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Zhou Y, Wang S, Wang P, Li N, Wang X, Zheng W. Optimization of image reconstruction method of cerebral blood flow perfusion imaging with digital CZT SPECT. Nucl Med Commun 2022. [PMID: 35102075 DOI: 10.1097/MNM.0000000000001540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study is to evaluate the effects of filtered back projection (FBP), ordered subset expectation maximisation (OSEM), and different filters on cadmium zinc telluride single-photon emission computed tomography [CZT single-photon emission computed tomography (SPECT)] cerebral blood perfusion image quality to optimise the image reconstruction method. METHODS Under routine clinical conditions, tomographic imaging was performed on the phantom and patients. Image processing included image reconstruction using FBP and OSEM, and the filtering method used Butterworth (Bw) and Gaussian (Gs) filters. Visual and semi-quantitative parameters [integral uniformity, root mean square (RMS) noise and contrast and contrast-to-noise ratio (CNR)] were used to evaluate image quality to optimise image reconstruction parameters. One-way and two-way analysis of variance were used to process phantom and clinical data. RESULTS In the tomographic images of the phantom, the semi-quantitative analysis showed that the integral uniformity of FBP+Bw was better than that of OSEM+Bw and OSEM+Gs (P < 0.05), and that the RMS noise of FBP+Bw was lower than that of OSEM+Bw and OSEM+Gs (P < 0.001). The contrast of FBP+Bw and OSEM+Bw in the cold area diameter ≥2 cm group was higher than that of OSEM+Gs (P < 0.001), whereas the CNR of FBP+Bw was higher than that of OSEM+Bw and OSEM+Gs (P < 0.001); the contrast of OSEM+Bw cold area diameter <2 cm was higher than that of FBP+Bw (P < 0.01). The semi-quantitative analysis results of the clinical images were consistent with the phantom's. CONCLUSION In CZT SPECT cerebral blood flow perfusion imaging, it is suggested that the image postprocessing method of FBP+Bw (fc = 0.40; n = 10) should be used routinely in clinical application, and if there are uncertain small lesions in the processed image, it is suggested to use the reconstruction method of OSEM+Bw (EM-equivalent iterations = 60; fc = 0.45; n = 10) instead.
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Kinnel M, Sanguineti F, Pezel T, Unterseeh T, Hovasse T, Toupin S, Landon V, Champagne S, Morice MC, Garot P, Louvard Y, Garot J. Prognostic value of vasodilator stress perfusion CMR in patients with previous coronary artery bypass graft. Eur Heart J Cardiovasc Imaging 2020; 22:1264-1272. [PMID: 33313780 DOI: 10.1093/ehjci/jeaa316] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/05/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS The accuracy and prognostic value of stress perfusion cardiac magnetic resonance (CMR) are established in coronary artery disease (CAD) patients. Because myocardial contrast kinetics may be altered after coronary artery bypass graft (CABG), most studies excluded CABG patients. This study aimed to assess the prognostic value of vasodilator stress perfusion CMR in CABG patients. METHODS AND RESULTS Consecutive CABG patients referred for stress CMR were retrospectively included and followed for the occurrence of major adverse cardiovascular events (MACE) including cardiovascular (CV) death or non-fatal myocardial infarction (MI). Cox regression analyses were performed to determine the prognostic association of inducible ischaemia and late gadolinium enhancement (LGE) by CMR. Of 866 consecutive CABG patients, 852 underwent the stress CMR protocol and 771 (89%) completed the follow-up [median (interquartile range) 4.2 (3.3-6.2) years]. There were 85 MACE (63 CV deaths and 22 non-fatal MI). Using Kaplan-Meier analysis, the presence of inducible ischaemia identified the occurrence of MACE [hazard ratio (HR) 3.52, 95% confidence interval (CI): 2.27-5.48; P < 0.001] and CV death (HR 2.55, 95% CI: 1.52-4.25; P < 0.001). In a multivariable stepwise Cox regression including clinical characteristics and CMR indexes, the presence of inducible ischaemia was an independent predictor of a higher incidence of MACE (HR 3.22, 95% CI: 2.06-5.02; P < 0.001) and CV death (HR 2.15, 95% CI: 1.28-3.62; P = 0.003), and the same was observed for LGE (both P = 0.02). CONCLUSION Stress CMR has a good discriminative prognostic value in patients after CABG, with a higher incidence of MACE and CV death in patients with inducible ischaemia and/or LGE.
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Affiliation(s)
- Marine Kinnel
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | - Francesca Sanguineti
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | - Théo Pezel
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France.,Division of Cardiology, Johns Hopkins University, Baltimore, MD 21287-0409, USA
| | - Thierry Unterseeh
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | - Thomas Hovasse
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | - Solenn Toupin
- Department of Engineering, Siemens Healthcare France, 93200 Saint-Denis, France
| | - Valentin Landon
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | - Stéphane Champagne
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | - Marie Claude Morice
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | - Philippe Garot
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | - Yves Louvard
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | - Jérôme Garot
- The Institut Cardiovasculaire Paris Sud, Department of Cardiovascular Magnetic Resonance, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300 Massy, France
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Esteban-Fernández A, Bastarrika G, Castanon E, Coma-Canella I, Barba-Cosials J, Jiménez-Martín M, Alpendurada F, Gavira JJ, Azcárate-Agüero PM. Valor pronóstico de la cardiorresonancia magnética de estrés en pacientes ancianos. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Esteban-Fernández A, Bastarrika G, Castanon E, Coma-Canella I, Barba-Cosials J, Jiménez-Martín M, Alpendurada F, Gavira JJ, Azcárate-Agüero PM. Prognostic role of stress cardiac magnetic resonance in the elderly. ACTA ACUST UNITED AC 2019; 73:241-247. [PMID: 30930252 DOI: 10.1016/j.rec.2019.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 02/12/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION AND OBJECTIVES Several trials have tested the diagnostic and prognostic value of stress cardiac magnetic resonance (CMR) in ischemic heart disease. However, scientific evidence is lacking in the older population, and the available techniques have limitations in this population. The aim of this study was to evaluate the usefulness of stress CMR in the elderly. METHODS We prospectively studied consecutive patients referred for stress CMR to rule out myocardial ischemia. The cutoff age for the elderly population was 70 years. Stress CMR study was performed according to standardized international protocols. Hypoperfusion severity was classified according to the number of affected segments: mild (1-2 segments), moderate (3-4 segments), or severe (> 4 segments). We analyzed the occurrence of major events during follow-up (death, acute coronary syndrome, or revascularization). Survival was studied with the Kaplan-Meier method and multivariate Cox regression models. RESULTS Of an initial cohort of 333 patients, 110 were older than 70 years. In 40.9% patients, stress CMR was positive for ischemia. The median follow-up was 26 [18-37] months. In elderly patients there were 35 events (15 deaths, 10 acute coronary syndromes, and 10 revascularizations). Patients with moderate or severe ischemia were at a higher risk of events, adjusted for age, sex, and cardiovascular risk (HR, 3.53 [95%CI, 1.41-8.79]; P=.01). CONCLUSIONS Moderate to severe perfusion defects in stress CMR strongly predict cardiovascular events in people older than 70 years, without relevant adverse effects.
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Affiliation(s)
| | - Gorka Bastarrika
- Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Eduardo Castanon
- Departamento de Oncología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Isabel Coma-Canella
- Departamento de Cardiología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Joaquín Barba-Cosials
- Departamento de Cardiología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Marta Jiménez-Martín
- Departamento de Cardiología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Francisco Alpendurada
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom
| | - Juan José Gavira
- Departamento de Cardiología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
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Li Q, Li H, Wang L, Liu C, Li S, Chen Y, Zhang Y, Gu C. Observation of local cardiac electrophysiological changes during off-pump coronary artery bypass grafting using epicardial mapping. Perfusion 2018; 34:116-124. [PMID: 30070175 DOI: 10.1177/0267659118787664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES At present, there is no effective method of evaluating the electrophysiological changes in cardiac myocytes during off-pump coronary artery bypass grafting (OPCAB). Therefore, we preliminarily explored the relationship between electrophysiological characteristics and the changes in cardiac function of 24 patients undergoing OPCAB. METHODS We used the CARTO3 system for epicardial electrophysiological mapping before surgery, during left anterior descending branch anastomosis, diagonal branch anastomosis and after surgery for 24 patients undergoing OPCAB. Data, including local activation time (LAT), bipolar voltage value (BV) and conduction velocity, were processed and analyzed by the system. Intraoperative invasive blood pressure, heart rate and arterial blood gas analysis data were recorded. Continuous electrocardiography (ECG) monitoring was performed three days after surgery. Routine resting myocardial perfusion imaging (MPI) and adenosine stress-gated MPI were performed before surgery. Patients were re-examined before discharge. RESULTS By analyzing the change in the LAT value, we found that the order of excitation of local myocardial cells changed after surgery. In addition, the LAT change in myocardial cells closer to the anastomosis was more significant. The earliest pacing point on the left anterior descending (LAD) coronary artery territory map was the third point (from the proximal to distal LAD) before OPCAB, but the earliest pacing point moved down to the fourth point (closer to the anastomosis) after the diagonal (DIA) anastomosis was complete. On the DIA territory map, the earliest pacing point was the fourth point before OPCAB; this moved up to the third point (closer to the anastomosis) after DIA bypass grafting. The voltages of all points were increased after myocardial revascularization. Compared with the preoperative period, the third, fourth and fifth points on the LAD territory map increased significantly after LAD anastomosis was complete (p=0.007, p=0.001, p=0.009, respectively). On the DIA territory map, the voltages of the first, second and third points were remarkably increased after completing the DIA anastomosis compared to before OPCAB and after LAD anastomosis completion (p=0.001, p=0.008, p<0.001 and p=0.006, p=0.032, p=0.002, respectively). The average conduction velocity (ACV) of all mapped points increased after OPCAB compared with before OPCAB (p<0.05). Postoperative resting MPI and adenosine stress-gated MPI showed that left ventricular global systolic function improved, the left ventricular ejection fraction (LVEF) increased significantly (p<0.05) and the left ventricular end systolic volume (LVESV) decreased significantly (p<0.05) compared to the preoperative MPI. CONCLUSIONS Adequate surgical coronary revascularization could lead to more stable electrical activity of local cardiomyocytes, thus, illustrating the specific mechanism of coronary revascularization for improving the cardiac function from an electrophysiological perspective.
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Affiliation(s)
- Qin Li
- 1 Department of Cardiac Surgery, Capital Medical University Affiliated Anzhen Hospital, Beijing, People's Republic of China
| | - Haiming Li
- 1 Department of Cardiac Surgery, Capital Medical University Affiliated Anzhen Hospital, Beijing, People's Republic of China
| | - Liangshan Wang
- 2 Center for Cardiac Intensive Care, Capital Medical University Affiliated Anzhen Hospital, Beijing, People's Republic of China
| | - Changcheng Liu
- 1 Department of Cardiac Surgery, Capital Medical University Affiliated Anzhen Hospital, Beijing, People's Republic of China
| | - Songnan Li
- 3 Department of Cardiology, Capital Medical University Affiliated Anzhen Hospital, Beijing, People's Republic of China
| | - Yingwei Chen
- 4 The First Affiliated Hospital of Zhengzhou University, Henan, People's Republic of China
| | - Yafei Zhang
- 5 People's Hospital of Zhengzhou, Henan, People's Republic of China
| | - Chengxiong Gu
- 1 Department of Cardiac Surgery, Capital Medical University Affiliated Anzhen Hospital, Beijing, People's Republic of China
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Abstract
In contrast to invasive techniques, the goal of non-invasive cardiac imaging is to identify or exclude heart disease in response to a patient's clinical history of cardiac localizing symptoms. Imaging also aims to establish the risk of an individual developing future heart disease with a view to preventing major cardiovascular events such as myocardial infarction. As well as a role in risk stratification, non-invasive cardiac imaging also helps with decision making for future medical and procedural interventions. This review outlines the non-invasive imaging modalities available to physicians to identify and risk stratify cardiovascular disease. It discusses the strengths of each imaging technique, in which circumstances it is most useful and its diagnostic accuracy.
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Affiliation(s)
- Mark J Davies
- Cardiology Registrar, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, and Department of Cardiology, Wycombe Hospital, Buckinghamshire NHS Trust, High Wycombe, Buckinghamshire HP11 2TT
| | - James D Newton
- Consultant Cardiologist, Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford
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