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We integrated an external device with novel post-processing software into a 3 Tesla (T) scanner to assess feasibility and accuracy for reconstructing 12-lead ECGs prior to and during adenosine infusion.\n                    <jats:italic>Methods<\/jats:italic>\n                    Reference 12-lead ECGs were first recorded outside the MR-environment. Using three MR-safe electrode patches, in-bore ECGs were then recorded prior to and during adenosine infusion. Post-processing removed artefacts and 12-lead ECGs were reconstructed from the raw signal using a subject-specific matrix. In-bore and reference ECGs were compared using Pearson\u2019s correlation coefficient on the PQRST waveform and by manual measurements of QRS and QT durations. Adenosine-induced ischaemic changes were compared with corresponding territories on stress perfusion maps.\n                    <jats:italic>Results<\/jats:italic>\n                    In 26 participants (70.8\u2009\u00b1\u200913.0 years; 34.6% female), in-bore ECGs were recorded without additional scan time. Reconstruction took\u2009&lt;\u20092 min per participant. In-bore and reference ECGs were strongly correlated (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.81, interquartile range 0.72\u20130.88), and mean differences in QRS and QT durations were small (-12.5 ms [95% limits of agreement\u2009\u2212\u200942.5, 17.5 ms], and \u2212\u20095.5 ms [-54.6, 43.6 ms] respectively). Ischaemic ECG changes during adenosine predicted stress myocardial blood flow (MBF)\u2009&lt;\u20091.75 ml\/g\/min with sensitivity 91.7% (95% confidence interval 66.7, 100.0), specificity 59.3% (39.6, 77.6), positive predictive value (PPV) 33.3% (11.4, 57.7), negative predictive value (NPV) 97.0% (90.0, 100.0) and area under curve 0.74 (0.61, 0.86).\n                    <jats:italic>Conclusion<\/jats:italic>\n                    In this proof-of-concept study, in-bore ECGs correlated closely with reference ECGs. In-bore ECGs during stress perfusion have high specificity and NPV, but low sensitivity and PPV for predicting stress MBF\u2009&lt;\u20091.5 ml\/g\/min. 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