Quantitative Coronary Hemodynamics Derived from CT Angiography

CT 血管造影得出的定量冠状动脉血流动力学

• 批准号: 8827768
• 负责人: Dimitrios Mitsouras
• 金额: $ 17.33万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-15 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8827768
• 关键词: 3D Print; Address; Adenosine; Algorithms; Angiography; Arteries; Back; Beryllium; Blood; Blood Circulation; Blood flow; Cardiac; Cardiovascular system; Catheters; Cause of Death; Clinical; Clinical Data; Clinical Management; Contrast Media; Coronary; Coronary Arteriosclerosis; Coronary artery; Data; Detection; Development; Diagnostic; Diagnostic Imaging; Drug Formulations; Engineering; Evaluation; Funding; Goals; Health; Health Care Costs; Health Sciences; Health Technology; High Performance Computing; Image; In Vitro; Individual; Intervention; K-Series Research Career Programs; Learning; Lesion; Light; Link; Liquid substance; Literature; Mathematics; Measurement; Measures; Medicine; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Modeling; Myocardial perfusion; Noise; Patients; Pattern; Pattern Recognition; Performance; Perfusion; Photons; Physics; Population; Problem Solving; Protocols documentation; Publishing; Radiology Specialty; Research; Research Personnel; Research Project Grants; Residual state; Rest; Risk; Role; Science; Scientist; Sensitivity and Specificity; Severities; Signal Transduction; Solutions; Stenosis; Stress; Structure; System; Techniques; Technology; Testing; Time; Training; Training Programs; Translating; Trees; Variant; Western World; Work; X-Ray Computed Tomography; base; cardiovascular imaging; career; career development; clinical application; clinical care; cohort; collaborative environment; computer science; contrast enhanced; coronary computed tomography angiography; design; diagnostic accuracy; hemodynamics; improved; in vivo; information model; innovation; mathematical model; non-invasive imaging; novel; novel strategies; professor; prospective; research study; signal processing; simulation; skills; time use

DESCRIPTION (provided by applicant): This mentored career development award will enable the training and career transition of a productive, innovative, successful junior scientist. A key element is training and mentorship by thought-leaders in the field of cardiovascular diagnostic imaging and medicine. The applicant, Dr. Mitsouras, has been trained in computer science, physics, and applied mathematics at Brown and MIT. He is a successful MR physicist with important contributions to the field. He is Assistant Professor of Radiology at Harvard, and the Director of MR Physics and Engineering of the BWH Applied Imaging Science Lab (AISL), directed by Dr. Rybicki. A successful PI and skilled mentor, Dr. Rybicki will enthusiastically support and mentor Dr. Mitsouras to career independence. Noninvasive imaging for patients with coronary artery disease (CAD) is gravitating to CT; the proposed research addresses some of its current limitations in clinical care. The AISL evaluates new CT technologies, and has studied and published the potential of coronary enhancement to extend clinical information. It is recognized that the next leap in clinical cardiac CT is flow quantification; Dr. Mitsouras proposes a transformative new approach to this body of work. For the candidate, the transition from MR basic physics to clinical CT applications creates a large, unmet training need. Classroom based (Harvard/MIT Division of Health Sciences and Technology) and practical imaging based (BWH noninvasive cardiovascular imaging program) training will ideally bridge this gap. This K01 proposal also integrates mentorship from renowned experts who know and are eager to work with Dr. Mitsouras. The team includes Dr. Mel Clouse, an exceptional clinician and mentor, Dr. Xiaochuan Pan, an expert in CT physics, Dr. Tae Bae, an expert in contrast delivery, Dr. Al Lardo, an expert in modeling myocardial perfusion, and Dr. Joao Lima, an expert in advanced clinical applications. This exceptional team will navigate Dr. Mitsouras in a structured research project, capitalizing on their collective expertise and Dr. Mitsouras' existing skills. Together, tey will extend the role of noninvasive CAD imaging by applying innovative methods to extract blood flow from clinical CT angiography. At present, noninvasive access to flow is limited to simulated fluid dynamics using an arterial lumen segmented from clinical images. We advance this field with a novel transition from such CT-based flow, to CT-derived flow: quantitative flow that is derived either directly or indirectly from the spatio-temporal patterns of arterial contrast enhancement observed in vivo. A growing body of literature supports qualitative flow information is embedded in CTA enhancement patterns across an artery. We show these patterns in fact possess smooth space and time variations that are intrinsically linked to flow. By unifying signal processing and pattern recognition with high-performance fluid dynamics modeling, this information will be accessed for the first time to quantify true patient-specific flow and yield lesion-specific hemodynamic metrics such as fractional flow reserve.

描述（由申请人提供）：这个指导的职业发展奖将使一位富有成效，创新，成功的初级科学家的培训和职业过渡。一个关键因素是在心血管诊断成像和医学领域的思想领袖培训和指导。申请人Mitsouras博士在Brown and Mit接受了计算机科学，物理和应用数学的培训。他是一位成功的物理学家，对该领域有重要贡献。他是哈佛放射学助理教授，也是由Rybicki博士执导的BWH Applied Imaging Science Lab（AISL）MR物理学和工程主任。 Rybicki博士是一位成功的PI和熟练的导师，将热情地支持Mitsouras博士，以实现职业独立性。 冠状动脉疾病（CAD）患者的无创成像引诱到CT；拟议的研究涉及其目前在临床护理中的一些局限性。 AISL评估了新的CT技术，并研究并发表了冠状动脉增强的潜力以扩展临床信息。人们认识到，临床心脏CT的下一个飞跃是流量定量。 Mitsouras博士建议 这项工作的一种变革性的新方法。对于候选人，从MR Basic Physics到临床CT应用的过渡会产生庞大的未满足的培训需求。基于课堂的（哈佛/麻省理工学院健康科学与技术部）和实用成像（BWH无创心血管成像计划）培训理想情况下将弥合这一差距。该K01提案还融合了知名专家的指导，他们渴望与Mitsouras博士合作。该团队包括梅尔·克鲁斯（Mel Clouse）博士，杰出的临床医生兼导师，米乔安·潘（Xioochuan Pan）博士，CT物理学专家，对比度交付专家Tae Bae博士Al Lardo博士，建模心肌灌注的专家，以及高级临床应用专家Joao Lima博士。 这个杰出的团队将在一个结构化的研究项目中浏览Mitsouras博士，并利用其集体专业知识和Mitsouras博士的现有技能。 TEY将通过应用创新方法从临床CT血管造影中提取血流，从而扩展非侵入性CAD成像的作用。目前，使用从临床图像中分割的动脉腔内，非侵入性进入流量仅限于模拟流体动力学。我们通过从这种基于CT的流量到CT衍生流的新型过渡来推进这一领域：定量流是直接或间接从动脉对比增强的时空模式中得出的，在体内观察到。越来越多的文献支持定性流量信息嵌入了动脉的CTA增强模式中。我们显示这些模式实际上具有光滑的空间和时间变化，这些变化与流动本质上相关。通过使用高性能流体动力学建模统一信号处理和模式识别，将首次访问此信息，以量化真正的患者特异性流量和产生病变特异性的血液动力学指标，例如分数流量储备。

项目成果

Accuracy and reproducibility of automated, standardized coronary transluminal attenuation gradient measurements.

• DOI: 10.1007/s10554-014-0446-4
• 发表时间: 2014-08
• 期刊: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
• 影响因子: 2.1
• 作者: Chatzizisis, Yiannis S.;George, Elizabeth;Cai, Tianrun;Fulwadhva, Urvi P.;Kumamaru, Kanako K.;Schultz, Kurt;Fujisawa, Yasuko;Rassi, Carlos;Steigner, Michael;Mather, Richard T.;Blankstein, Ron;Rybicki, Frank J.;Mitsouras, Dimitrios
• 通讯作者: Mitsouras, Dimitrios

Patterns of Opacification in Coronary CT Angiography: Contrast Differences and Gradients.

冠状动脉 CT 血管造影中的混浊模式：对比度差异和梯度。

• DOI: 10.1007/s12410-014-9291-z
• 发表时间: 2014
• 期刊: Current cardiovascular imaging reports
• 影响因子: 0.9
• 作者: Rybicki,FrankJ;Juan,Yu-Hsiang;Saboo,SachinS;George,Elizabeth;Bhivasankar,Rani;Mitsouras,Dimitrios
• 通讯作者: Mitsouras,Dimitrios

Expanding the Radiologist's Arsenal against Abdominal Aortic Aneurysms, a Versatile Adversary.

扩大放射科医生对抗腹主动脉瘤这一多面手的武器。

• DOI: 10.1148/radiol.2020200531
• 发表时间: 2020
• 期刊: Radiology
• 影响因子: 19.7
• 作者: Mitsouras,Dimitrios;Leach,JosephR
• 通讯作者: Leach,JosephR

Accurate and reproducible reconstruction of coronary arteries and endothelial shear stress calculation using 3D OCT: comparative study to 3D IVUS and 3D QCA.

• DOI: 10.1016/j.atherosclerosis.2015.04.011
• 发表时间: 2015-06
• 期刊: Atherosclerosis
• 影响因子: 5.3
• 作者: K. Toutouzas;Y. Chatzizisis;M. Riga;A. Giannopoulos;A. Antoniadis;S. Tu;Y. Fujino;D. Mitsouras

Quantifying the effect of side branches in endothelial shear stress estimates.

• DOI: 10.1016/j.atherosclerosis.2016.06.038
• 发表时间: 2016-08
• 期刊: Atherosclerosis
• 影响因子: 5.3
• 作者: Giannopoulos AA;Chatzizisis YS;Maurovich-Horvat P;Antoniadis AP;Hoffmann U;Steigner ML;Rybicki FJ;Mitsouras D
• 通讯作者: Mitsouras D