Sanchez-Gonzalez, JavierFernandez-Jimenez, RodrigoNothnagel, Nils D.Lopez-Martin, Gonzalo J.Fuster, ValentinIbáñez, Borja2017-12-012017-12-012015J Cardiovasc Magn Reson. 2015; 17(1):1161097-6647http://hdl.handle.net/20.500.12105/5515Background: In-vivo quantification of cardiac perfusion is of great research and clinical value. The dual-bolus strategy is universally used in clinical protocols but has known limitations. The dual-saturation acquisition strategy has been proposed as a more accurate alternative, but has not been validated across the wide range of perfusion rates encountered clinically. Dual-saturation acquisition also lacks a clinically-applicable procedure for optimizing parameter selection. Here we present a comprehensive validation study of dual-saturation strategy in vitro and in vivo. Methods: The impact of saturation time and profile ordering in acquisitions was systematically analyzed in a phantom consisting of 15 tubes containing different concentrations of contrast agent. In-vivo experiments in healthy pigs were conducted to evaluate the effect of R2{*} on the definition of the arterial input function (AIF) and to evaluate the relationship between R2{*} and R1 variations during first-pass of the contrast agent. Quantification by dual-saturation perfusion was compared with the reference-standard dual-bolus strategy in 11 pigs with different grades of myocardial perfusion. Results: Adequate flow estimation by the dual-saturation strategy is achieved with myocardial tissue saturation times around 100 ms (always < 30 ms of AIF), with the lowest echo time, and following a signal model for contrast conversion that takes into account the residual R2{*} effect and profile ordering. There was a good correlation and agreement between myocardial perfusion quantitation by dual-saturation and dual-bolus techniques (R-2 = 0.92, mean difference of 0.1 ml/min/g; myocardial perfusion ranges between 0.18 and 3.93 ml/min/g). Conclusions: The dual-saturation acquisition strategy produces accurate estimates of absolute myocardial perfusion in vivo. The procedure presented here can be applied with minimal interference in standard clinical procedures.enghttp://creativecommons.org/licenses/by/4.0/Dual saturation acquisition strategyAbsolute quantitative cardiac perfusionCardiovascular magnetic resonanceCARDIOVASCULAR MAGNETIC-RESONANCECORONARY-ARTERY-DISEASENONINVASIVE DETECTIONT1 MEASUREMENTSINPUT FUNCTIONDOGSISCHEMIA/REPERFUSIONENHANCEMENTT2-ASTERISKRELAXATIONjournal articleAtribución 4.0 Internacional258809701710.1186/s12968-015-0116-21532-429XJournal of Cardiovascular Magnetic Resonanceopen access