Abstract
Myocardial perfusion imaging, coupled with quantitative perfusion analysis, provides an important diagnostic tool for the identification of ischaemic heart disease caused by coronary stenoses. The accurate mapping between coronary anatomy and under-perfused areas of the myocardium is important for diagnosis and treatment. However, in the absence of the actual coronary anatomy during the reporting of perfusion images, areas of ischaemia are allocated to a coronary territory based on a population-derived 17-segment (American Heart Association) AHA model of coronary blood supply. This work presents a solution for the fusion of 2D Magnetic Resonance (MR) myocardial perfusion images and 3D MR angiography data with the aim to improve the detection of ischaemic heart disease. The key contribution of this work is a novel method for the mediated spatiotemporal registration of perfusion and angiography data and a novel method for the calculation of patient-specific coronary supply territories. The registration method uses 4D cardiac MR cine series spanning the complete cardiac cycle in order to overcome the under-constrained nature of non-rigid slice-to-volume perfusion-to-angiography registration. This is achieved by separating out the deformable registration problem and solving it through phase-to-phase registration of the cine series. The use of patient-specific blood supply territories in quantitative perfusion analysis (instead of the population-based model of coronary blood supply) has the potential of increasing the accuracy of perfusion analysis. Quantitative perfusion analysis diagnostic accuracy evaluation with patient-specific territories against the AHA model demonstrates the value of the mediated spatiotemporal registration in the context of ischaemic heart disease diagnosis.
Highlights
In the last decade, dynamic contrast-enhanced magnetic resonance (DCE-Magnetic Resonance (MR)) myocardial perfusion imaging has become an important diagnostic tool for the identification of ischaemic heart disease
An extensive project relating to the combined analysis of DCEMRI, late gadolinium enhancement (LGE) magnetic resonance images and magnetic resonance angiography (MRA) images was reported by Hennemuth et al (2008) where they propose a solution for fusion of DCE-MRI and LGE through the use of the high-resolution MRA reference volume
50 clinical data-sets were available for evaluation, the evaluation steps which involved MRA whole-heart volumes were carried out in smaller numbers due to the low quality of some of the MRA data-sets which affected the reliability of manual segmentations
Summary
Dynamic contrast-enhanced magnetic resonance (DCE-MR) myocardial perfusion imaging has become an important diagnostic tool for the identification of ischaemic heart disease. The authors propose the use of the affine transform as the means of dealing with cardiac phase differences; the authors acknowledge that slice-to-volume registration with an affine transformation is not suitable for compensation of large cardiac phase differences It is acknowledged in numerous publications (some of which are reviewed further ) that cardiac phase difference is more accurately modelled with deformable transforms. The consecutive cine frame-to-frame registration produces vector deformation fields (VDFs) which are used to transform LGE images into a synthetic cine series This solution is based on a non-rigid registration algorithm known as multiple scale signal matching (MSSM) (Siebert & Marshall 2000) and the Cross-Correlation image similarity metric. Consecutive frameto-frame registration features in multiple registration instances listed
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