Volumetric quantification of myocardial perfusion using analysis of multi-detector computed tomography 3D datasets: comparison with nuclear perfusion imaging

Background  

Although the ability of multi-detector computed tomography (MDCT) to detect perfusion abnormalities associated with acute and chronic myocardial infarction (MI) has been demonstrated, this methodology is based on visual interpretation of selected 2D slices.     

The impact of viability assessment using myocardial perfusion imaging on patient management and outcome

Background  

Prior studies show that ischemic cardiomyopathy (ICM) patients with substantial viable myocardium have better survival with coronary revascularization (CR) than medical therapy (MT). When myocardial perfusion imaging (MPI) is used, the analysis is often based on visual scoring. We sought to determine the value of automated quantitative viability analysis in guiding management and predicting outcome.     

Combined quantitative analysis of attenuation corrected and non-corrected myocadial perfusion SPECT: Method development and clinical validation

Background  

Attenuation corrected myocardial perfusion SPECT (AC-MPS) has been demonstrated to improve the specificity of detecting coronary artery disease (CAD) by visual analysis which utilizes both non-corrected (NC) and AC data. However, the combined automated quantification of NC and AC-MPS has not been previously described. We aimed to develop a combined quantitative analysis from AC and NC data to improve the accuracy of automated detection of CAD from AC-MPS.     

Pulmonary ventilation and perfusion imaging with dual-energy CT

Objective  

To evaluate the feasibility of dual-energy CT (DECT) ventilation imaging in combination with DE perfusion mapping for a comprehensive assessment of ventilation, perfusion, morphology and structure of the pulmonary parenchyma.     

CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms

Introduction  

Computed tomography perfusion (CTP) and magnetic resonance perfusion (MRP) are expected to be usable for ancillary tests of brain death by detection of complete absence of cerebral perfusion; however, the detection limit of hypoperfusion has not been determined. Hence, we examined whether commercial software can visualize very low cerebral blood flow (CBF) and cerebral blood volume (CBV) by creating and using digital phantoms.     

Assessment of cerebral perfusion from bypass arteries using magnetic resonance regional perfusion imaging in patients with moyamoya disease

Purpose  

The purpose of this study was to evaluate whether cerebral perfusion from bypassed arteries can be demonstrated on regional perfusion imaging (RPI) using arterial spin labeling. We then compared cerebral perfusion on RPI and digital subtraction angiography (DSA) in moyamoya patients who underwent extracranial-intracranial bypass surgery.     

64-row MDCT perfusion of head and neck squamous cell carcinoma: technical feasibility and quantitative analysis of perfusion parameters

Objectives  

To evaluate the technical feasibility of 64-row computed tomography (CT) quantitative perfusion imaging of head and neck squamous cell carcinoma (SCC).     

Prognostic value of quantitative high-speed myocardial perfusion imaging

Background

We studied the prognostic value of fully automated quantitative analysis software applied to new solid-state, high-speed (HS) SPECT-myocardial perfusion imaging (MPI).

Methods

1,613 consecutive patients undergoing exercise or adenosine HS-MPI were followed for 2.6?±?0.5?years for all-cause mortality (ACM). Automated quantitative software was used to compute stress total perfusion deficit (sTPD) and was compared to semi-quantitative visual analysis. MPI was characterized as 0% (normal), 1%-4% (minimal perfusion defect), 5%-10% (mildly abnormal), and >10% (moderately/severely abnormal).

Results

During follow-up, 79 patients died (4.9%). Annualized ACM increased with progressively increasing sTPD; 0% (0.87%), 1%-4% (1.94%), 5%-10% (3.10%), and >10% (5.33%) (log-rank P?<?.0001). While similar overall findings were observed with visual analysis, only sTPD demonstrated increased risk in patients with minimal perfusion defects. In multivariable analysis, sTPD?>?10% was a mortality predictor (HR 3.03, 95% CI 1.30-7.09, P?=?.01). Adjusted mortality rate was substantial in adenosine MPI, but low in exercise MPI (9.0% vs 1.0%, P?<?.0001).

Conclusions

By quantitative analysis, ACM increases with increasing perfusion abnormality among patients undergoing stress HS-MPI. These findings confirm previous results obtained with visual analysis using conventional Anger camera imaging systems.     

Diagnostic and clinical benefit of combined coronary calcium and perfusion assessment in patients undergoing PET/CT myocardial perfusion stress imaging

Background  

A limitation of stress myocardial perfusion imaging (MPI) is the inability to detect non-obstructive coronary artery disease (CAD). One advantage of MPI with a hybrid CT device is the ability to obtain same-setting measurement of the coronary artery calcium score (CACS).     

Myocardial perfusion GSPECT imaging in patients with myocardial bridging

Background  

The aim of this study was to investigate the incidence, reversibility, and severity of LV perfusion abnormalities in patients with isolated myocardial bridges using a gated myocardial perfusion SPECT study (GSPECT).     

Gender disparity and the appropriateness of myocardial perfusion imaging

Background  

Appropriate use criteria (AUC) were developed to guide the use of myocardial perfusion imaging (MPI). While MPI use has grown exponentially, women remain under tested. Given this bias in testing, we sought to determine if gender disparity exists in tests categorized by appropriateness and the role of referral bias.     

Real-time breath-hold triggering of myocardial perfusion imaging with a novel cadmium-zinc-telluride detector gamma camera

Purpose  

The aim of this study was to assess the ability of real-time breath-hold-triggered myocardial perfusion imaging (MPI) using a novel cadmium-zinc-telluride (CZT) gamma camera to discriminate artefacts from true perfusion defects.     

Protocol modifications for CT perfusion (CTp) examinations of abdomen-pelvic tumors: Impact on radiation dose and data processing time

Purpose  

To evaluate the effect of CT perfusion (CTp) protocol modifications on quantitative perfusion parameters, radiation dose and data processing time.     

New starch-based radiotracer for lung perfusion scintigraphy

Purpose  

In order to avoid the microbiological risks linked to human serum albumin macroaggregates (MAA) used for lung perfusion scintigraphy, we developed a new starch-based Tc-99m potential radiopharmaceutical.     

Validation of an automated method to quantify stress-induced ischemia and infarction in rest-stress myocardial perfusion SPECT

Background

Myocardial perfusion SPECT (MPS) is one of the frequently used methods for quantification of perfusion defects in patients with known or suspected coronary artery disease. This article describes open access software for automated quantification in MPS of stress-induced ischemia and infarction and provides phantom and in vivo validation.

Methods and Results

A total of 492 patients with known or suspected coronary artery disease underwent both stress and rest MPS. The proposed perfusion analysis algorithm (Segment) was trained in 140 patients and validated in the remaining 352 patients using visual scoring in MPS by an expert reader as reference standard. Furthermore, validation was performed with simulated perfusion defects in an anthropomorphic computer model. Total perfusion deficit (TPD, range 0-100), including both extent and severity of the perfusion defect, was used as the global measurement of the perfusion defects. Mean bias ± SD between TPD by Segment and the simulated TPD was 3.6 ± 3.8 (R ² = 0.92). Mean bias ± SD between TPD by Segment and the visual scoring in the patients was 1.2 ± 2.9 (R ² = 0.64) for stress-induced ischemia and ?0.3 ± 3.1 (R ² = 0.86) for infarction.

Conclusion

The proposed algorithm can detect and quantify perfusion defects in MPS with good agreement to expert readers and to simulated values in a computer phantom.     

Interrelation of ST-segment depression during bicycle ergometry and extent of myocardial ischaemia by myocardial perfusion SPECT

Purpose  

The aim of this study was to compare ST-segment depression (STD) during bicycle ergometry and extent of myocardial ischaemia assessed by myocardial perfusion SPECT (MPS) in a large patient cohort.     

Prompt-gamma compensation in Rb-82 myocardial perfusion 3D PET/CT

Objective  

To compare the diagnostic accuracy of Rb-82 myocardial perfusion three-dimensional (3D) PET with and without prompt-gamma compensation (PGC).     

Prognostic implications of post-stress ejection fraction decrease detected by gated SPECT in the absence of stress-induced perfusion abnormalities

Purpose  

The prognostic meaning of a post-stress ejection fraction (EF) decrease detected by perfusion gated SPECT is still unclear. We therefore followed up patients with post-stress EF decrease in the absence of stress-induced perfusion abnormalities.     

Prediction of bone loss in elderly female subjects by MR perfusion imaging and spectroscopy

Objective  

To determine whether MR perfusion indices or marrow fat content at baseline can predict areal bone mineral density (BMDa) loss.     

Repeatability of left ventricular dyssynchrony and function parameters in serial gated myocardial perfusion SPECT studies

Background  

The purpose of this study was to establish the repeatability of left-ventricular (LV) dyssynchrony and function parameters measured from serial gated myocardial perfusion SPECT (GMPS) studies.