Voxel-wise quantification of myocardial perfusion by cardiac magnetic resonance. Feasibility and methods comparison.

The purpose of this study is to enable high spatial resolution voxel-wise quantitative analysis of myocardial perfusion in dynamic contrast-enhanced cardiovascular MR, in particular by finding the most favorable quantification algorithm in this context. Four deconvolution algorithms--Fermi function modeling, deconvolution using B-spline basis, deconvolution using exponential basis, and autoregressive moving average modeling--were tested to calculate voxel-wise perfusion estimates. The algorithms were developed on synthetic data and validated against a true gold-standard using a hardware perfusion phantom. The accuracy of each method was assessed for different levels of spatial averaging and perfusion rate. Finally, voxel-wise analysis was used to generate high resolution perfusion maps on real data acquired from five patients with suspected coronary artery disease and two healthy volunteers. On both synthetic and perfusion phantom data, the B-spline method had the highest error in estimation of myocardial blood flow. The autoregressive moving average modeling and exponential methods gave accurate estimates of myocardial blood flow. The Fermi model was the most robust method to noise. Both simulations and maps in the patients and hardware phantom showed that voxel-wise quantification of myocardium perfusion is feasible and can be used to detect abnormal regions.