Abstract
Dynamic contrast enhanced CT has been successfully applied in cardiac imaging for the estimation of myocardial blood flow (MBF). In general, these acquisitions impart a relatively high radiation dose because they require continuous or gated imaging of the heart for 15-40 seconds. At present, there is no consensus on the appropriate estimation method to derive MBF and on the appropriate acquisition technique to minimize dose while maintaining MBF estimation accuracy and precision. This work explores the tradeoff of accuracy and precision of MBF estimates with several estimation methods and acquisition techniques in support of the fundamental goal of optimizing dynamic cardiac CT in terms of radiation dose and MBF estimation fidelity. We simulated time attenuation curves (TACs) for a range of flow states (Flow = [0.8, 1.6, 2.4, 3.2] ml/g/min) and several acquisition techniques. We estimated MBF with 5 different methods for each simulated TAC. From multiple independent realizations, we assessed the accuracy and precision of each method. Results show that acquisition techniques with 1/3 tube current or 1/3 temporal sampling permits accurate MBF estimates with most methods with reduction in MBF estimate precision by on average 30%. Furthermore, reduction in model complexity can be beneficial for improving the precision of MBF estimates.