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Entezarmahdi SM, Faghihi R, Yazdi M, Shahamiri N, Geramifar P, Haghighatafshar M. QCard-NM: Developing a semiautomatic segmentation method for quantitative analysis of the right ventricle in non-gated myocardial perfusion SPECT imaging. EJNMMI Phys 2023; 10:21. [PMID: 36959409 PMCID: PMC10036722 DOI: 10.1186/s40658-023-00539-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/01/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Recent studies have shown that the right ventricular (RV) quantitative analysis in myocardial perfusion imaging (MPI) SPECT can be beneficial in the diagnosis of many cardiopulmonary diseases. This study proposes a new algorithm for right ventricular 3D segmentation and quantification. METHODS The proposed Quantitative Cardiac analysis in Nuclear Medicine imaging (QCard-NM) algorithm provides RV myocardial surface estimation and creates myocardial contour using an iterative 3D model fitting method. The founded contour is then used for quantitative RV analysis. The proposed method was assessed using various patient datasets and digital phantoms. First, the physician's manually drawn contours were compared to the QCard-NM RV segmentation using the Dice similarity coefficient (DSC). Second, using repeated MPI scans, the QCard-NM's repeatability was evaluated and compared with the QPS (quantitative perfusion SPECT) algorithm. Third, the bias of the calculated RV cavity volume was analyzed using 31 digital phantoms using the QCard-NM and QPS algorithms. Fourth, the ability of QCard-NM analysis to diagnose coronary artery diseases was assessed in 60 patients referred for both MPI and coronary angiography. RESULTS The average DSC value was 0.83 in the first dataset. In the second dataset, the coefficient of repeatability of the calculated RV volume between two repeated scans was 13.57 and 43.41 ml for the QCard-NM and QPS, respectively. In the phantom study, the mean absolute percentage errors for the calculated cavity volume were 22.6% and 42.2% for the QCard-NM and QPS, respectively. RV quantitative analysis using QCard-NM in detecting patients with severe left coronary system stenosis and/or three-vessel diseases achieved a fair performance with the area under the ROC curve of 0.77. CONCLUSION A novel model-based iterative method for RV segmentation task in non-gated MPI SPECT is proposed. The precision, accuracy, and consistency of the proposed method are demonstrated by various validation techniques. We believe this preliminary study could lead to developing a framework for improving the diagnosis of cardiopulmonary diseases using RV quantitative analysis in MPI SPECT.
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Affiliation(s)
- Seyed Mohammad Entezarmahdi
- Nuclear Engineering Department, Shiraz University, Shiraz, Iran
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Faghihi
- Nuclear Engineering Department, Shiraz University, Shiraz, Iran.
| | - Mehran Yazdi
- School of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran
| | - Negar Shahamiri
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Computer Science and Engineering and IT, Shiraz University, Shiraz, Iran
| | - Parham Geramifar
- Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Haghighatafshar
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Nuclear Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Hosseinzadeh E, Ghodsirad M, Alirezaie T, Arfenia M, Amoui M, Pirayesh E, Norouzi G, Khoshbakht S. Assessing the prevalence and predicting factors of an abnormal gated myocardial perfusion SPECT in asymptomatic patients with type 2 diabetes. Int J Cardiovasc Imaging 2021; 38:457-464. [PMID: 34482508 DOI: 10.1007/s10554-021-02400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
Considering the significant prevalence of silent myocardial ischemia and its related morbidity and mortality in asymptomatic type 2 diabetic patients, it is not well known whether early screening with MPI is cost-effective and predicting factors are not well elucidated. This was a cross-sectional study including 63 asymptomatic patients with type 2 diabetes mellitus (T2DM), with normal ECG and ejection fraction. Patients with any history of documented valvular, congestive or ischemic heart disease, renal or hepatic failure were excluded. At first all patients were interviewed and checked for risk factors and then patients underwent a two-day rest/stress 99mTc-MIBI gated MPI SPECT. Data was assessed by QPS/QGS and 4DM software and evaluated by a nuclear medicine specialist with summed stress score (SSS) of more than 4 defined as CAD. There were 42 females (67%) and 21 males (33%), with a mean age of 61.33 ± 6.98 years and 7.97 ± 4.86 years history of T2DM. CAD was detected in 26 (41.3%) patients and was significantly associated with male gender, smoking and requiring insulin therapy (P-value = 0.019, 0.046, 0.05, respectively). A significant association was found between the duration of diabetes, especially when > 15 years, and the probability of having CAD. Multivariable logistic regression revealed that smoking; male gender and diabetes duration were the strongest independent predictors of abnormal MPI results. We found a high (46%) prevalence of abnormal stress MPI SPECT in patients with type 2 diabetes mellitus, despite being asymptomatic. Asymptomatic patients with a history of smoking, long duration of diabetes, being under insulin treatment and male gender might benefit from MPI for early detection of silent ischemia.
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Affiliation(s)
- E Hosseinzadeh
- Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Nuclear Medicine Department, Shohada Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadali Ghodsirad
- Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Nuclear Medicine Department, Shohada Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Shohada Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.
| | - T Alirezaie
- Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Cardiology Department, Shohada Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Arfenia
- Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Nuclear Medicine Department, Shohada Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Amoui
- Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Nuclear Medicine Department, Shohada Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - E Pirayesh
- Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Nuclear Medicine Department, Shohada Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - G Norouzi
- Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Nuclear Medicine Department, Shohada Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Khoshbakht
- Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Nuclear Medicine Department, Shohada Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bernsen MLE, Koppes JCC, Straver B, Verberne HJ. Left ventricular ischemia after arterial switch procedure: Role of myocardial perfusion scintigraphy and cardiac CT. J Nucl Cardiol 2020; 27:651-658. [PMID: 31119712 PMCID: PMC7174277 DOI: 10.1007/s12350-019-01738-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/12/2019] [Indexed: 11/05/2022]
Abstract
Transposition of the great arteries is a congenital heart defect defined by an abnormal connection between the aorta, pulmonary artery, and the ventricles, resulting in parallel systemic and pulmonary circulations. Long-term follow-up data of patients who underwent correction via an arterial switch operation have recently shown that as a result of re-implantation of the coronary arteries in the neo-aorta, coronary stenosis and occlusion are relatively common complications. In this report, we discuss two cases illustrating the added value of myocardial perfusion imaging (MPI) and cardiac CT for the assessment of these patients. Based on the available literature we conclude that MPI and cardiac CT are excellent non-invasive methods to evaluate coronary anatomy and myocardial function also in this specific group of patients.
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Affiliation(s)
- Marie Louise E Bernsen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Meibergdreef 9, 1109 AZ, Amsterdam, The Netherlands.
| | - Josephina C C Koppes
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Meibergdreef 9, 1109 AZ, Amsterdam, The Netherlands
| | - Bart Straver
- Department of Cardiology, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Meibergdreef 9, 1109 AZ, Amsterdam, The Netherlands
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Vadi SK, Mehrotra S, Sood A, Parmar M, Dasagrandhi V, Kaur K, Mittal BR. Flip-flop right ventricle myocardial perfusion on stress-rest 99mTc-MIBI myocardial perfusion scintigraphy: An indirect evidence for severe left ventricular coronary arterial disease? J Nucl Cardiol 2019; 26:1033-1035. [PMID: 30547296 DOI: 10.1007/s12350-018-01565-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 12/03/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Shelvin Kumar Vadi
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - Saurabh Mehrotra
- Department of Cardiology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - Ashwani Sood
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India.
| | - Madan Parmar
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - Vaishnavi Dasagrandhi
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - Komalpreet Kaur
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - Bhagwant Rai Mittal
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
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Murarka S, Movahed MR. Review of Movahed's sign (D shaped left ventricle seen on gated SPECT) suggestive of right ventricular overload. Int J Cardiovasc Imaging 2010; 26:553-7. [PMID: 20213472 DOI: 10.1007/s10554-010-9600-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2009] [Accepted: 02/08/2010] [Indexed: 12/11/2022]
Abstract
Recently, D shaped ventricle seen on gated SPECT imaging (Movahed's sign) has shown to correlate with right ventricular overload similar to the D shape ventricle seen on echocardiography. Right ventricle (RV) imaging during gated SPECT studies is challenging because of the low tracer uptake due to relatively smaller right ventricular myocardial mass and lower coronary flow to the RV. Increased mass or workload causes higher tracer uptake in the RV wall secondary to increase in RV wall thickness and higher coronary flow. Furthermore, increased RV volume or pressure load can cause displacement of the septum towards the left ventricle causing septal flattening and a D shaped configuration of the left ventricular septum. This is an important finding that should be a part of nuclear gated SPECT interpretation.
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