1
|
Midgett DE, Thorn SL, Ahn SS, Uman S, Avendano R, Melvinsdottir I, Lysyy T, Kim JS, Duncan JS, Humphrey JD, Papademetris X, Burdick JA, Sinusas AJ. CineCT platform for in vivo and ex vivo measurement of 3D high resolution Lagrangian strains in the left ventricle following myocardial infarction and intramyocardial delivery of theranostic hydrogel. J Mol Cell Cardiol 2022; 166:74-90. [PMID: 35227737 PMCID: PMC9035115 DOI: 10.1016/j.yjmcc.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 02/10/2022] [Accepted: 02/16/2022] [Indexed: 02/07/2023]
Abstract
Myocardial infarction (MI) produces acute changes in strain and stiffness within the infarct that can affect remote areas of the left ventricle (LV) and drive pathological remodeling. We hypothesized that intramyocardial delivery of a hydrogel within the MI region would lower wall stress and reduce adverse remodeling in Yorkshire pigs (n = 5). 99mTc-Tetrofosmin SPECT imaging defined the location and geometry of induced MI and border regions in pigs, and in vivo and ex vivo contrast cine computed tomography (cineCT) quantified deformations of the LV myocardium. Serial in vivo cineCT imaging provided data in hearts from control pigs (n = 3) and data from pigs (n = 5) under baseline conditions before MI induction, post-MI day 3, post-MI day 7, and one hour after intramyocardial delivery of a hyaluronic acid (HA)-based hydrogel with shear-thinning and self-healing properties to the central infarct area. Isolated, excised hearts underwent similar cineCT imaging using an ex vivo perfused heart preparation with cyclic LV pressurization. Deformations were evaluated using nonlinear image registration of cineCT volumes between end-diastole (ED) and end-systole (ES), and 3D Lagrangian strains were calculated from the displacement gradients. Post-MI day 3, radial, circumferential, maximum principal, and shear strains were reduced within the MI region (p < 0.04) but were unchanged in normal regions (p > 0.6), and LV end diastolic volume (LV EDV) increased (p = 0.004), while ejection fraction (EF) and stroke volume (SV) decreased (p < 0.02). Post-MI day 7, radial strains in MI border zones increased (p = 0.04) and dilation of LV EDV continued (p = 0.052). There was a significant negative linear correlation between regional radial and maximum principal/shear strains and percent infarcted tissue in all hearts (R2 > 0.47, p < 0.004), indicating that cineCT strain measures could predict MI location and degree of injury. Post-hydrogel day 7 post-MI, LV EDV was significantly reduced (p = 0.009), EF increased (p = 0.048), and radial (p = 0.021), maximum principal (p = 0.051), and shear strain (p = 0.047) increased within regions bordering the infarct. A smaller strain improvement within the infarct and normal regions was also noted on average along with an improvement in SV in 4 out of 5 hearts. CineCT provides a reliable method to assess regional changes in strains post-MI and the therapeutic effects of intramyocardial hydrogel delivery.
Collapse
Affiliation(s)
- D E Midgett
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States of America; Department of Biomedical Engineering, Yale University, New Haven, CT, United States of America
| | - S L Thorn
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States of America
| | - S S Ahn
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States of America
| | - S Uman
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States of America
| | - R Avendano
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States of America
| | - I Melvinsdottir
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States of America
| | - T Lysyy
- Department of Surgery, Yale University School of Medicine, New Haven, CT, United States of America
| | - J S Kim
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, United States of America
| | - J S Duncan
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States of America; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, United States of America
| | - J D Humphrey
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States of America
| | - X Papademetris
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States of America; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, United States of America
| | - J A Burdick
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States of America
| | - A J Sinusas
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States of America; Department of Biomedical Engineering, Yale University, New Haven, CT, United States of America; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, United States of America.
| |
Collapse
|
2
|
Regional Myocardial Strain and Function: From Novel Techniques to Clinical Applications. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/978-1-4939-8841-9_5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
|
3
|
Sinusas AJ, Peters DC. Diffusion Tensor CMR: A Novel Approach for Evaluation of Myocardial Regeneration. JACC Basic Transl Sci 2018; 3:110-113. [PMID: 30062197 PMCID: PMC6058948 DOI: 10.1016/j.jacbts.2018.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Albert J Sinusas
- Yale Translational Research Imaging Center, Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.,Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Dana C Peters
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
4
|
|
5
|
Satriano A, Heydari B, Narous M, Exner DV, Mikami Y, Attwood MM, Tyberg JV, Lydell CP, Howarth AG, Fine NM, White JA. Clinical feasibility and validation of 3D principal strain analysis from cine MRI: comparison to 2D strain by MRI and 3D speckle tracking echocardiography. Int J Cardiovasc Imaging 2017; 33:1979-1992. [PMID: 28685315 PMCID: PMC5698377 DOI: 10.1007/s10554-017-1199-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 06/22/2017] [Indexed: 11/29/2022]
Abstract
Two-dimensional (2D) strain analysis is constrained by geometry-dependent reference directions of deformation (i.e. radial, circumferential, and longitudinal) following the assumption of cylindrical chamber architecture. Three-dimensional (3D) principal strain analysis may overcome such limitations by referencing intrinsic (i.e. principal) directions of deformation. This study aimed to demonstrate clinical feasibility of 3D principal strain analysis from routine 2D cine MRI with validation to strain from 2D tagged cine analysis and 3D speckle tracking echocardiography. Thirty-one patients undergoing cardiac MRI were studied. 3D strain was measured from routine, multi-planar 2D cine SSFP images using custom software designed to apply 4D deformation fields to 3D cardiac models to derive principal strain. Comparisons of strain estimates versus those by 2D tagged cine, 2D non-tagged cine (feature tracking), and 3D speckle tracking echocardiography (STE) were performed. Mean age was 51 ± 14 (36% female). Mean LV ejection fraction was 66 ± 10% (range 37–80%). 3D principal strain analysis was feasible in all subjects and showed high inter- and intra-observer reproducibility (ICC range 0.83–0.97 and 0.83–0.98, respectively—p < 0.001 for all directions). Strong correlations of minimum and maximum principal strain were respectively observed versus the following: 3D STE estimates of longitudinal (r = 0.81 and r = −0.64), circumferential (r = 0.76 and r = −0.58) and radial (r = −0.80 and r = 0.63) strain (p < 0.001 for all); 2D tagged cine estimates of longitudinal (r = 0.81 and r = −0.81), circumferential (r = 0.87 and r = −0.85), and radial (r = −0.76 and r = 0.81) strain (p < 0.0001 for all); and 2D cine (feature tracking) estimates of longitudinal (r = 0.85 and −0.83), circumferential (r = 0.88 and r = −0.87), and radial strain (r = −0.79 and r = 0.84, p < 0.0001 for all). 3D principal strain analysis is feasible using routine, multi-planar 2D cine MRI and shows high reproducibility with strong correlations to 2D conventional strain analysis and 3D STE-based analysis. Given its independence from geometry-related directions of deformation this technique may offer unique benefit for the detection and prognostication of myocardial disease, and warrants expanded investigation.
Collapse
Affiliation(s)
- Alessandro Satriano
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Bobak Heydari
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Mariam Narous
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Derek V Exner
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Yoko Mikami
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada
| | - Monica M Attwood
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - John V Tyberg
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Carmen P Lydell
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Department of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada
| | - Andrew G Howarth
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Nowell M Fine
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - James A White
- Stephenson Cardiac Imaging Centre, University of Calgary, Suite 0700 Foothills Medical Centre - 1403 29th St NW, Calgary, AB, T2N 2T9, Canada. .,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
6
|
Palit A, Franciosa P, Bhudia SK, Arvanitis TN, Turley GA, Williams MA. Passive diastolic modelling of human ventricles: Effects of base movement and geometrical heterogeneity. J Biomech 2016; 52:95-105. [PMID: 28065473 DOI: 10.1016/j.jbiomech.2016.12.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 12/14/2016] [Accepted: 12/19/2016] [Indexed: 11/19/2022]
Abstract
Left-ventricular (LV) remodelling, associated with diastolic heart failure, is driven by an increase in myocardial stress. Therefore, normalisation of LV wall stress is the cornerstone of many therapeutic treatments. However, information regarding such regional stress-strain for human LV is still limited. Thus, the objectives of our study were to determine local diastolic stress-strain field in healthy LVs, and consequently, to identify the regional variations amongst them due to geometric heterogeneity. Effects of LV base movement on diastolic model predictions, which were ignored in the literature, were further explored. Personalised finite-element modelling of five normal human bi-ventricles was carried out using subject-specific myocardium properties. Model prediction was validated individually through comparison with end-diastolic volume and a new shape-volume based measurement of LV cavity, extracted from magnetic resonance imaging. Results indicated that incorporation of LV base movement improved the model predictions (shape-volume relevancy of LV cavity), and therefore, it should be considered in future studies. The LV endocardium always experienced higher fibre stress compared to the epicardium for all five subjects. The LV wall near base experienced higher stress compared to equatorial and apical locations. The lateral LV wall underwent greater stress distribution (fibre and sheet stress) compared to other three regions. In addition, normal ranges of different stress-strain components in different regions of LV wall were reported for five healthy ventricles. This information could be used as targets for future computational studies to optimise diastolic heart failure treatments or design new therapeutic interventions/devices.
Collapse
Affiliation(s)
- Arnab Palit
- WMG, The University of Warwick, Coventry, UK; Institute of Digital Healthcare, WMG, The University of Warwick, Coventry, UK.
| | | | - Sunil K Bhudia
- University Hospitals Coventry and Warwickshire, Coventry, UK.
| | | | | | | |
Collapse
|
7
|
Li FP, Rajchl M, White JA, Goela A, Peters TM. Ultrasound guidance for beating heart mitral valve repair augmented by synthetic dynamic CT. IEEE TRANSACTIONS ON MEDICAL IMAGING 2015; 34:2025-2035. [PMID: 25775487 DOI: 10.1109/tmi.2015.2412465] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Minimally invasive valvular intervention commonly requires intra-procedural navigation to provide spatial and temporal information of relevant cardiac structures and device components. Recently intra-procedural trans-esophageal echocardiography (TEE) has been exploited for this purpose due to its accessibility, low cost, ease of use, and real-time imaging capacity. However, the position and orientation of tissue targets relative to surgical tools can be challenging to perceive, particularly using 2D imaging planes. In this paper, we propose the use of CT images to provide a high-quality 3D context to enhance ultrasound images through image registration, providing an augmented guidance system with minimal impact on standard clinical workflow. We also describe an approach to generate synthetic 4D CT images through non-rigid registration of available ultrasound. This can be employed to avoid a requirement for higher radiation. Synthetic CT images were validated through direct comparison of synthetic and real multi-phase CT images. Validation of CT and ultrasound image registration was performed for both dynamic and synthetic CT image datasets. Our results demonstrated that the synthetically generated dynamic CT images provide similar anatomical representation for relevant cardiac anatomy relative to real dynamic CT images, and similar high registration accuracy that can be achieved for intra-procedural TEE to this versus real dynamic CT images.
Collapse
|
8
|
Morris L, Fahy P, Stefanov F, Finn R. The Effects That Cardiac Motion has on Coronary Hemodynamics and Catheter Trackability Forces for the Treatment of Coronary Artery Disease: An In Vitro Assessment. Cardiovasc Eng Technol 2015; 6:430-49. [PMID: 26577477 DOI: 10.1007/s13239-015-0241-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 08/06/2015] [Indexed: 01/09/2023]
Abstract
The coronary arterial tree experiences large displacements due to the contraction and expansion of the cardiac muscle and may influence coronary haemodynamics and stent placement. The accurate measurement of catheter trackability forces within physiological relevant test systems is required for optimum catheter design. The effects of cardiac motion on coronary flowrates, pressure drops, and stent delivery has not been previously experimentally assessed. A cardiac simulator was designed and manufactured which replicates physiological coronary flowrates and cardiac motion within a patient-specific geometry. A motorized delivery system delivered a commercially available coronary stent system and monitored the trackability forces along three phantom patient-specific thin walled compliant coronary vessels supported by a dynamic cardiac phantom model. Pressure drop variation is more sensitive to cardiac motion than outlet flowrates. Maximum pressure drops varied from 7 to 49 mmHg for a stenosis % area reduction of 56 to 90%. There was a strong positive linear correlation of cumulative trackability force with the cumulative curvature. The maximum trackability forces and curvature ranged from 0.24 to 0.87 N and 0.06 to 0.22 mm(-1) respectively for all three vessels. There were maximum and average percentage differences in trackability forces of (23-49%) and (1.9-5.2%) respectively when comparing a static pressure case with the inclusion of pulsatile flow and cardiac motion. Cardiac motion with pulsatile flow significantly altered (p value <0.001) the trackability forces along the delivery pathways with high local percentage variations and pressure drop measurements.
Collapse
Affiliation(s)
- Liam Morris
- Galway Medical Technologies Centre, Department of Mechanical and Industrial Engineering, Galway Mayo Institute of Technology, Galway, Ireland.
| | - Paul Fahy
- Galway Medical Technologies Centre, Department of Mechanical and Industrial Engineering, Galway Mayo Institute of Technology, Galway, Ireland
| | - Florian Stefanov
- Galway Medical Technologies Centre, Department of Mechanical and Industrial Engineering, Galway Mayo Institute of Technology, Galway, Ireland
| | - Ronan Finn
- Galway Medical Technologies Centre, Department of Mechanical and Industrial Engineering, Galway Mayo Institute of Technology, Galway, Ireland
| |
Collapse
|
9
|
Three-Dimensional Principal Strain Analysis for Characterizing Subclinical Changes in Left Ventricular Function. J Am Soc Echocardiogr 2014; 27:1041-1050.e1. [DOI: 10.1016/j.echo.2014.05.014] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Indexed: 01/11/2023]
|
10
|
Gao H, Allan A, McComb C, Luo X, Berry C. Left ventricular strain and its pattern estimated from cine CMR and validation with DENSE. Phys Med Biol 2014; 59:3637-56. [PMID: 24922458 DOI: 10.1088/0031-9155/59/13/3637] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Measurement of local strain provides insight into the biomechanical significance of viable myocardium. We attempted to estimate myocardial strain from cine cardiovascular magnetic resonance (CMR) images by using a b-spline deformable image registration method. Three healthy volunteers and 41 patients with either recent or chronic myocardial infarction (MI) were studied at 1.5 Tesla with both cine and DENSE CMR. Regional circumferential and radial left ventricular strains were estimated from cine and DENSE acquisitions. In all healthy volunteers, there was no difference for peak circumferential strain (- 0.18 ± 0.04 versus - 0.18 ± 0.03, p = 0.76) between cine and DENSE CMR, however peak radial strain was overestimated from cine (0.84 ± 0.37 versus 0.49 ± 0.2, p < 0.01). In the patient study, the peak strain patterns predicted by cine were similar to the patterns from DENSE, including the strain evolution related to recovery time and strain patterns related to MI scar extent. Furthermore, cine-derived strain disclosed different strain patterns in MI and non-MI regions, and regions with transmural and non-transmural MI as DENSE. Although there were large variations with radial strain measurements from cine CMR images, useful circumferential strain information can be obtained from routine clinical CMR imaging. Cine strain analysis has potential to improve the diagnostic yield from routine CMR imaging in clinical practice.
Collapse
Affiliation(s)
- Hao Gao
- School of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QW, UK
| | | | | | | | | |
Collapse
|
11
|
Wang H, Amini AA. Cardiac motion and deformation recovery from MRI: a review. IEEE TRANSACTIONS ON MEDICAL IMAGING 2012; 31:487-503. [PMID: 21997253 DOI: 10.1109/tmi.2011.2171706] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Magnetic resonance imaging (MRI) is a highly advanced and sophisticated imaging modality for cardiac motion tracking and analysis, capable of providing 3D analysis of global and regional cardiac function with great accuracy and reproducibility. In the past few years, numerous efforts have been devoted to cardiac motion recovery and deformation analysis from MR image sequences. Many approaches have been proposed for tracking cardiac motion and for computing deformation parameters and mechanical properties of the heart from a variety of cardiac MR imaging techniques. In this paper, an updated and critical review of cardiac motion tracking methods including major references and those proposed in the past ten years is provided. The MR imaging and analysis techniques surveyed are based on cine MRI, tagged MRI, phase contrast MRI, DENSE, and SENC. This paper can serve as a tutorial for new researchers entering the field.
Collapse
Affiliation(s)
- Hui Wang
- Department of Electrical and Computer Engineering,University of Louisville, Louisville, KY 40292 USA.
| | | |
Collapse
|
12
|
Graf IM, Miri R, Smalling RW, Emelianov S. Clinical benefits of integrating cardiac and vascular models. EXPERT OPINION ON MEDICAL DIAGNOSTICS 2011; 5:501-515. [PMID: 23484748 DOI: 10.1517/17530059.2011.616195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Recent advances in computational methods and medical imaging techniques have enabled non-invasive exploration of cardiovascular pathologies, from cardiac level to complex arterial networks. The potential of cardiac and vascular modeling in guiding and monitoring therapies could be further extended through the integration of the two systems. AREAS COVERED This review includes advances in methods for cardiac electromechanics and vascular flow simulations. The results of a literature search depicting the state of the art in cardiac and vascular modeling are reviewed. The paper goes on to address the benefits and challenges of combined cardiovascular modeling, highlighting the relevance of specific cardiovascular features and implementation. Various alternative approaches and insights on future directions are presented and analyzed with respect to their applicability to clinical practice. EXPERT OPINION The article has emerged from the exploration of currently available cardiac and vascular mathematical tools and their corresponding clinical application. The summarized analysis suggests that future efforts should be aimed at developing more accurate and patient-specific mathematical models integrating cardiac and vascular functions to enhance the knowledge of cardiovascular pathologies.
Collapse
Affiliation(s)
- Iulia M Graf
- University of Texas at Austin , Department of Biomedical Engineering , BME Building, Room 4.414, 107 W. Dean Keeton Street, 1 University Station C0800, Austin, TX 78712 , USA +1 512 232 2892 ; +1 512 471 0616 ;
| | | | | | | |
Collapse
|
13
|
Veress AI, Segars WP, Tsui BMW, Gullberg GT. Incorporation of a left ventricle finite element model defining infarction into the XCAT imaging phantom. IEEE TRANSACTIONS ON MEDICAL IMAGING 2011; 30:915-927. [PMID: 21041157 PMCID: PMC3097415 DOI: 10.1109/tmi.2010.2089801] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The 4D extended cardiac-torso (XCAT) phantom was developed to provide a realistic and flexible model of the human anatomy and cardiac and respiratory motions for use in medical imaging research. A prior limitation to the phantom was that it did not accurately simulate altered functions of the heart that result from cardiac pathologies such as coronary artery disease (CAD). We overcame this limitation in a previous study by combining the phantom with a finite-element (FE) mechanical model of the left ventricle (LV) capable of more realistically simulating regional defects caused by ischemia. In the present work, we extend this model giving it the ability to accurately simulate motion abnormalities caused by myocardial infarction (MI), a far more complex situation in terms of altered mechanics compared with the modeling of acute ischemia. The FE model geometry is based on high resolution CT images of a normal male subject. An anterior region was defined as infarcted and the material properties and fiber distribution were altered, according to the bio-physiological properties of two types of infarction, i.e., fibrous and remodeled infarction (30% thinner wall than fibrous case). Compared with the original, surface-based 4D beating heart model of the XCAT, where regional abnormalities are modeled by simply scaling down the motion in those regions, the FE model was found to provide a more accurate representation of the abnormal motion of the LV due to the effects of fibrous infarction as well as depicting the motion of remodeled infarction. In particular, the FE models allow for the accurate depiction of dyskinetic motion. The average circumferential strain results were found to be consistent with measured dyskinetic experimental results. Combined with the 4D XCAT phantom, the FE model can be used to produce realistic multimodality sets of imaging data from a variety of patients in which the normal or abnormal cardiac function is accurately represented.
Collapse
Affiliation(s)
| | - W. Paul Segars
- Department of Radiology, Duke University, Durham, NC 27705 USA
| | | | - Grant T. Gullberg
- E. O. Lawrence Berkeley National Laboratory, Life Science Division, Berkeley, CA 94720 USA
| |
Collapse
|
14
|
iLogDemons: A Demons-Based Registration Algorithm for Tracking Incompressible Elastic Biological Tissues. Int J Comput Vis 2010. [DOI: 10.1007/s11263-010-0405-z] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Measuring regional changes in the diastolic deformation of the left ventricle of SHR rats using microPET technology and hyperelastic warping. Ann Biomed Eng 2008; 36:1104-17. [PMID: 18437574 DOI: 10.1007/s10439-008-9497-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Accepted: 04/04/2008] [Indexed: 10/22/2022]
Abstract
The objective of this research was to assess applicability of a technique known as hyperelastic warping for the measurement of local strains in the left ventricle (LV) directly from microPET image data sets. The technique uses differences in image intensities between template (reference) and target (loaded) image data sets to generate a body force that deforms a finite element (FE) representation of the template so that it registers with the target images. For validation, the template image was defined as the end-systolic microPET image data set from a Wistar Kyoto (WKY) rat. The target image was created by mapping the template image using the deformation results obtained from a FE model of diastolic filling. Regression analysis revealed highly significant correlations between the simulated forward FE solution and image derived warping predictions for fiber stretch (R (2) = 0.96), circumferential strain (R (2) = 0.96), radial strain (R (2) = 0.93), and longitudinal strain (R (2) = 0.76) (p < 0.001 for all cases). The technology was applied to microPET image data of two spontaneously hypertensive rats (SHR) and a WKY control. Regional analysis revealed that, the lateral freewall in the SHR subjects showed the greatest deformation compared with the other wall segments. This work indicates that warping can accurately predict the strain distributions during diastole from the analysis of microPET data sets.
Collapse
|
16
|
Veress AI, Segars WP, Weiss JA, Tsui BMW, Gullberg GT. Normal and pathological NCAT image and phantom data based on physiologically realistic left ventricle finite-element models. IEEE TRANSACTIONS ON MEDICAL IMAGING 2006; 25:1604-16. [PMID: 17167995 DOI: 10.1109/tmi.2006.884213] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The four-dimensional (4-D) NURBS-based cardiac-torso (NCAT) phantom, which provides a realistic model of the normal human anatomy and cardiac and respiratory motions, is used in medical imaging research to evaluate and improve imaging devices and techniques, especially dynamic cardiac applications. One limitation of the phantom is that it lacks the ability to accurately simulate altered functions of the heart that result from cardiac pathologies such as coronary artery disease (CAD). The goal of this work was to enhance the 4-D NCAT phantom by incorporating a physiologically based, finite-element (FE) mechanical model of the left ventricle (LV) to simulate both normal and abnormal cardiac motions. The geometry of the FE mechanical model was based on gated high-resolution X-ray multislice computed tomography (MSCT) data of a healthy male subject. The myocardial wall was represented as a transversely isotropic hyperelastic material, with the fiber angle varying from -90 degrees at the epicardial surface, through 0 degrees at the midwall, to 90 degrees at the endocardial surface. A time-varying elastance model was used to simulate fiber contraction, and physiological intraventricular systolic pressure-time curves were applied to simulate the cardiac motion over the entire cardiac cycle. To demonstrate the ability of the FE mechanical model to accurately simulate the normal cardiac motion as well as the abnormal motions indicative of CAD, a normal case and two pathologic cases were simulated and analyzed. In the first pathologic model, a subendocardial anterior ischemic region was defined. A second model was created with a transmural ischemic region defined in the same location. The FE-based deformations were incorporated into the 4-D NCAT cardiac model through the control points that define the cardiac structures in the phantom which were set to move according to the predictions of the mechanical model. A simulation study was performed using the FE-NCAT combination to investigate how the differences in contractile function between the subendocardial and transmural infarcts manifest themselves in myocardial Single photon emission computed tomography (SPECT) images. The normal FE model produced strain distributions that were consistent with those reported in the literature and a motion consistent with that defined in the normal 4-D NCAT beating heart model based on tagged magnetic resonance imaging (MRI) data. The addition of a subendocardial ischemic region changed the average transmural circumferential strain from a contractile value of -0.09 to a tensile value of 0.02. The addition of a transmural ischemic region changed average circumferential strain to a value of 0.13, which is consistent with data reported in the literature. Model results demonstrated differences in contractile function between subendocardial and transmural infarcts and how these differences in function are documented in simulated myocardial SPECT images produced using the 4-D NCAT phantom. Compared with the original NCAT beating heart model, the FE mechanical model produced a more accurate simulation for the cardiac motion abnormalities. Such a model, when incorporated into the 4-D NCAT phantom, has great potential for use in cardiac imaging research. With its enhanced physiologically based cardiac model, the 4-D NCAT phantom can be used to simulate realistic, predictive imaging data of a patient population with varying whole-body anatomy and with varying healthy and diseased states of the heart that will provide a known truth from which to evaluate and improve existing and emerging 4-D imaging techniques used in the diagnosis of cardiac disease.
Collapse
MESH Headings
- Algorithms
- Artifacts
- Computer Simulation
- Finite Element Analysis
- Heart Ventricles/diagnostic imaging
- Heart Ventricles/pathology
- Heart Ventricles/physiopathology
- Humans
- Imaging, Three-Dimensional/methods
- Models, Anatomic
- Models, Cardiovascular
- Movement
- Phantoms, Imaging
- Radiographic Image Enhancement/methods
- Radiographic Image Interpretation, Computer-Assisted/methods
- Reproducibility of Results
- Sensitivity and Specificity
- Tomography, X-Ray Computed/instrumentation
- Tomography, X-Ray Computed/methods
- Ventricular Dysfunction, Left/diagnostic imaging
- Ventricular Dysfunction, Left/pathology
- Ventricular Dysfunction, Left/physiopathology
Collapse
Affiliation(s)
- Alexander I Veress
- Department of Bioengineering and the Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112-9202, USA.
| | | | | | | | | |
Collapse
|
17
|
Verhey JF, Nathan NS. Utilizing FEM-Software to quantify pre- and post-interventional cardiac reconstruction data based on modelling data sets from surgical ventricular repair therapy (SVRT) and cardiac resynchronisation therapy (CRT). Biomed Eng Online 2006; 5:58. [PMID: 17076902 PMCID: PMC1636054 DOI: 10.1186/1475-925x-5-58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Accepted: 10/31/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Left ventricle (LV) 3D structural data can be easily obtained using standard transesophageal echocardiography (TEE) devices but quantitative pre- and intraoperative volumetry and geometry analysis of the LV is presently not feasible in the cardiac operation room (OR). Finite element method (FEM) modelling is necessary to carry out precise and individual volume analysis and in the future will form the basis for simulation of cardiac interventions. METHOD A Philips/HP Sonos 5500 ultrasound device stores volume data as time-resolved 4D volume data sets. In this prospective study TomTec LV Analysis TEE Software was used for semi-automatic endocardial border detection, reconstruction, and volume-rendering of the clinical 3D echocardiographic data. With the software FemCoGen a quantification of partial volumes and surface directions of the LV was carried out for two patients data sets. One patient underwent surgical ventricular repair therapy (SVR) and the other a cardiac resynchronisation therapy (CRT). RESULTS For both patients a detailed volume and surface direction analysis is provided. Partial volumes as well as normal directions to the LV surface are pre- and post-interventionally compared. CONCLUSION The operation results for both patients are quantified. The quantification shows treatment details for both interventions (e.g. the elimination of the discontinuities for CRT intervention and the segments treated for SVR intervention). The LV quantification is feasible in the cardiac OR and it gives a detailed and immediate quantitative feedback of the quality of the intervention to the medical.
Collapse
Affiliation(s)
- Janko F Verhey
- MVIP ImagingProducts GmbH, Nörten-Hardenberg, Germany
- Department of Medical Informatics, University Hospital Göttingen, Göttingen, Germany
| | - Nadia S Nathan
- Department of Anesthesiology, Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
18
|
Dorri F, Niederer PF, Lunkenheimer PP. A finite element model of the human left ventricular systole. Comput Methods Biomech Biomed Engin 2006; 9:319-41. [PMID: 17132618 DOI: 10.1080/10255840600960546] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Local wall stress is the pivotal determinant of the heart muscle's systolic function. Under in vivo conditions, however, such stresses cannot be measured systematically and quantitatively. In contrast, imaging techniques based on magnetic resonance (MR) allow the determination of the deformation pattern of the left ventricle (LV) in vivo with high accuracy. The question arises to what extent deformation measurements are significant and might provide a possibility for future diagnostic purposes. The contractile forces cause deformation of LV myocardial tissue in terms of wall thickening, longitudinal shortening, twisting rotation and radial constriction. The myocardium is thereby understood to act as a densely interlaced mesh. Yet, whole cycle image sequences display a distribution of wall strains as function of space and time heralding a significant amount of inhomogeneity even under healthy conditions. We made similar observations previously by direct measurement of local contractile activity. The major reasons for these inhomogeneities derive from regional deviations of the ventricular walls from an ideal spheroidal shape along with marked disparities in focal fibre orientation. In response to a lack of diagnostic tools able to measure wall stress in clinical routine, this communication is aimed at an analysis and functional interpretation of the deformation pattern of an exemplary human heart at end-systole. To this end, the finite element (FE) method was used to simulate the three-dimensional deformations of the left ventricular myocardium due to contractile fibre forces at end-systole. The anisotropy associated with the fibre structure of the myocardial tissue was included in the form of a fibre orientation vector field which was reconstructed from the measured fibre trajectories in a post mortem human heart. Contraction was modelled by an additive second Piola-Kirchhoff active stress tensor. As a first conclusion, it became evident that longitudinal fibre forces, cross-fibre forces and shear along with systolic fibre rearrangement have to be taken into account for a useful modelling of systolic deformation. Second, a realistic geometry and fibre architecture lead to typical and substantially inhomogeneous deformation patterns as they are recorded in real hearts. We therefore, expect that the measurement of systolic deformation might provide useful diagnostic information.
Collapse
Affiliation(s)
- F Dorri
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, CH-8092, Zurich, Switzerland.
| | | | | |
Collapse
|
19
|
Veress AI, Gullberg GT, Weiss JA. Measurement of Strain in the Left Ventricle during Diastole with cine-MRI and Deformable Image Registration. J Biomech Eng 2005; 127:1195-207. [PMID: 16502662 DOI: 10.1115/1.2073677] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The assessment of regional heart wall motion (local strain) can localize ischemic myocardial disease, evaluate myocardial viability, and identify impaired cardiac function due to hypertrophic or dilated cardiomyopathies. The objectives of this research were to develop and validate a technique known as hyperelastic warping for the measurement of local strains in the left ventricle from clinical cine-magnetic resonance imaging (MRI) image datasets. The technique uses differences in image intensities between template (reference) and target (loaded) image datasets to generate a body force that deforms a finite element (FE) representation of the template so that it registers with the target image. To validate the technique, MRI image datasets representing two deformation states of a left ventricle were created such that the deformation map between the states represented in the images was known. A beginning diastolic cine-MRI image dataset from a normal human subject was defined as the template. A second image dataset (target) was created by mapping the template image using the deformation results obtained from a forward FE model of diastolic filling. Fiber stretch and strain predictions from hyperelastic warping showed good agreement with those of the forward solution (R2=0.67 stretch, R2=0.76 circumferential strain, R2=0.75 radial strain, and R2=0.70 in-plane shear). The technique had low sensitivity to changes in material parameters (deltaR2= -0.023 fiber stretch, deltaR2=-0.020 circumferential strain, deltaR2=-0.005 radial strain, and deltaR2=0.0125 shear strain with little or no change in rms error), with the exception of changes in bulk modulus of the material. The use of an isotropic hyperelastic constitutive model in the warping analyses degraded the predictions of fiber stretch. Results were unaffected by simulated noise down to a signal-to-noise ratio (SNR) of 4.0 (deltaR2= -0.032 fiber stretch, deltaR2=-0.023 circumferential strain, deltaR2=-0.04 radial strain, and deltaAR2=0.0211 shear strain with little or no increase in rms error). This study demonstrates that warping in conjunction with cine-MRI imaging can be used to determine local ventricular strains during diastole.
Collapse
Affiliation(s)
- Alexander I Veress
- Department of Bioengineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112-9202, USA
| | | | | |
Collapse
|
20
|
Cheng A, Langer F, Rodriguez F, Criscione JC, Daughters GT, Miller DC, Ingels NB. Transmural cardiac strains in the lateral wall of the ovine left ventricle. Am J Physiol Heart Circ Physiol 2005; 288:H1546-56. [PMID: 15591101 DOI: 10.1152/ajpheart.00716.2004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The constant-volume property of contracting cardiac muscle has been invoked in models of heart wall mechanics that predict that systolic subendocardial left ventricular (LV) wall thickening must significantly exceed subepicardial thickening. To examine this prediction, we implanted arrays of radiopaque markers to measure lateral equatorial wall transmural strains and global and regional LV geometry in seven sheep and studied the four-dimensional dynamics of these arrays using biplane videofluoroscopy (60 Hz) in anesthetized intact animals 1 and 8 wk after surgery. A transmural gradient of systolic lateral wall thickening was observed at 1 wk ( P = 0.009; linear regression) but was no longer present at 8 wk ( P = 0.243). Referenced to end diastole, group mean (±SD) end-systolic radial subepicardial, midwall, and subendocardial wall thickening strains were, respectively, 0.08 ± 0.08, 0.14 ± 0.08, and 0.22 ± 0.12 at 1 wk and 0.19 ± 0.07 ( P = 0.02; 1 vs. 8 wk), 0.20 ± 0.04, and 0.23 ± 0.07 at 8 wk. With the exception of an 8-ml (7%) increase in end-diastolic volume ( P = 0.04) from 1 to 8 wk, LV shape and hemodynamics were otherwise unchanged. We conclude that equivalent hemodynamics can be generated by the left ventricle with or without a transmural gradient of systolic wall thickening in this region; thus such a gradient is unlikely to be a fundamental property of the contracting LV myocardium. We discuss some implications of these findings regarding mechanisms involved in systolic wall thickening.
Collapse
Affiliation(s)
- Allen Cheng
- Department of Cardiovascular and Thoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | | | | | | | | |
Collapse
|
21
|
Duncan JS, Staib LH. Image processing and analysis at IPAG. IEEE TRANSACTIONS ON MEDICAL IMAGING 2003; 22:1505-1518. [PMID: 14649742 DOI: 10.1109/tmi.2003.819935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
|