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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

View larger version (15K): [in a new window]   FIGURE 1. Schematics of 16-segment model used for visual scoring and segmental division of 3D myocardial template. HLA = horizontal long axis; VLA = vertical long axis.

View larger version (95K): [in a new window]   FIGURE 2. Example of image display allowing visual quality control of automated registration of serial image volumes under MPS-Quant (Quantificare S.A.).

View larger version (49K): [in a new window]   FIGURE 3. Representation of the key steps needed for calculation of deficit load. (A) Patient’s image volume (stress 1) is matched to reference template (white overlay). All voxels with an intensity 1.8 SDs of the corresponding value from the normal population model (B) are considered hypoperfused (C) and allow the determination of an SDR mask (D, white overlay), within which all further calculations will be performed.

View larger version (18K): [in a new window]   FIGURE 4. Comparison between hypoperfusion indices calculated by visual segmental scoring and 3D quantitative approach, for stress acquisition at time 1: linear regression (A) and Bland-Altman analysis (B).

View larger version (29K): [in a new window]   FIGURE 5. ROC curve obtained by varying the voxelized reperfusion index threshold to separate permeable from reoccluded patients. The best sensitivity/specificity compromise, shown at the heavy point, corresponds to a reperfusion index of 51.7%.