Feasibility of determining myocardial transient ischemic dilation from cardiac CT by automated stress/rest registration

Abstract

Transient ischemic dilation (TID) of the left ventricle measured by myocardial perfusion Single Photon Emission Computed Tomography (SPECT) and defined as a the ratio of stress myocardial blood volume to rest myocardial blood volume has been shown to be highly specific for detection of severe coronary artery disease. This work investigates automated quantification of TID from cardiac Computed Tomography (CT) perfusion images. To date, TID has not been computed from CT. Previous studies to compute TID have assumed accurate segmentation of the left ventricle and performed subsequent analysis of volume change mainly on static or less often on gated myocardial perfusion SPECT. This, however, may limit the accuracy of TID due to potential errors from segmentation, perfusion defects or volume measurement from both images. In this study, we propose to use registration methods to determine TID from cardiac CT scans where deformation field within the structure of interest is used to measure the local volume change between stress and rest. Promising results have been demonstrated with 7 datasets, showing the potential of this approach as a comparative method for measuring TID.