MOTION CORRECTED TREADMILL NUCLEAR ANGIOGRAPHY

运动校正跑步机核血管造影

• 批准号: 6338506
• 负责人: JEFFREY L LACY
• 金额: $ 14.21万
• 依托单位: PROPORTIONAL TECHNOLOGIES, INC.
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-05-15 至 2002-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6338506
• 关键词: angiography; bioimaging /biomedical imaging; biomedical equipment development; chordate locomotion; clinical research; computer program /software; computer system design /evaluation; exercise; human subject; image enhancement; portable biomedical equipment; radionuclide imaging /scanning; scintillation cameras

Peak exercise left ventricular function measured by radionuclide angiography (RNA) is known to have strong prognostic value and therefore can be very helpful for screening patients with a low to intermediate likelihood of CAD. The technique has seen little clinical use, however, because of the inadequacy of current methods for correction of motion artifact produced by treadmill exercise. In the Phase I study, a novel technique of motion correction was developed using a combined ultrasonic/intertial position tracking system along with the previously developed multiwire proportional camera. High quality motion corrected treadmill images were obtained both in laboratory tests and in a group of patients at Cornell-New York Hospital, proving feasibility of the technique. The Phase II work will involve substantial development, including improved image correction and clinically convenient acquisition, correction, and display software as well as refinement of the structural design and mechanical assembly of the system. Prototype systems will be constructed and placed in two well-established nuclear cardiology laboratories. Clinical studies will be performed in a total of 600 patients to establish the normal response for the new technique in low risk patients and to assess the use of the test for screening this population. As a very practical, low-cost test, the motion corrected treadmill angiography system can greatly improve risk stratification of suspected CAD patients and decrease the frequency of false positive diagnoses. As a result, far fewer patients would be unnecessarily shuttled into expensive and invasive diagnostic tests such as SPECT imaging and cardiac catheterization, greatly reducing cost in the prodigious process of coronary disease diagnosis. PROPOSED COMMERCIAL APPLICATIONS: Current diagnostic tools for stratification of CAD patients have substantial technical and/or financial drawbacks. A motion corrected treadmill nuclear angiography could serve as a highly accurate front-line screening mechanism to be incorporated in the decision-making tree. Because of the huge number of patients who report mild to moderate symptoms/risk factors but show normal perfusion and cath results, a technique which identifies appropriate candidates for further evaluation would have a large commercial market and significantly reduce unnecessary spending of precious heath care dollars.

已知通过放射性核素血管造影术（RNA）测量的峰值运动左心室功能具有很强的预后价值，因此对于筛选低至中等CAD可能性的患者非常有帮助。然而，由于目前用于校正由跑步机运动产生的运动伪影的方法的不足，该技术几乎没有临床应用。在第一阶段的研究中，开发了一种新的技术，运动校正使用组合超声波/惯性位置跟踪系统沿着与以前开发的多线比例摄像机。高质量的运动校正跑步机图像，在实验室测试和一组患者在康奈尔-纽约约克医院，证明该技术的可行性。第二阶段的工作将涉及重大的发展，包括改进图像校正和临床方便的采集，校正和显示软件，以及改进系统的结构设计和机械装配。原型系统将被建造并放置在两个完善的核心脏病学实验室。将在总共600名患者中进行临床研究，以确定新技术在低风险患者中的正常反应，并评估该测试在筛选该人群中的使用。运动校正平板血管造影系统作为一种非常实用、低成本的检查方法，可以大大改善疑似冠心病患者的危险分层，降低假阳性诊断率。因此，很少有患者会不必要地穿梭于昂贵的和侵入性的诊断测试，如SPECT成像和心导管插入术，大大降低了冠状动脉疾病诊断的巨大过程中的成本。拟议的商业应用：目前用于CAD患者分层的诊断工具具有实质性的技术和/或经济缺陷。运动校正跑步机核血管造影可以作为一个高度准确的前线筛选机制，纳入决策树。由于大量患者报告轻度至中度症状/风险因素但显示正常灌注和导管插入结果，因此识别用于进一步评估的适当候选者的技术将具有巨大的商业市场，并显著减少宝贵的医疗保健费用的不必要支出。