Dynamic cardiac SPECT

动态心脏SPECT

基本信息

批准号：
9318808
负责人：
GRANT T GULLBERG
金额：
$ 58.59万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-05-01 至 2021-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9318808
关键词：
Address Algorithms Analysis of Variance Anterior Area Bayesian Method Blood Blood flow Blood specimen Calibration Cardiac Cardiac development Clinical Clinical Protocols Collimator Computer Simulation Coronary Coronary Angiography Coronary Arteriosclerosis Coronary artery Data Data Analyses Data Collection Detection Development Diagnosis Diffuse Dimensions Disease Management Dose Early Diagnosis Early identification Event Gold Heart Heart Transplantation Image Intervention Kinetics Label Left Left Ventricular Ejection Fraction Linear Models Liver Location Magnetic Resonance Imaging Measurement Measures Mechanics Methods Microvascular Dysfunction Modeling Motion Myocardial Myocardial perfusion Myocardial tissue Names Outcome Patients Perfusion Physics Positron-Emission Tomography Protocols documentation Respiration Rest Risk stratification Rotation Speed Stenosis Stress Study Subject Testing Time Tissues Transplant Recipients Universities Vascular Diseases Work X-Ray Computed Tomography attenuation base cardiac single photon emission computed tomography clinical application clinical development clinical imaging clinical practice computerized data processing cost heart allograft heart motion human subject imaging agent improved interest myocardial biopsy patient population perfusion imaging prognostic reconstruction respiratory response single photon emission computed tomography spatiotemporal tool uptake vector

项目摘要

Project Summary (Abstract) Quantitation of regional myocardial blood flow (MBF) and coronary flow reserve (CFR) is not currently widely performed for diagnosis and management of coronary artery disease (CAD). The development of a widely available, accurate, inexpensive, quantitative noninvasive method for the measurement of MBF and CFR would provide a thorough assessment of the full extent of CAD and diffuse microvascular diseases. It would also pro- vide an early detection of the development of cardiac allograft vasculopathy (CAV) in orthotopic heart transplant (OHT) patients. Single photon emission computed tomography (SPECT), the most widely applied noninvasive method for the detection and risk stratification of CAD, is less costly for both operator and patients and more widely available than positron emission tomography (PET), the gold standard for the quantification of MBF and CFR. In our earlier work we developed methods to noninvasively quantify MBF and CFR with the acquisition of dynamic data on a conventional SPECT camera. This method demonstrated the capability of estimating MBF from widely used clinical imaging agents with marginal flow-extraction products. Our hypothesis is that dy- namic cardiac SPECT with conventional 99mTc-labeled agents provides quantitation of MBF and CFR which cannot be obtained by conventional static SPECT. This promises to improve the diagnosis and prognostic as- sessment of CAD, and permit early identification of the onset and progression of CAV in OHT patients. We propose a systematic study of quantitative myocardial perfusion imaging using a combined dynamic and static cardiac SPECT (DSC-SPECT) rest/stress protocol 1) to assess the extent of coronary involvement in patients with known and highly suspected CAD, and 2) to evaluate MBF and CFR as an early indicator of CAV. A unique aspect of this work is our ability to quantify MBF by estimating kinetic model parameters and the blood input function, directly from acquired projections using slow camera rotation speed without any need for arterial blood sampling. Our methods include corrections for cardiac motion due to cardiac deformation and respiration (6D dynamic modeling). Our study addresses the challenges related to the development of algorithms that convert dynamically acquired scintigraphic data to meaningful clinical information and optimizes the related clinical protocols. We believe that with the successful demonstration of dynamic SPECT in the proposed protocols, our methods will support a change of the current static SPECT myocardial perfusion imaging (MPI) protocols to dynamic SPECT MPI protocols with application of even standard dual-headed cameras.

项目概要（摘要）局部心肌血流量（MBF）和冠状动脉血流储备（CFR）的定量目前尚未广泛应用进行冠状动脉疾病（CAD）的诊断和治疗。发展了一个广泛用于测量 MBF 和 CFR 的可用、准确、廉价、定量无创方法提供对 CAD 和弥漫性微血管疾病的全面评估。它还将亲早期检测原位心脏移植中心脏同种异体移植血管病变 (CAV) 的发展（OHT）患者。单光子发射计算机断层扫描（SPECT），应用最广泛的非侵入性方法用于 CAD 的检测和风险分层，对操作者和患者来说成本更低，而且应用范围更广比正电子发射断层扫描 (PET) 更有效，正电子发射断层扫描 (PET) 是 MBF 和 CFR 量化的黄金标准。在在我们早期的工作中，我们开发了通过获取动态数据来无创量化 MBF 和 CFR 的方法传统 SPECT 相机上的数据。该方法展示了通过以下方式估计 MBF 的能力：广泛使用的临床显像剂与边缘血流提取产品。我们的假设是 dy- 使用传统 99mTc 标记试剂进行的纳米心脏 SPECT 可以对 MBF 和 CFR 进行定量，无法通过传统的静态 SPECT 获得。这有望改善诊断和预后 CAD 的评估，并允许早期识别 OHT 患者 CAV 的发病和进展。我们提出使用动态和静态相结合的定量心肌灌注成像的系统研究心脏 SPECT (DSC-SPECT) 休息/应激方案 1) 评估患者冠状动脉受累程度已知和高度怀疑 CAD，以及 2) 评估 MBF 和 CFR 作为 CAV 的早期指标。一个独特的这项工作的一个方面是我们能够通过估计动力学模型参数和血液输入来量化 MBF 功能，直接从使用慢速相机旋转速度获取的投影中获得，无需动脉血采样。我们的方法包括对由于心脏变形和呼吸（6D 动态建模）。我们的研究解决了与开发将数据转换为数据的算法相关的挑战动态采集闪烁扫描数据以获取有意义的临床信息并优化相关临床协议。我们相信，随着动态 SPECT 在拟议协议中的成功演示，我们的方法将支持当前静态 SPECT 心肌灌注成像 (MPI) 协议的更改动态 SPECT MPI 协议甚至可应用标准双头相机。