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Manini C, Nemchyna O, Akansel S, Walczak L, Tautz L, Kolbitsch C, Falk V, Sündermann S, Kühne T, Schulz-Menger J, Hennemuth A. A simulation-based phantom model for generating synthetic mitral valve image data-application to MRI acquisition planning. Int J Comput Assist Radiol Surg 2024; 19:553-569. [PMID: 37679657 PMCID: PMC10881710 DOI: 10.1007/s11548-023-03012-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/31/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE Numerical phantom methods are widely used in the development of medical imaging methods. They enable quantitative evaluation and direct comparison with controlled and known ground truth information. Cardiac magnetic resonance has the potential for a comprehensive evaluation of the mitral valve (MV). The goal of this work is the development of a numerical simulation framework that supports the investigation of MRI imaging strategies for the mitral valve. METHODS We present a pipeline for synthetic image generation based on the combination of individual anatomical 3D models with a position-based dynamics simulation of the mitral valve closure. The corresponding images are generated using modality-specific intensity models and spatiotemporal sampling concepts. We test the applicability in the context of MRI imaging strategies for the assessment of the mitral valve. Synthetic images are generated with different strategies regarding image orientation (SAX and rLAX) and spatial sampling density. RESULTS The suitability of the imaging strategy is evaluated by comparing MV segmentations against ground truth annotations. The generated synthetic images were compared to ones acquired with similar parameters, and the result is promising. The quantitative analysis of annotation results suggests that the rLAX sampling strategy is preferable for MV assessment, reaching accuracy values that are comparable to or even outperform literature values. CONCLUSION The proposed approach provides a valuable tool for the evaluation and optimization of cardiac valve image acquisition. Its application to the use case identifies the radial image sampling strategy as the most suitable for MV assessment through MRI.
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Affiliation(s)
- Chiara Manini
- Institute of Computer-Assisted Cardiovascular Medicine, Deutsches Herzzentrum Der Charité (DHZC), Berlin, Germany.
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
| | - Olena Nemchyna
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Der Charité (DHZC), Berlin, Germany
| | - Serdar Akansel
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Der Charité (DHZC), Berlin, Germany
| | - Lars Walczak
- Institute of Computer-Assisted Cardiovascular Medicine, Deutsches Herzzentrum Der Charité (DHZC), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
- Fraunhofer MEVIS, Berlin, Germany
| | | | - Christoph Kolbitsch
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Volkmar Falk
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Der Charité (DHZC), Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Simon Sündermann
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Der Charité (DHZC), Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Titus Kühne
- Institute of Computer-Assisted Cardiovascular Medicine, Deutsches Herzzentrum Der Charité (DHZC), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Jeanette Schulz-Menger
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Department of Cardiology and Nephrology, Helios Hospital Berlin-Buch, Berlin, Germany
| | - Anja Hennemuth
- Institute of Computer-Assisted Cardiovascular Medicine, Deutsches Herzzentrum Der Charité (DHZC), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
- Fraunhofer MEVIS, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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He M, Han W, Shi C, Wang M, Li J, He W, Xu X, Gan Q, Guan S, Zhang L, Chen Y, Chang X, Li T, Qu X. A Comparison of Dynamic SPECT Coronary Flow Reserve with TIMI Frame Count in the Treatment of Non-Obstructive Epicardial Coronary Patients. Clin Interv Aging 2023; 18:1831-1839. [PMID: 37937265 PMCID: PMC10627069 DOI: 10.2147/cia.s429450] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023] Open
Abstract
Background Microvascular dysfunction in patients with non-obstructive epicardial coronary may aggravate patient's symptoms or lead to various clinical events. Objective To investigate the correlation between dynamic single photon emission computed tomography (D-SPECT) derived coronary flow reserve (CFR) and TIMI frame count (TFC) in patients with non-obstructive epicardial coronary patients. Methods Patients with suspected or known stable CAD who were recommended to undergo invasive coronary angiography were prospectively enrolled in this study. Those who had non-obstructive coronary received TIMI frame count (TFC) and D-SPECT. A cut-off value of >40 was defined as slow flow referred to TFC. Results A total of 47 patients diagnosed with non-obstructive coronary were enrolled. The mean age of patients was 66.09 ± 8.36 years, and 46.8% were male. Dynamic SPECT derived coronary flow reserve (CFR) was significantly correlated with TIMI frame count in 3 epicardial coronary (LAD: r=-0.506, P = 0.0003; LCX: r= -0.532, P = 0.0001; RCA: r= -0.657, P < 0.0001). The sensitivity and specificity of CFR in identifying abnormal TIMI frame count < 40 was 100.0% and 57.6% in LAD, 62.5% and 87.0% in LCX, 83.9% and 75.0% in RCA, respectively. The optimal CFR cut-off values were 2.02, 2.47, and 1.96 among the three vessels. Conclusion In patients with non-obstructive coronary, CFR derived from D-SPECT was strongly correlated with TFC. This study demonstrates that that CFR may be an alternative non-invasive method for identifying slow flow in non-obstructive coronary.
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Affiliation(s)
- Mingping He
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Wenzheng Han
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Chuan Shi
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Ming Wang
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Junheng Li
- Department of Nuclear Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Wei He
- Department of Nuclear Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Xinxin Xu
- Clinical Research Center for Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Qian Gan
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Shaofeng Guan
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Liang Zhang
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Yang Chen
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Xifeng Chang
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Tianqi Li
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Xinkai Qu
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
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Krakovich A, Gelbart E, Moalem I, Naimushin A, Rozen E, Scheinowitz M, Goldkorn R. Dose-consistent dynamic SPECT. J Nucl Cardiol 2023; 30:1341-1351. [PMID: 36477896 DOI: 10.1007/s12350-022-03160-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Coronary flow reserve (CFR) values measured by dynamic SPECT systems are typically consistent with other modalities (e.g., PET). However, large discrepancies are often observed for individual patients. Positioning of the region-of-interest (ROI), representing the arterial input function (AIF) could explain some of these discrepancies. We explored the possibility of positioning the ROI in a manner that evaluates its consistency with patient-based injected radiotracer doses. METHODS Dose-consistent dynamic SPECT methodology was introduced, and its application was demonstrated in a twenty-patient clinical study. The effect of various ROI positions was investigated and comparison to myocardial perfusion imaging was performed. RESULTS Mean AIF ratios were consistent with the injected dose ratios for all examined ROI positions. Good agreement (> 80%) between total perfusion deficit and CFR was found in the detection of obstructive CAD patients for all ROIs considered. However, for individual patients, significant dependence on ROI position was observed (altering CFR by typically 30%). The proposed methodology's uncertainty was evaluated (~ 7%) and found to be smaller than the variability due to choice of ROI position. CONCLUSION Dose-consistent dynamic SPECT may contribute to evaluating uncertainty of CFR measurements and may potentially decrease uncertainty by allowing improved ROI positioning for individual patients.
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Affiliation(s)
- A Krakovich
- Department of Biomedical Engineering, Tel-Aviv University, Tel Aviv, Israel.
| | - E Gelbart
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - I Moalem
- Nuclear Cardiology Center, Leviev Heart Institute, Sheba Medical Center, Ramat Gan, Israel
| | - A Naimushin
- Nuclear Cardiology Center, Leviev Heart Institute, Sheba Medical Center, Ramat Gan, Israel
| | - E Rozen
- Nuclear Cardiology Center, Leviev Heart Institute, Sheba Medical Center, Ramat Gan, Israel
| | - M Scheinowitz
- Department of Biomedical Engineering, Tel-Aviv University, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - R Goldkorn
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Nuclear Cardiology Center, Leviev Heart Institute, Sheba Medical Center, Ramat Gan, Israel
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D'Antonio A, Assante R, Zampella E, Mannarino T, Buongiorno P, Cuocolo A, Acampa W. Myocardial blood flow evaluation with dynamic cadmium-zinc-telluride single-photon emission computed tomography: Bright and dark sides. Diagn Interv Imaging 2023; 104:323-329. [PMID: 36797156 DOI: 10.1016/j.diii.2023.02.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 02/16/2023]
Abstract
Myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) assessment with non-invasive techniques represent an important tool to evaluate both coronary artery disease severity and extent. Currently, cardiac positron emission tomography-computed tomography (PET-CT) is the "gold standard" for the assessment of coronary function and provides accurate estimations of baseline and hyperemic MBF and MFR. Nevertheless, due to the high cost and complexity, PET-CT is not widely used in clinical practice. The introduction of cardiac-dedicated cadmium-zinc-telluride (CZT) cameras has renewed researchers' interest on MBF quantitation by single-photon emission computed tomography (SPECT). Indeed, many studies evaluated MPR and MBF measurements by dynamic CZT-SPECT in different cohorts of patients with suspected or overt coronary artery disease. As well, many others have compared the values obtained by CZT-SPECT to the ones by PET-CT, showing good correlations in detecting significant stenosis, although with different and non-standardized cut-off values. Nevertheless, the lack of standardized protocol for acquisition, reconstruction and elaboration makes more difficult to compare different studies and to further assess the real advantages of MBF quantitation by dynamic CZT-SPECT in clinical routine. Many are the issues involved in the bright and dark sides of dynamic CZT-SPECT. They include different type of CZT cameras, different execution protocols, different tracers with different myocardial extraction fraction and distribution, different software packages with different tools and algorithms, often requiring manual post-processing elaboration. This review article provides a clear summary of the state of the art on MBF and MPR evaluation by dynamic CZT-SPECT and outlines the major issues to solve to optimize this technique.
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Affiliation(s)
- Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Pietro Buongiorno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
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Krakovich A, Zaretsky U, Gelbart E, Moalem I, Naimushin A, Rozen E, Scheinowitz M, Goldkorn R. Anthropomorphic cardiac phantom for dynamic SPECT. J Nucl Cardiol 2023; 30:516-527. [PMID: 35760983 DOI: 10.1007/s12350-022-03024-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND As myocardial blood flow measurement (MBF) in SPECT systems became recently available, significant effort has been devoted to its validation. For that purpose, we have developed a cardiac phantom that is able to mimic physiological radiotracer variation in the left ventricle cavity and in the myocardium, while performing beating-like motion. The new phantom is integrated inside a standard anthropomorphic torso allowing a realistic tissue attenuation and gamma-ray scattering METHODS AND RESULTS: A mechanical cardiac phantom was integrated in a commercially available anthropomorphic torso. Using a GE Discovery 530c SPECT, measurements were performed. It was found that gamma-ray attenuation effects are significant and limit the MBF measurements to global/three-vessel resolution. Dynamic SPECT experiments were performed to validate MBF accuracy and showed mean relative error of 14%. Finally, the effect of varying radiotracer dose on the accuracy of dynamic SPECT was studied CONCLUSIONS: A dynamic cardiac phantom has been developed and successfully integrated in a standard SPECT torso. A good agreement was found between SPECT-reported MBF values and the expected results. Despite increased noise-to-signal ratio when radiotracer doses were reduced, MBF uncertainty did not increase significantly down to very low doses, thanks to the temporal integration of the activity during the measurement.
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Affiliation(s)
- A Krakovich
- Department of Biomedical Engineering, Tel-Aviv University, Tel-Aviv, Israel.
| | - U Zaretsky
- Department of Biomedical Engineering, Tel-Aviv University, Tel-Aviv, Israel
| | - E Gelbart
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - I Moalem
- Nuclear Cardiology Unit, Sheba Medical Center, Lev Leviev Heart Institute, Ramat Gan, Israel
| | - A Naimushin
- Nuclear Cardiology Unit, Sheba Medical Center, Lev Leviev Heart Institute, Ramat Gan, Israel
| | - E Rozen
- Nuclear Cardiology Unit, Sheba Medical Center, Lev Leviev Heart Institute, Ramat Gan, Israel
| | - M Scheinowitz
- Department of Biomedical Engineering, Tel-Aviv University, Tel-Aviv, Israel
| | - R Goldkorn
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Nuclear Cardiology Unit, Sheba Medical Center, Lev Leviev Heart Institute, Ramat Gan, Israel
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Wells RG, Klein R. Dynamic phantoms: Making the right tool for the job. J Nucl Cardiol 2021; 28:2310-2312. [PMID: 32124249 DOI: 10.1007/s12350-020-02083-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 10/24/2022]
Affiliation(s)
- R Glenn Wells
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada.
| | - Ran Klein
- Division Nuclear Medicine, Department of Medicine, University of Ottawa, Ottawa, Canada
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