Estimation of Regional Myocardial Blood Flow Using Computed Tomography: A Stochastic Formulation

Previously, we have presented a deterministic formulation for estimation of regional myocardial blood flow (RMBF) using X-ray computed tomography (CT) [1]. Quantitation of RMBF with the deterministic theory requires computing the zeroth and first moments of extrapolated myocardial contrast enhancement (CT numbers versus time) curves. This extrapolation is a potential source of error in the presence of recirculation, especially in myocardial regions with reduced flows. In the present paper, a stochastic approach for parameter estimation is undertaken, which renders an optimal RMBF estimate based upon the least squares error criteria. Random measurement errors are minimized, curve extrapolation is avoided, and the accuracy of RMBF estimates is predicted. The advantages of the stochastic versus the deterministic approach are demonstrated in the results obtained from the in vivo estimation of RMBF in normal and acutely ischemic myocardium of dogs.