UNIFIED APPROACH TO QUANTIFY & VISUALIZE CARDIAC IMAGES

心脏病仍然是世界上的头号杀手。 美国，超过25%的死亡与冠状动脉有关 疾病（CAD）。 CAD的发病率和死亡率长期以来被认为是 与冠状动脉阻塞的范围和严重程度直接相关 和心肌梗死风险的心肌量。 冠状动脉造影 以及最近的血管内超声（IVUS）提供解剖学上的 信息，并被用作评估的"黄金标准"， 动脉粥样硬化性阻塞 单光子发射断层扫描（SPECT） 或正电子发射放射性核素（PET）提供生理信息 并被用作临床"金标准"， 低灌注和低代谢。 心电图同步发射断层扫描具有 在评估心肌功能障碍的程度方面也有价值。 准确评估CAD的范围和严重程度需要 解剖生理信息多维整合 独立于这些心脏成像模式获得。 然而，在这方面， 传统上，集成是主观的、耗时的、缺乏 标准化，难以概念化。 的长期目标 拟议的研究是继续开发和验证基于计算机的 方法的多维量化，统一和 冠状动脉的互补、多模态心脏图像的可视化 解剖学和心肌灌注、代谢和功能。 具体而言，拟议研究的目标包括发展， 自动化和验证以下每个4D（x，y，z，t） 方法：1）冠状动脉双平面重建的扩展 使用两个不同时的单一投影，以融合 血管内超声的动脉树，并优化动脉造影程序 通过计算机引导的龙门架，2）延伸的数据为基础的 一种使用心肌灌注、代谢和功能的量化方法 EKG门控PET和SPECT，并根据此信息确定 风险，以及3）完成冠状动脉的配准和可视化 血管和心肌的灌注、代谢和功能为统一， 冠状动脉疾病的综合评估和 心肌梗死风险的心肌量。

DESCRIPTION: Heart disease continues to be the number one killer in the United States, with over 25% of all deaths related to coronary artery disease (CAD). Morbidity and mortality in CAD has long been recognized to be directly related to the extent and the severity of coronary obstruction and the amount of myocardium at risk of infarction. Coronary arteriography and more recently intravascular ultrasound (IVUS) provide anatomic information and are used as the "gold standard" for the assessment of atheromatous obstruction. Emission tomography using single photon (SPECT) or positron emitting radionuclides (PET) provides physiologic information and is used as the clinical "gold standard" for the assessment of regional hypoperfusion and hypometabolism. EKG-synchronized emission tomography has also been valuable in assessing the extent of myocardial dysfunction. Accurate assessment of the extent and severity of CAD requires the multidimensional integration of anatomic and physiologic information obtained independently from these cardiac imaging modalities. However, integration has traditionally been subjective, time consuming, lacking standardization and difficult to conceptualize. The long term objective of the proposed research is to continue to develop and validate computer-based methods for the multidimensional quantification, unification and visualization of complementary, multi-modality cardiac images of coronary anatomy and myocardial perfusion, metabolism and function. Specifically, the aims of the proposed research consist of development, automation and validation of each of the following 4D (x,y,z,t) methodologies: 1) extension of the biplane reconstruction of the coronary vasculature to use two non-simultaneous single projections, to fuse the arterial tree with IVUS, and to optimize the arteriographic procedure through computer guidance of the gantry, 2) extension of the data-based approach to quantify myocardial perfusion, metabolism and function using EKG-gated PET and SPECT and from this information determine the area at risk, and 3) complete the registration and visualization of the coronary vasculature and myocardial perfusion, metabolism and function for a unified, comprehensive assessment of coronary artery disease and determination of amount of myocardium at risk of infarction.