorded without additional scan time. Reconstruction took < 2 min per participant. In-bore and reference ECGs were strongly correlated (r = 0.81, interquartile range 0.72-0.88), and mean differences in QRS and QT durations were small (-12.5 ms [95% limits of agreement - 42.5, 17.5 ms], and - 5.5 ms [-54.6, 43.6 ms] respectively). Ischaemic ECG changes during adenosine predicted stress myocardial blood flow (MBF) < 1.75 ml/g/min with sensitivity 91.7% (95% confidence interval 66.7, 100.0), specificity 59.3% (39.6, 77.6), positive predictive value (PPV) 33.3% (11.4, 57.7), negative predictive value (NPV) 97.0% (90.0, 100.0) and area under curve 0.74 (0.61, 0.86). Conclusion In this proof-of-concept study, in-bore ECGs correlated closely with reference ECGs. In-bore ECGs during stress perfusion have high specificity and NPV, but low sensitivity and PPV for predicting stress MBF < 1.5 ml/g/min. This may hold value for improving R-peak detection, patient monitoring and stress perfusion map interpretation.
No takes yet. Share an insight, caveat, or question.
Falconer et al. (2026) conducted an observational in Inducible myocardial perfusion defects (n=26). In-bore 12-lead ECG reconstruction vs. Out-of-bore reference 12-lead ECG was evaluated on Correlation of PQRST waveform between in-bore and reference ECGs (r = 0.81 (IQR 0.72-0.88)). In-bore 12-lead ECGs reconstructed during 3-Tesla MR scanning correlated strongly with reference out-of-bore ECGs and detected reduced stress myocardial blood flow with high negative predictive value.
Synapse has enriched 10 related papers. Consider them for comparative context: