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Erschienen in: European Radiology 1/2014

01.01.2014 | Cardiac

Dynamic CT myocardial perfusion imaging: performance of 3D semi-automated evaluation software

verfasst von: Ullrich Ebersberger, Roy P. Marcus, U. Joseph Schoepf, Gladys G. Lo, Yining Wang, Philipp Blanke, Lucas L. Geyer, J. Cranston Gray III, Andrew D. McQuiston, Young Jun Cho, Michael Scheuering, Christian Canstein, Konstantin Nikolaou, Ellen Hoffmann, Fabian Bamberg

Erschienen in: European Radiology | Ausgabe 1/2014

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Abstract

Objectives

To evaluate the performance of three-dimensional semi-automated evaluation software for the assessment of myocardial blood flow (MBF) and blood volume (MBV) at dynamic myocardial perfusion computed tomography (CT).

Methods

Volume-based software relying on marginal space learning and probabilistic boosting tree-based contour fitting was applied to CT myocardial perfusion imaging data of 37 subjects. In addition, all image data were analysed manually and both approaches were compared with SPECT findings. Study endpoints included time of analysis and conventional measures of diagnostic accuracy.

Results

Of 592 analysable segments, 42 showed perfusion defects on SPECT. Average analysis times for the manual and software-based approaches were 49.1 ± 11.2 and 16.5 ± 3.7 min respectively (P < 0.01). There was strong agreement between the two measures of interest (MBF, ICC = 0.91, and MBV, ICC = 0.88, both P < 0.01) and no significant difference in MBF/MBV with respect to diagnostic accuracy between the two approaches for both MBF and MBV for manual versus software-based approach; respectively; all comparisons P > 0.05.

Conclusions

Three-dimensional semi-automated evaluation of dynamic myocardial perfusion CT data provides similar measures and diagnostic accuracy to manual evaluation, albeit with substantially reduced analysis times. This capability may aid the integration of this test into clinical workflows.

Key Points

Myocardial perfusion CT is attractive for comprehensive coronary heart disease assessment.
Traditional image analysis methods are cumbersome and time-consuming.
Automated 3D perfusion software shortens analysis times.
Automated 3D perfusion software increases standardisation of myocardial perfusion CT.
Automated, standardised analysis fosters myocardial perfusion CT integration into clinical practice.
Literatur
1.
Zurück zum Zitat Bamberg F, Becker A, Schwarz F et al (2011) Detection of hemodynamically significant coronary artery stenosis: incremental diagnostic value of dynamic CT-based myocardial perfusion imaging. Radiology 260:689–698PubMedCrossRef Bamberg F, Becker A, Schwarz F et al (2011) Detection of hemodynamically significant coronary artery stenosis: incremental diagnostic value of dynamic CT-based myocardial perfusion imaging. Radiology 260:689–698PubMedCrossRef
2.
Zurück zum Zitat Wang Y, Qin L, Shi X et al (2012) Adenosine-stress dynamic myocardial perfusion imaging with second-generation dual-source CT: comparison with conventional catheter coronary angiography and SPECT nuclear myocardial perfusion imaging. AJR Am J Roentgenol 198:521–529PubMedCrossRef Wang Y, Qin L, Shi X et al (2012) Adenosine-stress dynamic myocardial perfusion imaging with second-generation dual-source CT: comparison with conventional catheter coronary angiography and SPECT nuclear myocardial perfusion imaging. AJR Am J Roentgenol 198:521–529PubMedCrossRef
3.
Zurück zum Zitat George RT, Arbab-Zadeh A, Miller JM et al (2009) Adenosine stress 64- and 256-row detector computed tomography angiography and perfusion imaging: a pilot study evaluating the transmural extent of perfusion abnormalities to predict atherosclerosis causing myocardial ischemia. Circ Cardiovasc Imaging 2:174–182PubMedCentralPubMedCrossRef George RT, Arbab-Zadeh A, Miller JM et al (2009) Adenosine stress 64- and 256-row detector computed tomography angiography and perfusion imaging: a pilot study evaluating the transmural extent of perfusion abnormalities to predict atherosclerosis causing myocardial ischemia. Circ Cardiovasc Imaging 2:174–182PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Feuchtner GM, Plank F, Pena C et al (2012) Evaluation of myocardial CT perfusion in patients presenting with acute chest pain to the emergency department: comparison with SPECT-myocardial perfusion imaging. Heart 98:1510–1517PubMedCrossRef Feuchtner GM, Plank F, Pena C et al (2012) Evaluation of myocardial CT perfusion in patients presenting with acute chest pain to the emergency department: comparison with SPECT-myocardial perfusion imaging. Heart 98:1510–1517PubMedCrossRef
5.
Zurück zum Zitat Bastarrika G, Ramos-Duran L, Rosenblum MA, Kang DK, Rowe GW, Schoepf UJ (2010) Adenosine-stress dynamic myocardial CT perfusion imaging: initial clinical experience. Invest Radiol 45:306–313PubMed Bastarrika G, Ramos-Duran L, Rosenblum MA, Kang DK, Rowe GW, Schoepf UJ (2010) Adenosine-stress dynamic myocardial CT perfusion imaging: initial clinical experience. Invest Radiol 45:306–313PubMed
6.
Zurück zum Zitat Bastarrika G, Lee YS, Huda W, Ruzsics B, Costello P, Schoepf UJ (2009) CT of coronary artery disease. Radiology 253:317–338PubMedCrossRef Bastarrika G, Lee YS, Huda W, Ruzsics B, Costello P, Schoepf UJ (2009) CT of coronary artery disease. Radiology 253:317–338PubMedCrossRef
7.
Zurück zum Zitat Cerqueira MD, Weissman NJ, Dilsizian V et al (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 105:539–542PubMedCrossRef Cerqueira MD, Weissman NJ, Dilsizian V et al (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 105:539–542PubMedCrossRef
8.
Zurück zum Zitat Bruder H, Raupach R, Klotz E, Stierstorfer K, Flohr T (2009) Spatio-temporal filtration of dynamic CT data using diffusion filters. Med Imaging 7258:57–87 Bruder H, Raupach R, Klotz E, Stierstorfer K, Flohr T (2009) Spatio-temporal filtration of dynamic CT data using diffusion filters. Med Imaging 7258:57–87
9.
Zurück zum Zitat Zheng Y, Barbu A, Georgescu B, Scheuering M, Comaniciu D (2008) Four-chamber heart modeling and automatic segmentation for 3-D cardiac CT volumes using marginal space learning and steerable features. IEEE Trans Med Imaging 27:1668–1681PubMedCrossRef Zheng Y, Barbu A, Georgescu B, Scheuering M, Comaniciu D (2008) Four-chamber heart modeling and automatic segmentation for 3-D cardiac CT volumes using marginal space learning and steerable features. IEEE Trans Med Imaging 27:1668–1681PubMedCrossRef
10.
Zurück zum Zitat Stenner P, Schmidt B, Allmendinger T, Flohr T, Kachelrie M (2010) Dynamic iterative beam hardening correction (DIBHC) in myocardial perfusion imaging using contrast-enhanced computed tomography. Invest Radiol 45:314–323PubMed Stenner P, Schmidt B, Allmendinger T, Flohr T, Kachelrie M (2010) Dynamic iterative beam hardening correction (DIBHC) in myocardial perfusion imaging using contrast-enhanced computed tomography. Invest Radiol 45:314–323PubMed
11.
Zurück zum Zitat Henzlova MJ, Cerqueira MD, Mahmarian JJ, Yao SS (2006) Stress protocols and tracers. J Nucl Cardiol 13:80–90CrossRef Henzlova MJ, Cerqueira MD, Mahmarian JJ, Yao SS (2006) Stress protocols and tracers. J Nucl Cardiol 13:80–90CrossRef
12.
Zurück zum Zitat Bateman TM, Heller GV, McGhie AI et al (2006) Diagnostic accuracy of rest/stress ECG-gated Rb-82 myocardial perfusion PET: comparison with ECG-gated Tc-99m sestamibi SPECT. J Nucl Cardiol 13:24–33PubMedCrossRef Bateman TM, Heller GV, McGhie AI et al (2006) Diagnostic accuracy of rest/stress ECG-gated Rb-82 myocardial perfusion PET: comparison with ECG-gated Tc-99m sestamibi SPECT. J Nucl Cardiol 13:24–33PubMedCrossRef
13.
Zurück zum Zitat Hamon M, Fau G, Née G, Ehtisham J, Morello R, Hamon M (2010) Meta-analysis of the diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease. J Cardiovasc Magn Reson 12:29PubMedCentralPubMedCrossRef Hamon M, Fau G, Née G, Ehtisham J, Morello R, Hamon M (2010) Meta-analysis of the diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease. J Cardiovasc Magn Reson 12:29PubMedCentralPubMedCrossRef
14.
Zurück zum Zitat Greenwood JP, Maredia N, Younger JF et al (2012) Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): a prospective trial. Lancet 379:453–460PubMedCentralPubMedCrossRef Greenwood JP, Maredia N, Younger JF et al (2012) Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): a prospective trial. Lancet 379:453–460PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Ruzsics B, Lee H, Powers ER, Flohr TG, Costello P, Schoepf UJ (2008) Images in cardiovascular medicine. Myocardial ischemia diagnosed by dual-energy computed tomography: correlation with single-photon emission computed tomography. Circulation 117:1244–1245PubMedCrossRef Ruzsics B, Lee H, Powers ER, Flohr TG, Costello P, Schoepf UJ (2008) Images in cardiovascular medicine. Myocardial ischemia diagnosed by dual-energy computed tomography: correlation with single-photon emission computed tomography. Circulation 117:1244–1245PubMedCrossRef
16.
Zurück zum Zitat Blankstein R, Shturman LD, Rogers IS et al (2009) Adenosine-induced stress myocardial perfusion imaging using dual-source cardiac computed tomography. J Am Coll Cardiol 54:1072–1084PubMedCrossRef Blankstein R, Shturman LD, Rogers IS et al (2009) Adenosine-induced stress myocardial perfusion imaging using dual-source cardiac computed tomography. J Am Coll Cardiol 54:1072–1084PubMedCrossRef
17.
Zurück zum Zitat Okada DR, Ghoshhajra BB, Blankstein R et al (2010) Direct comparison of rest and adenosine stress myocardial perfusion CT with rest and stress SPECT. J Nucl Cardiol 17:27–37PubMedCentralPubMedCrossRef Okada DR, Ghoshhajra BB, Blankstein R et al (2010) Direct comparison of rest and adenosine stress myocardial perfusion CT with rest and stress SPECT. J Nucl Cardiol 17:27–37PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Rocha-Filho JA, Blankstein R, Shturman LD et al (2010) Incremental value of adenosine-induced stress myocardial perfusion imaging with dual-source CT at cardiac CT angiography. Radiology 254:410–419PubMedCentralPubMedCrossRef Rocha-Filho JA, Blankstein R, Shturman LD et al (2010) Incremental value of adenosine-induced stress myocardial perfusion imaging with dual-source CT at cardiac CT angiography. Radiology 254:410–419PubMedCentralPubMedCrossRef
Metadaten
Titel
Dynamic CT myocardial perfusion imaging: performance of 3D semi-automated evaluation software
verfasst von
Ullrich Ebersberger
Roy P. Marcus
U. Joseph Schoepf
Gladys G. Lo
Yining Wang
Philipp Blanke
Lucas L. Geyer
J. Cranston Gray III
Andrew D. McQuiston
Young Jun Cho
Michael Scheuering
Christian Canstein
Konstantin Nikolaou
Ellen Hoffmann
Fabian Bamberg
Publikationsdatum
01.01.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 1/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2997-5

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