Myocardial Perfusion Imaging and Coronary Angiography Using Low Dose HYPR-CT

使用低剂量 HYPR-CT 进行心肌灌注成像和冠状动脉造影

• 批准号: 7810731
• 负责人: MICHAEL S. VAN LYSEL
• 金额: $ 48.19万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-15 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7810731
• 关键词: Address; Adoption; Algorithms; Anatomy; Angiography; Calcium; Cardiac; Cardiac Catheterization Procedures; Cerebrum; Coronary; Coronary Angiography; Coronary Arteriosclerosis; Coronary Stenosis; Coronary artery; Detection; Development; Diagnosis; Diagnostic Imaging; Diagnostic Procedure; Dose; Evaluation; Family suidae; Goals; Human Volunteers; Image; Imaging Techniques; Lesion; Maps; Measures; Methods; Metric; Modeling; Myocardial; Myocardial perfusion; Patients; Performance; Perfusion; Physiological; Pilot Projects; Predictive Value; Protocols documentation; Radiation; Radioisotopes; Research; Research Proposals; Resolution; Rest; Rotation; Scanning; Stenosis; Stress; Techniques; Testing; Three-Dimensional Image; Time; Tissues; Uncertainty; Vasodilator Agents; X-Ray Computed Tomography; base; clinically relevant; density; detector; novel; reconstruction; single photon emission computed tomography

DESCRIPTION (provided by applicant): Fast-rotation, multi-detector computed tomography (MDCT) has revolutionized noninvasive coronary angiography. Contrast-enhanced CT of the coronary arteries (CTA) has a high negative predictive value for coronary artery disease (CAD), obviating the need for invasive coronary angiography in symptomatic patients in whom coronary stenoses are not detected during CTA. However, when CTA demonstrates a stenosis there can be significant uncertainty regarding the physiological significance of the lesion. The goal of this proposal is the development of a combined angiographic/myocardial-perfusion MDCT-based diagnostic procedure to both detect coronary lesions and also assess their physiological significance. This will be accomplished with two CT scans, one acquired at rest and a second during pharmacological stress. A major obstacle to the widespread adoption of a combined angiographic/perfusion imaging procedure using conventional techniques is the need to deliver a radiation dose on the order of 10 times that of conventional CTA. This is due to the two extended scans necessary to record the myocardial time-density curve at both rest and during stress. This proposal seeks to develop a combined angiographic/perfusion examination without increasing the dose currently delivered during conventional CTA by using a novel reconstruction algorithm. HighlY constrained backPRojection (HYPR) is an approach to time-resolved tomographic imaging that exploits spatio-temporal correlations to greatly reduce the required number of projections per image. Preliminary studies indicate the potential for HYPR-CT reconstruction to provide dose reduction of at least a factor of 10 compared to conventional cardiac CT imaging. We propose to develop a HYPR-CT algorithm for combined angiographic/perfusion imaging. This algorithm will be developed (Aim 1) and validated (Aim 2) in a porcine model. The resulting algorithm will then be compared with radionuclide perfusion imaging and cardiac catheterization imaging in cardiac patients (Aim 3). Determination of the physiological significance of coronary artery stenoses is critical for optimizing revascularization decisions in CAD patients. The successful conclusion of this research will be a noninvasive diagnostic imaging exam for the detection and assessment of coronary artery disease.

描述（由申请人提供）：快速旋转，多探测器计算机断层扫描（MDCT）已彻底改变了无创冠状动脉造影。冠状动脉（CTA）的对比增强的CT具有冠状动脉疾病（CAD）的高阴性预测价值，从而消除了在CTA期间未发现冠状动脉炎症的有症状性患者中侵袭性冠状动脉血管造影的需求。但是，当CTA表现出狭窄时，关于病变的生理意义可能存在重大不确定性。该提案的目的是开发基于基于MDCT的综合血管造影/心肌 - 诊断程序，以检测冠状动脉病变并评估其生理意义。这将通过两次CT扫描来完成，一次扫描在静止时获得，在药理学应力下进行了第二次获得。使用常规技术广泛采用联合血管造影/灌注成像程序的主要障碍是需要按照常规CTA的10倍进行辐射剂量。这是由于在休息和压力期间记录心肌时间密度曲线所需的两次扩展扫描。该提案旨在开发一项联合血管造影/灌注检查，而不会通过使用新型的重建算法来增加常规CTA期间提供的剂量。高度约束的反射（HYPR）是时间分辨层析成像的一种方法，可利用时空相关性以大大减少每个图像所需的投影数量。初步研究表明，与常规心脏CT成像相比，HYPR-CT重建的潜力至少降低了10倍。我们建议开发一种用于血管造影/灌注成像的HYPR-CT算法。该算法将在猪模型中开发（AIM 1）并经过验证（AIM 2）。然后，将与心脏患者的放射性核素灌注成像和心脏导管成像进行比较（AI​​M 3）。确定冠状动脉促炎的生理意义对于优化CAD患者的血运重建决策至关重要。这项研究的成功结论将是用于检测和评估冠状动脉疾病的无创诊断成像检查。