Estimation of regional myocardial mass at risk based on distal arterial lumen volume and length using 3D micro-CT images

Abstract

The determination of regional myocardial mass at risk distal to a coronary occlusion provides valuable prognostic information for a patient with coronary artery disease. The coronary arterial system follows a design rule which allows for the use of arterial branch length and lumen volume to estimate regional myocardial mass at risk. Image processing techniques, such as segmentation, skeletonization and arterial network tracking, are presented for extracting anatomical details of the coronary arterial system using micro-computed tomography (micro-CT). Moreover, a method of assigning tissue voxels to their corresponding arterial branches is presented to determine the dependent myocardial region. The proposed micro-CT technique was utilized to investigate the relationship between the sum of the distal coronary arterial branch lengths and volumes to the dependent regional myocardial mass using a polymer cast of a porcine heart. The correlations of the logarithm of the total distal arterial lengths ( L) to the logarithm of the regional myocardial mass ( M) for the left anterior descending (LAD), left circumflex (LCX) and right coronary (RCA) arteries were log( L) = 0.73 log( M) + 0.09 ( R = 0.78), log( L) = 0.82 log( M) + 0.05 ( R = 0.77) and log( L) = 0.85 log( M) + 0.05 ( R = 0.87), respectively. The correlation of the logarithm of the total distal arterial lumen volumes ( V) to the logarithm of the regional myocardial mass for the LAD, LCX and RCA were log( V) = 0.93 log( M) − 1.65 ( R = 0.81), log( V) = 1.02 log( M) − 1.79 ( R = 0.78) and log( V) = 1.17 log( M) − 2.10 ( R = 0.82), respectively. These morphological relations did not change appreciably for diameter truncations of 600–1400 μm. The results indicate that the image processing procedures successfully extracted information from a large 3D dataset of the coronary arterial tree to provide prognostic indications in the form of arterial tree parameters and anatomical area at risk.