Program Information
Determining Patient-Specific Myocardial Perfusion Territories Using Computed Tomography Coronary Angiography
s malkasian*, L Hubbard , B Dertli , J Kwon , P Abbona , S Molloi , University of California, Irvine, CA
Presentations
TH-CD-601-2 (Thursday, August 3, 2017) 10:00 AM - 12:00 PM Room: 601
Purpose: Using a standard X-ray computed tomography coronary angiography (CTA) examination, a novel method, utilizing the Fast-Marching algorithm, is proposed to determine patient-specific myocardial perfusion territories for the three coronary arteries; Left Anterior Descending (LAD), Left Circumflex (LCX) and Right Coronary Artery (RCA).
Methods: Fast-Marching myocardial assignment (FMA) used vessel centerlines and a binary myocardial mask to accurately determine the myocardial territories perfused by each coronary artery, on a patient-specific basis. For the LAD, LCX and RCA, a 3-dimensional distance-transform was generated, constrained to the myocardial mask. With these distance-transforms, each voxel of the myocardium was assigned to its closest coronary artery. Using a 320-slice multi-detector CT system (Toshiba Aquilion ONE, Toshiba American Medical Systems, Tustin, CA), six swine (50 – 90 kg) underwent a standard CTA examination, followed by imaging while contrast was directly injected into either the Right Coronary Artery (RCA) or Left Coronary Artery (LCA). After segmenting vessel centerlines and myocardium from the CTA acquisition, perfusion territories were determined for the LCA and RCA using FMA. Gold-standard perfusion territories for the LCA and RCA were segmented from direct contrast injection images, and compared with FMA LCA and RCA territories.
Results: Overall, FMA LCA and RCA territories showed good agreement with direct contrast injection territories, having an average Dice Coefficient of 0.88. FMA LCA and RCA territories had a mass percent error of 11.32 % and a Root-Mean Square Error of 2.88 g, when compared with LCA and RCA territories determined from direct contrast injection images.
Conclusion: FMA shows great agreement in determining perfusion territories for the LCA and RCA. In addition to determining LCA and RCA perfusion territories, FMA can be used to approximate myocardium at-risk distal to a stenosis and branch-specific myocardial perfusion territories; using only information yielded from a standard CTA examination.
Funding Support, Disclosures, and Conflict of Interest: Grant funding from Toshiba America Medical Systems.
Contact Email: