Quantitative First-Pass Perfusion CMR: from technical principles to clinical practice

TL;DR

This paper reviews the principles and clinical applications of quantitative first-pass myocardial perfusion CMR, highlighting recent advances including AI-based methods for improved analysis and diagnosis of coronary artery disease.

Contribution

It provides a comprehensive overview of the technical and clinical aspects of quantitative pCMR, including new automated and AI-driven tools for analysis.

Findings

Quantitative pCMR offers more reliable, observer-independent analysis.

Emerging AI tools are enhancing image reconstruction and motion correction.

The review discusses protocols and pipelines for clinical implementation.

Abstract

Myocardial perfusion cardiovascular magnetic resonance (pCMR) using first-pass contrast-enhanced imaging could play an important role in the detection of epicardial and microvascular coronary artery disease. Recently, the emergence of quantitative pCMR has provided a more reliable and observer-independent analysis compared to visual interpretation of dynamic images. This review aims to cover the basics of quantitative pCMR, from acquisition protocols, its use in preclinical and clinical studies, image reconstruction and motion handling, to automated quantitative pCMR pipelines. It also offers an overview of emerging tools in the field, including artificial intelligence-based methods.