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An Improved Method for Automatic Segmentation of the Left Ventricle in Myocardial Perfusion SPECT

Department of Clinical Physiology, Lund University Hospital, Lund, Sweden

View larger version (11K): [in this window] [in a new window]   FIGURE 1.  (A) Distribution of SRS and SSS in test population. Scores are calculated by QPS, and score of 0 indicates no defect. (B) Distribution of perfusion defects according to coronary artery territories for both rest and stress studies. One patient could be represented in more than 1 group because of presence of multivessel coronary artery disease. LAD = left anterior descending coronary artery; LCx = left circumflex coronary artery; RCA = right coronary artery.

View larger version (15K): [in this window] [in a new window]   FIGURE 2.  Flow scheme for proposed segmentation algorithm.

View larger version (48K): [in this window] [in a new window]   FIGURE 3.  Illustration of resampling process. One radial profile in original image slice (A) is sampled every 4.5°, which results in 80 columns in resampled image (B). Black line in images illustrates estimated mid-mural line through center of myocardium. r = radial direction; = circular direction.

View larger version (65K): [in this window] [in a new window]   FIGURE 4.  Illustration of segmentation of LVM in 1 patient with high discrepancies between new method and QPS. (A) MR images with manual LV segmentation. (B) MPS images with segmentation performed by new method. (C) MPS images with segmentation performed by QPS. LV segmentation is illustrated as white lines in all images. LVM quantified by MRI was 171 g, by new method 176 g, and by QPS 202 g. New method, compared with LVM by MRI, overestimated LVM by 3% LVM and QPS by 24% LVM.

View larger version (26K): [in this window] [in a new window]   FIGURE 5.  (A) Relationship between LVM measured by MPS, segmented by new method, and by MRI. Dashed line is line of identity. (B) Relationship between LVM measured by MPS, segmented by QPS, and by MRI. Dashed line is line of identity. (C) Relationship between error in LVM, for new method, and LVM by MRI. (D) Relationship between error in LVM, for QPS, and LVM by MRI. (E) Relationship between error in LVM, for new method, and LVM by MPS. (F) Relationship between error in LVM, for QPS, and LVM by MPS. Note in C and D trend of decreasing error and variability with increasing LVM by MRI. This trend is not present in E and F when LVM by MPS is on horizontal axis. This absence of trend illustrates that LVM from MPS alone cannot be used to adjust algorithm to improve agreement between MPS and MRI.