Imperial College London

Professor MENGXING TANG

Faculty of EngineeringDepartment of Bioengineering

Professor of Biomedical Imaging
 
 
 
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Contact

 

+44 (0)20 7594 3664mengxing.tang Website

 
 
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Location

 

3.13Royal School of MinesSouth Kensington Campus

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Summary

 

Publications

Publication Type
Year
to

238 results found

Riemer K, Toulemonde M, Yan J, Lerendegui M, Stride E, Weinberg PD, Dunsby C, Tang M-Xet al., 2022, Fast and selective super-resolution ultrasound <i>in vivo</i> with acoustically activated nanodroplets, IEEE Transactions on Medical Imaging, Pages: 1-1, ISSN: 0278-0062

Journal article

Tang M, 2022, Super-resolution ultrasound localization microscopy of microvascular structure and flow for distinguishing metastatic lymph nodes – an initial human study, Ultraschall in der Medizin, ISSN: 0172-4614

Journal article

Lubel E, Sgambato BG, Barsakcioglu DY, Ibanez J, Tang M-X, Farina Det al., 2022, Kinematics of individual muscle units in natural contractions measured in vivo using ultrafast ultrasound, JOURNAL OF NEURAL ENGINEERING, Vol: 19, ISSN: 1741-2560

Journal article

Cudeiro-blanco J, Cueto C, Bates O, Strong G, Robins T, Toulemonde M, Warner M, Tang M-X, Agudo OC, Guasch Let al., 2022, DESIGN AND CONSTRUCTION OF A LOW-FREQUENCY ULTRASOUND ACQUISITION DEVICE FOR 2-D BRAIN IMAGING USING FULL-WAVEFORM INVERSION, ULTRASOUND IN MEDICINE AND BIOLOGY, Vol: 48, Pages: 1995-2008, ISSN: 0301-5629

Journal article

Yan J, Zhang T, Broughton-Venner J, Huang P, Tang Met al., 2022, Super-resolution ultrasound through sparsity-based deconvolution and multi-feature tracking, IEEE Transactions on Medical Imaging, Vol: 41, Pages: 1938-1947, ISSN: 0278-0062

Ultrasound super-resolution imaging through localisation and tracking of microbubbles can achieve sub-wave-diffraction resolution in mapping both micro-vascular structure and flow dynamics in deep tissue in vivo. Currently, it is still challenging to achieve high accuracy in localisation and tracking particularly with limited imaging frame rates and in the presence of high bubble concentrations. This study introduces microbubble image features into a Kalman tracking framework, and makes the framework compatible with sparsity-based deconvolution to address these key challenges. The performance of the method is evaluated on both simulations using individual bubble signals segmented from in vivo data and experiments on a mouse brain and a human lymph node. The simulation results show that the deconvolution not only significantly improves the accuracy of isolating overlapping bubbles, but also preserves some image features of the bubbles. The combination of such features with Kalman motion model can achieve a significant improvement in tracking precision at a low frame rate over that using the distance measure, while the improvement is not significant at the highest frame rate. The in vivo results show that the proposed framework generates SR images that are significantly different from the current methods with visual improvement, and is more robust to high bubble concentrations and low frame rates.

Journal article

Hirata S, Hagihara Y, Yoshida K, Yamaguchi T, Toulemonde MEG, Tang M-Xet al., 2022, Evaluation of contrast enhancement ultrasound images of Sonazoid microbubbles in tissue-mimicking phantom obtained by optimal Golay pulse compression, JAPANESE JOURNAL OF APPLIED PHYSICS, Vol: 61, ISSN: 0021-4922

Journal article

Cueto C, Bates O, Strong G, Cudeiro J, Luporini F, Calderón Agudo Ò, Gorman G, Guasch L, Tang M-Xet al., 2022, Stride: a flexible software platform for high-performance ultrasound computed tomography, Computer Methods and Programs in Biomedicine, Vol: 221, ISSN: 0169-2607

BACKGROUND AND OBJECTIVE: Advanced ultrasound computed tomography techniques like full-waveform inversion are mathematically complex and orders of magnitude more computationally expensive than conventional ultrasound imaging methods. This computational and algorithmic complexity, and a lack of open-source libraries in this field, represent a barrier preventing the generalised adoption of these techniques, slowing the pace of research, and hindering reproducibility. Consequently, we have developed Stride, an open-source Python library for the solution of large-scale ultrasound tomography problems. METHODS: On one hand, Stride provides high-level interfaces and tools for expressing the types of optimisation problems encountered in medical ultrasound tomography. On the other, these high-level abstractions seamlessly integrate with high-performance wave-equation solvers and with scalable parallelisation routines. The wave-equation solvers are generated automatically using Devito, a domain-specific language, and the parallelisation routines are provided through the custom actor-based library Mosaic. RESULTS: We demonstrate the modelling accuracy achieved by our wave-equation solvers through a comparison (1) with analytical solutions for a homogeneous medium, and (2) with state-of-the-art modelling software applied to a high-contrast, complex skull section. Additionally, we show through a series of examples how Stride can handle realistic numerical and experimental tomographic problems, in 2D and 3D, and how it can scale robustly from a local multi-processing environment to a multi-node high-performance cluster. CONCLUSIONS: Stride enables researchers to rapidly and intuitively develop new imaging algorithms and to explore novel physics without sacrificing performance and scalability. This will lead to faster scientific progress in this field and will significantly ease clinical translation.

Journal article

Zhou X, Wang Y, Li Y, Zhao Y, Shan T, Gong X, Li F, Tang M-X, Wang Zet al., 2022, Acoustic Beam Mapping for Guiding HIFU Therapy In Vivo Using Sub-Therapeutic Sound Pulse and Passive Beamforming, IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, Vol: 69, Pages: 1663-1673, ISSN: 0018-9294

Journal article

Bates O, Guasch L, Strong G, Robins TC, Calderon-Agudo O, Cueto C, Cudeiro J, Tang Met al., 2022, A probabilistic approach to tomography and adjoint state methods, with an application to full waveform inversion in medical ultrasound, INVERSE PROBLEMS, Vol: 38, ISSN: 0266-5611

Journal article

Weinberg P, Riemer K, Rowland E, Broughton-Venner J, Leow CH, Tang Met al., 2022, Contrast agent free assessment of blood flow and wall shear stress in the rabbit aorta using ultrasound image velocimetry, Ultrasound in Medicine and Biology, Vol: 48, Pages: 437-449, ISSN: 0301-5629

Blood flow velocity and wall shear stress (WSS) influence and are influencedby vascular disease. Their measurement is consequently useful in the laboratory and clinic. Contrast enhanced ultrasound image velocimetry (UIV) canestimate them accurately but the need to inject contrast agents limits utility. Singular value decomposition and high frame rate imaging may rendercontrast agents dispensable. Here we determined whether contrast agent freeUIV can measure flow and WSS. In simulation, accurate measurements wereachieved with a signal-to-noise ratio of 13.5 dB or higher. Signal intensity inthe rabbit aorta increased monotonically with mechanical index and was lowest during stagnant flow and uneven across the vessel. In vivo measurementswith contrast free and contrast enhanced UIV differed by 4.4 % and 1.9 % forvelocity magnitude and angle and by 9.47 % for WSS. Bland–Altman analysis of waveforms showed good agreement between contrast free and contrast enhanced UIV. In five rabbits the root-mean-square error was as low as 0.022m/s (0.81 %) and 0.11 Pa (1.7 %). This study demonstrates that with anoptimised protocol, UIV can assess flow and WSS without contrast agents.Unlike contrast enhanced UIV, it could be routinely employed.

Journal article

Cueto C, Guasch L, Cudeiro J, Agudo OC, Robins T, Bates O, Strong G, Tang M-Xet al., 2022, Spatial response identification enables robust experimental ultrasound computed tomography, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control, Vol: 69, Pages: 27-37, ISSN: 0885-3010

Ultrasound computed tomography techniques have the potential to provide clinicians with 3-D, quantitative and high-resolution information of both soft and hard tissues such as the breast or the adult human brain. Their practical application requires accurate modeling of the acquisition setup: the spatial location, orientation, and impulse response (IR) of each ultrasound transducer. However, the existing calibration methods fail to accurately characterize these transducers unless their size can be considered negligible when compared with the dominant wavelength, which reduces signal-to-noise ratios below usable levels in the presence of high-contrast tissues such as the skull. In this article, we introduce a methodology that can simultaneously estimate the location, orientation, and IR of the ultrasound transducers in a single calibration. We do this by extending spatial response identification (SRI), an algorithm that we have recently proposed to estimate transducer IRs. Our proposed methodology replaces the transducers in the acquisition device with a surrogate model whose effective response matches the experimental data by fitting a numerical model of wave propagation. This results in a flexible and robust calibration procedure that can accurately predict the behavior of the ultrasound acquisition device without ever having to know where the real transducers are or their individual IR. Experimental results using a ring acquisition system show that SRI produces calibrations of significantly higher quality than standard methodologies across all transducers, both in transmission and in reception. Experimental full-waveform inversion (FWI) reconstructions of a tissue-mimicking phantom demonstrate that SRI generates more accurate reconstructions than those produced with standard calibration techniques.

Journal article

Reavette RM, Sherwin SJ, Tang M-X, Weinberg PDet al., 2021, Wave intensity analysis combined with machine learning can detect impaired stroke volume in simulations of heart failure, Frontiers in Bioengineering and Biotechnology, Vol: 9, Pages: 1-13, ISSN: 2296-4185

Heart failure is treatable, but in the United Kingdom, the 1-, 5- and 10-year mortality rates are 24.1, 54.5 and 75.5%, respectively. The poor prognosis reflects, in part, the lack of specific, simple and affordable diagnostic techniques; the disease is often advanced by the time a diagnosis is made. Previous studies have demonstrated that certain metrics derived from pressure-velocity-based wave intensity analysis are significantly altered in the presence of impaired heart performance when averaged over groups, but to date, no study has examined the diagnostic potential of wave intensity on an individual basis, and, additionally, the pressure waveform can only be obtained accurately using invasive methods, which has inhibited clinical adoption. Here, we investigate whether a new form of wave intensity based on noninvasive measurements of arterial diameter and velocity can detect impaired heart performance in an individual. To do so, we have generated a virtual population of two-thousand elderly subjects, modelling half as healthy controls and half with an impaired stroke volume. All metrics derived from the diameter-velocity-based wave intensity waveforms in the carotid, brachial and radial arteries showed significant crossover between groups-no one metric in any artery could reliably indicate whether a subject's stroke volume was normal or impaired. However, after applying machine learning to the metrics, we found that a support vector classifier could simultaneously achieve up to 99% recall and 95% precision. We conclude that noninvasive wave intensity analysis has significant potential to improve heart failure screening and diagnosis.

Journal article

Braga M, Leow CH, Gil JH, Teh JH, Carroll L, Long NJ, Tang M-X, Aboagye EOet al., 2021, Investigating CXCR4 expression of tumor cells and the vascular compartment: A multimodal approach, PLOS ONE, Vol: 16, ISSN: 1932-6203

Journal article

Zhou X, Toulemonde M, Zhou X, Hansen-Shearer J, Senior R, Tang M-Xet al., 2021, Volumetric Flow Estimation in a Coronary Artery Phantom Using High-Frame-Rate Contrast-Enhanced Ultrasound, Speckle Decorrelation, and Doppler Flow Direction Detection, IEEE TRANSACTIONS ON ULTRASONICS FERROELECTRICS AND FREQUENCY CONTROL, Vol: 68, Pages: 3299-3308, ISSN: 0885-3010

Journal article

Hansen-Shearer J, Lerendegui M, Toulemonde M, Tang Met al., 2021, Ultrafast 3D ultrasound imaging using row-column array specific Frame-Multiply-and-Sum beamforming, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control, Vol: 69, Pages: 480-488, ISSN: 0885-3010

Row-column arrays have been shown to be able to generate 3-D ultrafast ultrasound images with an order of magnitude less independent electronic channels than traditional 2-D matrix arrays. Unfortunately, row-column array images suffer from major imaging artefacts due to high side-lobes, particularly when operating at high frame rates. This paper proposes a rowcolumn specific beamforming technique, for orthogonal plane wave transmissions, that exploits the incoherent nature of certain row-column array artefacts. A series of volumetric images are produced using row or column transmissions of 3-D plane waves. The voxel-wise geometric mean of the beamformed volumetric images from each row and column pair is taken prior to compounding, which drastically reduces the incoherent imaging artefacts in the resulting image compared to traditional coherent compounding. The effectiveness of this technique was demonstrated in silico and in vitro, and the results show a significant reduction in side-lobe level with over 16 dB improvement in sidelobe to main-lobe energy ratio. Significantly improved contrast was demonstrated with contrast ratio increased by ∼10dB and generalised contrast-to-noise ratio increased by 158% when using the proposed new method compared to existing delay and sum during in vitro studies. The new technique allowed for higher quality 3-D imaging whilst maintaining high frame rate potential

Journal article

Teh JH, Braga M, Allott L, Barnes C, Hernandez-Gil J, Tang M-X, Aboagye EO, Long NJet al., 2021, A kit-based aluminium-[F-18]fluoride approach to radiolabelled microbubbles, CHEMICAL COMMUNICATIONS, Vol: 57, Pages: 11677-11680, ISSN: 1359-7345

Journal article

Morris M, Toulemonde M, Sinnett V, Allen S, Downey K, Tunariu N, Lucy C, Gothard L, Hopkinson G, Scurr E, Harris E, Tang M, Blackledge M, Somaiah Net al., 2021, Super-resolution ultrasound and MRI imaging for monitoring breast tumour response to radiotherapy, Publisher: ELSEVIER IRELAND LTD, Pages: S660-S661, ISSN: 0167-8140

Conference paper

Hirata S, Leow CH, Toulemonde MEG, Tang M-Xet al., 2021, Selection on Golay complementary sequences in binary pulse compression for microbubble detection, JAPANESE JOURNAL OF APPLIED PHYSICS, Vol: 60, ISSN: 0021-4922

Journal article

Peralta L, Hajnal J, Tang M-X, Christensen-Jeffries Ket al., 2021, Effects of Aberration on Super-Resolution Ultrasound Imaging using Microbubbles, IEEE International Ultrasonics Symposium (IEEE IUS), Publisher: IEEE, ISSN: 1948-5719

Conference paper

Dumas R, Riemer K, Toulemonde M, Lerendegui M, Weinberg PD, Tang M-X, Varray Fet al., 2021, 4D ultrafast blood flow imaging comparison: vector Doppler, transverse oscillation and speckle tracking, IEEE International Ultrasonics Symposium (IEEE IUS), Publisher: IEEE, ISSN: 1948-5719

Conference paper

Wang B, Riemer K, Toulemonde M, Broughton-Venner J, Zhou X, Tang M-Xet al., 2021, Volumetric Super-Resolution Ultrasound with a 1D array probe: a simulation study, IEEE International Ultrasonics Symposium (IEEE IUS), Publisher: IEEE, ISSN: 1948-5719

Conference paper

Cueto C, Cudeiro J, Agudo OC, Guasch L, Tang M-Xet al., 2021, Spatial Response Identification for Flexible and Accurate Ultrasound Transducer Calibration and its Application to Brain Imaging, IEEE TRANSACTIONS ON ULTRASONICS FERROELECTRICS AND FREQUENCY CONTROL, Vol: 68, Pages: 143-153, ISSN: 0885-3010

Journal article

Davies HJ, Morse SV, Copping MJ, Sujarittam K, Bourgin VD, Tang M-X, Choi JJet al., 2021, Imaging with therapeutic acoustic wavelets–short pulses enable acoustic localization when time of arrival is combined with delay and sum, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, Vol: 68, Pages: 178-190, ISSN: 0885-3010

—Passive acoustic mapping (PAM) is an algorithm that reconstructs the location of acoustic sourcesusing an array of receivers. This technique can monitor therapeutic ultrasound procedures to confirm the spatial distribution and amount of microbubble activity induced. CurrentPAM algorithms have an excellentlateral resolution but havea poor axial resolution, making it difficult to distinguishacoustic sources within the ultrasound beams. With recentstudies demonstrating that short-length and low-pressurepulses—acoustic wavelets—have the therapeutic function,we hypothesizedthat the axial resolution could be improvedwith a quasi-pulse-echo approach and that the resolutionimprovement would depend on the wavelet’s pulse length.This article describes an algorithm that resolves acousticsources axially using time of flight and laterally using delayand-sum beamforming, which we named axial temporalposition PAM (ATP-PAM). The algorithm accommodates arapid short pulse (RaSP) sequence that can safely deliverdrugs across the blood–brain barrier. We developed ouralgorithm with simulations (k-wave) and in vitro experiments for one-, two-, and five-cycle pulses, comparingour resolution against that of two current PAM algorithms.We then tested ATP-PAM in vivo and evaluated whether thereconstructed acoustic sources mapped to drug delivery

Journal article

Reavette RM, Sherwin SJ, Tang M, Weinberg PDet al., 2020, Comparison of arterial wave intensity analysis by pressure-velocity and diameter-velocity methods in a virtual population of adult subjects., Proceedings of the Institution of Mechanical Engineers Part H: Journal of Engineering in Medicine, Vol: 234, Pages: 1260-1276, ISSN: 0954-4119

Pressure-velocity-based analysis of arterial wave intensity gives clinically relevant information about the performance of the heart and vessels, but its utility is limited because accurate pressure measurements can only be obtained invasively. Diameter-velocity-based wave intensity can be obtained noninvasively using ultrasound; however, due to the nonlinear relationship between blood pressure and arterial diameter, the two wave intensities might give disparate clinical indications. To test the magnitude of the disagreement, we have generated an age-stratified virtual population to investigate how the two dominant nonlinearities 'viscoelasticity and strain-stiffening' cause the two formulations to differ. We found strong agreement between the pressure-velocity and diameter-velocity methods, particularly for the systolic wave energy, the ratio between systolic and diastolic wave heights, and older subjects. The results are promising regarding the introduction of noninvasive wave intensities in the clinic.

Journal article

Vos HJ, Voorneveld JD, Jebbink EG, Leow CH, Nie L, van den Bosch AE, Tang M-X, Freear S, Bosch JGet al., 2020, CONTRAST-ENHANCED HIGH-FRAME-RATE ULTRASOUND IMAGING OF FLOW PATTERNS IN CARDIAC CHAMBERS AND DEEP VESSELS, ULTRASOUND IN MEDICINE AND BIOLOGY, Vol: 46, Pages: 2875-2890, ISSN: 0301-5629

Journal article

Choi J, Pouliopoulos A, Smith C, Bezer J, El Ghamrawy A, Boulding C, Morse SV, Meng-Xing Tet al., 2020, Doppler passive acoustic mapping, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control, Vol: 67, Pages: 2692-2703, ISSN: 0885-3010

In therapeutic ultrasound using microbubbles, it is essential to drive the microbubbles into the correct type of activity and the correct location to produce the desired biological response. Although passive acoustic mapping (PAM) is capable of locating where microbubble activities are generated, it is well known that microbubbles move rapidly within the ultrasound beam. We propose a technique that can image microbubble movement by estimating their velocities within the focal volume. Microbubbles embedded within a wall-less channel of a tissue-mimicking material were sonicated using 1-MHz focused ultrasound. The acoustic emissions generated by the microbubbles were captured with a linear array (L7-4). PAM with robust Capon beamforming was used to localize the microbubble acoustic emissions. We spectrally analyzed the time trace of each position and isolated the higher harmonics. Microbubble velocity maps were constructed from the position-dependent Doppler shifts at different time points during sonication. Microbubbles moved primarily away from the transducer at velocities on the order of 1 m/s due to primary acoustic radiation forces, producing a time-dependent velocity distribution. We detected microbubble motion both away and towards the receiving array, revealing the influence of acoustic radiation forces and fluid motion due to the ultrasound exposure. High-speed optical images confirmed the acoustically-measured microbubble velocities. Doppler PAM enables passive estimation of microbubble motion and may be useful in therapeutic applications, such as drug delivery across the blood-brain barrier, sonoporation, sonothrombolysis and drug release.

Journal article

Riemer K, Rowland EM, Leow CH, Tang MX, Weinberg PDet al., 2020, Determining haemodynamic wall shear stress in the rabbit aorta in vivo using contrast-enhanced ultrasound image velocimetry, Annals of Biomedical Engineering, Vol: 48, Pages: 1728-1739, ISSN: 0090-6964

Abnormal blood flow and wall shear stress (WSS) can cause and be caused by cardiovascular disease. To date, however, no standard method has been established for mapping WSS in vivo. Here we demonstrate wide-field assessment of WSS in the rabbit abdominal aorta using contrast-enhanced ultrasound image velocimetry (UIV). Flow and WSS measurements were made independent of beam angle, curvature or branching. Measurements were validated in an in silico model of the rabbit thoracic aorta with moving walls and pulsatile flow. Mean errors over a cardiac cycle for velocity and WSS were 0.34 and 1.69%, respectively. In vivo time average WSS in a straight segment of the suprarenal aorta correlated highly with simulations (PC = 0.99) with a mean deviation of 0.29 Pa or 5.16%. To assess fundamental plausibility of the measurement, UIV WSS was compared to an analytic approximation derived from the Poiseuille equation; the discrepancy was 17%. Mapping of WSS was also demonstrated in regions of arterial branching. High time average WSS (TAWSSxz = 3.4 Pa) and oscillatory flow (OSIxz = 0.3) were observed near the origin of conduit arteries. In conclusion, we have demonstrated that contrast-enhanced UIV is capable of measuring spatiotemporal variation in flow velocity, arterial wall location and hence WSS in vivo with high accuracy over a large field of view.

Journal article

Christensen-Jeffries K, Couture O, Dayton PA, Eldar YC, Hynynen K, Kiessling F, O'Reilly M, Pinton IGF, Schmitz G, Tang M-X, Tanter M, Van Sloun RJGet al., 2020, SUPER-RESOLUTION ULTRASOUND IMAGING, ULTRASOUND IN MEDICINE AND BIOLOGY, Vol: 46, Pages: 865-891, ISSN: 0301-5629

Journal article

Guasch L, Calderon Agudo O, Tang M-X, Nachev P, Warner Met al., 2020, Full-waveform inversion imaging of the human brain, npj Digital Medicine, Vol: 3, Pages: 1-12, ISSN: 2398-6352

Magnetic resonance imaging and X-ray computed tomography provide the two principal methods available for imaging the brain at high spatial resolution, but these methods are not easily portable and cannot be applied safely to all patients. Ultrasound imaging is portable and universally safe, but existing modalities cannot image usefully inside the adult human skull. We use in silico simulations to demonstrate that full-waveform inversion, a computational technique originally developed in geophysics, is able to generate accurate three-dimensional images of the brain with sub-millimetre resolution. This approach overcomes the familiar problems of conventional ultrasound neuroimaging by using the following: transcranial ultrasound that is not obscured by strong reflections from the skull, low frequencies that are readily transmitted with good signal-to-noise ratio, an accurate wave equation that properly accounts for the physics of wave propagation, and adaptive waveform inversion that is able to create an accurate model of the skull that then compensates properly for wavefront distortion. Laboratory ultrasound data, using ex vivo human skulls and in vivo transcranial signals, demonstrate that our computational experiments mimic the penetration and signal-to-noise ratios expected in clinical applications. This form of non-invasive neuroimaging has the potential for the rapid diagnosis of stroke and head trauma, and for the provision of routine monitoring of a wide range of neurological conditions.

Journal article

Dewey M, Siebes M, Kachelrieß M, Kofoed KF, Maurovich-Horvat P, Nikolaou K, Bai W, Kofler A, Manka R, Kozerke S, Chiribiri A, Schaeffter T, Michallek F, Bengel F, Nekolla S, Knaapen P, Lubberink M, Senior R, Tang M-X, Piek JJ, van de Hoef T, Martens J, Schreiber L, Quantitative Cardiac Imaging Study Groupet al., 2020, Clinical quantitative cardiac imaging for the assessment of myocardial ischaemia, Nature Reviews Cardiology, Vol: 17, Pages: 427-450, ISSN: 1759-5002

Cardiac imaging has a pivotal role in the prevention, diagnosis and treatment of ischaemic heart disease. SPECT is most commonly used for clinical myocardial perfusion imaging, whereas PET is the clinical reference standard for the quantification of myocardial perfusion. MRI does not involve exposure to ionizing radiation, similar to echocardiography, which can be performed at the bedside. CT perfusion imaging is not frequently used but CT offers coronary angiography data, and invasive catheter-based methods can measure coronary flow and pressure. Technical improvements to the quantification of pathophysiological parameters of myocardial ischaemia can be achieved. Clinical consensus recommendations on the appropriateness of each technique were derived following a European quantitative cardiac imaging meeting and using a real-time Delphi process. SPECT using new detectors allows the quantification of myocardial blood flow and is now also suited to patients with a high BMI. PET is well suited to patients with multivessel disease to confirm or exclude balanced ischaemia. MRI allows the evaluation of patients with complex disease who would benefit from imaging of function and fibrosis in addition to perfusion. Echocardiography remains the preferred technique for assessing ischaemia in bedside situations, whereas CT has the greatest value for combined quantification of stenosis and characterization of atherosclerosis in relation to myocardial ischaemia. In patients with a high probability of needing invasive treatment, invasive coronary flow and pressure measurement is well suited to guide treatment decisions. In this Consensus Statement, we summarize the strengths and weaknesses as well as the future technological potential of each imaging modality.

Journal article

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