The increasing role of quantification in clinical nuclear cardiology: The Emory approach
The increasing role of quantification in clinical nuclear cardiology: The Emory approach
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DOI：
10.1016/j.nuclcard.2007.06.009
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发表时间：
2007-07-01
影响因子：
2.4
通讯作者：
Santana, Cesar
中科院分区：
文献类型：
--
作者：
Garcia, Ernest V.;Faber, Tracy L.;Santana, Cesar
单光子发射计算机断层扫描(SPECT)心肌灌注成像已经被临床广泛接受，作为已知或可疑冠状动脉疾病患者的标准护理。这一成功的一个重要贡献是使用计算机技术在解释这些研究时提供客观的定量评估。我们实施了Emory心脏工具箱(ECTB)，作为分发我们和其他人研究、开发并验证为临床有用的软件工具的管道，以便各地的诊断医生都能从我们的工作中受益。我们的经验表明，将所有软件工具集成到一个公共平台中是提高准确性和效率的最佳方法。ECTB方法的重要特点包括：(1)我们为SPECT和正电子发射断层扫描(PET)研究提供了大量的正常血流灌注数据库，每个数据库均包含至少150名患者；(2)我们利用傅立叶分析区域增厚，以确保正确的时间分辨率，并精确测量左心功能和不同步现象；(3)我们开发PET工具来量化心肌冬眠和存活状态；(4)我们开发三维显示器，并将其用作血流灌注和CT血管成像图像融合的平台；以及(5)使用专家系统来提供决策支持。ECTB是从所有类型的心脏放射性核素分布中提取定量参数的重要工具。ECTb应继续在建立心脏SPECT和PET的血流、功能、代谢和神经支配的临床应用中发挥重要作用。
Single photon emission computed tomography (SPECT) myocardial perfusion imaging has attained widespread clinical acceptance as a standard of care for patients with known or suspected coronary artery disease. A significant contribution to this success has been the use of computer techniques to provide objective quantitative assessment in interpreting these studies. We have implemented the Emory Cardiac Toolbox (ECTb) as a pipeline to distribute the software tools that we and others have researched, developed, and validated to be clinically useful so that diagnosticians everywhere can benefit from our work. Our experience has demonstrated that integration of all software tools in a common platform is the optimal approach to promote both accuracy and efficiency. Important attributes of the ECTb approach are (1) our extensive number of normal perfusion databases for SPECT and positron emission tomography (PET) studies, each created with at least 150 patients; (2) our use of Fourier analysis of regional thickening to ensure proper temporal resolution and to allow accurate measurement of left ventricular function and dyssynchrony; (3) our development of PET tools to quantify myocardial hibernation and viability; (4) our development of 3-dimensional displays and the use of these displays as a platform for image fusion of perfusion and computed tomography angiography; and (5) the use of expert systems for decision support. ECTb is an important tool for extracting quantitative parameters from all types of cardiac radionuclide distributions. ECTb should continue to play an important role in establishing cardiac SPECT and PET for flow, function, metabolism, and innervation clinical applications.