MRI Quantification of Postinfarct Myocardial Viability

梗死后心肌活力的 MRI 定量

• 批准号: 7678039
• 负责人: Akos Varga-Szemes
• 金额: $ 38.08万
• 依托单位: ELGAVISH PARAMAGNETICS, INC.
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-15 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7678039
• 关键词: Area; Autopsy; Bolus Infusion; Canis familiaris; Cardiac; Chloride Ion; Chlorides; Clinical; Computer software; Continuous Infusion; Contrast Media; Decision Making; Development; Diagnostic; Ensure; Evolution; Eye; Gadolinium DTPA; Goals; Gold; Healed; Heart; Heart Arrest; Histocytochemistry; Histology; Human; Image; Image Enhancement; Infarction; Letters; Magnetic Resonance Imaging; Manufacturer Name; Maps; Marketing; Methods; Modeling; Monitor; Myocardial; Myocardial Infarction; Myocardial tissue; Pathology; Phase; Phase I Clinical Trials; Photography; Physicians; Process; Recovery; Reporting; Research Personnel; Resolution; Scanning; Slice; Staining method; Stains; Techniques; Testing; Tetrazolium; Thick; Time; Tissues; Touch sensation; Validation; Writing; base; commercialization; healing; heart imaging; in vivo; interest; islet; novel; radiologist; research study; software development; success; tool

DESCRIPTION (provided by applicant): The overall goal of this Phase II project is to develop a novel R1-based method for MRI quantification of postinfarct myocardial viability using a commercially available contrast agent Gd(DTPA). The commercial embodiment of this method will be a software package that will convert a set of 2D cardiac MRI images to a 3D myocardial viability map, the Percent Infarct Map (PIM) with a voxel-by-voxel resolution. In ultimate human clinical use, the package would be interfaced with commercial MRI scanners providing physicians with an immediately available diagnostic tool at the end of the scanning session. The main target market for this package will be either the major manufacturers of MRI scanners or an established company that creates and markets cardiac MRI software. We already have had interest expressed in our plans by one such major company, Medis (see letter from Medis). Assessment of viability is crucial in the monitoring of myocardial infarction (MI). A high spatial-resolution method that can distinguish quantitatively between areas of infarct and viable islets in the infarct areas would be useful for clinical decision making. The objective of Phase I was the validation (with statistical significance), in a canine model of reperfused MI, of the PIM method to provide a reliable viability maps in the canine model of reperfused MI. PIM was also compared with the current MRI standard, Delayed Enhancement (DE), in the same dogs and MRI sessions, to ensure comparison at the same time point. All objectives of Phase I have been achieved: PIM yielded accurate quantitative information about infarct size and distribution, agreed with the pathology gold standard, TTC-staining histochemistry, and was superior to DE. While the primary aim of the Phase II project will be the development and testing of the software package itself, we also want to enhance the desirability of this package in the eyes of clinicians so that market demands for it would be optimized. Clinical usefulness depends on the reliability of a technique not just at a single selected time point along the evolution of infarct, but rather at all relevant time points of infarct tissue development, both reperfused and non-reperfused. Thus we plan to demonstrate the utility of the package at several crucial time points of infarct evolution in both reperfused and non-reperfused myocardial infarction models. To aid in coregistration of MRI and histology, based on the success in Phase I. studies, we will also incorporate ex-vivo imaging and histology to validate our findings with MRI and the post-processing software.

描述（由申请人提供）：该 II 期项目的总体目标是开发一种基于 R1 的新型方法，使用市售造影剂 Gd(DTPA) 对梗塞后心肌活力进行 MRI 定量。该方法的商业实施例将是一个软件包，它将一组 2D 心脏 MRI 图像转换为 3D 心肌活力图，即具有逐体素分辨率的梗塞百分比图 (PIM)。在最终的人类临床应用中，该软件包将与商用 MRI 扫描仪连接，为医生在扫描结束时提供立即可用的诊断工具。该软件包的主要目标市场将是 MRI 扫描仪的主要制造商或创建和销售心脏 MRI 软件的老牌公司。一家这样的大公司 Medis 已经对我们的计划表示了兴趣（参见 Medis 的来信）。生存能力评估对于心肌梗死 (MI) 的监测至关重要。一种能够定量区分梗塞区域和梗塞区域中存活胰岛的高空间分辨率方法将有助于临床决策。第一阶段的目标是在再灌注 MI 的犬模型中验证 PIM 方法（具有统计学意义），以在再灌注 MI 的犬模型中提供可靠的活力图。 PIM 还在相同的狗和 MRI 会话中与当前 MRI 标准延迟增强 (​​DE) 进行了比较，以确保在同一时间点进行比较。第一阶段的所有目标均已实现：PIM 产生了有关梗塞大小和分布的准确定量信息，与病理学金标准、TTC 染色组织化学一致，并且优于 DE。虽然二期项目的主要目标是软件包本身的开发和测试，但我们也希望提高该软件包在临床医生眼中的吸引力，从而优化市场需求。临床实用性不仅取决于梗塞演变过程中单个选定时间点的技术可靠性，还取决于梗塞组织发育的所有相关时间点（再灌注和非再灌注）的可靠性。因此，我们计划在再灌注和非再灌注心肌梗塞模型中证明该软件包在梗塞演变的几个关键时间点的实用性。为了帮助 MRI 和组织学的共同配准，基于第一阶段研究的成功，我们还将结合离体成像和组织学，以通过 MRI 和后处理软件验证我们的发现。

项目成果

Determination of infarct size in ex vivo swine hearts by multidetector computed tomography using gadolinium as contrast medium.

• DOI: 10.1097/rli.0b013e31823fabc6
• 发表时间: 2012-05
• 期刊: Investigative radiology
• 影响因子: 6.7
• 作者: Varga-Szemes A;Ruzsics B;Kirschner R;Singh SP;Kiss P;Brott BC;Simor T;Elgavish A;Elgavish GA
• 通讯作者: Elgavish GA

Infarct density distribution by MRI in the porcine model of acute and chronic myocardial infarction as a potential method transferable to the clinic.

• DOI: 10.1007/s10554-014-0408-x
• 发表时间: 2014-06
• 期刊: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
• 影响因子: 2.1
• 作者: Varga-Szemes, Akos;Simor, Tamas;Lenkey, Zsofia;van der Geest, Rob J.;Kirschner, Robert;Toth, Levente;Brott, Brigitta C.;Elgavish, Ada;Elgavish, Gabriel A.
• 通讯作者: Elgavish, Gabriel A.

Embozeneýýý microspheres induced nonreperfused myocardial infarction in an experimental swine model.

Embozenea 微球在实验猪模型中诱导非再灌注心肌梗塞。

• DOI: 10.1002/ccd.24418
• 发表时间: 2013
• 期刊: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
• 作者: Varga-Szemes,Akos;Kiss,Pal;Brott,BrigittaC;Wang,Dezhi;Simor,Tamas;Elgavish,GabrielA
• 通讯作者: Elgavish,GabrielA

Age-independent myocardial infarct quantification by signal intensity percent infarct mapping in swine.

通过猪梗塞信号强度百分比图谱对年龄无关的心肌梗塞进行量化。

• DOI: 10.1002/jmri.25046
• 发表时间: 2016
• 期刊: Journal of magnetic resonance imaging : JMRI
• 作者: Lenkey,Zsofia;Varga-Szemes,Akos;Simor,Tamas;vanderGeest,RobJ;Kirschner,Robert;Toth,Levente;Bodnar,Tamas;Brott,BrigittaC;Elgavish,Ada;Elgavish,GabrielA
• 通讯作者: Elgavish,GabrielA