Abstract: The present invention provides an image processing method to assess quantitative myocardial blood flow and/or myocardial flow reserve, comprising the steps of: (a) pre-processing of images comprises: (i) reconstructing dynamic cine 3D tomographic myocardial perfusion imaging (MPI) data, (ii) optionally, denoising to improve the quality of image, (iii) extracting blood input function from a region of interest (ROI) of the left ventricle blood cavity, (iv) estimating the distribution volume (DV), given by the ratio of uptake and washout rates (K1/k2) to stabilize and improve estimation of K1, k2 and total blood volume (TBV) and subsequent myocardial blood flow measures, and (v) data normalization by dividing by the maximum of the blood input function; (b) assessing the individual signals pre-processed in step (a) in order to generate K1 and TBV parametric maps using artificial neural network; (c) post-processing of K1, k2 and TBV parametric maps; and of rest and stress myocardial blood flow to estimate myoca