Myocardial first-pass perfusion magnetic resonance imaging: A multicenter dose-ranging study

S. D. Wolff, J. Schwitter, R. Coulden, M. G. Friedrich, D. A. Bluemke, R. W. Biederman, E. T. Martin, A. J. Lansky, F. Kashanian, T. K.F. Foo, P. E. Licato, C. R. Comeau

Research output: Contribution to journalArticlepeer-review

Abstract

Background-MRI can identify patients with obstructive coronary artery disease by imaging the left ventricular myocardium during a first-pass contrast bolus in the presence and absence of pharmacologically induced myocardial hyperemia. The purpose of this multicenter dose-ranging study was to determine the minimally efficacious dose of gadopentetate dimeglumine injection (Magnevist Injection; Berlex Laboratories) for detecting obstructive coronary artery disease. Method and Results-A total of 99 patients scheduled for coronary artery catheterization as part of their clinical evaluation were enrolled in this study. Patients were randomized to 1 of 3 doses of gadopentate dimeglumine: 0.05, 0.10, or 0.15 mmol/kg. First-pass perfusion imaging was performed during hyperemia (induced by a 4-minute infusion of adenosine at a rate of 140 μg · kg-1 · min-1) and then again in the absence of adenosine with otherwise identical imaging parameters and the same contrast dose. Perfusion defects were evaluated subjectively by 4 blinded reviewers. Receiver-operating curve analysis showed that the areas under the receiver-operating curve were 0.90, 0.72, and 0.83 for the low-, medium-, and high-contrast doses, respectively, compared with quantitative coronary angiography (diameter stenosis ≥70%). For the low-dose group, mean sensitivity was 93±0%, mean specificity was 75±7%, and mean accuracy was 85±3%. Conclusions-First-pass perfusion MRI is a safe and accurate test for identifying patients with obstructive coronary artery disease. A low dose of 0.05 mmol/kg gadopentetate dimeglumine is at least as efficacious as higher doses.

Original languageEnglish (US)
Pages (from-to)732-737
Number of pages6
JournalCirculation
Volume110
Issue number6
DOIs
StatePublished - Aug 10 2004

Keywords

  • Adenosine
  • Contrast media
  • Ischemia
  • Magnetic resonance imaging
  • Perfusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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