Cardiac Reconstruction Algorithms Research Articles

Cardiac mesh morphing method for finite element modeling of heart failure with preserved ejection fraction

Numerical modeling of heart biomechanics can realistically capture morphological variations in diseases and has been helpful in advancing our understanding of the physiology. Subject-specific models require anatomic representation of medical images, and it is desirable to have a consistently repeatable models for any given morphology. In this study, we propose a novel and easily adaptable cardiac reconstruction algorithm by morphing an existing discretized mesh of an advanced finite element (FE) model, to match anatomies acquired from porcine cardiac magnetic resonance imaging (cMRI) scans. The morphing algorithm involves iterative FE simulations with visco-hyperelastic material properties. The living heart porcine model (LHPM) was chosen as the input baseline FE mesh, in order to preserve detailed anatomical features that cannot be captured in routine scans such as myofiber orientations and conduction pathways. The algorithm was demonstrated for the recreation of porcine hearts of a healthy subject and of a subject induced with heart failure with preserved ejection fraction (HFpEF) conditions, where there were substantial hypertrophy and anatomical alterations. We further used the morphed meshes for FE modeling of cardiac contraction and relaxation, thus demonstrating the applicability of the proposed algorithm in producing viable meshes. The results show that our algorithm can recreate the characteristic anatomical changes of cardiac remodeling, including heart muscle thickening, as well as replicate the reduction in ventricular volume. This algorithm allows for the creation of subject-specific models with the same mesh connectivity, thus enabling spatial comparison and analysis of pathologic progress.

Optimal choice of OSEM and SD reconstruction algorithms in CZT SPECT for hypertrophic cardiomyopathy patients

BackgroundThe spectrum dynamics (SD) algorithm is a cardiac reconstruction algorithm of D-SPECT, which improves spatial resolution compared with the ordered-subsets expectation maximization (OSEM) algorithm. We evaluated the wall thickness and left ventricular (LV) volume in patients with hypertrophic cardiomyopathy (HCM) using the SD algorithm. MethodsIn a phantom study, the myocardial wall was scanned with varying wall thicknesses (10-40 mm). In the clinical study, 30 and 27 normal and HCM patients underwent myocardial perfusion imaging. ResultsIn a phantom study, LV volume using the SD algorithm was increased by thickening the wall of the phantom. In the clinical study, the wall thickness and LV volume of OSEM and SD algorithms showed a difference between HCM and normal groups. The wall thickness using OSEM and SD algorithms were 19.4 ± 2.0 and 16.7 ± 1.5 mm in patients with normal, and 27.9 ± 4.9 and 21.8 ± 2.6 mm in patients with HCM. ConclusionThe SD algorithm in cases of HCM may not be able to correctly assess wall thickness and LV volume. Our study suggests that the OSEM is more suitable in cases of HCM than the SD algorithm.

Comprehensive CT Cardiothoracic Imaging: A New Challenge for Chest Imaging

In the past, thoracic and cardiac imaging were two distinct specialties of radiology. The technical evolution, however, has changed their boundaries with an important impact on CT imaging practices and has opened the new era of "cardiothoracic" imaging, due to the strong anatomic, mechanical, physiologic, physiopathologic, and therapeutic cardiopulmonary correlations. Modern thoracic radiologists can no longer avoid the assessment of heart and coronary arteries, as they used to do with earlier generations of CT scanner. The advent of ECG gating and state-of-art CT scanner faster rotation speed, high spatial and temporal resolution, high-pitch mode, shorter acquisition time, and dedicated cardiac reconstruction algorithms has opened new possibilities for chest imaging, integrating cardiac morphologic and even functional information within a diagnostic chest CT scan. The aim of this review is to briefly show and summarize the concept of integrated cardiothoracic imaging, which redefines the boundaries of chest CT imaging, opening the door to a new radiologic specialty.

Imaging the Heart-lung Relationships During a Chest Computed Tomography Examination

Before the advent of fast-scanning multidetector-row computed tomography (CT) technology, thoracic CT studies were exclusively used for the morphologic assessment of thoracic organs, as the concurrent examination of the heart was hampered by image degradation from cardiac motion artifacts. The introduction of fast rotation speed and dedicated cardiac reconstruction algorithms has opened new possibilities for chest imaging, starting with the possibility to integrate cardiac morphologic and functional information into a diagnostic CT scan of the chest. Initiated with 16-slice multidetector-row CT, this concept of integrating morphology and function has been further simplified with 64-slice CT scanners, thus allowing radiologists to provide vital information in the management of patients with a wide variety of acute or chronic respiratory disorders. Because this CT technology offers the possibility of generating high-resolution and motion-free images of the coronary arteries, evaluation of the coronary arteries during CT examinations of the chest should further widen the clinical applications of CT for respiratory patients, keeping in mind that cigarette smoking is a shared risk factor for both impaired lung function and cardiovascular events. The recent advent of high temporal resolution and high pitch modes with dual-source CT simplifies the concept of integrated cardiothoracic imaging, introducing non-electrocardiographic-gated coronary artery imaging. The purpose of this article is to review the successive approaches of these redefined borders of thoracic imaging.

ECG-gated multidetector-row computed tomography in the assessment of left ventricular function

An accurate quantitative and qualitative assessment of cardiac function is critical for clinical diagnosis, risk stratification, management and prognosis in patients with suspected or documented heart disease. Magnetic resonance, owing to its excellent temporal and spatial resolution, is currently considered a reference standard in the assessment of cardiac function. Multidetector-row computed tomographic scanners, with sub-second rotation times and dedicated cardiac reconstruction algorithms, have shown their ability to acquire high-resolution images suitable for coronary imaging. With retrospective ECG - gating technique, diastolic and systolic images can be produced and analyzed to assess left ventricle functional parameters. The combination of noninvasive coronary artery imaging and assessment of cardiac function with multidetector-row computed tomography is a suitable approach to a conclusive cardiac work-up in patients with suspected coronary artery disease.

Sémiologie des atteintes du cœur droit en pathologie pulmonaire

Numerous respiratory disorders may be responsible for right heart dysfunction, frequently suboptimally assessed in routine clinical practice. Multidetector-row CT systems with fast scanning capabilities can acquire images of the thorax with reduced cardiac motion artifacts, enabling improved evaluation of the heart. Moreover, the introduction of fast rotation speed and dedicated cardiac reconstruction algorithms exploiting the multislice acquisition scheme of the data has opened the possibility of integrating right cardiac functional information into a diagnostic CT scan of the chest, without or with ECG gating.

Vascular Disease in Chronic Obstructive Pulmonary Disease

Since the introduction of multi-detector row computed tomography (MDCT), most attention has been directed toward the use of this technique to improve the characterization of anatomic changes at the level of the airways and lung parenchyma in patients with chronic obstructive pulmonary disease. The introduction of fast rotation speed and dedicated cardiac reconstruction algorithms exploiting the multislice acquisition scheme of the data has opened new possibilities for thoracic imaging, starting with the possibility to integrate cardiac functional information into a diagnostic CT scan of the chest. Initiated with 16-slice MDCT, this concept of integrating morphology and function has been further simplified with 64-slice CT scanners, thus allowing radiologists to provide vital information in the management of patients with a wide variety of acute or chronic respiratory disorders. Because this CT technology also offers the possibility of generating high-resolution and motion-free images of the coronary arteries, evaluation of the coronary arteries in asymptomatic patients at risk for coronary artery disease during CT examinations of the chest can widen the clinical applications of CT for respiratory patients. More recently, the introduction of dual-source CT and its subsequent ability to apply dual energy to chest imaging has added another area of clinical interest at the level of the pulmonary capillary level. The purpose of this article is to review the potential applications of these technological developments in the population of patients with chronic obstructive pulmonary disease to provide a noninvasive depiction of the cardiovascular abnormalities known to occur in this subset of patients.

The Effects of Trimetazidine on the Enhancement Patterns of Multi-Detector Computed Tomography in a Porcine Myocardial Infarction Model: What is the Meaning of the MDCT Enhancement Pattern in this Myocardial Infarction Model?

The recently introduced multidetector-row CT(MDCT), with sub-second rotation times and dedicated cardiac reconstruction algorithms, offers a new opportunity in cardiac CT imaging; in particular, as it can perform highresolution MDCT coronary angiography. The improved spatial and temporal resolutions of MDCT have made it possible to assess the myocardium. 1-3) Contrast-enhanced, two-phase MDCT reveals an early myocardial perfusion defect and late enhancement of acute myocardial infarction(MI), which is consistent with the findings observed in nuclear imaging and on contrast-enhanced MRI. 4) The infarct size determined by delayed enhanced MDCT and delayed enhanced MRI shows good correlation with that found in the pathology of an animal model. 5)

Direct cone‐beam cardiac reconstruction algorithm with cardiac banding artifact correction

Multislice helical computed tomography (CT) is a promising noninvasive technique for coronary artery imaging. Various factors can cause inconsistencies in cardiac CT data, which can result in degraded image quality. These inconsistencies may be the result of the patient physiology (e.g., heart rate variations), the nature of the data (e.g., cone-angle), or the reconstruction algorithm itself. An algorithm which provides the best temporal resolution for each slice, for example, often provides suboptimal image quality for the entire volume since the cardiac temporal resolution (TRc) changes from slice to slice. Such variations in TRc can generate strong banding artifacts in multiplanar reconstruction images or three-dimensional images. Discontinuous heart walls and coronary arteries may compromise the accuracy of the diagnosis. A beta-blocker is often used to reduce and stabilize patients' heart rate but cannot eliminate the variation. In order to obtain robust and optimal image quality, a software solution that increases the temporal resolution and decreases the effect of heart rate is highly desirable. This paper proposes an ECG-correlated direct cone-beam reconstruction algorithm (TCOT-EGR) with cardiac banding artifact correction (CBC) and disconnected projections redundancy compensation technique (DIRECT). First the theory and analytical model of the cardiac temporal resolution is outlined. Next, the performance of the proposed algorithms is evaluated by using computer simulations as well as patient data. It will be shown that the proposed algorithms enhance the robustness of the image quality against inconsistencies by guaranteeing smooth transition of heart cycles used in reconstruction.

Kymogram detection and kymogram-correlated image reconstruction from subsecond spiral computed tomography scans of the heart.

Subsecond single-slice, multi-slice or cone-beam spiral computed tomography (SSCT, MSCT, CBCT) offer great potential for improving heart imaging. Together with the newly developed phase-correlated cardiac reconstruction algorithms 180 degrees MCD and 180 degrees MCI [Med. Phys. 27, 1881-1902 (2000)] or related algorithms provided by the CT manufacturers, high image quality can be achieved. These algorithms require information about the cardiac motion, i.e., typically the simultaneously recorded electrocardiogram (ECG), to synchronize the reconstruction with the cardiac motion. Neither data acquired without ECG information (standard patients) nor acquisitions with corrupted ECG information can be handled adequately. We developed a method to extract the appropriate information about cardiac motion directly from the measured raw data (projection data). The so-called kymogram function is a measure of the cardiac motion as a function of time t or as a function of the projection angle alpha. In contrast to the ECG which is a global measure of the heart's electric excitation, the kymogram is a local measure of the heart motion at the z-position z(a) at projection angle a. The patient's local heart rate as well as the necessary synchronization information to be used with phase-correlated algorithms can be extracted from the kymogram by using a series of signal processing steps. The kymogram information is shown to be adequate to substitute the ECG information. Computer simulations with simulated ECG and patient measurements with simultaneously acquired ECG were carried out for a multislice scanner providing M = 4 slices to evaluate these new approaches. Both the ECG function and the kymogram function were used for reconstruction. Both were highly correlated regarding the periodicity information used for reconstruction. In 21 out of 25 consecutive cases the kymogram approach was equivalent to the ECG-correlated reconstruction; only minor differences in image quality between both methods were observed. For one patient the synchronization information detected by the ECG monitor turned out to be wrong; here, the kymogram constituted the only approach that provided useful reconstructions. Patient studies with 12 and 16 slices indicate the usefulness of our approach for cone-beam CT scans. Kymogram-correlated reconstructions also appear to have the potential to improve imaging of pericardial lung areas in general.

ECG-correlated image reconstruction from subsecond multi-slice spiral CT scans of the heart.

Subsecond spiral computed tomography (CT) offers great potential for improving heart imaging. The new multi-row detector technology adds significantly to this potential. We therefore developed and validated dedicated cardiac reconstruction algorithms for imaging the heart with subsecond multi-slice spiral CT utilizing electrocardiogram (ECG) information. The single-slice cardiac z-interpolation algorithms 180 degrees CI and 180 degrees CD [Med. Phys. 25, 2417-2431 (1998)] were generalized to allow imaging of the heart for M-slice scanners. Two classes of algorithms were investigated: 180 degrees MCD (multi-slice cardio delta), a partial scan reconstruction of 180 degrees + delta data with a < phi (fan angle) resulting in effective scan times of 250 ms (central ray) when a 0.5 s rotation mode is available, and 180 degrees MCI (multi-slice cardio interpolation), a piecewise weighted interpolation between successive spiral data segments belonging to the same heart phase, potentially providing a relative temporal resolution of 12.5% of the heart cycle when a four-slice scanner is used and the table increment is chosen to be greater than or equal to the collimated slice thickness. Data segments are selected by correlation with the simultaneously recorded ECG signal. Theoretical studies, computer simulations, as well as patient measurements were carried out for a multi-slice scanner providing M = 4 slices to evaluate these new approaches and determine the optimal scan protocol. Both algorithms, 180 degrees MCD and 180 degrees MCI, provide significant improvements in image quality, including extremely arythmic cases. Artifacts in the reconstructed images as well as in 3D displays such as multiplanar reformations were largely reduced as compared to the standard z-interpolation algorithm 180 degrees MLI (multi-slice linear interpolation). Image quality appears adequate for precise calcium scoring and CT angiography of the coronary arteries with conventional subsecond multislice spiral CT. It turned out that for heart rates fH > or = 70 min(-1) the partial scan approach 180 degrees MCD yields unsatisfactory results as compared to 180 degrees MCI. Our theoretical considerations show that a freely selectable scanner rotation time chosen as a function of the patient's heart rate, would further improve the relative temporal resolution and thus further reduce motion artifacts. In our case an additional 0.6 s mode besides the available 0.5 s mode would be very helpful. Moreover, if technically feasible, lower rotation times such as 0.3 s or even less would result in improved image quality. The use of multi-slice techniques for cardiac CT together with the new z-interpolation methods improves the quality of heart imaging significantly. The high temporal resolution of 180 degrees MCI is adequate for spatial and temporal tracking of anatomic structures of the heart (4D reconstruction).

ECG-correlated imaging of the heart with subsecond multislice spiral CT.

The new spiral multislice computed tomography (CT) scanners and the significant increase in rotation speed offer great potential for cardiac imaging with X-ray CT. We have therefore developed the dedicated cardiac reconstruction algorithms 180 degrees multislice cardio interpolation (MCI) and 180 degrees multislice cardio delta (MCD) and here offer further details and validation. The algorithm 180 degreesMCI is an electrocardiogram (ECG)-correlated filtering (or weighting) algorithm in both the cardiac phase and in the z-position. Effective scan times (absolute temporal resolution) of as low as t(eff) = 56 ms are possible, assuming M 4 simultaneously measured slices at a rotation time of t(rot) = 0.5 s and S < or = d < or = 3S for the table feed d per rotation, where S denotes the collimated slice thickness. The relative temporal resolution w (fraction of the heart cycle depicted in the image), which is the more important parameter in cardiac imaging, will then be as low as w = 12.5% of the heart cycle. The second approach, 180 degreesMCD, is an ECG-correlated partial scan reconstruction of 180 degrees + delta data with delta << phi (fan-angle). Its absolute temporal resolution lies in the order of 250 ms (for the central ray, i.e., for the center of rotation), and the relative temporal resolution w increases with increasing heart rate, e.g., from typically w = 25% at fH = 60 min(-1) to w = 50% at fH = 120 min(-1), assuming again t(rot) = 0.5 s. For validation purposes, we have done simulations of a virtual cardiac motion phantom, measurements of a dedicated cardiac calibration and motion phantom, and we have reconstructed patient data with simultaneously acquired ECG. Both algorithms significantly improve the image quality compared with the standard reconstruction algorithms 180 degrees multislice linear interpolation (MLI) and 180 degrees multislice filtered interpolation (MFI). However, 180 degreesMCI is clearly superior to 180 degreesMCD for all heart rates. This is best illustrated by multiplanar reformations (MPR) or other three-dimensional (3-D) displays of the volume. 180 degreesMCI, due to its higher temporal resolution, is best for spatial and temporal four-dimensional (4-D) tracking of the anatomy. A tunable scanner rotation time to avoid resonance behavior of the heart rate and the scanner's rotation and shorter rotation times would be of further benefit.