Low-dose Myocardial Perfusion Imaging by CT

CT 低剂量心肌灌注成像

• 批准号: 8290709
• 负责人: Adam M Alessio
• 金额: $ 44.38万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-17 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8290709
• 关键词: Algorithms; Anatomy; Behavior; Blood flow; Cardiac; Catheterization; Clinical; Computer software; Consensus; Contrast Media; Coronary heart disease; Coupled; Data; Diagnostic; Disease; Dose; Flow-It; Goals; Heart; Image; Image Enhancement; Imaging Techniques; Ionizing radiation; Kinetics; Knowledge; Low Dose Radiation; Mainstreaming; Manufacturer Name; Measures; Methods; Modeling; Myocardial; Myocardial perfusion; Noise; Nuclear; Patients; Performance; Perfusion; Physiology; Positioning Attribute; Positron-Emission Tomography; Procedures; Process; Protocols documentation; Radiation; Resolution; Sampling; Scanning; Scheme; Severities; Techniques; Time; Tube; Variant; Work; X-Ray Computed Tomography; attenuation; base; blood flow measurement; clinical application; data acquisition; image reconstruction; improved; mathematical model; novel; novel strategies; patient safety; reconstruction; research and development; restoration; simulation; tool

DESCRIPTION (provided by applicant) The objective of this proposal is to develop clinically viable strategies for the quantitative estimation of myocardial blood flow (MBF) from dynamic computed tomography (CT) imaging with low radiation doses comparable to those received in common nuclear myocardial perfusion studies. Despite the proven clinical value of quantifying MBF (in ml/g/min), there are no widespread clinical methods to easily measure MBF in absolute units. Dynamic CT offers the potential to quantify flow, but the radiation dose imparted from these studies prohibits widespread acceptance. The specific aims of the proposal are to develop 1) optimal myocardial blood flow estimation methods, 2) low-dose dynamic CT acquisition strategies for MBF estimation, 3) unbiased data restoration algorithms and 4) image reconstruction methods based on trading off spatial resolution for noise reduction and constraining noise with a priori knowledge. These aims will be developed with simulations of dynamic contrast enhanced CT imaging and evaluated with patient exams. We hypothesize that accurate subendo- and subepi-cardial MBF estimates can be determined with low- dose dynamic CT through selection of acquisition strategies and judicious application of noise reduction strategies. This work proposes novel low-dose acquisition and data/image enhancement strategies to enable accurate quantitative estimates of blood flow in absolute units of ml/g/min. These methods will allow for substantial reductions in radiation dose, which is essential for patient safety, clinical application of dynamic CT for MBF measurement, and for other proven applications of dynamic CT. This work will position cardiac dynamic CT as a safe, easy, and widely available tool for quantitative MBF estimation, providing valuable clinical information for quantification of flow limiting disease, minimizing unnecessary catheterization procedures, informing therapy choices, and developing new therapies. PUBLIC HEALTH RELEVANCE: A quantitative estimate of blood flow in the heart provides valuable clinical information regarding the severity and extent of coronary heart disease. Dynamic computed tomography (CT) offers the potential to quantify blood flow, but it is not widely accepted because of the radiation dose associated with these studies. This proposal will develop strategies to substantially reduce the radiation dose from dynamic CT, enabling quantitative myocardial blood flow estimation from an easy, widely available, and safe CT imaging study.

描述（由申请人提供） 本提案的目的是开发临床上可行的策略，通过动态计算机断层扫描（CT）成像定量估计心肌血流量（MBF），辐射剂量可与普通核心肌灌注研究中收到的辐射剂量相当。尽管量化 MBF（以 ml/g/min 为单位）的临床价值已得到证实，但尚无广泛的临床方法可以轻松测量绝对单位的 MBF。动态 CT 提供了量化流量的潜力，但这些研究产生的辐射剂量阻碍了广泛接受。该提案的具体目标是开发 1) 最佳心肌血流估计方法，2) 用于 MBF 估计的低剂量动态 CT 采集策略，3) 无偏数据恢复算法和 4) 基于权衡空间分辨率的图像重建方法利用先验知识降低噪声并抑制噪声。这些目标将通过动态对比增强 CT 成像的模拟来制定，并通过患者检查进行评估。我们假设通过选择采集策略和明智地应用降噪策略，可以使用低剂量动态 CT 来确定准确的心内膜下和心外膜下 MBF 估计。这项工作提出了新颖的低剂量采集和数据/图像增强策略，能够以毫升/克/分钟的绝对单位准确定量估计血流量。这些方法将大大减少辐射剂量，这对于患者安全、动态 CT 测量 MBF 的临床应用以及动态 CT 的其他经过验证的应用至关重要。这项工作将心脏动态 CT 定位为一种安全、简单且广泛使用的定量 MBF 估计工具，为流量限制疾病的量化提供有价值的临床信息，最大限度地减少不必要的导管插入手术，为治疗选择提供信息，并开发新疗法。 公共卫生相关性：心脏血流量的定量估计提供了有关冠心病严重程度和范围的宝贵临床信息。动态计算机断层扫描 (CT) 提供了量化血流的潜力，但由于与这些研究相关的辐射剂量，它并未被广泛接受。该提案将制定策略，大幅减少动态 CT 的辐射剂量，从而通过简单、广泛使用且安全的 CT 成像研究来定量心肌血流量估计。