HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH RSS TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Itti, E. Articles by Thirion, J.-P. Search for Related Content PubMed PubMed Citation Articles by Itti, E. Articles by Thirion, J.-P.

Assessment of Myocardial Reperfusion After Myocardial Infarction Using Automatic 3-Dimensional Quantification and Template Matching

¹ Nuclear Medicine, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris/Paris XII University, Créteil, France
² Research and Development, Quantificare S.A., Sophia-Antipolis, France
³ Cardiology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris/Paris XII University, Créteil, France

Assessment of perfusion defect extent is essential for determining prognosis after a myocardial infarction (MI), but quantification methods usually rely on segmental analysis, which may lack accuracy. We present an automated voxel-based and template-based approach for precise quantification of perfusion defect extent and reperfusion evolution. Methods: Coronary angiography and stress/reinjection ²⁰¹Tl tomography were performed prospectively on 49 patients with recent MI (45 men; mean age ± SD, 54 ± 10 y), before and 3 mo after revascularization (40 angioplasties and 9 bypasses). Perfusion defect extent was quantified using expert 16-segment visual scoring of the slices and a 3-dimensional (3D) method with spatial normalization between times 1 and 2. Briefly, the latter automatically extracted myocardial edges, matched them to a reference template, and compared the perfusion intensity in each voxel with the intensity of the corresponding voxel in a control population of 100 healthy subjects. Results: Reocclusion occurred in 12 patients within 3 mo of surgery (all had undergone angioplasty). The perfusion gain between times 1 and 2, assessed by visual analysis, was significantly higher in permeable patients than in reoccluded patients: 12.4% ± 13.3% and 2.3% ± 8.2% of the initial stress defect, respectively (P = 0.02). Proportional gains, measured with the quantitative 3D method, were 4.5% ± 3.6% and 1.9% ± 2.7%, respectively (P = 0.02). Furthermore, the 3D method allowed measurement within the initial ischemic defect (reversible part of the stress defect at time 1), the extent of myocardium whose perfusion improved at time 2 (reperfusion), and the extent of myocardium whose perfusion remained unchanged (residual ischemia). A voxel-by-voxel analysis of these regions revealed that the proportion of reperfusion was significantly higher in permeable patients than in reoccluded patients: 60.0% ± 21.3% versus 40.0% ± 22.5%, respectively (P = 0.008). This was cumbersome to quantify using visual analysis and did not reach statistical significance, likely because of segmental division (partial-volume effect) and absence of spatial normalization. Conclusion: The 3D voxel-based quantification allows satisfying assessment of reperfusion 3 mo after MI. Moreover, the automated analysis using spatial normalization should facilitate a reproducible assessment of large populations over time.

Key Words: quantification • coregistration • myocardial perfusion • myocardial infarction

Related articles in JNM:

THIS MONTH IN JNM

JNM 2004 45: 8a-9a. [Full Text]  

This article has been cited by other articles:

				P. J. Slomka, D. S. Berman, and G. Germano Quantification of Serial Changes in Myocardial Perfusion J. Nucl. Med., December 1, 2004; 45(12): 1978 - 1980. [Full Text] [PDF]