CoViCAD: Comprehensive Visualization of Coronary Artery Disease

Termeer, Maurice; Bescós, Javier Oliván; Breeuwer, Marcel; Vilanova, Anna; Gerritsen, Frans; Gröller, M. Eduard

doi:10.1109/tvcg.2007.70550

Cited by 49 publications

(30 citation statements)

References 12 publications

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“…While polar plots are commonly used in nuclear cardiology, these plots are only sporadically used in cardiac MRI today [20] [21]. Because co-registered morphological MR images are by default available in PET/MRI, we performed segmentation of myocardial boundaries in MR images.…”

Section: Discussionmentioning

confidence: 99%

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Integrated Assessment of Cardiac PET/MRI: Co-Registered PET and MRI Polar Plots by Mutual MR-Based Segmentation of the Left Ventricular Myocardium

Nensa¹,

Poeppel²,

Tezgah³

et al. 2017

WJCD

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Background: In the present study, we sought to describe a procedure for the creation of co-registered positron emission tomography (PET) and magnetic resonance imaging (MRI) polar plots of cardiac PET/MRI examinations, validate the resulting plots against available standard methods in patients with myocardial infarction and provide examples that demonstrate the advantage of the novel approach over existing standards. Methods: Co-registered LGE and PET short-axis images were transformed into polar maps based on a radial sampling pattern. LGE was automatically detected using an automated thresholding algorithm (ATA). In 20 PET/MRI examinations in patients with acute myocardial infarction, agreement between manual LGE assessment and the ATA classification was calculated. Also agreement between MRI-segmentation based PET polar plots and standard PET polar plots (created with the Corridor4DM software package) was assessed. Results: No statistically significant difference in infarct sizes between manual and ATA segmentation was found (p = 0.12). Both methods were highly correlated (Pearson's r = 0.96, p < 0.01). Bland-Altman analysis revealed lower and upper limits of agreement of −4.7 g and 3.6 g. Agreement between MRI-segmentation based PET polar plots and standard PET polar plots was very high (mean kappa of 0.91 ± 0.10; p < 0.01 in all cases). In three additional patients with myocardial inflammation, the software successfully created polar plots that demonstrate How to cite this paper: Nensa, F., Poeppel, T.D., Tezgah, E., Heusch, P., Nassenstein, K., Forsting, M., Bockisch, A., Erbel, R. and 92the location and extent of pathologic tracer uptake in the left ventricular myocardium. Conclusion: A straightforward software approach for the creation of co-registered PET and MRI polar plots was described and successfully demonstrated in PET/MRI studies of myocardial infarction and inflammation.

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Section: Discussionmentioning

confidence: 99%

“…All patients gave written informed consent prior to the examination. PET/MRI was performed in 20 patients with acute myocardial infarction after interventional reperfusion (20 …”

Section: Patientsmentioning

confidence: 99%

Integrated Assessment of Cardiac PET/MRI: Co-Registered PET and MRI Polar Plots by Mutual MR-Based Segmentation of the Left Ventricular Myocardium

Nensa¹,

Poeppel²,

Tezgah³

et al. 2017

WJCD

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“…Based on this type of visualization, also the detail of the 3D volume has been reduced to a 2D surface, resulting in loss of useful information. An alternative approach to the representation of scar transmurality was presented by Termeer et al [14]. He suggests the use of a volumetric bull's eye plot in which the distribution of scar in the heart wall can be assessed at a glance.…”

Section: Related Workmentioning

confidence: 99%

Cardiac MRI visualization for ventricular tachycardia ablation

et al. 2012

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Objective The integrated visualization of cardiac MRI during a ventricular tachycardia (VT) mapping and ablation procedure would provide improved catheter guidance and tissue assessment. We developed a system for and explored the added value of simultaneous visualization of intracardiac voltage measurements and MRI-derived myocardial scar information during VT ablation procedures. Method We propose the use of a synchronized 3D and 2D view. In 3D, the catheter will be guided optimally by assessing 3D scar characteristics and its relation to the ventricular anatomy. In 2D, a detailed assessment of the tissue can be made. We developed several 3D visualization techniques, including volume rendering of the scar and myocardial surfaces colored according to the voltage measurements. We also visualized context structures in the heart. For the 2D view, we proposed showing three adjacent slices simultaneously. To link the 3D with the 2D view, we added a linking plane and linking contours; the slice level shown in the 2D view is indicated in the 3D view. Results We evaluated our method via a case study during which we simulated the visual environment of an ablation procedure. The MRI-based volume rendering of scar tissue and the linking between the 3D and 2D views were both positively received. However, the visualization of the voltage measurements was found to be hard to interpret, partly due to the perceptually suitable but non-standard colormap. Conclusions Based on this study, we can conclude that our approach of displaying MRI data and integrating it with voltage measurements has potential to improve VT ablation procedures.

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“…Termeer et al 5 proposed a comprehensive visualization framework (called CoViCAD) to relate whole-body and perfusion MRI data. The distinction of our work with Termeer's is that Termeer extracted coronary centerlines from MR images, whereas we obtained the complete coronary tree segmentation from CTA images.…”

Section: Introductionmentioning

confidence: 99%

A patient-specific visualization tool for comprehensive analysis of coronary CTA and perfusion MRI data

et al. 2011

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Cardiac magnetic resonance perfusion imaging (CMR) and computed tomography angiography (CTA) are widely used to assess heart disease. CMR is used to measure the global and regional myocardial function and to evaluate the presence of ischemia; CTA is used for diagnosing coronary artery disease, such as coronary stenoses. Nowadays, the hemodynamic significance of coronary artery stenoses is determined subjectively by combining information on myocardial function with assumptions on coronary artery territories. As the anatomy of coronary arteries varies greatly between individuals, we developed a patient-specific tool for relating CTA and perfusion CMR data. The anatomical and functional information extracted from CTA and CMR data are combined into a single frame of reference. Our graphical user interface provides various options for visualization. In addition to the standard perfusion Bull's Eye Plot (BEP), it is possible to overlay a 2D projection of the coronary tree on the BEP, to add a 3D coronary tree model and to add a 3D heart model. The perfusion BEP, the 3D-models and the CTA data are also interactively linked. Using the CMR and CTA data of 14 patients, our tool directly established a spatial correspondence between diseased coronary artery segments and myocardial regions with abnormal perfusion. The location of coronary stenoses and perfusion abnormalities were visualized jointly in 3D, thereby facilitating the study of the relationship between the anatomic causes of a blocked artery and the physiological effects on the myocardial perfusion. This tool is expected to improve diagnosis and therapy planning of early-stage coronary artery disease.

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CoViCAD: Comprehensive Visualization of Coronary Artery Disease

Cited by 49 publications

References 12 publications

Integrated Assessment of Cardiac PET/MRI: Co-Registered PET and MRI Polar Plots by Mutual MR-Based Segmentation of the Left Ventricular Myocardium

Integrated Assessment of Cardiac PET/MRI: Co-Registered PET and MRI Polar Plots by Mutual MR-Based Segmentation of the Left Ventricular Myocardium

Cardiac MRI visualization for ventricular tachycardia ablation

A patient-specific visualization tool for comprehensive analysis of coronary CTA and perfusion MRI data

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