Detecting Changes in Myocardial Perfusion and Function

检测心肌灌注和功能的变化

• 批准号: 6543906
• 负责人: TRACY L FABER
• 金额: $ 36.19万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-15 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6543906
• 关键词: bioimaging /biomedical imaging; cardiovascular disorder diagnosis; computer assisted diagnosis; computer simulation; coronary disorder; diagnosis design /evaluation; diagnosis quality /standard; heart circulation; heart function; heart imaging /visualization /scanning; human tissue; magnetic resonance imaging; mathematical model; perfusion; positron emission tomography; single photon emission computed tomography; swine

Coronary heart disease caused 476,124 deaths in 1996 and continues to be the leading cause of death in America today. Over 12 million people alive today have a history of myocardial infarction, angina pectoris, or both. Every year in the US about 5 million perfusion studies are performed to evaluate extent and severity of CAD, thereby enabling clinical decisions regarding diagnosis, prognosis, and therapy for patients with heart disease. Of these, 1 million undergo angioplasty and about 500,000 have bypass surgery, and millions of others undergo drug therapy and or lifestyle changes to prevent progression of cardiac disease. It is widely recognized that computer quantification of myocardial perfusion images improves diagnostic accuracy and enhances confidence and reproducibility of interpretation. Theses quantitative approaches are well- established for assessing abnormalities in myocardial perfusion and function. However, they have not been developed or optimized for detecting changes in serial studies of the same patient such as is needed for assessing the effect of interventions, medical therapy, or disease progression. In this project, we will develop and validate computer-based methods to automatically quantify and visualize serial changes in myocardial perfusion and function from perfusion SPECT. The work can be separated into 4 projects: 1) To assess changes in myocardial perfusion, 2) to assess changes in myocardial function, 3) to design a virtual heart suitable for creating simulation data for optimizing and analyzing our algorithms, and 4) to validate the methods using both simulations and animal studies. Important subprojects include: a) development of 3-d and 4-d surface detection methods for defining LV endocardial and epicardial surfaces, b) development of algorithms for non-rigid alignment of static and/or dynamic serial SPECT images so that they may be more directly compared, c) development of motion analysis methods using similar non-linear alignment techniques to measure regional myocardial function and also to correct ungated SPECT scans for motion blur, and d) creation of new statistical approaches to determine significant changes in both global and regional perfusion and functional variables. The ultimate goal of this project is to create a clinically useful tool for detecting changes in serial SPECT studies. Most importantly, the tools will be extremely well characterized as to their sensitivity in detecting small changes as well as for overall accuracy.

1996年，冠心病导致476,124人死亡，至今仍是美国人的主要死因。今天在世的1200多万人有心肌梗死、心绞痛或两者兼有的病史。在美国，每年进行大约500万次灌注研究，以评估CAD的范围和严重程度，从而使临床能够对心脏病患者的诊断、预后和治疗做出决定。其中，100万人接受了血管成形术，约50万人接受了搭桥手术，还有数百万人接受了药物治疗和/或生活方式的改变，以防止心脏病的恶化。人们普遍认为，心肌灌注图像的计算机量化提高了诊断的准确性，增强了判读的置信度和重复性。这些定量方法在评估心肌灌注和功能异常方面是行之有效的。然而，它们还没有被开发或优化来检测同一患者的系列研究中的变化，例如评估干预、药物治疗或疾病进展的效果所需的变化。在这个项目中，我们将开发和验证基于计算机的方法，从SPECT灌注断层扫描中自动量化和可视化心肌灌注和功能的连续变化。这项工作可以分为四个项目：1)评估心肌灌注的变化，2)评估心肌功能的变化，3)设计适合于创建模拟数据的虚拟心脏，以优化和分析我们的算法，以及4)使用模拟和动物研究来验证方法。重要的子项目包括：a)开发确定左心内膜和心外膜表面的三维和四维表面检测方法；b)开发静态和/或动态序列SPECT图像的非刚性比对算法，以便可以更直接地进行比较；c)开发使用类似的非线性比对技术的运动分析方法，以测量局部心肌功能并校正非门控SPECT扫描的运动模糊；以及d)创建新的统计方法，以确定全球和区域血流灌注和功能变量的显著变化。该项目的最终目标是创建一种临床上有用的工具，用于检测系列SPECT研究中的变化。最重要的是，这些工具的特点将非常好，因为它们在检测微小变化方面的敏感性以及总体准确性。