Assessment of myocardial perfusion with MRI using a modified dual bolus method

Quantification of regional myocardial blood flow (rMBF) with first-pass magnetic resonance imaging (FP-MRI) requires two contrast agent injections (dual bolus technique), inducing error in the determined rMBF if the injections differ. We hypothesize that using input and residue curves of the same injection would be more reliable. We aim to introduce and evaluate a novel method to correct the high concentration arterial input function (AIF) for determination of rMBF. Sixteen patients with non-Hodgkin's lymphoma were examined before and after chemotherapy. The input function was solved by correcting initial high concentration AIF using the ratio of low and high contrast AIF areas, normalized by corresponding heart rates (modified dual bolus method). For comparison, the scaled low contrast AIF was used as an input function (dual bolus method). Unidirectional transfer coefficient K^trans was calculated using both methods. K^trans-values determined with the dual bolus (0.81 ± 0.32 ml g⁻¹ min⁻¹) and modified dual bolus (0.77 ± 0.42 ml g⁻¹ min⁻¹) methods were in agreement (p = 0.21). Mean K^trans-values increased from 0.76 ± 0.43 to 0.89 ± 0.55 ml g⁻¹ min⁻¹ after chemotherapy (p = 0.17). The modified dual bolus technique agrees with the dual bolus technique (R2 = 0.899) when the low and high contrast injections are similar. However, when this is not the case, the modified dual bolus technique may be more reliable. (paper)