1
|
Hadjiabdolhamid N, Zhao Y, Hubbard L, Molloi S. Reproducibility of a single-volume dynamic CT myocardial blood flow measurement technique: validation in a swine model. Eur Radiol Exp 2024; 8:91. [PMID: 39143412 PMCID: PMC11324639 DOI: 10.1186/s41747-024-00498-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/15/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND We prospectively assessed the reproducibility of a novel low-dose single-volume dynamic computed tomography (CT) myocardial blood flow measurement technique. METHODS Thirty-four pairs of measurements were made under rest and stress conditions in 13 swine (54.3 ± 12.3 kg). One or two acquisition pairs were acquired in each animal with a 10-min delay between each pair. Contrast (370 mgI/mL; 0.5 mL/kg) and a diluted contrast/saline chaser (0.5 mL/kg; 30:70 contrast/saline) were injected peripherally at 5 mL/s, followed by bolus tracking and acquisition of a single volume scan (100 kVp; 200 mA) with a 320-slice CT scanner. Bolus tracking and single volume scan data were used to derive perfusion in mL/min/g using a first-pass analysis model; the coronary perfusion territories of the left anterior descending (LAD), left circumflex (LCx), and right coronary artery (RCA) were automatically assigned using a previously validated minimum-cost path technique. The reproducibility of CT myocardial perfusion measurement within the LAD, LCx, RCA, and the whole myocardium was assessed via regression analysis. The average CT dose index (CTDI) of perfusion measurement was recorded. RESULTS The repeated first (Pmyo1) and second (Pmyo2) single-volume CT perfusion measurements were related by Pmyo2 = 1.01Pmyo1 - 0.03(ρ = 0.96; RMSE = 0.08 mL/min/g; RMSE = 0.07 mL/min/g) for the whole myocardium, and by Preg2 = 0.86Preg1 + 0.13(ρ = 0.87; RMSE = 0.31 mL/min/g; RMSE = 0.29 mL/min/g) for the LAD, LCx, and RCA perfusion territories. The average CTDI of the single-volume CT perfusion measurement was 10.5 mGy. CONCLUSION The single-volume CT blood flow measurement technique provides reproducible low-dose myocardial perfusion measurement using only bolus tracking data and a single whole-heart volume scan. RELEVANCE STATEMENT The single-volume CT blood flow measurement technique is a noninvasive tool that reproducibly measures myocardial perfusion and provides coronary CT angiograms, allowing for simultaneous anatomic-physiologic assessment of myocardial ischemia. KEY POINTS A low-dose single-volume dynamic CT myocardial blood flow measurement technique is reproducible. Motion misregistration artifacts are eliminated using a single-volume CT perfusion technique. This technique enables combined anatomic-physiologic assessment of coronary artery disease.
Collapse
Affiliation(s)
- Negin Hadjiabdolhamid
- Department of Radiological Sciences, University of California, Irvine, Irvine, CA, 92697, USA
| | - Yixiao Zhao
- Department of Radiological Sciences, University of California, Irvine, Irvine, CA, 92697, USA
| | - Logan Hubbard
- Department of Radiological Sciences, University of California, Irvine, Irvine, CA, 92697, USA
| | - Sabee Molloi
- Department of Radiological Sciences, University of California, Irvine, Irvine, CA, 92697, USA.
| |
Collapse
|
2
|
Cheng X, Liu Y, Qi B, Wang Y, Zheng Y, Liang X, Chang Y, Ning M, Gao W, Li T. Glycyrrhizic acid alleviated MI/R-induced injuries by inhibiting Hippo/YAP signaling pathways. Cell Signal 2024; 115:111036. [PMID: 38185229 DOI: 10.1016/j.cellsig.2024.111036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
BACKGROUND Previous research has demonstrated that glycyrrhizic acid (GA) exhibits antioxidant, anti-inflammatory, and antiapoptotic characteristics. Using myocardial ischemia/reperfusion injury as a case study, this study aims to clarify the functional significance of GA and to elucidate the mechanisms involved. MATERIALS AND METHODS In this study, an MI/R injury model was established both in vivo and in vitro to investigate the impact of GA on MI/R injury. The viability of H9c2 cells was evaluated using the Cell Counting Kit-8. Myocardial damage was assessed through the measurement of creatine kinase myocardial band (CK-MB) levels and lactate dehydrogenase (LDH), HE staining, and MASSON staining. Inflammatory cytokine levels (IL-6, IL-1β, IL-10, and TNF-α) were measured to determine the presence of inflammation. Cellular oxidative stress was evaluated by measuring ROS and MMP levels, while cardiac function was assessed using cardiac color Doppler ultrasound. Immunofluorescence staining to determine the nuclear translocation of YAP, TUNEL to determine apoptosis, and western blotting to determine gene expression. RESULTS GA treatment effectively alleviated myocardial injury induced by MI/R, as evidenced by reduced levels of inflammatory cytokines (IL-1β, IL-6, IL-10, and TNF-α) and cardiac biomarkers (CK-MB, LDH) in MI/R rats. Moreover, There was a significant increase in cell viability in vitro after GA treatment and inhibited reactive oxygen species (ROS) during oxidative stress, while also increasing mitochondrial membrane potential (MMP) in vitro. The Western blot findings indicate that GA treatment effectively suppressed apoptosis in both in vivo and in vitro settings. Additionally, GA demonstrated inhibitory effects on the activation of the Hippo/YAP signaling pathway triggered by MI/R and facilitated YAP nuclear translocation both in vitro and in vivo. It has been found, however, in vitro, that silencing the YAP gene negates GA's protective effect against hypoxia/reoxygenation-induced myocardial injury. CONCLUSION This study suggests that GA regulates YAP nuclear translocation by inhibiting the Hippo/YAP signaling pathway, which protects ists against MI/R injury. This finding may present a novel therapeutic approach for the treatment of MI/R.
Collapse
Affiliation(s)
- Xian Cheng
- The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China; Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; Nankai University Affiliated Third Center Hospital, No. 83, Jintang Road, Hedong District, Tianjin 300170, China; Tianjin ECMO Treatment and Training Base, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin, China.
| | - Yanwu Liu
- The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China; Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; Nankai University Affiliated Third Center Hospital, No. 83, Jintang Road, Hedong District, Tianjin 300170, China; Tianjin ECMO Treatment and Training Base, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin, China
| | - Bingcai Qi
- The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China; Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; Nankai University Affiliated Third Center Hospital, No. 83, Jintang Road, Hedong District, Tianjin 300170, China; Tianjin ECMO Treatment and Training Base, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin, China
| | - Yuchao Wang
- Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; School of Medicine, Nankai University, Tianjin 300071, China; Nankai University Affiliated Third Center Hospital, No. 83, Jintang Road, Hedong District, Tianjin 300170, China; Tianjin ECMO Treatment and Training Base, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin, China
| | - Yue Zheng
- Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; School of Medicine, Nankai University, Tianjin 300071, China; Nankai University Affiliated Third Center Hospital, No. 83, Jintang Road, Hedong District, Tianjin 300170, China; Tianjin ECMO Treatment and Training Base, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin, China
| | - Xiaoyu Liang
- Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; Nankai University Affiliated Third Center Hospital, No. 83, Jintang Road, Hedong District, Tianjin 300170, China; Tianjin ECMO Treatment and Training Base, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin, China
| | - Yun Chang
- Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; Nankai University Affiliated Third Center Hospital, No. 83, Jintang Road, Hedong District, Tianjin 300170, China; Tianjin ECMO Treatment and Training Base, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin, China
| | - Meng Ning
- Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; Nankai University Affiliated Third Center Hospital, No. 83, Jintang Road, Hedong District, Tianjin 300170, China; Tianjin ECMO Treatment and Training Base, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin, China
| | - Wenqing Gao
- Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; School of Medicine, Nankai University, Tianjin 300071, China; Nankai University Affiliated Third Center Hospital, No. 83, Jintang Road, Hedong District, Tianjin 300170, China; Tianjin ECMO Treatment and Training Base, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin, China.
| | - Tong Li
- The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China; Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China; School of Medicine, Nankai University, Tianjin 300071, China; Nankai University Affiliated Third Center Hospital, No. 83, Jintang Road, Hedong District, Tianjin 300170, China; Tianjin ECMO Treatment and Training Base, Tianjin 300170, China; Artificial Cell Engineering Technology Research Center, Tianjin, China.
| |
Collapse
|
3
|
Molloi S, Polivka AR, Zhao Y, Redmond J, Itkin M, Antunes I, Yu Z. Dynamic Contrast-enhanced CT Lymphangiography to Quantify Thoracic Duct Lymphatic Flow. Radiology 2023; 309:e230959. [PMID: 38112547 DOI: 10.1148/radiol.230959] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Background CT lymphangiography has been used to image the lymphatic anatomy and assess lymphatic abnormalities. There is, however, a need to develop a method for quantification of lymphatic flow rate in the thoracic duct (TD). Purpose To develop and validate a TD lymphatic flow measurement technique using dynamic contrast-enhanced CT lymphangiography. Materials and Methods Lymphatic flow rate was measured with two techniques: a first-pass analysis technique based on a single compartment model and a thresholding technique distinguishing between opacified and nonopacified voxels within the TD. The measurements were validated in a swine animal model between November 2021 and September 2022. CT images were acquired at 100 kV and 200 mA using a fast-pitched helical scan mode covering the entire TD following contrast material injection into the bilateral inguinal lymph nodes. Two helical CT scans, acquired at the base and peak contrast enhancement of the TD, were used to measure lymphatic flow rate. A US flow probe surgically placed around the TD provided the reference standard measurement. CT lymphatic flow measurements were compared with the reference US flow probe measurements using regression and Bland-Altman analysis. Repeatability was determined using repeated flow measurements within approximately 10 minutes of each other. Results Eleven swine (10 male; mean weight, 43.6 kg ± 2.6 [SD]) were evaluated with 71 dynamic CT acquisitions. The lymphatic flow rates measured using the first-pass analysis and thresholding techniques were highly correlated with the reference US flow probe measurements (r = 0.99 and 0.91, respectively) and showed good agreement with the reference standard, with Bland-Altman analysis showing small mean differences of 0.04 and 0.05 mL/min, respectively. The first-pass analysis and thresholding techniques also showed good agreement for repeated flow measurements (r = 0.94 and 0.90, respectively), with small mean differences of 0.09 and 0.03 mL/min, respectively. Conclusion The first-pass analysis and thresholding techniques could be used to accurately and noninvasively quantify TD lymphatic flow using dynamic contrast-enhanced CT lymphangiography. © RSNA, 2023 See also the editorial by Choyke in this issue.
Collapse
Affiliation(s)
- Sabee Molloi
- From the Departments of Radiological Sciences (S.M., A.R.P., Y.Z., I.A.) and Statistics (Z.Y.), University of California Irvine, Medical Sciences I, B-140, Irvine, CA 92697; Department of Radiological Sciences, University of California San Diego, San Diego, Calif (J.R.); and Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.I.)
| | - Alesh R Polivka
- From the Departments of Radiological Sciences (S.M., A.R.P., Y.Z., I.A.) and Statistics (Z.Y.), University of California Irvine, Medical Sciences I, B-140, Irvine, CA 92697; Department of Radiological Sciences, University of California San Diego, San Diego, Calif (J.R.); and Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.I.)
| | - Yixiao Zhao
- From the Departments of Radiological Sciences (S.M., A.R.P., Y.Z., I.A.) and Statistics (Z.Y.), University of California Irvine, Medical Sciences I, B-140, Irvine, CA 92697; Department of Radiological Sciences, University of California San Diego, San Diego, Calif (J.R.); and Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.I.)
| | - Jonas Redmond
- From the Departments of Radiological Sciences (S.M., A.R.P., Y.Z., I.A.) and Statistics (Z.Y.), University of California Irvine, Medical Sciences I, B-140, Irvine, CA 92697; Department of Radiological Sciences, University of California San Diego, San Diego, Calif (J.R.); and Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.I.)
| | - Maxim Itkin
- From the Departments of Radiological Sciences (S.M., A.R.P., Y.Z., I.A.) and Statistics (Z.Y.), University of California Irvine, Medical Sciences I, B-140, Irvine, CA 92697; Department of Radiological Sciences, University of California San Diego, San Diego, Calif (J.R.); and Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.I.)
| | - Ines Antunes
- From the Departments of Radiological Sciences (S.M., A.R.P., Y.Z., I.A.) and Statistics (Z.Y.), University of California Irvine, Medical Sciences I, B-140, Irvine, CA 92697; Department of Radiological Sciences, University of California San Diego, San Diego, Calif (J.R.); and Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.I.)
| | - Zhaoxia Yu
- From the Departments of Radiological Sciences (S.M., A.R.P., Y.Z., I.A.) and Statistics (Z.Y.), University of California Irvine, Medical Sciences I, B-140, Irvine, CA 92697; Department of Radiological Sciences, University of California San Diego, San Diego, Calif (J.R.); and Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.I.)
| |
Collapse
|
4
|
Hubbard L, Molloi S. Low-dose quantitative CT myocardial flow measurement using a single volume scan: phantom and animal validation. J Med Imaging (Bellingham) 2023; 10:056002. [PMID: 37915404 PMCID: PMC10617548 DOI: 10.1117/1.jmi.10.5.056002] [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: 03/06/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023] Open
Abstract
Purpose To validate a low-dose, single-volume quantitative CT myocardial flow technique in a cardiovascular flow phantom and a swine animal model of coronary artery disease. Approach A cardiovascular flow phantom was imaged dynamically over different flow rates (0.97 to 2.45 mL / min / g ) using 15 mL of contrast per injection. Six swine (37 ± 8 kg ) were also imaged dynamically, with different left anterior descending coronary artery balloon stenoses assessed under intracoronary adenosine stress, using 1 mL / kg of contrast per injection. The resulting images were used to simulate dynamic bolus tracking and peak volume scan acquisition. After which, first-pass single-compartment modeling was performed to derive quantitative flow, where the pre-contrast myocardial attenuation was assumed to be spatially uniform. The accuracy of CT flow was then assessed versus ultrasound and microsphere flow in the phantom and animal models, respectively, using regression analysis. Results Single-volume quantitative CT flow measurements in the phantom (Q CT _ PHANTOM ) were related to reference ultrasound flow measurements (Q US ) by Q CT _ PHANTOM = 1.04 Q US - 0.1 (Pearson's r = 0.98 ; RMSE = 0.09 mL / min / g ). In the animal model (Q CT _ ANIMAL ), they were related to reference microsphere flow measurements (Q MICRO ) by Q CT _ ANIMAL = 1.00 Q MICRO - 0.05 (Pearson's r = 0.96 ; RMSE = 0.48 mL / min / g ). The effective dose per CT measurement was 1.21 mSv. Conclusions The single-volume quantitative CT flow technique only requires bolus tracking data, spatially uniform pre-contrast myocardial attenuation, and a single volume scan acquired near the peak aortic enhancement for accurate, low-dose, myocardial flow measurement (in mL/min/g) under rest and adenosine stress conditions.
Collapse
Affiliation(s)
- Logan Hubbard
- University of California, Irvine, Department of Radiological Sciences, Irvine, California, United States
| | - Sabee Molloi
- University of California, Irvine, Department of Radiological Sciences, Irvine, California, United States
| |
Collapse
|
5
|
Vats N, Mayer P, Kortes F, Klauß M, Grenacher L, Stiller W, Kauczor HU, Skornitzke S. Evaluation and timing optimization of CT perfusion first pass analysis in comparison to maximum slope model in pancreatic adenocarcinoma. Sci Rep 2023; 13:10595. [PMID: 37391443 PMCID: PMC10313720 DOI: 10.1038/s41598-023-37381-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/21/2023] [Indexed: 07/02/2023] Open
Abstract
For implementation, performance evaluation and timing optimization of CT perfusion first pass analysis (FPA) by correlation with maximum slope model (MSM) in pancreatic adenocarcinoma, dynamic CT perfusion acquisitions of 34 time-points were performed in 16 pancreatic adenocarcinoma patients. Regions of interest were marked in both parenchyma and carcinoma. FPA, a low radiation exposure CT perfusion technique, was implemented. Blood flow (BF) perfusion maps were calculated using FPA and MSM. Pearson's correlation between FPA and MSM was calculated at each evaluated time-point to determine optimum timing for FPA. Differences in BF between parenchyma and carcinoma were calculated. Average BF for MSM was 106.8 ± 41.5 ml/100 ml/min in parenchyma and 42.0 ± 24.8 ml/100 ml/min in carcinoma, respectively. For FPA, values ranged from 85.6 ± 37.5 ml/100 ml/min to 117.7 ± 44.5 ml/100 ml/min in parenchyma and from 27.3 ± 18.8 ml/100 ml/min to 39.5 ± 26.6 ml/100 ml/min in carcinoma, depending on acquisition timing. A significant difference (p value < 0.0001) between carcinoma and parenchyma was observed at all acquisition times based on FPA measurements. FPA shows high correlation with MSM (r > 0.90) and 94% reduction in the radiation dose compared to MSM. CT perfusion FPA, where the first scan is obtained after the arterial input function exceeds a threshold of 120 HU, followed by a second scan after 15.5-20.0 s, could be used as a potential imaging biomarker with low radiation exposure for diagnosing and evaluating pancreatic carcinoma in clinical practice, showing high correlation with MSM and the ability to differentiate between parenchyma and carcinoma.
Collapse
Affiliation(s)
- Neha Vats
- Clinic for Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Philipp Mayer
- Clinic for Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Franziska Kortes
- Clinic for Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
- Radiology Rhein-Neckar, Bodelschwinghstraße 10, 68723, Schwetzingen, Germany
| | - Miriam Klauß
- Clinic for Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Lars Grenacher
- Clinic for Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
- Conradia Radiology and Medical Prevention, Conradia Radiologie München, Augustenstraße 115, 80798, Munich, Germany
| | - Wolfram Stiller
- Clinic for Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Clinic for Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Stephan Skornitzke
- Clinic for Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| |
Collapse
|
6
|
Dynamic CT myocardial perfusion without image registration. Sci Rep 2022; 12:12608. [PMID: 35871187 PMCID: PMC9308794 DOI: 10.1038/s41598-022-16573-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to validate a motion-immune (MI) solution to dynamic CT myocardial perfusion measurement, in the presence of motion without image registration. The MI perfusion technique was retrospectively validated in six swine (37.3 ± 7.5 kg) with a motion-susceptible (MS) perfusion technique performed for comparison. In each swine, varying severities of stenoses were generated in the left anterior descending (LAD) coronary artery using a balloon under intracoronary adenosine stress, followed by contrast-enhanced imaging with 20 consecutive volume scans per stenosis. Two volume scans were then systematically selected from each acquisition for both MI and MS perfusion measurement, where the resulting LAD and left circumflex (LCx) measurements were compared to reference microsphere perfusion measurements using regression and diagnostic performance analysis. The MI (PMI) and microsphere (PMICRO) perfusion measurements were related through regression by PMI = 0.98 PMICRO + 0.03 (r = 0.97), while the MS (PMS) and microsphere (PMICRO) perfusion measurements were related by PMS = 0.62 PMICRO + 0.15 (r = 0.89). The accuracy of the MI and MS techniques in detecting functionally significant stenosis was 93% and 84%, respectively. The motion-immune (MI) perfusion technique provides accurate myocardial perfusion measurement in the presence of motion without image registration.
Collapse
|
7
|
Cressoni M, Cozzi A, Schiaffino S, Cadringher P, Vitali P, Basso G, Ippolito D, Sardanelli F. Computation of contrast-enhanced perfusion using only two CT scan phases: a proof-of-concept study on abdominal organs. Eur Radiol Exp 2022; 6:37. [PMID: 36031643 PMCID: PMC9420683 DOI: 10.1186/s41747-022-00292-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Computed tomography perfusion imaging (CTPI) by repeated scanning has clinical relevance but implies relatively high radiation exposure. We present a method to measure perfusion from two CT scan phases only, considering tissue enhancement, feeding vessel (aortic) peak enhancement, and bolus shape.
Methods
CTPI scans (each with 40 frames acquired every 1.5 s) of 11 patients with advanced hepatocellular carcinoma (HCC) enrolled between 2012 and 2016 were retrospectively analysed (aged 69 ± 9 years, 8/11 males). Perfusion was defined as the maximal slope of the time-enhancement curve divided by the peak enhancement of the feeding vessel (aorta). Perfusion was computed two times, first using the maximum slope derived from all data points and then using the peak tissue enhancement and the bolus shape obtained from the aortic curve.
Results
Perfusion values from the two methods were linearly related (r2 = 0.92, p < 0.001; Bland–Altman analysis bias -0.12). The mathematical model showed that the perfusion ratio of two ROIs with the same feeding vessel (aorta) corresponds to their peak enhancement ratio (r2 = 0.55, p < 0.001; Bland–Altman analysis bias -0.68). The relationship between perfusion and tissue enhancement is predicted to be linear in the clinical range of interest, being only function of perfusion, peak feeding vessel enhancement, and bolus shape.
Conclusions
This proof-of-concept study showed that perfusion values of HCC, kidney, and pancreas could be computed using enhancement measured only with two CT scan phases, if aortic peak enhancement and bolus shape are known.
Collapse
|
8
|
Nappi C, Ponsiglione A, Falzarano M, Imbriaco M, Klain M, Cuocolo A. Insights into Myocardial Perfusion PET Imaging: the Coronary Flow Capacity. CURRENT CARDIOVASCULAR IMAGING REPORTS 2022. [DOI: 10.1007/s12410-022-09568-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Abstract
Purpose of Review
The present work summarizes the clinical relevance of coronary flow capacity (CFC) with an eye on future perspectives.
Recent findings
CFC concept has been recently introduced providing a comprehensive framework for coronary physiology evaluation.
Summary
It has been widely demonstrated that coronary artery disease (CAD) is a complex disease with a multifactorial etiology resulting from different pathogenic mechanisms. Cardiac positron emission tomography (PET) currently represents the gold standard for CAD assessment, providing absolute myocardial perfusion data including coronary flow reserve (CFR), calculated as the ratio of hyperemic to rest absolute myocardial blood flows. CFC can be obtained from dynamic PET images by plotting the primary stress perfusion data and CFR values for each pixel on a graph of predefined exact ranges. The routine evaluation of this parameter may add diagnostic and prognostic value to clinical and conventional imaging data.
Collapse
|
9
|
Zhao Y, Hubbard L, Malkasian S, Abbona P, Molloi S. Contrast timing optimization of a two-volume dynamic CT pulmonary perfusion technique. Sci Rep 2022; 12:8212. [PMID: 35581304 PMCID: PMC9114423 DOI: 10.1038/s41598-022-12016-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/21/2022] [Indexed: 11/12/2022] Open
Abstract
The purpose of this study is to develop and validate an optimal timing protocol for a low-radiation-dose CT pulmonary perfusion technique using only two volume scans. A total of 24 swine (48.5 ± 14.3 kg) underwent contrast-enhanced dynamic CT. Multiple contrast injections were made under different pulmonary perfusion conditions, resulting in a total of 141 complete pulmonary arterial input functions (AIFs). Using all the AIF curves, an optimal contrast timing protocol was developed for a first-pass, two-volume dynamic CT perfusion technique (one at the base and the other at the peak of AIF curve). A subset of swine was used to validate the prospective two-volume pulmonary perfusion technique. The prospective two-volume perfusion measurements were quantitatively compared to the previously validated retrospective perfusion measurements with t-test, linear regression, and Bland–Altman analysis. As a result, the pulmonary artery time-to-peak (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$${T}_{PA}$$\end{document}TPA) was related to one-half of the contrast injection duration (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\frac{{T}_{Inj}}{2}$$\end{document}TInj2) by \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$${T}_{PA}=1.01\frac{{T}_{Inj}}{2}+1.01$$\end{document}TPA=1.01TInj2+1.01 (r = 0.95). The prospective two-volume perfusion measurements (PPRO) were related to the retrospective measurements (PRETRO) by PPRO = 0.87PRETRO + 0.56 (r = 0.88). The CT dose index and size-specific dose estimate of the two-volume CT technique were estimated to be 28.4 and 47.0 mGy, respectively. The optimal timing protocol can enable an accurate, low-radiation-dose two-volume dynamic CT perfusion technique.
Collapse
Affiliation(s)
- Yixiao Zhao
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA
| | - Logan Hubbard
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA
| | - Shant Malkasian
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA
| | - Pablo Abbona
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA
| | - Sabee Molloi
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA.
| |
Collapse
|
10
|
Yu Y, Yu L, Dai X, Zhang J. CT Fractional Flow Reserve for the Diagnosis of Myocardial Bridging-Related Ischemia: A Study Using Dynamic CT Myocardial Perfusion Imaging as a Reference Standard. Korean J Radiol 2021; 22:1964-1973. [PMID: 34668350 PMCID: PMC8628161 DOI: 10.3348/kjr.2021.0043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/27/2021] [Accepted: 07/26/2021] [Indexed: 01/02/2023] Open
Abstract
Objective To investigate the diagnostic performance of CT fractional flow reserve (CT-FFR) for myocardial bridging-related ischemia using dynamic CT myocardial perfusion imaging (CT-MPI) as a reference standard. Materials and Methods Dynamic CT-MPI and coronary CT angiography (CCTA) data obtained from 498 symptomatic patients were retrospectively reviewed. Seventy-five patients (mean age ± standard deviation, 62.7 ± 13.2 years; 48 males) who showed myocardial bridging in the left anterior descending artery without concomitant obstructive stenosis on the imaging were included. The change in CT-FFR across myocardial bridging (ΔCT-FFR, defined as the difference in CT-FFR values between the proximal and distal ends of the myocardial bridging) in different cardiac phases, as well as other anatomical parameters, were measured to evaluate their performance for diagnosing myocardial bridging-related myocardial ischemia using dynamic CT-MPI as the reference standard (myocardial blood flow < 100 mL/100 mL/min or myocardial blood flow ratio ≤ 0.8). Results ΔCT-FFRsystolic (ΔCT-FFR calculated in the best systolic phase) was higher in patients with vs. without myocardial bridging-related myocardial ischemia (median [interquartile range], 0.12 [0.08–0.17] vs. 0.04 [0.01–0.07], p < 0.001), while CT-FFRsystolic (CT-FFR distal to the myocardial bridging calculated in the best systolic phase) was lower (0.85 [0.81–0.89] vs. 0.91 [0.88–0.96], p = 0.043). In contrast, ΔCT-FFRdiastolic (ΔCT-FFR calculated in the best diastolic phase) and CT-FFRdiastolic (CT-FFR distal to the myocardial bridging calculated in the best diastolic phase) did not differ significantly. Receiver operating characteristic curve analysis showed that ΔCT-FFRsystolic had largest area under the curve (0.822; 95% confidence interval, 0.717–0.901) for identifying myocardial bridging-related ischemia. ΔCT-FFRsystolic had the highest sensitivity (91.7%) and negative predictive value (NPV) (97.8%). ΔCT-FFRdiastolic had the highest specificity (85.7%) for diagnosing myocardial bridging-related ischemia. The positive predictive values of all CT-related parameters were low. Conclusion ΔCT-FFRsystolic reliably excluded myocardial bridging-related ischemia with high sensitivity and NPV. Myocardial bridging showing positive CT-FFR results requires further evaluation.
Collapse
Affiliation(s)
- Yarong Yu
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lihua Yu
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xu Dai
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jiayin Zhang
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
11
|
Abbona P, Zhao Y, Hubbard L, Malkasian S, Flynn B, Molloi S. Absolute cerebral blood flow: Assessment with a novel low-radiation-dose dynamic CT perfusion technique in a swine model. J Neuroradiol 2021; 49:173-179. [PMID: 34634295 DOI: 10.1016/j.neurad.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/23/2021] [Indexed: 11/19/2022]
Abstract
RATIONALE AND OBJECTIVES To validate the accuracy of a novel low-dose dynamic CT perfusion technique in a swine model using fluorescent microsphere measurement as the reference standard. MATERIALS AND METHODS Contrast-enhanced dynamic CT perfusion was performed in five swine at baseline and following brain embolization. Reference microspheres and intravenous contrast (370 mg/ml iodine, 1 ml/kg) were injected (5 ml/s), followed by dynamic CT perfusion. Scan parameters were 320×0.5 mm, 100 kVp and 200 mA. On average, 47 contrast-enhanced volume scans were acquired per acquisition to capture the time attenuation curve. For each acquisition, only two systematically selected volume scans were used to quantify brain perfusion with first-pass analysis technique. The first volume scan was selected at the base, simulating bolus tracking, while the second volume at the peak of the time attenuation curve similar to a CT angiogram. Regional low-dose CT perfusion measurements were compared to the microsphere perfusion measurements with t-test, linear regression and Bland-Altman analysis. The radiation dose of the two-volume CT perfusion technique was determined. RESULTS Low-dose CT perfusion measurements (PCT) showed excellent correlation with reference microsphere perfusion measurements (PMICRO) by PCT = 1.15 PMICRO - 0.01 (r = 0.93, p ≤ 0.01). The CT dose index and dose-length product for the two-volume CT perfusion technique were 25.6 mGy and 409.6 mGy, respectively. CONCLUSIONS The accuracy and repeatability of a low-dose dynamic CT perfusion technique was validated in a swine model. This technique has the potential for accurate diagnosis and follow up of stroke and vasospasm.
Collapse
Affiliation(s)
- Pablo Abbona
- Department of Radiological Sciences(a), University of California, Irvine, Irvine, CA, 92697, United States of America
| | - Yixiao Zhao
- Department of Radiological Sciences(a), University of California, Irvine, Irvine, CA, 92697, United States of America
| | - Logan Hubbard
- Department of Radiological Sciences(a), University of California, Irvine, Irvine, CA, 92697, United States of America
| | - Shant Malkasian
- Department of Radiological Sciences(a), University of California, Irvine, Irvine, CA, 92697, United States of America
| | - Brooklynn Flynn
- Department of Radiological Sciences(a), University of California, Irvine, Irvine, CA, 92697, United States of America
| | - Sabee Molloi
- Department of Radiological Sciences(a), University of California, Irvine, Irvine, CA, 92697, United States of America.
| |
Collapse
|
12
|
Cai W, Wang Y, Gu L, Ji X, Shen Q, Ren X. Detection of 3D Arterial Centerline Extraction in Spiral CT Coronary Angiography. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:2670793. [PMID: 34471506 PMCID: PMC8405334 DOI: 10.1155/2021/2670793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/08/2021] [Accepted: 08/12/2021] [Indexed: 11/17/2022]
Abstract
This paper presents an in-depth study and analysis of the 3D arterial centerline in spiral CT coronary angiography, and constructs its detection and extraction technique. The first time, the distance transform is used to complete the boundary search of the original figure; the second time, the distance transform is used to calculate the value of the distance transform of all voxels, and according to the value of the distance transform, unnecessary voxels are deleted, to complete the initial contraction of the vascular region and reduce the computational consumption in the next process; then, the nonwitnessed voxels are used to construct the maximum inner joint sphere model and find the skeletal voxels that can reflect the shape of the original figure. Finally, the skeletal lines were optimized on these initially extracted skeletal voxels using a dichotomous-like principle to obtain the final coronary artery centerline. Through the evaluation of the experimental results, the algorithm can extract the coronary centerline more accurately. In this paper, the segmentation method is evaluated on the test set data by two kinds of indexes: one is the index of segmentation result evaluation, including dice coefficient, accuracy, specificity, and sensitivity; the other is the index of clinical diagnosis result evaluation, which is to refine the segmentation result for vessel diameter detection. The results obtained in this paper were compared with the physicians' labeling results. In terms of network performance, the Dice coefficient obtained in this paper was 0.89, the accuracy was 98.36%, the sensitivity was 93.36%, and the specificity was 98.76%, which reflected certain advantages in comparison with the advanced methods proposed by previous authors. In terms of clinical evaluation indexes, by performing skeleton line extraction and diameter calculation on the results obtained by the segmentation method proposed in this paper, the absolute error obtained after comparing with the diameter of the labeled image was 0.382 and the relative error was 0.112, which indicates that the segmentation method in this paper can recover the vessel contour more accurately. Then, the results of coronary artery centerline extraction with and without fine branch elimination were evaluated, which proved that the coronary artery centerline has higher accuracy after fine branch elimination. The algorithm is also used to extract the centerline of the complete coronary artery tree, and the results prove that the algorithm has better results for the centerline extraction of the complete coronary vascular tree.
Collapse
Affiliation(s)
- Wenjuan Cai
- Changshu Hospital of Chinese Medicine, Changshu 215516, Jiangsu, China
| | - Yanzhe Wang
- Changshu Hospital of Chinese Medicine, Changshu 215516, Jiangsu, China
| | - Liya Gu
- Changshu Hospital of Chinese Medicine, Changshu 215516, Jiangsu, China
| | - Xuefeng Ji
- Changshu Hospital of Chinese Medicine, Changshu 215516, Jiangsu, China
| | - Qiusheng Shen
- Changshu Hospital of Chinese Medicine, Changshu 215516, Jiangsu, China
| | - Xiaogang Ren
- Changshu Hospital of Chinese Medicine, Changshu 215516, Jiangsu, China
- School of Information and Control Engineering, China University of Mining and Technology, Xuzhou 221116, Jiangsu, China
| |
Collapse
|
13
|
Hubbard L, Malkasian S, Zhao Y, Abbona P, Molloi S. Combining perfusion and angiography with a low-dose cardiac CT technique: a preliminary investigation in a swine model. Int J Cardiovasc Imaging 2021; 37:1767-1779. [PMID: 33506345 PMCID: PMC8105235 DOI: 10.1007/s10554-020-02130-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 12/04/2020] [Indexed: 12/17/2022]
Abstract
Morphological and physiological assessment of coronary artery disease (CAD) is necessary for proper stratification of CAD risk. The objective was to evaluate a low-dose cardiac CT technique that combines morphological and physiological assessment of CAD. The low-dose technique was evaluated in twelve swine, where three of the twelve had coronary balloon stenosis. The technique consisted of rest perfusion measurement combined with angiography followed by stress perfusion measurement, where the ratio of stress to rest was used to derive coronary flow reserve (CFR). The technique only required two volume scans for perfusion measurement in mL/min/g; hence, four volume scans were acquired in total; two for rest with angiography and two for stress. All rest, stress, and CFR measurements were compared to a previously validated reference technique that employed 20 consecutive volume scans for rest perfusion measurement combined with angiography, and stress perfusion measurement, respectively. The 32 cm diameter volumetric CT dose index (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$${\text{CTDI}}_{\text{vol}}^{32}$$\end{document}CTDIvol32) and size-specific dose estimate (SSDE) of the low-dose technique were also recorded. All low-dose perfusion measurements (PLOW) in mL/min/g were related to reference perfusion measurements (PREF) through regression by PLOW = 1.04 PREF − 0.08 (r = 0.94, RMSE = 0.32 mL/min/g). The \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$${\text{CTDI}}_{\text{vol}}^{32}$$\end{document}CTDIvol32 and SSDE of the low-dose cardiac CT technique were 8.05 mGy and 12.80 mGy respectively, corresponding to an estimated effective dose and size-specific effective dose of 1.8 and 2.87 mSv, respectively. Combined morphological and physiological assessment of coronary artery disease is feasible using a low-dose cardiac CT technique.
Collapse
Affiliation(s)
- Logan Hubbard
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, CA, 92697, USA
| | - Shant Malkasian
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, CA, 92697, USA
| | - Yixiao Zhao
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, CA, 92697, USA
| | - Pablo Abbona
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, CA, 92697, USA
| | - Sabee Molloi
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, CA, 92697, USA.
| |
Collapse
|
14
|
Yang MX, Xu HY, Zhang L, Chen L, Xu R, Fu H, Liu H, Li XS, Fu C, Liu KL, Li H, Zhou XY, Guo YK, Yang ZG. Myocardial perfusion assessment in the infarct core and penumbra zones in an in-vivo porcine model of the acute, sub-acute, and chronic infarction. Eur Radiol 2020; 31:2798-2808. [PMID: 33156386 DOI: 10.1007/s00330-020-07220-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 07/12/2020] [Accepted: 08/21/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To assess the longitudinal changes of microvascular function in different myocardial regions after myocardial infarction (MI) using myocardial blood flow derived by dynamic CT perfusion (CTP-MBF), and compare CTP-MBF with the results of cardiac magnetic resonance (CMR) and histopathology. METHODS The CTP scanning was performed in a MI porcine model 1 day (n = 15), 7 days (n = 10), and 3 months (n = 5) following induction surgery. CTP-MBF was measured in the infarcted myocardium, penumbra, and remote myocardium, respectively. CMR perfusion and histopathology were performed for validation. RESULTS From baseline to follow-up scans, CTP-MBF presented a stepwise increase in the infarcted myocardium (68.51 ± 11.04 vs. 86.73 ± 13.32 vs. 109.53 ± 26.64 ml/100 ml/min, p = 0.001) and the penumbra (104.92 ± 29.29 vs. 120.32 ± 24.74 vs. 183.01 ± 57.98 ml/100 ml/min, p = 0.008), but not in the remote myocardium (150.05 ± 35.70 vs. 166.66 ± 38.17 vs. 195.36 ± 49.64 ml/100 ml/min, p = 0.120). The CTP-MBF correlated with max slope (r = 0.584, p < 0.001), max signal intensity (r = 0.357, p < 0.001), and time to max (r = - 0.378, p < 0.001) by CMR perfusion. Moreover, CTP-MBF defined the infarcted myocardium on triphenyl tetrazolium chloride staining (AUC: 0.810, p < 0.001) and correlated with microvascular density on CD31 staining (r = 0.561, p = 0.002). CONCLUSION CTP-MBF could quantify the longitudinal changes of microvascular function in different regions of the post-MI myocardium, which demonstrates good agreement with contemporary CMR and histopathological findings. KEY POINTS • The CT perfusion-based myocardial blood flow (CTP-MBF) could quantify the microvascular impairment in different myocardial regions after myocardial infarction (MI) and track its recovery over time. • The assessment of CTP-MBF is in good agreement with contemporary cardiac MRI and histopathological findings, which potentially facilitates a rapid approach for pathophysiological insights following MI.
Collapse
Affiliation(s)
- Meng-Xi Yang
- Department of Radiology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hua-Yan Xu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Lu Zhang
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Lin Chen
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Rong Xu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Hang Fu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Hui Liu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Xue-Sheng Li
- Department of Radiology, West China Second Hospital, Sichuan University, Chengdu, China
| | - Chuan Fu
- Department of Radiology, West China Second Hospital, Sichuan University, Chengdu, China
| | - Ke-Ling Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Xiao-Yue Zhou
- MR Collaboration, Siemens Healthcare Ltd, Shanghai, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Zhi-Gang Yang
- Department of Radiology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China. .,Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
15
|
Malkasian S, Hubbard L, Abbona P, Dertli B, Kwon J, Molloi S. Vessel-specific coronary perfusion territories using a CT angiogram with a minimum cost path technique and its direct comparison to the American Heart Association 17-segment model. Eur Radiol 2020; 30:3334-3345. [PMID: 32072257 DOI: 10.1007/s00330-020-06697-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/10/2020] [Accepted: 01/31/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVES This study compared the accuracy of an automated, vessel-specific minimum cost path (MCP) myocardial perfusion territory assignment technique as compared with the standard American Heart Association 17-segment (AHA) model. METHODS Six swine (42 ± 9 kg) were used to evaluate the accuracy of the MCP technique and the AHA method. In each swine, a dynamic acquisition, comprised of twenty consecutive whole heart volume scans, was acquired with a computed tomography scanner, following peripheral injection of contrast material. From this acquisition, MCP and AHA perfusion territories were determined, for the left (LCA) and right (RCA) coronary arteries. Each animal underwent additional dynamic acquisitions, consisting of twenty consecutive volume scans, following direct intracoronary contrast injection into the LCA or RCA. These images were used as the reference standard (REF) LCA and RCA perfusion territories. The MCP and AHA techniques' perfusion territories were then quantitatively compared with the REF perfusion territories. RESULTS The myocardial mass of MCP perfusion territories (MMCP) was related to the mass of reference standard perfusion territories (MREF) by MMCP = 0.99MREF + 0.39 g (r = 1.00; R2 = 1.00). The mass of AHA perfusion territories (MAHA) was related to MREF by MAHA = 0.81MREF + 5.03 g (r = 0.99; R2 = 0.98). CONCLUSION The vessel-specific MCP myocardial perfusion territory assignment technique more accurately quantifies LCA and RCA perfusion territories as compared with the current standard AHA 17-segment model. Therefore, it can potentially provide a more comprehensive and patient-specific evaluation of coronary artery disease. KEY POINTS • The minimum cost path (MCP) technique accurately determines left and right coronary artery perfusion territories, as compared with the American Heart Association 17-segment (AHA) model. • The minimum cost path (MCP) technique could be applied to cardiac computed-tomography angiography images to accurately determine patient-specific left and right coronary artery perfusion territories. • The American Heart Association 17-segment (AHA) model often fails to accurately determine left and right coronary artery perfusion territories, especially in the inferior and inferoseptal walls of the left ventricular myocardium.
Collapse
Affiliation(s)
- Shant Malkasian
- Department of Radiological Sciences, Medical Sciences I, B-14, University of California, Irvine, CA, 92697, USA
| | - Logan Hubbard
- Department of Radiological Sciences, Medical Sciences I, B-14, University of California, Irvine, CA, 92697, USA
| | - Pablo Abbona
- Department of Radiological Sciences, Medical Sciences I, B-14, University of California, Irvine, CA, 92697, USA
| | - Brian Dertli
- Department of Radiological Sciences, Medical Sciences I, B-14, University of California, Irvine, CA, 92697, USA
| | - Jungnam Kwon
- Department of Radiological Sciences, Medical Sciences I, B-14, University of California, Irvine, CA, 92697, USA
| | - Sabee Molloi
- Department of Radiological Sciences, Medical Sciences I, B-14, University of California, Irvine, CA, 92697, USA.
| |
Collapse
|
16
|
van de Wouw J, Sorop O, van Drie RWA, van Duin RWB, Nguyen ITN, Joles JA, Verhaar MC, Merkus D, Duncker DJ. Perturbations in myocardial perfusion and oxygen balance in swine with multiple risk factors: a novel model of ischemia and no obstructive coronary artery disease. Basic Res Cardiol 2020; 115:21. [PMID: 32100119 PMCID: PMC7042191 DOI: 10.1007/s00395-020-0778-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/14/2020] [Indexed: 12/12/2022]
Abstract
Comorbidities of ischemic heart disease, including diabetes mellitus (DM), hypercholesterolemia (HC) and chronic kidney disease (CKD), are associated with coronary microvascular dysfunction (CMD). Increasing evidence suggests that CMD may contribute to myocardial ‘Ischemia and No Obstructive Coronary Artery disease’ (INOCA). In the present study, we tested the hypothesis that CMD results in perturbations in myocardial perfusion and oxygen delivery using a novel swine model with multiple comorbidities. DM (streptozotocin), HC (high-fat diet) and CKD (renal embolization) were induced in 10 female swine (DM + HC + CKD), while 12 healthy female swine on a normal diet served as controls (Normal). After 5 months, at a time when coronary atherosclerosis was still negligible, myocardial perfusion, metabolism, and function were studied at rest and during treadmill exercise. DM + HC + CKD animals showed hyperglycemia, hypercholesterolemia, and impaired kidney function. During exercise, DM + HC + CKD swine demonstrated perturbations in myocardial blood flow and oxygen delivery, necessitating a higher myocardial oxygen extraction—achieved despite reduced capillary density—resulting in lower coronary venous oxygen levels. Moreover, myocardial efficiency was lower, requiring higher oxygen consumption for a given level of myocardial work. These perturbations in myocardial oxygen balance were associated with lower myocardial lactate consumption, stroke volume, and LVdP/dtmax, suggestive of myocardial ischemia and dysfunction. Further analyses showed a reduction in adenosine-recruitable coronary flow reserve, but this was exclusively the result of an increase in basal coronary blood flow, while maximal coronary flow per gram of myocardium was maintained; the latter was consistent with the unchanged arteriolar wall/lumen ratio, arteriolar density and peri-arteriolar collagen content. However, isolated small arteries displayed selective blunting of endothelium-dependent vasodilation in response to bradykinin in DM + HC + CKD swine, suggesting that changes in coronary microvascular function rather than in structure contributed to the perturbations in myocardial oxygen delivery. In conclusion, common comorbidities in swine result in CMD, in the absence of appreciable atherosclerosis, which is severe enough to produce perturbations in myocardial oxygen balance, particularly during exercise, resembling key features of INOCA.
Collapse
Affiliation(s)
- Jens van de Wouw
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Oana Sorop
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Ruben W A van Drie
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Richard W B van Duin
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Isabel T N Nguyen
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jaap A Joles
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marianne C Verhaar
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Daphne Merkus
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Walter Brendel Center of Experimental Medicine (WBex), LMU Munich, 81377, Munich, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance (MHA), 81377, Munich, Germany
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| |
Collapse
|
17
|
Zhao Y, Hubbard L, Malkasian S, Abbona P, Molloi S. Dynamic pulmonary CT perfusion using first-pass analysis technique with only two volume scans: Validation in a swine model. PLoS One 2020; 15:e0228110. [PMID: 32049969 PMCID: PMC7015394 DOI: 10.1371/journal.pone.0228110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/07/2020] [Indexed: 12/02/2022] Open
Abstract
PURPOSE To evaluate the accuracy of a low-dose first-pass analysis (FPA) CT pulmonary perfusion technique in comparison to fluorescent microsphere measurement as the reference standard. METHOD The first-pass analysis CT perfusion technique was validated in six swine (41.7 ± 10.2 kg) for a total of 39 successful perfusion measurements. Different perfusion conditions were generated in each animal using serial balloon occlusions in the pulmonary artery. For each occlusion, over 20 contrast-enhanced CT images were acquired within one breath (320 x 0.5mm collimation, 100kVp, 200mA or 400mA, 350ms gantry rotation time). All volume scans were used for maximum slope model (MSM) perfusion measurement, but only two volume scans were used for the FPA measurement. Both MSM and FPA perfusion measurements were then compared to the reference fluorescent microsphere measurements. RESULTS The mean lung perfusion of MSM, FPA, and microsphere measurements were 6.21 ± 3.08 (p = 0.008), 6.59 ± 3.41 (p = 0.44) and 6.68 ± 3.89 ml/min/g, respectively. The MSM (PMSM) and FPA (PFPA) perfusion measurements were related to the corresponding reference microsphere measurement (PMIC) by PMSM = 0.51PMIC + 2.78 (r = 0.64) and PFPA = 0.79PMIC + 1.32 (r = 0.90). The root-mean-square-error for the MSM and FPA techniques were 3.09 and 1.72 ml/min/g, respectively. The root-mean-square-deviation for the MSM and FPA techniques were 2.38 and 1.50 ml/min/g, respectively. The CT dose index for MSM and FPA techniques were 138.7 and 8.4mGy, respectively. CONCLUSIONS The first-pass analysis technique can accurately measure regional pulmonary perfusion and has the potential to reduce the radiation dose associated with dynamic CT perfusion for assessment of pulmonary disease.
Collapse
Affiliation(s)
- Yixiao Zhao
- Department of Radiological Sciences, University of California Irvine, Irvine, California, United States of America
| | - Logan Hubbard
- Department of Radiological Sciences, University of California Irvine, Irvine, California, United States of America
| | - Shant Malkasian
- Department of Radiological Sciences, University of California Irvine, Irvine, California, United States of America
| | - Pablo Abbona
- Department of Radiological Sciences, University of California Irvine, Irvine, California, United States of America
| | - Sabee Molloi
- Department of Radiological Sciences, University of California Irvine, Irvine, California, United States of America
| |
Collapse
|
18
|
Li W, Lyu L, Yang W, Zhang R, Wang G, Fang D, Song W, Yin J, Yang J, Li W, Chen L, Luo T. A Pilot Study of Third-Generation Dual-Source Computed Tomography for the Assessment of Global Dynamic Changes in Left Ventricular Structure and Function in a Porcine Model of Acute Myocardial Infarction. MEDICAL SCIENCE MONITOR : INTERNATIONAL MEDICAL JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019; 25:7989-7997. [PMID: 31649233 PMCID: PMC6825397 DOI: 10.12659/msm.919122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background First-generation and second-generation dual-source computed tomography (DSCT) are useful for analyzing left ventricle (LV) structure and function. This pilot study aimed to investigate the feasibility and role of third-generation DSCT for the evaluation of dynamic changes in LV structural and functional characteristics in a Diannan small-ear pig model of acute myocardial infarction (AMI). Material/Methods The model of AMI was established by balloon occlusion of the distal third of the left anterior descending (LAD) coronary artery in 14 Diannan small-eared pigs. Third-generation DSCT was performed to observe dynamic changes in LV structure and function before and after AMI was induced, with a follow-up period of 30 days. Results The mean structural measurements at baseline included interventricular septum thickness (8.50±0.90 mm), LV anterior wall thickness (8.40±1.30 mm), LV posterior wall thickness (7.80±1.20 mm), LV end-diastolic dimension (LVEDD) (45.00±4.90 mm), and LV end-systolic dimension (LVESD) (25.90±4.10 mm). The mean functional measurements at baseline included the LV end-diastolic volume (LVEDV) (74.62±13.54 ml), LV end-systolic volume (LVESV) (23.06±7.46 ml), LV ejection fraction (LVEF) (69.29±6.83%), LV mass (86.35±14.02 g), stroke volume (SV) (51.56±9.77 ml), and cardiac output (CO) (4.22±2.14 l/min). Trends of time-dependent changes were observed for LVESV, LVEF, SV, and CO, but not for LVEDV or LV mass. Conclusions Third-generation DSCT was validated as a tool for assessing dynamic changes in LV global function in a porcine model of AMI.
Collapse
Affiliation(s)
- Wenjia Li
- Chongqing Medical University, Chongqing, China (mainland).,Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Liang Lyu
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Weixin Yang
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Rongshun Zhang
- Department of Radiology, Third People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Gang Wang
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Dong Fang
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Wei Song
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Junkun Yin
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Jiangmao Yang
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Wei Li
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Liling Chen
- Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Tianyou Luo
- Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| |
Collapse
|
19
|
Low-Radiation-Dose Stress Myocardial Perfusion Measurement Using First-Pass Analysis Dynamic Computed Tomography: A Preliminary Investigation in a Swine Model. Invest Radiol 2019; 54:774-780. [PMID: 31633574 DOI: 10.1097/rli.0000000000000613] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to assess the feasibility of a prospective first-pass analysis (FPA) dynamic computed tomography (CT) perfusion technique for accurate low-radiation-dose global stress perfusion measurement. MATERIALS AND METHODS The prospective FPA technique was evaluated in 10 swine (42 ± 12 kg) by direct comparison to a previously validated retrospective FPA technique. Of the 10 swine, 3 had intermediate stenoses with fractional flow reserve severities of 0.70 to 0.90. In each swine, contrast and saline were injected peripherally followed by dynamic volume scanning with a 320-slice CT scanner. Specifically, for the reference standard retrospective FPA technique, volume scans were acquired continuously at 100 kVp and 200 mA over 15 to 20 seconds, followed by systematic selection of only 2 volume scans for global perfusion measurement. For the prospective FPA technique, only 2 volume scans were acquired at 100 kVp and 50 mA for global perfusion measurement. All prospective global stress perfusion measurements were then compared with the corresponding reference standard retrospective global stress perfusion measurements through regression analysis. The CTDIvol and size-specific dose estimate of the prospective FPA technique were also determined. RESULTS All prospective global stress perfusion measurements (PPRO) at 50 mA were in good agreement with the reference standard retrospective global stress perfusion measurements (PREF) at 200 mA (PPRO = 1.07 PREF -0.09, r = 0.94; root-mean-square error = 0.30 mL/min per gram). The CTDIvol and size-specific dose estimate of the prospective FPA technique were 2.3 and 3.7 mGy, respectively. CONCLUSIONS Accurate low-radiation-dose global stress perfusion measurement is feasible using a prospective FPA dynamic CT perfusion technique.
Collapse
|
20
|
Rossi A, Ferrante G. Imaging of coronary flow capacity: is there a role for dynamic CT perfusion imaging? Eur J Nucl Med Mol Imaging 2019; 46:1765-1767. [PMID: 31152206 DOI: 10.1007/s00259-019-04362-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: 04/29/2019] [Accepted: 05/13/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Alexia Rossi
- Department of Biomedical Sciences, Humanitas Clinical and Research Hospital, Humanitas University, Pieve Emanuele, Milan, Italy.
- Department of Diagnostic Imaging, Humanitas Clinical and Research Hospital - IRCCS, Rozzano, Milan, Italy.
| | - Giuseppe Ferrante
- Department of Biomedical Sciences, Humanitas Clinical and Research Hospital, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Cardiovascular Medicine, Humanitas Clinical and Research Hospital - IRCCS, Rozzano, Milan, Italy
| |
Collapse
|
21
|
The Future of Cardiovascular Computed Tomography. JACC Cardiovasc Imaging 2019; 12:1058-1072. [DOI: 10.1016/j.jcmg.2018.11.037] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 11/19/2022]
|
22
|
Hubbard L, Malkasian S, Zhao Y, Abbona P, Molloi S. Timing optimization of low-dose first-pass analysis dynamic CT myocardial perfusion measurement: validation in a swine model. Eur Radiol Exp 2019; 3:16. [PMID: 30945100 PMCID: PMC6447643 DOI: 10.1186/s41747-019-0093-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/21/2019] [Indexed: 11/19/2022] Open
Abstract
Background Myocardial perfusion measurement with a low-dose first-pass analysis (FPA) dynamic computed tomography (CT) perfusion technique depends upon acquisition of two whole-heart volume scans at the base and peak of the aortic enhancement. Hence, the objective of this study was to validate an optimal timing protocol for volume scan acquisition at the base and peak of the aortic enhancement. Methods Contrast-enhanced CT of 28 Yorkshire swine (weight, 55 ± 24 kg, mean ± standard deviation) was performed under rest and stress conditions over 20–30 s to capture the aortic enhancement curves. From these curves, an optimal timing protocol was simulated, where one volume scan was acquired at the base of the aortic enhancement while a second volume scan was acquired at the peak of the aortic enhancement. Low-dose FPA perfusion measurements (PFPA) were then derived and quantitatively compared to the previously validated retrospective FPA perfusion measurements as a reference standard (PREF). The 32-cm diameter volume CT dose index, \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$ {\mathrm{CTDI}}_{\mathrm{vol}}^{32} $$\end{document}CTDIvol32 and size-specific dose estimate (SSDE) of the low-dose FPA perfusion protocol were also determined. Results PFPA were related to the reference standard by PFPA = 0.95 · PREF + 0.07 (r = 0.94, root-mean-square error = 0.27 mL/min/g, root-mean-square deviation = 0.04 mL/min/g). The \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$ {\mathrm{CTDI}}_{\mathrm{vol}}^{32} $$\end{document}CTDIvol32 and SSDE of the low-dose FPA perfusion protocol were 9.2 mGy and 14.6 mGy, respectively. Conclusions An optimal timing protocol for volume scan acquisition at the base and peak of the aortic enhancement was retrospectively validated and has the potential to be used to implement an accurate, low-dose, FPA perfusion technique.
Collapse
Affiliation(s)
- Logan Hubbard
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA
| | - Shant Malkasian
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA
| | - Yixiao Zhao
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA
| | - Pablo Abbona
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA
| | - Sabee Molloi
- Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA.
| |
Collapse
|
23
|
Malkasian S, Hubbard L, Dertli B, Kwon J, Molloi S. Quantification of vessel-specific coronary perfusion territories using minimum-cost path assignment and computed tomography angiography: Validation in a swine model. J Cardiovasc Comput Tomogr 2018; 12:425-435. [PMID: 30042078 DOI: 10.1016/j.jcct.2018.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/25/2018] [Accepted: 06/15/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND As combined morphological and physiological assessment of coronary artery disease (CAD) is necessary to reliably resolve CAD severity, the objective of this study was to validate an automated minimum-cost path assignment (MCP) technique which enables accurate, vessel-specific assignment of the left (LCA) and right (RCA) coronary perfusion territories using computed tomography (CT) angiography data for both left and right ventricles. METHODS Six swine were used to validate the MCP technique. In each swine, a dynamic acquisition comprised of twenty consecutive volume scans was acquired with a 320-slice CT scanner following peripheral injection of contrast material. From this acquisition the MCP technique was used to automatically assign LCA and RCA perfusion territories for the left and right ventricles, independently. Each animal underwent another dynamic CT acquisition following direct injection of contrast material into the LCA or RCA. Using this acquisition, reference standard LCA and RCA perfusion territories were isolated from the myocardial blush. The accuracy of the MCP technique was evaluated by quantitatively comparing the MCP-derived LCA and RCA perfusion territories to these reference standard territories. RESULTS All MCP perfusion territory masses (MassMCP) and all reference standard perfusion territory masses (MassRS) in the left ventricle were related by MassMCP = 0.99MassRS+0.35 g (r = 1.00). MassMCP and MassRS in the right ventricle were related by MassMCP = 0.94MassRS+0.39 g (r = 0.96). CONCLUSION The MCP technique was validated in a swine animal model and has the potential to be used for accurate, vessel-specific assignment of LCA and RCA perfusion territories in both the left and right ventricular myocardium using CT angiography data.
Collapse
Affiliation(s)
- Shant Malkasian
- Department of Radiological Sciences, University of California Irvine, Irvine, CA, 92697, USA
| | - Logan Hubbard
- Department of Radiological Sciences, University of California Irvine, Irvine, CA, 92697, USA
| | - Brian Dertli
- Department of Radiological Sciences, University of California Irvine, Irvine, CA, 92697, USA
| | - Jungnam Kwon
- Department of Radiological Sciences, University of California Irvine, Irvine, CA, 92697, USA
| | - Sabee Molloi
- Department of Radiological Sciences, University of California Irvine, Irvine, CA, 92697, USA.
| |
Collapse
|