A quality assurance pipeline for quantitative cardiovascular magnetic resonance myocardial perfusion imaging in myofit46

Abstract Background Quantitative cardiovascular magnetic resonance (CMR) myocardial perfusion imaging is a widely employed technique in both clinical and research settings, but a detailed quality assurance (QA) framework for its analysis is lacking. Purpose To develop and implement a comprehensive QA process for quantitative CMR stress perfusion imaging in MyoFit46–the cardiovascular sub-study of the National Survey of Health and Development. Methods 505 participants were prospectively recruited to undergo quantitative stress and rest perfusion CMR in MyoFit46, using adenosine as the stress agent and the dual cannulation method by default. Stress adequacy was assessed based on heart rate (HR), blood pressure (BP), oxygen saturation (SpO2), symptomatology and splenic switch off. QA also involved global hyperaemia grading of stress in-line maps and assessment of RR interval stability, arterial input function (AIF) curves, artefacts and respiratory excursion (full protocol in Figure 1). QA parameters were compared between sexes and between cannulation setups (dual vs single). Results 484 participants (76.28±0.81 years; male=271) completed CMR, of which 444 completed both rest and stress perfusion imaging, and 62.5% were fitted with two cannulas. All response variables differed between stress and rest, including increased HR and SpO2 (respectively 81 vs 64bpm; 98 vs 97%; both p