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Purpose The purpose of this study was to further develop and combine several innovative sequence designs to achieve quantitative 3D myocardial perfusion. These developments include an optimized 3D stack-of-stars readout (150 ms per beat), efficient acquisition of a 2D arterial input function, tailored saturation pulse design, and potential whole heart coverage during quantitative stress perfusion. Theory and methods All studies were performed free-breathing on a Prisma 3T MRI scanner. Phantom validation was used to verify sequence accuracy. A total of 21 subjects (3 patients with known disease) were scanned, 12 with a rest only protocol and 9 with both stress (regadenoson) and rest protocols. First pass quantitative perfusion was performed with gadoteridol (0.075 mmol/kg). Results Implementation and quantitative perfusion results are shown for healthy subjects and subjects with known coronary disease. Average rest perfusion for the 15 included healthy subjects was 0.79 ± 0.19 mL/g/min, the average stress perfusion for 6 healthy subject studies was 2.44 ± 0.61 mL/g/min, and the average global myocardial perfusion reserve ratio for 6 healthy subjects was 3.10 ± 0.24. Perfusion deficits for 3 patients with ischemia are shown. Average resting heart rate was 59 ± 7 bpm and the average stress heart rate was 81 ± 10 bpm. Conclusion This work demonstrates that a quantitative 3D myocardial perfusion sequence with the acquisition of a 2D arterial input function is feasible at high stress heart rates such as during stress. T1 values and gadolinium concentrations of the sequence match the reference standard well in a phantom, and myocardial rest and stress perfusion and myocardial perfusion reserve values are consistent with those published in literature.

Purpose To evaluate the use of three different pre-reconstruction interpolation methods to convert non-Cartesian k-space data to Cartesian samples such that iterative reconstructions can be performed more simply and more rapidly. Methods Phantom as well as cardiac perfusion radial datasets were reconstructed by four different methods. Three of the methods used pre-reconstruction interpolation once followed by a fast Fourier transform (FFT) at each iteration. The methods were: bilinear interpolation of nearest-neighbor points (BINN), 3-point interpolation, and a multi-coil interpolator called GRAPPA Operator Gridding (GROG). The fourth method performed a full non-Uniform FFT (NUFFT) at each iteration. An iterative reconstruction with spatiotemporal total variation constraints was used with each method. Differences in the images were quantified and compared. Results The GROG multi-coil interpolation, the 3-point interpolation, and the NUFFT-at-each-iteration approaches produced high quality images compared to BINN, with the GROG-derived images having the fewest streaks among the three pre-interpolation approaches. However, all reconstruction methods produced approximately equal results when applied to perfusion quantitation tasks. Pre-reconstruction interpolation gave approximately an 83% reduction in reconstruction time. Conclusion Image quality suffers little from using a pre-reconstruction interpolation approach compared to the more accurate NUFFT-based approach. GROG-based pre-reconstruction interpolation appears to offer the best compromise by using multi-coil information to perform the interpolation to Cartesian sample points prior to image reconstruction. Speed gains depend on the implementation and relatively standard optimizations on a MATLAB platform result in pre-interpolation speedups of ~6 compared to using NUFFT at every iteration, reducing the reconstruction time from around 42 minutes to 7 minutes. This article is protected by copyright. All rights reserved.