The diagnostic accuracy of model-based quantitative perfusion cardiac MR at 3.0T for the detection of flow-limiting coronary artery disease

Motivation: Model-based quantitative myocardial perfusion MRI is feasible. However, few studies have investigated its diagnostic accuracy in detecting significant coronary artery disease (CAD). Goal(s): To evaluate the diagnostic accuracy of quantitative stress myocardial perfusion MRI using Patlak plot method for the detection of significant CAD. Approach: Myocardial blood flow (MBF) and myocardial flow reserve (MFR) determined by Patlak analysis of stress perfusion MRI with LV blood saturation correction were compared with fractional flow reserve. Results: Model-based quantitative stress perfusion MRI has a high diagnostic accuracy for detecting significant CAD with the AUC of 0.739 and 0.745 for stress MBF and MFR, respectively. Impact: Absolute quantification of myocardial blood flow and myocardial flow reserve by stress-rest myocardial perfusion MRI with model-based approach permits accurate and objective assessment of myocardial ischemia due to flow-limiting obstructive coronary artery disease, which can aid daily routine clinical practice.