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Poon J, Thompson RB, Deyell MW, Schellenberg D, Clark H, Reinsberg S, Thomas S. Analysis of left ventricle regional myocardial motion for cardiac radioablation: Left ventricular motion analysis. J Appl Clin Med Phys 2024; 25:e14333. [PMID: 38493500 PMCID: PMC11087184 DOI: 10.1002/acm2.14333] [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: 11/03/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 03/19/2024] Open
Abstract
PURPOSE Left ventricle (LV) regional myocardial displacement due to cardiac motion was assessed using cardiovascular magnetic resonance (CMR) cine images to establish region-specific margins for cardiac radioablation treatments. METHODS CMR breath-hold cine images and LV myocardial tissue contour points were analyzed for 200 subjects, including controls (n = 50) and heart failure (HF) patients with preserved ejection fraction (HFpEF, n = 50), mid-range ejection fraction (HFmrEF, n = 50), and reduced ejection fraction (HFrEF, n = 50). Contour points were divided into segments according to the 17-segment model. For each patient, contour point displacements were determined for the long-axis (all 17 segments) and short-axis (segments 1-12) directions. Mean overall, tangential (longitudinal or circumferential), and normal (radial) displacements were calculated for the 17 segments and for each segment level. RESULTS The greatest overall motion was observed in the control group-long axis: 4.5 ± 1.2 mm (segment 13 [apical anterior] epicardium) to 13.8 ± 3.0 mm (segment 6 [basal anterolateral] endocardium), short axis: 4.3 ± 0.8 mm (segment 9 [mid inferoseptal] epicardium) to 11.5 ± 2.3 mm (segment 1 [basal anterior] endocardium). HF patients exhibited lesser motion, with the smallest overall displacements observed in the HFrEF group-long axis: 4.3 ± 1.7 mm (segment 13 [apical anterior] epicardium) to 10.6 ± 3.4 mm (segment 6 [basal anterolateral] endocardium), short axis: 3.9 ± 1.3 mm (segment 8 [mid anteroseptal] epicardium) to 7.4 ± 2.8 mm (segment 1 [basal anterior] endocardium). CONCLUSIONS This analysis provides an estimate of epicardial and endocardial displacement for the 17 segments of the LV for patients with normal and impaired LV function. This reference data can be used to establish treatment planning margin guidelines for cardiac radioablation. Smaller margins may be used for patients with higher degree of impaired heart function, depending on the LV segment.
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Affiliation(s)
- Justin Poon
- Department of Physics and AstronomyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Department of Medical PhysicsBC CancerVancouverBritish ColumbiaCanada
| | - Richard B. Thompson
- Department of Biomedical EngineeringUniversity of AlbertaEdmontonAlbertaCanada
| | - Marc W. Deyell
- Heart Rhythm ServicesDivision of CardiologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Haley Clark
- Department of Physics and AstronomyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Department of Medical PhysicsBC CancerSurreyBritish ColumbiaCanada
| | - Stefan Reinsberg
- Department of Physics and AstronomyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Steven Thomas
- Department of Medical PhysicsBC CancerVancouverBritish ColumbiaCanada
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Chin V, Finnegan RN, Chlap P, Holloway L, Thwaites DI, Otton J, Delaney GP, Vinod SK. Dosimetric Impact of Delineation and Motion Uncertainties on the Heart and Substructures in Lung Cancer Radiotherapy. Clin Oncol (R Coll Radiol) 2024:S0936-6555(24)00143-2. [PMID: 38649309 DOI: 10.1016/j.clon.2024.04.002] [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] [Received: 07/17/2023] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024]
Abstract
AIMS Delineation variations and organ motion produce difficult-to-quantify uncertainties in planned radiation doses to targets and organs at risk. Similar to manual contouring, most automatic segmentation tools generate single delineations per structure; however, this does not indicate the range of clinically acceptable delineations. This study develops a method to generate a range of automatic cardiac structure segmentations, incorporating motion and delineation uncertainty, and evaluates the dosimetric impact in lung cancer. MATERIALS AND METHODS Eighteen cardiac structures were delineated using a locally developed auto-segmentation tool. It was applied to lung cancer planning CTs for 27 curative (planned dose ≥50 Gy) cases, and delineation variations were estimated by using ten mapping-atlases to provide separate substructure segmentations. Motion-related cardiac segmentation variations were estimated by auto-contouring structures on ten respiratory phases for 9/27 cases that had 4D-planning CTs. Dose volume histograms (DVHs) incorporating these variations were generated for comparison. RESULTS Variations in mean doses (Dmean), defined as the range in values across ten feasible auto-segmentations, were calculated for each cardiac substructure. Over the study cohort the median variations for delineation uncertainty and motion were 2.20-11.09 Gy and 0.72-4.06 Gy, respectively. As relative values, variations in Dmean were between 18.7%-65.3% and 7.8%-32.5% for delineation uncertainty and motion, respectively. Doses vary depending on the individual planned dose distribution, not simply on segmentation differences, with larger dose variations to cardiac structures lying within areas of steep dose gradient. CONCLUSION Radiotherapy dose uncertainties from delineation variations and respiratory-related heart motion were quantified using a cardiac substructure automatic segmentation tool. This predicts the 'dose range' where doses to structures are most likely to fall, rather than single DVH curves. This enables consideration of these uncertainties in cardiotoxicity research and for future plan optimisation. The tool was designed for cardiac structures, but similar methods are potentially applicable to other OARs.
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Affiliation(s)
- V Chin
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Department of Radiation Oncology, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia; University of Sydney, Image X Institute, Sydney, Australia.
| | - R N Finnegan
- Ingham Institute for Applied Medical Research, Sydney, Australia; University of Sydney, Institute of Medical Physics, Sydney, Australia; Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia
| | - P Chlap
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Department of Radiation Oncology, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
| | - L Holloway
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Department of Radiation Oncology, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia; University of Sydney, Institute of Medical Physics, Sydney, Australia
| | - D I Thwaites
- University of Sydney, Institute of Medical Physics, Sydney, Australia; St James's Hospital and University of Leeds, Leeds Institute of Medical Research, Radiotherapy Research Group, Leeds, United Kingdom
| | - J Otton
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool Hospital, Department of Cardiology, Sydney, Australia
| | - G P Delaney
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Department of Radiation Oncology, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
| | - S K Vinod
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Department of Radiation Oncology, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
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Chuah SH, Tan LK, Md Sari NA, Chan BT, Hasikin K, Lim E, Ung NM, Abdul Aziz YF, Jayabalan J, Liew YM. Remodeling in Aortic Stenosis With Reduced and Preserved Ejection Fraction: Insight on Motion Abnormality Via 3D + Time Personalized LV Modeling in Cardiac MRI. J Magn Reson Imaging 2024; 59:1242-1255. [PMID: 37452574 DOI: 10.1002/jmri.28915] [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: 03/15/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Increased afterload in aortic stenosis (AS) induces left ventricle (LV) remodeling to preserve a normal ejection fraction. This compensatory response can become maladaptive and manifest with motion abnormality. It is a clinical challenge to identify contractile and relaxation dysfunction during early subclinical stage to prevent irreversible deterioration. PURPOSE To evaluate the changes of regional wall dynamics in 3D + time domain as remodeling progresses in AS. STUDY TYPE Retrospective. POPULATION A total of 31 AS patients with reduced and preserved ejection fraction (14 AS_rEF: 7 male, 66.5 [7.8] years old; 17 AS_pEF: 12 male, 67.0 [6.0] years old) and 15 healthy (6 male, 61.0 [7.0] years old). FIELD STRENGTH/SEQUENCE 1.5 T Magnetic resonance imaging/steady state free precession and late-gadolinium enhancement sequences. ASSESSMENT Individual LV models were reconstructed in 3D + time domain and motion metrics including wall thickening (TI), dyssynchrony index (DI), contraction rate (CR), and relaxation rate (RR) were automatically extracted and associated with the presence of scarring and remodeling. STATISTICAL TESTS Shapiro-Wilk: data normality; Kruskal-Wallis: significant difference (P < 0.05); ICC and CV: variability; Mann-Whitney: effect size. RESULTS AS_rEF group shows distinct deterioration of cardiac motions compared to AS_pEF and healthy groups (TIAS_rEF : 0.92 [0.85] mm, TIAS_pEF : 5.13 [1.99] mm, TIhealthy : 3.61 [1.09] mm, ES: 0.48-0.83; DIAS_rEF : 17.11 [7.89]%, DIAS_pEF : 6.39 [4.04]%, DIhealthy : 5.71 [1.87]%, ES: 0.32-0.85; CRAS_rEF : 8.69 [6.11] mm/second, CRAS_pEF : 16.48 [6.70] mm/second, CRhealthy : 10.82 [4.57] mm/second, ES: 0.29-0.60; RRAS_rEF : 8.45 [4.84] mm/second; RRAS_pEF : 13.49 [8.56] mm/second, RRhealthy : 9.31 [2.48] mm/second, ES: 0.14-0.43). The difference in the motion metrics between healthy and AS_pEF groups were insignificant (P-value = 0.16-0.72). AS_rEF group was dominated by eccentric hypertrophy (47.1%) with concomitant scarring. Conversely, AS_pEF group was dominated by concentric remodeling and hypertrophy (71.4%), which could demonstrate hyperkinesia with slight wall dyssynchrony than healthy. Dysfunction of LV mechanics corresponded to the presence of myocardial scarring (54.9% in AS), which reverted the compensatory mechanisms initiated and performed by LV remodeling. DATA CONCLUSION The proposed 3D + time modeling technique may distinguish regional motion abnormalities between AS_pEF, AS_rEF, and healthy cohorts, aiding clinical diagnosis and monitoring of AS progression. Subclinical myocardial dysfunction is evident in early AS despite of normal EF. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Shoon Hui Chuah
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Li Kuo Tan
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- University Malaya Research Imaging Centre, Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nor Ashikin Md Sari
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Bee Ting Chan
- Department of Mechanical, Materials and Manufacturing Engineering, Faculty of Science and Engineering, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Khairunnisa Hasikin
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Einly Lim
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ngie Min Ung
- Clinical Oncology Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Yang Faridah Abdul Aziz
- University Malaya Research Imaging Centre, Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Jeyaraaj Jayabalan
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
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Ming Z, Pogosyan A, Gao C, Colbert CM, Wu HH, Finn JP, Ruan D, Hu P, Christodoulou AG, Nguyen KL. ECG-free cine MRI with data-driven clustering of cardiac motion for quantification of ventricular function. NMR Biomed 2024; 37:e5091. [PMID: 38196195 PMCID: PMC10947936 DOI: 10.1002/nbm.5091] [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] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Despite the widespread use of cine MRI for evaluation of cardiac function, existing real-time methods do not easily enable quantification of ventricular function. Moreover, segmented cine MRI assumes periodicity of cardiac motion. We aim to develop a self-gated, cine MRI acquisition scheme with data-driven cluster-based binning of cardiac motion. METHODS A Cartesian golden-step balanced steady-state free precession sequence with sorted k-space ordering was designed. Image data were acquired with breath-holding. Principal component analysis and k-means clustering were used for binning of cardiac phases. Cluster compactness in the time dimension was assessed using temporal variability, and dispersion in the spatial dimension was assessed using the Caliński-Harabasz index. The proposed and the reference electrocardiogram (ECG)-gated cine methods were compared using a four-point image quality score, SNR and CNR values, and Bland-Altman analyses of ventricular function. RESULTS A total of 10 subjects with sinus rhythm and 8 subjects with arrhythmias underwent cardiac MRI at 3.0 T. The temporal variability was 45.6 ms (cluster) versus 24.6 ms (ECG-based) (p < 0.001), and the Caliński-Harabasz index was 59.1 ± 9.1 (cluster) versus 22.0 ± 7.1 (ECG based) (p < 0.001). In subjects with sinus rhythm, 100% of the end-systolic and end-diastolic images from both the cluster and reference approach received the highest image quality score of 4. Relative to the reference cine images, the cluster-based multiphase (cine) image quality consistently received a one-point lower score (p < 0.05), whereas the SNR and CNR values were not significantly different (p = 0.20). In cases with arrhythmias, 97.9% of the end-systolic and end-diastolic images from the cluster approach received an image quality score of 3 or more. The mean bias values for biventricular ejection fraction and volumes derived from the cluster approach versus reference cine were negligible. CONCLUSION ECG-free cine cardiac MRI with data-driven clustering for binning of cardiac motion is feasible and enables quantification of cardiac function.
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Affiliation(s)
- Zhengyang Ming
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, CA, USA
| | - Arutyun Pogosyan
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, CA, USA
| | - Chang Gao
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, CA, USA
| | - Caroline M. Colbert
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, CA, USA
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, CA, USA
| | - Holden H. Wu
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - J. Paul Finn
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, CA, USA
| | - Dan Ruan
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA, CA, USA
| | - Peng Hu
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Anthony G. Christodoulou
- Department of Bioengineering, University of California, Los Angeles, CA, USA
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Kim-Lien Nguyen
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, CA, USA
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
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Poon J, Thompson RB, Deyell MW, Schellenberg D, Kohli K, Thomas S. Left ventricle segment-specific motion assessment for cardiac-gated radiosurgery. Biomed Phys Eng Express 2024; 10:025040. [PMID: 38359447 DOI: 10.1088/2057-1976/ad29a4] [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: 11/14/2023] [Accepted: 02/15/2024] [Indexed: 02/17/2024]
Abstract
Purpose.Cardiac radiosurgery is a non-invasive treatment modality for ventricular tachycardia, where a linear accelerator is used to irradiate the arrhythmogenic region within the heart. In this work, cardiac magnetic resonance (CMR) cine images were used to quantify left ventricle (LV) segment-specific motion during the cardiac cycle and to assess potential advantages of cardiac-gated radiosurgery.Methods.CMR breath-hold cine images and LV contour points were analyzed for 50 controls and 50 heart failure patients with reduced ejection fraction (HFrEF, EF < 40%). Contour points were divided into anatomic segments according to the 17-segment model, and each segment was treated as a hypothetical treatment target. The optimum treatment window (one fifth of the cardiac cycle) was determined where segment centroid motion was minimal, then the maximum centroid displacement and treatment area were determined for the full cardiac cycle and for the treatment window. Mean centroid displacement and treatment area reductions with cardiac gating were determined for each of the 17 segments.Results.Full motion segment centroid displacements ranged between 6-14 mm (controls) and 4-11 mm (HFrEF). Full motion treatment areas ranged between 129-715 mm2(controls) and 149-766 mm2(HFrEF). With gating, centroid displacements were reduced to 1 mm (controls and HFrEF), while treatment areas were reduced to 62-349 mm2(controls) and 83-393 mm2(HFrEF). Relative treatment area reduction ranged between 38%-53% (controls) and 26%-48% (HFrEF).Conclusion.This data demonstrates that cardiac cycle motion is an important component of overall target motion and varies depending on the anatomic cardiac segment. Accounting for cardiac cycle motion, through cardiac gating, has the potential to significantly reduce treatment volumes for cardiac radiosurgery.
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Affiliation(s)
- Justin Poon
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- Department of Medical Physics, BC Cancer, Vancouver, British Columbia V5Z 4E6, Canada
| | - Richard B Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, T6G 2V2, Canada
| | - Marc W Deyell
- Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, BC V6E 1M7, Canada
| | - Devin Schellenberg
- Department of Radiation Oncology, BC Cancer, Surrey, British Columbia V3V 1Z2, Canada
| | - Kirpal Kohli
- Department of Medical Physics, BC Cancer, Surrey, British Columbia V3V 1Z2, Canada
| | - Steven Thomas
- Department of Medical Physics, BC Cancer, Vancouver, British Columbia V5Z 4E6, Canada
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Raspe J, Harder FN, Rupp S, McTavish S, Peeters JM, Weiss K, Makowski MR, Braren RF, Karampinos DC, Van AT. Retrospective Motion Artifact Reduction by Spatial Scaling of Liver Diffusion-Weighted Images. Tomography 2023; 9:1839-1856. [PMID: 37888738 PMCID: PMC10610678 DOI: 10.3390/tomography9050146] [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: 08/31/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023] Open
Abstract
Cardiac motion causes unpredictable signal loss in respiratory-triggered diffusion-weighted magnetic resonance imaging (DWI) of the liver, especially inside the left lobe. The left liver lobe may thus be frequently neglected in the clinical evaluation of liver DWI. In this work, a data-driven algorithm that relies on the statistics of the signal in the left liver lobe to mitigate the motion-induced signal loss is presented. The proposed data-driven algorithm utilizes the exclusion of severely corrupted images with subsequent spatially dependent image scaling based on a signal-loss model to correctly combine the multi-average diffusion-weighted images. The signal in the left liver lobe is restored and the liver signal is more homogeneous after applying the proposed algorithm. Furthermore, overestimation of the apparent diffusion coefficient (ADC) in the left liver lobe is reduced. The proposed algorithm can therefore contribute to reduce the motion-induced bias in DWI of the liver and help to increase the diagnostic value of DWI in the left liver lobe.
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Affiliation(s)
- Johannes Raspe
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
- School of Natural Sciences, Technical University of Munich, 85748 Garching, Germany
| | - Felix N. Harder
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Selina Rupp
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Sean McTavish
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | | | - Kilian Weiss
- Philips GmbH Market DACH, 22335 Hamburg, Germany
| | - Marcus R. Makowski
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Rickmer F. Braren
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Dimitrios C. Karampinos
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Anh T. Van
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
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Omidi A, Weiss E, Wilson JS, Rosu-Bubulac M. Effects of respiratory and cardiac motion on estimating radiation dose to the left ventricle during radiotherapy for lung cancer. J Appl Clin Med Phys 2023; 24:e13855. [PMID: 36564951 PMCID: PMC10018663 DOI: 10.1002/acm2.13855] [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] [Received: 07/25/2022] [Revised: 10/11/2022] [Accepted: 11/02/2022] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Establish a workflow to evaluate radiotherapy (RT) dose variation induced by respiratory and cardiac motion on the left ventricle (LV) and left ventricular myocardium (LVM). METHODS Eight lung cancer patients underwent 4D-CT, expiratory T1-volumetric-interpolated-breath-hold-examination (VIBE), and cine MRI scans in expiration. Treatment plans were designed on the average intensity projection (AIP) datasets from 4D-CTs. RT dose from AIP was transferred onto 4D-CT respiratory phases. About 50% 4D-CT dose was mapped onto T1-VIBE (following registration) and from there onto average cine MRI datasets. Dose from average cine MRI was transferred onto all cardiac phases. Cumulative cardiac dose was estimated by transferring dose from each cardiac phase onto a reference cine phase following deformable image registration. The LV was contoured on each 4D-CT breathing phase and was called clinical LV (cLV); this structure is blurred by cardiac motion. Additionally, LV, LVM, and an American Heart Association (AHA) model were contoured on all cardiac phases. Relative maximum/mean doses for contoured regions were calculated with respect to each patient's maximum/mean AIP dose. RESULTS During respiration, relative maximum and mean doses on the cLV ranged from -4.5% to 5.6% and -14.2% to 16.5%, respectively, with significant differences in relative mean doses between inspiration and expiration (P < 0.0145). During cardiac motion at expiration, relative maximum and mean doses on the LV ranged from 1.6% to 59.3%, 0.5% to 27.4%, respectively. Relative mean doses were significantly different between diastole and systole (P = 0.0157). No significant differences were noted between systolic, diastolic, or cumulative cardiac doses compared to the expiratory 4D-CT (P > 0.14). Significant differences were observed in AHA segmental doses depending on tumour proximity compared to global LV doses on expiratory 4D-CT (P < 0.0117). CONCLUSION In this study, the LV dose was highest during expiration and diastole. Segmental evaluation suggested that future cardiotoxicity evaluations may benefit from regional assessments of dose that account for cardiopulmonary motion.
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Affiliation(s)
- Alireza Omidi
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Elisabeth Weiss
- Department of Radiation Oncology, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - John S Wilson
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, USA.,Pauley Heart Center, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Mihaela Rosu-Bubulac
- Department of Radiation Oncology, Virginia Commonwealth University Health System, Richmond, Virginia, USA
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Azizmohammadi F, Navarro Castellanos I, Miró J, Segars P, Samei E, Duong L. Patient-specific Cardio-respiratory Motion Prediction in X-ray Angiography using LSTM Networks. Phys Med Biol 2023; 68. [PMID: 36595253 DOI: 10.1088/1361-6560/acaba8] [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] [Received: 08/12/2022] [Accepted: 12/14/2022] [Indexed: 12/15/2022]
Abstract
Objective.To develop a novel patient-specific cardio-respiratory motion prediction approach for X-ray angiography time series based on a simple long short-term memory (LSTM) model.Approach.The cardio-respiratory motion behavior in an X-ray image sequence was represented as a sequence of 2D affine transformation matrices, which provide the displacement information of contrasted moving objects (arteries and medical devices) in a sequence. The displacement information includes translation, rotation, shearing, and scaling in 2D. A many-to-many LSTM model was developed to predict 2D transformation parameters in matrix form for future frames based on previously generated images. The method was developed with 64 simulated phantom datasets (pediatric and adult patients) using a realistic cardio-respiratory motion simulator (XCAT) and was validated using 10 different patient X-ray angiography sequences.Main results.Using this method we achieved less than 1 mm prediction error for complex cardio-respiratory motion prediction. The following mean prediction error values were recorded over all the simulated sequences: 0.39 mm (for both motions), 0.33 mm (for only cardiac motion), and 0.47 mm (for only respiratory motion). The mean prediction error for the patient dataset was 0.58 mm.Significance.This study paves the road for a patient-specific cardio-respiratory motion prediction model, which might improve navigation guidance during cardiac interventions.
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Affiliation(s)
- Fariba Azizmohammadi
- Interventional Imaging Lab, Department of software and IT engineering, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, Quebec, Canada H3C 1K3, Canada
| | | | - Joaquim Miró
- Department of Pediatrics, CHU Sainte-Justine, Montreal, Canada H3T 1C5, Canada
| | - Paul Segars
- Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Duke University Medical Center, Durham, NC, United States of America
| | - Ehsan Samei
- Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Duke University Medical Center, Durham, NC, United States of America
| | - Luc Duong
- Interventional Imaging Lab, Department of software and IT engineering, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, Quebec, Canada H3C 1K3, Canada
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Adams J, Khan N, Morris A, Elhabian S. Learning spatiotemporal statistical shape models for non-linear dynamic anatomies. Front Bioeng Biotechnol 2023; 11:1086234. [PMID: 36777257 PMCID: PMC9911425 DOI: 10.3389/fbioe.2023.1086234] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
Numerous clinical investigations require understanding changes in anatomical shape over time, such as in dynamic organ cycle characterization or longitudinal analyses (e.g., for disease progression). Spatiotemporal statistical shape modeling (SSM) allows for quantifying and evaluating dynamic shape variation with respect to a cohort or population of interest. Existing data-driven SSM approaches leverage information theory to capture population-level shape variations by learning correspondence-based (landmark) representations of shapes directly from data using entropy-based optimization schemes. These approaches assume sample independence and thus are unsuitable for sequential dynamic shape observations. Previous methods for adapting entropy-based SSM optimization schemes for the spatiotemporal case either utilize a cross-sectional design (ignoring within-subject correlation) or impose other limiting assumptions, such as the linearity of shape dynamics. Here, we present a principled approach to spatiotemporal SSM that relaxes these assumptions to correctly capture population-level shape variation over time. We propose to incorporate modeling the underlying time dependency into correspondence optimization via a regularized principal component polynomial regression. This approach is flexible enough to capture non-linear temporal dynamics while encoding population-specific spatial regularity. We demonstrate our method's efficacy on synthetic data and left atrium segmented from cardiac MRI scans. Our approach better captures the population modes of variation and a statistically significant time dependency than existing methods.
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Affiliation(s)
- Jadie Adams
- School of Computing, University of Utah, Salt Lake City, UT, United States
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
- *Correspondence: Jadie Adams, ; Nawazish Khan, ; Shireen Elhabian,
| | - Nawazish Khan
- School of Computing, University of Utah, Salt Lake City, UT, United States
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
- *Correspondence: Jadie Adams, ; Nawazish Khan, ; Shireen Elhabian,
| | - Alan Morris
- School of Computing, University of Utah, Salt Lake City, UT, United States
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
| | - Shireen Elhabian
- School of Computing, University of Utah, Salt Lake City, UT, United States
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
- *Correspondence: Jadie Adams, ; Nawazish Khan, ; Shireen Elhabian,
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10
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Qiao JH, Qi FG, Liang FL, Ma J, Lv H, Yu X, Xue HJ, An Q, Yan KD, Shi D, Qiao YH, Wang JQ, Zhang Y. Contactless multiscale measurement of cardiac motion using biomedical radar sensor. Front Cardiovasc Med 2022; 9:1057195. [PMID: 36582736 PMCID: PMC9792510 DOI: 10.3389/fcvm.2022.1057195] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction A contactless multiscale cardiac motion measurement method is proposed using impulse radio ultra-wideband (IR-UWB) radar at a center frequency of 7.29 GHz. Motivation Electrocardiograph (ECG), heart sound, and ultrasound are traditional state-of-the-art heartbeat signal measurement methods. These methods suffer from defects in contact and the existence of a blind information segment during the cardiogram measurement. Methods Experiments and analyses were conducted using coarse-to-fine scale. Anteroposterior and along-the-arc measurements were taken from five healthy male subjects (aged 25-43) when lying down or prone. In every measurement, 10 seconds of breath-holding data were recorded with a radar 55 cm away from the body surface, while the ECG was monitored simultaneously as a reference. Results Cardiac motion detection from the front was superior to that from the back in amplitude. In terms of radar detection angles, the best cardiac motion information was observed at a detection angle of 120°. Finally, in terms of cardiac motion cycles, all the ECG information, as well as short segments of cardiac motion details named blind ECGs segments, were detected. Significance A contactless and multiscale cardiac motion detection method is proposed with no blind detection of segments during the entire cardiac cycle. This paves the way for a potentially significant method of fast and accurate cardiac disease assessment and diagnosis that exhibits promising application prospects in contactless online cardiac monitoring and in-home healthcare.
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Affiliation(s)
- Jia-hao Qiao
- Department of Military Biomedical Engineering, Fourth Military Medical University, Xi'an, China,School of Electronic Information Engineering, Xi'an Technological University, Xi'an, China
| | - Fu-gui Qi
- Department of Military Biomedical Engineering, Fourth Military Medical University, Xi'an, China,*Correspondence: Fu-gui Qi
| | - Fu-lai Liang
- Department of Military Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Jin Ma
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Hao Lv
- Department of Military Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Xiao Yu
- Department of Military Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Hui-jun Xue
- Department of Military Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Qiang An
- Department of Military Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Ke-ding Yan
- School of Electronic Information Engineering, Xi'an Technological University, Xi'an, China
| | - Ding Shi
- Department of Military Biomedical Engineering, Fourth Military Medical University, Xi'an, China,School of Electronic Information Engineering, Xi'an Technological University, Xi'an, China
| | - Yong-hui Qiao
- State Key Laboratory of Clean Energy Utilization, Zhejiang University, Hangzhou, China
| | - Jian-qi Wang
- Department of Military Biomedical Engineering, Fourth Military Medical University, Xi'an, China,Jian-qi Wang
| | - Yang Zhang
- Department of Military Biomedical Engineering, Fourth Military Medical University, Xi'an, China,Yang Zhang
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11
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Falcão MBL, Di Sopra L, Ma L, Bacher M, Yerly J, Speier P, Rutz T, Prša M, Markl M, Stuber M, Roy CW. Pilot tone navigation for respiratory and cardiac motion-resolved free-running 5D flow MRI. Magn Reson Med 2021; 87:718-732. [PMID: 34611923 PMCID: PMC8627452 DOI: 10.1002/mrm.29023] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/17/2021] [Accepted: 09/03/2021] [Indexed: 11/07/2022]
Abstract
Purpose In this work, we integrated the pilot tone (PT) navigation system into a reconstruction framework for respiratory and cardiac motion‐resolved 5D flow. We tested the hypotheses that PT would provide equivalent respiratory curves, cardiac triggers, and corresponding flow measurements to a previously established self‐gating (SG) technique while being independent from changes to the acquisition parameters. Methods Fifteen volunteers and 9 patients were scanned with a free‐running 5D flow sequence, with PT integrated. Respiratory curves and cardiac triggers from PT and SG were compared across all subjects. Flow measurements from 5D flow reconstructions using both PT and SG were compared to each other and to a reference electrocardiogram‐gated and respiratory triggered 4D flow acquisition. Radial trajectories with variable readouts per interleave were also tested in 1 subject to compare cardiac trigger quality between PT and SG. Results The correlation between PT and SG respiratory curves were 0.95 ± 0.06 for volunteers and 0.95 ± 0.04 for patients. Heartbeat duration measurements in volunteers and patients showed a bias to electrocardiogram measurements of, respectively, 0.16 ± 64.94 ms and 0.01 ± 39.29 ms for PT versus electrocardiogram and of 0.24 ± 63.68 ms and 0.09 ± 32.79 ms for SG versus electrocardiogram. No significant differences were reported for the flow measurements between 5D flow PT and from 5D flow SG. A decrease in the cardiac triggering quality of SG was observed for increasing readouts per interleave, whereas PT quality remained constant. Conclusion PT has been successfully integrated in 5D flow MRI and has shown equivalent results to the previously described 5D flow SG technique, while being completely acquisition‐independent.
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Affiliation(s)
- Mariana B L Falcão
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Lorenzo Di Sopra
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Liliana Ma
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA
| | - Mario Bacher
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Siemens Healthcare GmbH, Erlangen, Germany.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | | | - Tobias Rutz
- Service of Cardiology, Centre de Resonance Magnétique Cardiaque (CRMC), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Milan Prša
- Woman-Mother-Child Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Christopher W Roy
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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12
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Mayer J, Jin Y, Wurster TH, Makowski MR, Kolbitsch C. Evaluation of synergistic image registration for motion-corrected coronary NaF-PET-MR. Philos Trans A Math Phys Eng Sci 2021; 379:20200202. [PMID: 33966463 PMCID: PMC8107649 DOI: 10.1098/rsta.2020.0202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Coronary artery disease (CAD) is caused by the formation of plaques in the coronary arteries and is one of the most common cardiovascular diseases. NaF-PET can be used to assess plaque composition, which could be important for therapy planning. One of the main challenges of NaF-PET is cardiac and respiratory motion which can strongly impair diagnostic accuracy. In this study, we investigated the use of a synergistic image registration approach which combined motion-resolved MR and PET data to estimate cardiac and respiratory motion. This motion estimation could then be used to improve the NaF-PET image quality. The approach was evaluated with numerical simulations and in vivo scans of patients suffering from CAD. In numerical simulations, it was shown, that combining MR and PET information can improve the accuracy of motion estimation by more than 15%. For the in vivo scans, the synergistic image registration led to an improvement in uptake visualization. This is the first study to assess the benefit of combining MR and NaF-PET for cardiac and respiratory motion estimation. Further patient evaluation is required to fully evaluate the potential of this approach. This article is part of the theme issue 'Synergistic tomographic image reconstruction: part 1'.
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Affiliation(s)
- Johannes Mayer
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Yining Jin
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Thomas-Heinrich Wurster
- Klinik für Kardiologie, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Marcus R. Makowski
- Department of Radiology, Charité, Universitätsmedizin Berlin, Berlin, Germany
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christoph Kolbitsch
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
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13
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Massera D, Doris MK, Cadet S, Kwiecinski J, Pawade TA, Peeters FECM, Dey D, Newby DE, Dweck MR, Slomka PJ. Analytical quantification of aortic valve 18F-sodium fluoride PET uptake. J Nucl Cardiol 2020; 27:962-972. [PMID: 30499069 PMCID: PMC6541558 DOI: 10.1007/s12350-018-01542-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 10/01/2018] [Accepted: 11/07/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Challenges to cardiac PET-CT include patient motion, prolonged image acquisition and a reduction of counts due to gating. We compared two analytical tools, FusionQuant and OsiriX, for quantification of gated cardiac 18F-sodium fluoride (18F-fluoride) PET-CT imaging. METHODS Twenty-seven patients with aortic stenosis were included, 15 of whom underwent repeated imaging 4 weeks apart. Agreement between analytical tools and scan-rescan reproducibility was determined using the Bland-Altman method and Lin's concordance correlation coefficients (CCC). RESULTS Image analysis was faster with FusionQuant [median time (IQR) 7:10 (6:40-8:20) minutes] compared with OsiriX [8:30 (8:00-10:10) minutes, p = .002]. Agreement of uptake measurements between programs was excellent, CCC = 0.972 (95% CI 0.949-0.995) for mean tissue-to-background ratio (TBRmean) and 0.981 (95% CI 0.965-0.997) for maximum tissue-to-background ratio (TBRmax). Mean noise decreased from 11.7% in the diastolic gate to 6.7% in motion-corrected images (p = .002); SNR increased from 25.41 to 41.13 (p = .0001). Aortic valve scan-rescan reproducibility for TBRmax was improved with FusionQuant using motion correction compared to OsiriX (error ± 36% vs ± 13%, p < .001) while reproducibility for TBRmean was similar (± 10% vs ± 8% p = .252). CONCLUSION 18F-fluoride PET quantification with FusionQuant and OsiriX is comparable. FusionQuant with motion correction offers advantages with respect to analysis time and reproducibility of TBRmax values.
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Affiliation(s)
- Daniele Massera
- Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY, USA
| | - Mhairi K Doris
- BHF Centre for Cardiovascular Science, Clinical Research Imaging Centre, Edinburgh Heart Centre, University of Edinburgh, Edinburgh, Scotland, UK
| | - Sebastien Cadet
- Department of Imaging, Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Ste A047 N, Los Angeles, CA, 90048, USA
| | - Jacek Kwiecinski
- BHF Centre for Cardiovascular Science, Clinical Research Imaging Centre, Edinburgh Heart Centre, University of Edinburgh, Edinburgh, Scotland, UK
- Department of Imaging, Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Ste A047 N, Los Angeles, CA, 90048, USA
| | - Tania A Pawade
- BHF Centre for Cardiovascular Science, Clinical Research Imaging Centre, Edinburgh Heart Centre, University of Edinburgh, Edinburgh, Scotland, UK
| | | | - Damini Dey
- Department of Imaging, Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Ste A047 N, Los Angeles, CA, 90048, USA
| | - David E Newby
- BHF Centre for Cardiovascular Science, Clinical Research Imaging Centre, Edinburgh Heart Centre, University of Edinburgh, Edinburgh, Scotland, UK
| | - Marc R Dweck
- BHF Centre for Cardiovascular Science, Clinical Research Imaging Centre, Edinburgh Heart Centre, University of Edinburgh, Edinburgh, Scotland, UK
| | - Piotr J Slomka
- Department of Imaging, Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Ste A047 N, Los Angeles, CA, 90048, USA.
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14
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Šprem J, de Vos BD, Lessmann N, de Jong PA, Viergever MA, Išgum I. Impact of automatically detected motion artifacts on coronary calcium scoring in chest computed tomography. J Med Imaging (Bellingham) 2018; 5:044007. [PMID: 30840743 DOI: 10.1117/1.jmi.5.4.044007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 06/14/2018] [Accepted: 11/16/2018] [Indexed: 11/14/2022] Open
Abstract
The amount of coronary artery calcification (CAC) quantified in computed tomography (CT) scans enables prediction of cardiovascular disease (CVD) risk. However, interscan variability of CAC quantification is high, especially in scans made without ECG synchronization. We propose a method for automatic detection of CACs that are severely affected by cardiac motion. Subsequently, we evaluate the impact of such CACs on CAC quantification and CVD risk determination. This study includes 1000 baseline and 585 one-year follow-up low-dose chest CTs from the National Lung Screening Trial. About 415 baseline scans are used to train and evaluate a convolutional neural network that identifies observer determined CACs affected by severe motion artifacts. Therefore, 585 paired scans acquired at baseline and follow-up were used to evaluate the impact of severe motion artifacts on CAC quantification and risk categorization. Based on the CAC amount, the scans were categorized into four standard CVD risk categories. The method identified CACs affected by severe motion artifacts with 85.2% accuracy. Moreover, reproducibility of CAC scores in scan pairs is higher in scans containing mostly CACs not affected by severe cardiac motion. Hence, the proposed method enables identification of scans affected by severe cardiac motion, where CAC quantification may not be reproducible.
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Affiliation(s)
- Jurica Šprem
- University Medical Center Utrecht, Image Sciences Institute, Utrecht, The Netherlands
| | - Bob D de Vos
- University Medical Center Utrecht, Image Sciences Institute, Utrecht, The Netherlands
| | - Nikolas Lessmann
- University Medical Center Utrecht, Image Sciences Institute, Utrecht, The Netherlands
| | - Pim A de Jong
- Utrecht University and University Medical Center Utrecht, Department of Radiology, Utrecht, The Netherlands
| | - Max A Viergever
- Utrecht University and University Medical Center Utrecht, Image Sciences Institute, Utrecht, The Netherlands
| | - Ivana Išgum
- University Medical Center Utrecht, Image Sciences Institute, Utrecht, The Netherlands
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15
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Hoang P, Huebsch N, Bang SH, Siemons BA, Conklin BR, Healy KE, Ma Z, Jacquir S. Quantitatively characterizing drug-induced arrhythmic contractile motions of human stem cell-derived cardiomyocytes. Biotechnol Bioeng 2018; 115:1958-1970. [PMID: 29663322 PMCID: PMC6283051 DOI: 10.1002/bit.26709] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 10/26/2017] [Revised: 03/07/2018] [Accepted: 04/06/2018] [Indexed: 12/31/2022]
Abstract
Quantification of abnormal contractile motions of cardiac tissue has been a noteworthy challenge and significant limitation in assessing and classifying the drug-induced arrhythmias (i.e., Torsades de pointes). To overcome these challenges, researchers have taken advantage of computational image processing tools to measure contractile motion from cardiomyocytes derived from human induced pluripotent stem cells (hiPSC-CMs). However, the amplitude and frequency analysis of contractile motion waveforms does not produce sufficient information to objectively classify the degree of variations between two or more sets of cardiac contractile motions. In this paper, we generated contractile motion data from beating hiPSC-CMs using motion tracking software based on optical flow analysis, and then implemented a computational algorithm, phase space reconstruction (PSR), to derive parameters (embedding, regularity, and fractal dimensions) to further characterize the dynamic nature of the cardiac contractile motions. Application of drugs known to cause cardiac arrhythmia induced significant changes to these resultant dimensional parameters calculated from PSR analysis. Integrating this new computational algorithm with the existing analytical toolbox of cardiac contractile motions will allow us to expand current assessments of cardiac tissue physiology into an automated, high-throughput, and quantifiable manner which will allow more objective assessments of drug-induced proarrhythmias.
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Affiliation(s)
- Plansky Hoang
- Department of Biomedical & Chemical Engineering, Syracuse University, Syracuse, NY, USA
- Syracuse Biomaterials Institute, Syracuse University, NY, USA
| | - Nathaniel Huebsch
- Department of Bioengineering, University of California, Berkeley, CA, USA
- Department of Material Science & Engineering, University of California, Berkeley, CA, USA
| | - Shin Hyuk Bang
- Department of Biomedical & Chemical Engineering, Syracuse University, Syracuse, NY, USA
| | - Brian A. Siemons
- Department of Bioengineering, University of California, Berkeley, CA, USA
| | - Bruce R. Conklin
- Glastone Institute of Cardiovascular Diseases, San Francisco, CA, USA
- Department of Medicine, and Cellular and Molecular Pharmacology, University of California, San Francisco, CA, USA
| | - Kevin E. Healy
- Department of Bioengineering, University of California, Berkeley, CA, USA
- Department of Material Science & Engineering, University of California, Berkeley, CA, USA
| | - Zhen Ma
- Department of Biomedical & Chemical Engineering, Syracuse University, Syracuse, NY, USA
- Syracuse Biomaterials Institute, Syracuse University, NY, USA
| | - Sabir Jacquir
- Laboratoire LE2I UMR CNRS 6306, Université de Bourgogne Franche-Comté, Dijon, France
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16
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Spear TJ, Stromp TA, Leung SW, Vandsburger MH. Influence of longitudinal position on the evolution of steady-state signal in cardiac cine balanced steady-state free precession imaging. Acta Radiol Open 2017; 6:2058460117729186. [PMID: 29201434 PMCID: PMC5700791 DOI: 10.1177/2058460117729186] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 08/08/2017] [Indexed: 11/18/2022] Open
Abstract
Background Emerging quantitative cardiac magnetic resonance imaging (CMRI) techniques use cine balanced steady-state free precession (bSSFP) to measure myocardial signal intensity and probe underlying physiological parameters. This correlation assumes that steady-state is maintained uniformly throughout the heart in space and time. Purpose To determine the effects of longitudinal cardiac motion and initial slice position on signal deviation in cine bSSFP imaging by comparing two-dimensional (2D) and three-dimensional (3D) acquisitions. Material and Methods Nine healthy volunteers completed cardiac MRI on a 1.5-T scanner. Short axis images were taken at six slice locations using both 2D and 3D cine bSSFP. 3D acquisitions spanned two slices above and below selected slice locations. Changes in myocardial signal intensity were measured across the cardiac cycle and compared to longitudinal shortening. Results For 2D cine bSSFP, 46% ± 9% of all frames and 84% ± 13% of end-diastolic frames remained within 10% of initial signal intensity. For 3D cine bSSFP the proportions increased to 87% ± 8% and 97% ± 5%. There was no correlation between longitudinal shortening and peak changes in myocardial signal. The initial slice position significantly impacted peak changes in signal intensity for 2D sequences (P < 0.001). Conclusion The initial longitudinal slice location significantly impacts the magnitude of deviation from steady-state in 2D cine bSSFP that is only restored at the center of a 3D excitation volume. During diastole, a transient steady-state is established similar to that achieved with 3D cine bSSFP regardless of slice location.
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Affiliation(s)
- Tyler J Spear
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA
| | - Tori A Stromp
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA.,Department of Physiology, University of Kentucky, Lexington, KY, USA
| | - Steve W Leung
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA.,Gill Heart Institute, University of Kentucky, Lexington, KY, USA
| | - Moriel H Vandsburger
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA.,Department of Physiology, University of Kentucky, Lexington, KY, USA.,Department of Bioengineering, University of California, Berkeley, CA, USA
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17
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Abstract
Computed tomography (CT)-guided lung biopsy of nodules located near the heart may be associated with potential complications. To understand the influences of cardiac motion on lung parenchyma during biopsy, we processed the cardiac phase images of coronary CT angiography (CCTA) and noticed shifts in mediastinum lung margin (MLM) at different zones.Thirty eight CCTA (27 men and 11 women) were retrospectively evaluated. Image processing was done with Fiji (an open source Java image processing program by Fiji contributors) using 10% to 90% phase images of CCTA; and tissue displacement (MLM shift) was shown on the resulting images.The participants were 58.29 ± 9.87 years old; their height was 166.32 ± 7.57 cm while their weight was 74.18 ± 13.59 kg. The mean values of MLM shifts in Zones 1 to 9 ranged from 1.98 to 7.76 mm. Large MLM shifts were observed in the free wall of the left ventricle (LV). MLM shift of the upper free wall of the LV was 6.98 ± 1.99 mm and that of the lower free wall of the LV was 7.76 ± 3.26 mm. The largest MLM shift among all patients was 16.05 mm, found in the lower free wall of the LV. The age factor had a weak positive correlation with the wall of the pulmonary artery (r = 0.350, P = .031) and that of the right atrial appendage (r = 0.418, P = .009). In contrast, a weak negative correlation of age factor was observed with the lower free wall of the LV (r = -0.336, P = .039).In conclusion, we suggest that physicians observe caution when performing lung biopsy if the distance between the lung lesion and the MLM is 1 to 2 cm. CT-guided lung biopsy should be avoided if the distance is <1 cm. Physicians should pay special attention to lung lesions near the LV.
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Affiliation(s)
- Li-Sheng Hsu
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi
- Department of Physical Education, Health and Recreation, National Chiayi University, Chiayi
- Chang Gung University College of Medicine, Taoyuan
| | - Chien-Wei Chen
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi
- Chang Gung University College of Medicine, Taoyuan
- Institute of Medicine, Chung Shan Medical University, Taichung
| | - Chia-Hao Chang
- College of Nursing and the Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
| | - Chien-Han Liao
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi
| | - Sheng-Lung Hsu
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi
- Chang Gung University College of Medicine, Taoyuan
| | - Wei-Ming Lin
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi
- Chang Gung University College of Medicine, Taoyuan
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18
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Fuetterer M, Stoeck CT, Kozerke S. Second-order motion compensated PRESS for cardiac spectroscopy. Magn Reson Med 2016; 77:57-64. [PMID: 26762792 DOI: 10.1002/mrm.26099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 07/14/2015] [Revised: 10/27/2015] [Accepted: 11/28/2015] [Indexed: 11/07/2022]
Abstract
PURPOSE Second-order motion compensation for point-resolved spectroscopy (PRESS) is proposed to allow for robust single-voxel cardiac spectroscopy throughout the entire cardiac cycle and at various heart rates. METHODS Bipolar FID spoiling gradient pairs compensating for first and second-order motion were designed and implemented into a cardiac-triggered PRESS sequence on a clinical MR system. A numerical three-dimensional model of cardiac motion was used to optimize and validate the gradient waveforms. In vivo measurements in healthy volunteers were obtained to assess the signal-to-noise ratio (SNR) and triglyceride-to-water ratio (TG/W). SNR gains and variability of TG/W of the proposed approach were evaluated against a conventional PRESS sequence with optimized gradients. RESULTS The proposed sequence increases the mean SNR by 32% (W) and 23% (TG) on average with significantly lower variability for different trigger delays. The variability of TG/W quantification over the cardiac cycle is significantly decreased with second-order motion compensated PRESS when compared with conventional PRESS with reduced-spoiler gradients (coefficient of variation: 0.1 ± 0.02 versus 0.37 ± 0.26). CONCLUSION Second-order motion compensated PRESS effectively reduces cardiac motion-induced signal degradation during FID spoiling, providing higher SNR and less variability for TG/W quantification. The sequence is considered promising to assess the TG/W modulation during various interventions including pharmacologically induced stress. Magn Reson Med 77:57-64, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Maximilian Fuetterer
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Christian T Stoeck
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.,Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.,Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
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Huang C, Petibon Y, Ouyang J, Reese TG, Ahlman MA, Bluemke DA, El Fakhri G. Accelerated acquisition of tagged MRI for cardiac motion correction in simultaneous PET-MR: phantom and patient studies. Med Phys 2015; 42:1087-97. [PMID: 25652521 PMCID: PMC4312342 DOI: 10.1118/1.4906247] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 07/24/2014] [Revised: 01/05/2015] [Accepted: 01/06/2015] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Degradation of image quality caused by cardiac and respiratory motions hampers the diagnostic quality of cardiac PET. It has been shown that improved diagnostic accuracy of myocardial defect can be achieved by tagged MR (tMR) based PET motion correction using simultaneous PET-MR. However, one major hurdle for the adoption of tMR-based PET motion correction in the PET-MR routine is the long acquisition time needed for the collection of fully sampled tMR data. In this work, the authors propose an accelerated tMR acquisition strategy using parallel imaging and/or compressed sensing and assess the impact on the tMR-based motion corrected PET using phantom and patient data. METHODS Fully sampled tMR data were acquired simultaneously with PET list-mode data on two simultaneous PET-MR scanners for a cardiac phantom and a patient. Parallel imaging and compressed sensing were retrospectively performed by GRAPPA and kt-FOCUSS algorithms with various acceleration factors. Motion fields were estimated using nonrigid B-spline image registration from both the accelerated and fully sampled tMR images. The motion fields were incorporated into a motion corrected ordered subset expectation maximization reconstruction algorithm with motion-dependent attenuation correction. RESULTS Although tMR acceleration introduced image artifacts into the tMR images for both phantom and patient data, motion corrected PET images yielded similar image quality as those obtained using the fully sampled tMR images for low to moderate acceleration factors (<4). Quantitative analysis of myocardial defect contrast over ten independent noise realizations showed similar results. It was further observed that although the image quality of the motion corrected PET images deteriorates for high acceleration factors, the images were still superior to the images reconstructed without motion correction. CONCLUSIONS Accelerated tMR images obtained with more than 4 times acceleration can still provide relatively accurate motion fields and yield tMR-based motion corrected PET images with similar image quality as those reconstructed using fully sampled tMR data. The reduction of tMR acquisition time makes it more compatible with routine clinical cardiac PET-MR studies.
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Affiliation(s)
- Chuan Huang
- Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Department of Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115; and Departments of Radiology, Psychiatry, Stony Brook Medicine, Stony Brook, New York 11794
| | - Yoann Petibon
- Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Department of Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114
| | - Jinsong Ouyang
- Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Department of Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 and Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115
| | - Timothy G Reese
- Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115 and Martinos Center for Biomedical Imaging, Charlestown, Massachusetts 02129
| | - Mark A Ahlman
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland 20892
| | - David A Bluemke
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland 20892
| | - Georges El Fakhri
- Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Department of Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 and Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115
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Marin T, Kalayehis MM, Parages FM, Brankov JG. Numerical Surrogates for Human Observers in Myocardial Motion Evaluation From SPECT Images. IEEE Trans Med Imaging 2014; 33:38-47. [PMID: 23981533 PMCID: PMC4148467 DOI: 10.1109/tmi.2013.2279517] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In medical imaging, the gold standard for image-quality assessment is a task-based approach in which one evaluates human observer performance for a given diagnostic task (e.g., detection of a myocardial perfusion or motion defect). To facilitate practical task-based image-quality assessment, model observers are needed as approximate surrogates for human observers. In cardiac-gated SPECT imaging, diagnosis relies on evaluation of the myocardial motion as well as perfusion. Model observers for the perfusion-defect detection task have been studied previously, but little effort has been devoted toward development of a model observer for cardiac-motion defect detection. In this work, we describe two model observers for predicting human observer performance in detection of cardiac-motion defects. Both proposed methods rely on motion features extracted using previously reported deformable mesh model for myocardium motion estimation. The first method is based on a Hotelling linear discriminant that is similar in concept to that used commonly for perfusion-defect detection. In the second method, based on relevance vector machines (RVM) for regression, we compute average human observer performance by first directly predicting individual human observer scores, and then using multi reader receiver operating characteristic analysis. Our results suggest that the proposed RVM model observer can predict human observer performance accurately, while the new Hotelling motion-defect detector is somewhat less effective.
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Affiliation(s)
- Thibault Marin
- The Medical imaging Research Center; Illinois Institute of Technology, Chicago, IL 60616 USA
| | - Mahdi M. Kalayehis
- The Department of Electrical Engineering and Computer Science; University of Central Florida
| | - Felipe M. Parages
- The Medical imaging Research Center; Illinois Institute of Technology, Chicago, IL 60616 USA
| | - Jovan G. Brankov
- The Medical imaging Research Center; Illinois Institute of Technology, Chicago, IL 60616 USA
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Abstract
This article introduces a new image processing technique for rapid analysis of tagged cardiac magnetic resonance image sequences. The method uses isolated spectral peaks in SPAMM-tagged magnetic resonance images, which contain information about cardiac motion. The inverse Fourier transform of a spectral peak is a complex image whose calculated angle is called a harmonic phase (HARP) image. It is shown how two HARP image sequences can be used to automatically and accurately track material points through time. A rapid, semiautomated procedure to calculate circumferential and radial Lagrangian strain from tracked points is described. This new computational approach permits rapid analysis and visualization of myocardial strain within 5-10 min after the scan is complete. Its performance is demonstrated on MR image sequences reflecting both normal and abnormal cardiac motion. Results from the new method are shown to compare very well with a previously validated tracking algorithm. Magn Reson Med 42:1048-1060, 1999.
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Affiliation(s)
- N F Osman
- Department of Electrical and Computer Engineering, Center for Imaging Science, The Johns Hopkins University, Baltimore, MD 21218, USA
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