Marina Piccinelli1, Sang-Geon Cho2, Ernest V Garcia3, Erick Alexanderson4, Joo Myung Lee5, C David Cooke3, Nikhil Goyal3, Mauricio Santos Sanchez4, Russel D Folks3, Zhengjia Chen6, John Votaw3, Bon-Kwon Koo7, Hee-Seung Bom2. 1. Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd, NE, Atlanta, GA, 3032, USA. mpiccin@emory.edu. 2. Department of Nuclear Medicine, Chonnam National University, Gwangju, Korea. 3. Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd, NE, Atlanta, GA, 3032, USA. 4. Nuclear Cardiology Department, Instituto Nacional de Cardiologia, Mexico City, Mexico. 5. Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Korea. 6. Department of Biostatistics & Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, USA. 7. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
Abstract
OBJECTIVES: The goal of the present work is to present a novel methodology for the extraction of MBF, MFR and RFR along coronary arteries by means of multimodality image fusion of dynamic PET and CCTA images. BACKGROUND: FFR is the reference standard to identify flow-limiting lesions, but its invasiveness limits broad application. New noninvasive methodologies are warranted to stratify patients and guide treatment. METHODS: A group of 16 low-risk CAD subjects who underwent both 13NH3 PET and CCTA were analyzed. Image fusion techniques were employed to align the studies and CCTA-derived anatomy used to identify coronaries trajectories. MBF was calculated by means of a 1-tissue compartmental model for the standard vascular territories and along patient-specific vessel paths from the base to the apex of the heart. RESULTS: Low-risk ranges for MBF. MFR and RFR for LAD, LCX and rPDA were computed for the entire cohort and separated by gender. Computed low-risk ranges were used to assess a prospective patient with suspected CAD. CONCLUSIONS: Our vessel-specific functional indexes and 3D displays offer promise to more closely replicate what is commonly performed during a catheterization session and have the potential of providing effective noninvasive tools for the identification of flow-limiting lesions and image-guided therapy.
OBJECTIVES: The goal of the present work is to present a novel methodology for the extraction of MBF, MFR and RFR along coronary arteries by means of multimodality image fusion of dynamic PET and CCTA images. BACKGROUND:FFR is the reference standard to identify flow-limiting lesions, but its invasiveness limits broad application. New noninvasive methodologies are warranted to stratify patients and guide treatment. METHODS: A group of 16 low-risk CAD subjects who underwent both 13NH3 PET and CCTA were analyzed. Image fusion techniques were employed to align the studies and CCTA-derived anatomy used to identify coronaries trajectories. MBF was calculated by means of a 1-tissue compartmental model for the standard vascular territories and along patient-specific vessel paths from the base to the apex of the heart. RESULTS: Low-risk ranges for MBF. MFR and RFR for LAD, LCX and rPDA were computed for the entire cohort and separated by gender. Computed low-risk ranges were used to assess a prospective patient with suspected CAD. CONCLUSIONS: Our vessel-specific functional indexes and 3D displays offer promise to more closely replicate what is commonly performed during a catheterization session and have the potential of providing effective noninvasive tools for the identification of flow-limiting lesions and image-guided therapy.
Authors: Marina Piccinelli; Cesar Santana; Gopi Kiran R Sirineni; Russell D Folks; C David Cooke; Chesnal D Arepalli; Santiago Aguade-Bruix; Zohar Keidar; Alex Frenkel; Ora Israel; Jaume Candell-Riera; Ernest V Garcia Journal: J Nucl Cardiol Date: 2017-02-13 Impact factor: 5.952
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Authors: Gwen M Bernacki; Samira Bahrainy; James H Caldwell; Wayne C Levy; Jeanne M Link; John R Stratton Journal: J Gerontol A Biol Sci Med Sci Date: 2016-03-08 Impact factor: 6.053
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Authors: Ricardo C Cury; Suhny Abbara; Stephan Achenbach; Arthur Agatston; Daniel S Berman; Matthew J Budoff; Karin E Dill; Jill E Jacobs; Christopher D Maroules; Geoffrey D Rubin; Frank J Rybicki; U Joseph Schoepf; Leslee J Shaw; Arthur E Stillman; Charles S White; Pamela K Woodard; Jonathon A Leipsic Journal: J Am Coll Radiol Date: 2016-06-15 Impact factor: 5.532
Authors: Marina Piccinelli; Tracy L Faber; Chesnal D Arepalli; Vikram Appia; Jakob Vinten-Johansen; Susan L Schmarkey; Russell D Folks; Ernest V Garcia; Anthony Yezzi Journal: J Nucl Cardiol Date: 2013-11-02 Impact factor: 5.952