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Quantitative assessment of atrial regional function using motion estimation computed tomography.

ABSTRACT: We validated a novel image-based motion estimation computed tomographic (CT) technique (iME) to quantify atrial regional function in swine in vivo.Domestic swine (n = 8) underwent CT scan with intravenous contrast before and after median sternotomy where 15 to 30 glass beads were sutured to the atria to calculate the motion estimation error. Four-dimensional motion vector field was estimated using iME. Area change ratio (%AC) was calculated over the atrial endocardium to assess the surface deformation.The error between the measured and the calculated coordinates based on motion vector field was 0.76 ± 0.43 mm. The %AC was regionally heterogeneous. The %AC time course was significantly different between the right and the left atriums (P < 0.001) as well as between the right atrial appendage and the right atrial chamber (P = 0.004).Quantitative assessment of atrial regional function using iME is highly accurate. Image-based motion estimation computed tomographic (CT) technique can quantify subtle regional dysfunction that is not apparent in global functional indices such as ejection fraction.

SUBMITTER: Ashikaga H

PROVIDER: S-EPMC4167165 | biostudies-literature | 2014 Sep-Oct

REPOSITORIES: biostudies-literature

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Quantitative assessment of atrial regional function using motion estimation computed tomography.

Ashikaga Hiroshi H Cammin Jochen J Tang Qiulin Q Knudsen Karly K Inoue Yuko Y Fishman Elliot K EK Taguchi Katsuyuki K

Journal of computer assisted tomography 20140901 5

<h4>Objectives</h4>We validated a novel image-based motion estimation computed tomographic (CT) technique (iME) to quantify atrial regional function in swine in vivo.<h4>Materials and methods</h4>Domestic swine (n = 8) underwent CT scan with intravenous contrast before and after median sternotomy where 15 to 30 glass beads were sutured to the atria to calculate the motion estimation error. Four-dimensional motion vector field was estimated using iME. Area change ratio (%AC) was calculated over t ...[more]

PMID: 24983435

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Project description:This work concerns computed tomography (CT)-based cardiac functional analysis (CFA) with a reduced radiation dose. As CT-CFA requires images over the entire heartbeat, the scans are often performed at 10-20% of the tube current settings that are typically used for coronary CT angiography. A large image noise then degrades the accuracy of motion estimation. Moreover, even if the scan was performed during the sinus rhythm, the cardiac motion observed in CT images may not be cyclic with patients with atrial fibrillation. In this study, we propose to use two CT scan data, one for CT angiography at a quiescent phase at a standard dose and the other for CFA over the entire heart beat at a lower dose.We have made the following four modifications to an image-based cardiac motion estimation method we have previously developed for a full-dose retrospectively gated coronary CT angiography: (a) a full-dose prospectively gated coronary CT angiography image acquired at the least motion phase was used as the reference image; (b) a three-dimensional median filter was applied to lower-dose retrospectively gated cardiac images acquired at 20 phases over one heartbeat in order to reduce image noise; (c) the strength of the temporal regularization term was made adaptive; and (d) a one-dimensional temporal filter was applied to the estimated motion vector field in order to decrease jaggy motion patterns. We describe the conventional method iME1 and the proposed method iME2 in this article. Five observers assessed the accuracy of the estimated motion vector field of iME2 and iME1 using a 4-point scale. The observers repeated the assessment with data presented in a new random order 1 week after the first assessment session.The study confirmed that the proposed iME2 was robust against the mismatch of noise levels, contrast enhancement levels, and shapes of the chambers. There was a statistically significant difference between iME2 and iME1 (accuracy score, 2.08 ± 0.81 versus 2.77 ± 0.98, P < 0.01) and the improvement by the score of + 0.69 seemed clinically relevant. Inter-observer concordance was good: The inter-class correlation coefficient was 0.63 and Kendall's rank correlation coefficients were in the range of 0.41-0.67 (P < 0.01), respectively. Intra-observer reproducibility between sessions was good with the inter-class correlation coefficient of 0.76.We have proposed iME2 method for CT-CFA with two CT scans. The observer study verified the robustness and accuracy of iME2 method and its improved performance over iME1 method.

Project description:BackgroundA reduced left atrial (LA) strain correlates with the presence of atrial fibrillation (AF). Conventional atrial strain analysis uses two-dimensional (2D) imaging, which is, however, limited by atrial foreshortening and an underestimation of through-plane motion. Retrospective gated computed tomography (RGCT) produces high-fidelity three-dimensional (3D) images of the cardiac anatomy throughout the cardiac cycle that can be used for estimating 3D mechanics. Its feasibility for LA strain measurement, however, is understudied.AimThe aim of this study is to develop and apply a novel workflow to estimate 3D LA motion and calculate the strain from RGCT imaging. The utility of global and regional strains to separate heart failure in patients with reduced ejection fraction (HFrEF) with and without AF is investigated.MethodsA cohort of 30 HFrEF patients with (n = 9) and without (n = 21) AF underwent RGCT prior to cardiac resynchronisation therapy. The temporal sparse free form deformation image registration method was optimised for LA feature tracking in RGCT images and used to estimate 3D LA endocardial motion. The area and fibre reservoir strains were calculated over the LA body. Universal atrial coordinates and a human atrial fibre atlas enabled the regional strain calculation and the fibre strain calculation along the local myofibre orientation, respectively.ResultsIt was found that global reservoir strains were significantly reduced in the HFrEF + AF group patients compared with the HFrEF-only group patients (area strain: 11.2 ± 4.8% vs. 25.3 ± 12.6%, P = 0.001; fibre strain: 4.5 ± 2.0% vs. 15.2 ± 8.8%, P = 0.001), with HFrEF + AF patients having a greater regional reservoir strain dyssynchrony. All regional reservoir strains were reduced in the HFrEF + AF patient group, in whom the inferior wall strains exhibited the most significant differences. The global reservoir fibre strain and LA volume + posterior wall reservoir fibre strain exceeded LA volume alone and 2D global longitudinal strain (GLS) for AF classification (area-under-the-curve: global reservoir fibre strain: 0.94 ± 0.02, LA volume + posterior wall reservoir fibre strain: 0.95 ± 0.02, LA volume: 0.89 ± 0.03, 2D GLS: 0.90 ± 0.03).ConclusionRGCT enables 3D LA motion estimation and strain calculation that outperforms 2D strain metrics and LA enlargement for AF classification. Differences in regional LA strain could reflect regional myocardial properties such as atrial fibrosis burden.

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Quantitative assessment of atrial regional function using motion estimation computed tomography.

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Quantitative assessment of atrial regional function using motion estimation computed tomography.

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