The present disclosure generally relates to methods and systems for visualization, in particular, for visualization of myocardial perfusion measure and coronary artery.
Conventionally, Computed Tomography (CT) and, in particular, Coronary Computed Tomography Angiography (CCTA) have been used to assess coronary arteries in terms of their morphology and geometry and predict the associated future risk for Major Adverse Cardiovascular Events (MACE). Spectral CT acquisitions have potential to allow to determine local myocardial perfusion by directly measuring an iodine content in the myocardial tissue, which yields a functional assessment of heart muscle. There is a need for a method to allow for a comprehensive risk assessment.
The description provided in the background section should not be assumed to be prior art merely because it is mentioned in or associated with the background section. The background section may include information that describes one or more aspects of the subject technology.
One embodiment of the present disclosure may provide a method for visualization. The method may include: obtaining data of a first perfusion measure of myocardial tissues of a patient; obtaining data of a geometry of a coronary artery of the patient; obtaining data of a second perfusion measure of the coronary artery; obtaining data of a flow impediment measure along the coronary artery based on the data of the second perfusion measure of the coronary artery; and visualizing, on a single image, the first perfusion measure of the myocardial tissues and the coronary artery, the coronary artery being overlaid with the first perfusion measure on the single image, the visualized coronary artery representing the geometry of the coronary artery and the flow impediment measure along the coronary artery.
Another embodiment of the present disclosure may provide a visualization system. The visualization system may include: a memory that stores a plurality of instructions; and processor circuitry that couples to the memory. The processor circuitry may be configured to execute the instructions to: obtain data of a first perfusion measure of myocardial tissues of a patient; obtain data of a geometry of a coronary artery of the patient; obtain data of a second perfusion measure of the coronary artery; obtain data of a flow impediment measure along the coronary artery based on the data of the second perfusion measure of the coronary artery; and visualize, on a single image, the first perfusion measure of the myocardial tissues and the coronary artery, the coronary artery being overlaid with the first perfusion measure on the single image, the visualized coronary artery representing the geometry of the coronary artery and the flow impediment measure along the coronary artery.
Another embodiment of the present disclosure may provide a non-transitory computer-readable medium having one or more executable instructions stored thereon, which, when executed by processor circuitry, cause the processor circuitry to perform a method for visualization. The method may include: obtaining data of a first perfusion measure of myocardial tissues of a patient; obtaining data of a geometry of a coronary artery of the patient; obtaining data of a second perfusion measure of the coronary artery; obtaining data of a flow impediment measure along the coronary artery based on the data of the second perfusion measure of the coronary artery; and visualizing, on a single image, the first perfusion measure of the myocardial tissues and the coronary artery, the coronary artery being overlaid with the first perfusion measure on the single image, the visualized coronary artery representing the geometry of the coronary artery and the flow impediment measure along the coronary artery.
The description of illustrative embodiments according to principles of the present disclosure is intended to be read in connection with the accompanying drawings, which are to be considered part of the entire written description. In the description of embodiments of the disclosure disclosed herein, any reference to direction or orientation is merely intended for convenience of description and is not intended in any way to limit the scope of the present disclosure. Relative terms such as “lower,” “upper,” “horizontal,” “vertical,” “above,” “below,” “up,” “down,” “top” and “bottom” as well as derivative thereof (e.g., “horizontally,” “downwardly,” “upwardly,” etc.) should be construed to refer to the orientation as then described or as shown in the drawing under discussion. These relative terms are for convenience of description only and do not require that the apparatus be constructed or operated in a particular orientation unless explicitly indicated as such. Terms such as “attached,” “affixed,” “connected,” “coupled,” “interconnected,” and similar refer to a relationship wherein structures are secured or attached to one another either directly or indirectly through intervening structures, as well as both movable or rigid attachments or relationships, unless expressly described otherwise. Moreover, the features and benefits of the disclosure are illustrated by reference to the exemplified embodiments. Accordingly, the disclosure expressly should not be limited to such exemplary embodiments illustrating some possible non-limiting combination of features that may exist alone or in other combinations of features; the scope of the disclosure being defined by the claims appended hereto.
This disclosure describes the best mode or modes of practicing the disclosure as presently contemplated. This description is not intended to be understood in a limiting sense, but provides an example of the disclosure presented solely for illustrative purposes by reference to the accompanying drawings to advise one of ordinary skill in the art of the advantages and construction of the disclosure. In the various views of the drawings, like reference characters designate like or similar parts.
It is important to note that the embodiments disclosed are only examples of the many advantageous uses of the innovative teachings herein. In general, statements made in the specification of the present application do not necessarily limit any of the various claimed disclosures. Moreover, some statements may apply to some inventive features but not to others. In general, unless otherwise indicated, singular elements may be in plural and vice versa with no loss of generality.
The present disclosure may visualize, on a single image, a perfusion measure of myocardial tissues and a coronary artery, where the coronary artery is overlaid with the perfusion measure on the single image, and the visualized coronary artery may represent a geometry of the coronary artery and a flow impediment measure along the coronary artery. The perfusion measure of the myocardial tissues allows for quantifying local blood and oxygen supply, as well as perfusion defects of the myocardium. The geometry of the coronary artery may relate the observed perfusion and the blood supply as well, and may be used to compute a common coordinate system. The flow impediment measure along the coronary artery may then be used to quantify a local effect of the coronary geometry on an actual blood flow. In one example, these three items (i.e., the perfusion measure of myocardial tissues, the geometry of the coronary artery, and the flow impediment measure along the coronary artery) may be computed from a single spectral CCTA scan and mapped into a variation on a common bull's eye visualization, allowing a user to judge the relative contribution of each of the complementary aspects in a unified graphical figure.
In some embodiments of the present disclosure, because the three items (i.e., the perfusion measure of myocardial tissues, the geometry of the coronary artery, and the flow impediment measure along the coronary artery) may be aggregated into a common representation suitable for visualization and predictive analytics, a comprehensive risk assessment may be achieved more efficiently. In addition, in some embodiments of the present disclosure, the representation may be easily mappable to a plane for quick visual inspection, reporting and documentation purposes. In some embodiments of the present disclosure, the representation may be synchronized with standard reporting schemes and population models in order to allow for transferrable statements.
The imaging device 100A may obtain image data 311 of a patient. In some embodiments, the imaging device 100A may include a CT imaging device, and the image data 311 may include CT angiography data of the patient. The CT imaging device may obtain spectral computed tomography volumetric image data organized in voxels, e.g., spectral CCTA data, by way of a spectral acquisition and a tomographic reconstruction.
The volumetric image data may include a contrast-enhanced volumetric image of a cardiac region in the patient's body and a baseline volumetric image of the cardiac region, where the contrast-enhanced volumetric image may convey anatomical information regarding coronary artery anatomy of the patient. In the method, an iodine contrast agent may be used.
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With reference to
The block 133 may obtain data 323 of a first perfusion measure 711 of the myocardial tissues 823 of the patient. The obtaining of the data 323 of the first perfusion measure 711 of the myocardial tissues 823 may be based on the segmented data 321 of the myocardium wall 820. The data 323 of the first perfusion measure 711 may be contained, for example, in a three dimensional volumetric image.
In the example shown in
With reference to
The block 143 may obtain data 333 of a geometry 713 of the coronary arteries 830 based on the segmented data 331 of the coronary arteries 830. For example, the geometry 333 of the coronary arteries 830 may be represented in terms of the centerlines of the coronary arteries 830 and the lumina of the coronary arteries 830.
An image used to obtain the data 333 of the geometry 713 of the coronary arteries 830 may be the same as, or may be different from, an image used to obtain the data 323 of the first perfusion measure 711 of the myocardial tissues 823. Instead of using the CCTA scan, the data 333 of the geometry 713 of the coronary arteries 830 may be obtained by using a different angiographic modality to extract coronary arteries or complement and refine the coronary arteries.
With reference to
The block 147 may obtain data 343 of the flow impediment measure 717 along the coronary arteries 830 based on the data 341 of the second perfusion measure 715 of the coronary arteries 830. In some embodiments, the obtaining of the data 323 of the first perfusion measure 711, the obtaining of the data 333 of the geometry 713 of the coronary arteries 830, and the obtaining of the data 343 of the flow impediment measure 717 along the coronary arteries 830 may be based on the same coronary computed tomography angiography data.
With reference to
In some embodiments, instead of processing the cumulative loss in a cross-sectional area, data of a flow impediment measure may be obtained by using other measures such as cumulative loss in radius/diameter, pressure drop (fractional flow reserve (FFR)), volumetric blood flow, blood flow velocity, etc. Instead of the linear tapering model used to compute the cumulative loss in a cross-sectional area, a more advanced vessel tapering model can be used. Additional information, such as population statistics, prior images of the same patient, etc. may be used to obtain data of a flow impediment measure.
With reference to
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The reference shape 20 includes the long axis 21 of the left ventricle, the inner reference surface 22 (e.g., the inner wall or endocardium) and the outer reference surface 23 (e.g., the outer wall or epicardium).
With reference to
The direction extending along the inter-surface distance of the reference shape 20 is maintained in the target shape 201, so that wall thickness along the direction indicated by reference numeral 27 of the reference shape is mapped into the direction of the depth dimension of the cylinder, as indicated by reference numeral 28.
As a result, the left ventricle may be mapped onto the target shape 201 in the form of a cylinder and where the dimension along the cylinder axis represents the thickness of the myocardial wall. The inner reference surface 22 (e.g., the inner wall or endocardium) thus may be projected onto the bottom of the cylinder, i.e. the first surface 29, whereas the and the outer reference surface 23 (e.g., the outer wall or epicardium) may be projected onto the top of the cylinder, i.e., the second surface 200. The tissue between the endocardium and the epicardium is projected onto the planes extending from the bottom to the top of the cylinder.
With reference to
In particular, the complementary imaging features (i.e., the perfusion measure 711 and the coronary arteries 830) may be visualized in the same coordinate system where the intensity in the plane may be an aggregated value of the first perfusion measure 711 throughout the myocardial wall 820. The aggregation can be done by averaging, for example. The width of the coronary arteries 830 may correspond to the effective local cross-sectional area such as to allow for visual stenosis assessment. In some examples, the color of the coronary arteries 830 may encode the flow impediment measure 717.
In some embodiments, the visualization can naturally be enriched by using functional information measured e.g. by invasive FFR, optical coherence tomography (OCT), intravascular ultrasound (IVUS), or X-ray angiography. In some embodiments, the visualization can be augmented by a pixel-to-outlet probability map, where the estimated connection between a vessel and the perfused territory can be seen. In other embodiments, in the single image, stenoses can be particularly highlighted to focus the attention.
In the present disclosure, because the single image 700 may show the first perfusion measure 711 of the myocardial tissues 823, the geometry 713 of the coronary arteries 830, and the flow impediment measure 717 of the coronary arteries 830, the relative contribution of each of the complementary aspects may be judged by the user in a unified graphical figure.
In an exemplary method according to one embodiment, in 701 of
In 713, the image data 311 of the patient may be segmented in accordance with the segment model of the coronary arteries 830 to provide the segmented data 331 of the coronary arteries 830. In 715, the data 333 of the geometry 713 of the coronary arteries 830 of the patient may be obtained based on the segmented data 331 of the coronary arteries 830. In 717, the data 341 of the second perfusion measure 715 of the coronary arteries 830 may be obtained based on the segmented data 331 of the coronary arteries 830. In 719, the data 343 of the flow impediment measure 717 along the coronary arteries 830 may be obtained based on the data 341 of the second perfusion measure 715 of the coronary arteries 830.
In some embodiments, the processes shown by 713, 715, 717, and 719 may be conducted prior to or in parallel with the processes shown by 703 and 705.
In 721, the data 323 of the first perfusion measure 711 of the myocardial tissues 823, the data 333 of the geometry 713 of the coronary arteries 830, and the data the of the flow impediment measure 717 along the coronary arteries 830 may be reformatted to fit the reference shape 20. In 723, the reformatted data 325 of the myocardial tissues 823, the reformatted data 335 of the geometry 713 of the coronary arteries 830, and the reformatted data 345 of the flow impediment measure 717 along the coronary arteries 830 may be mapped to the target shape 201. Then, in 725, based on the mapping, the first perfusion measure 711 of the myocardial tissues 823 and the coronary arteries 830 may be visualized on the single image 700. On the single image 700, the coronary arteries 830 may be overlaid with the first perfusion measure 71.
The methods according to the present disclosure may be implemented on a computer as a computer implemented method, or in dedicated hardware, or in a combination of both. Executable code for a method according to the present disclosure may be stored on a computer program product. Examples of computer program products include memory devices, optical storage devices, integrated circuits, servers, online software, etc. Preferably, the computer program product may include non-transitory program code stored on a computer readable medium for performing a method according to the present disclosure when said program product is executed on a computer. In an embodiment, the computer program may include computer program code adapted to perform all the steps of a method according to the present disclosure when the computer program is run on a computer. The computer program may be embodied on a computer readable medium.
While the present disclosure has been described at some length and with some particularity with respect to the several described embodiments, it is not intended that it should be limited to any such particulars or embodiments or any particular embodiment, but it is to be construed with references to the appended claims so as to provide the broadest possible interpretation of such claims in view of the prior art and, therefore, to effectively encompass the intended scope of the disclosure.
All examples and conditional language recited herein are intended for pedagogical purposes to aid the reader in understanding the principles of the disclosure and the concepts contributed by the inventor to furthering the art, and are to be construed as being without limitation to such specifically recited examples and conditions. Moreover, all statements herein reciting principles, aspects, and embodiments of the disclosure, as well as specific examples thereof, are intended to encompass both structural and functional equivalents thereof. Additionally, it is intended that such equivalents include both currently known equivalents as well as equivalents developed in the future, i.e., any elements developed that perform the same function, regardless of structure.
Filing Document | Filing Date | Country | Kind |
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PCT/EP2021/082456 | 11/22/2021 | WO |
Number | Date | Country | |
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63119308 | Nov 2020 | US |