TH-CD-206-07: Determination of Patient-Specific Myocardial Mass at Risk Using Computed Tomography Angiography

2016 ◽  
Vol 43 (6Part46) ◽  
pp. 3884-3884
Author(s):  
L Hubbard ◽  
B Ziemer ◽  
S Malkasian ◽  
J Lipinski ◽  
B Sadeghi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
At Risk ◽  
Computed Tomography Angiography ◽  
Patient Specific ◽  
Myocardial Mass

Abstract 11726: Novel Non-Invasive Method to Estimate Myocardial Mass at Risk Calculated From Cardiac Computed Tomography Data: Validation Study Using Angiographic Myocardial Jeopardy Scores in Patients With Single Vessel Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Seiko IDE ◽  
Satoru Sumitsuji ◽  
Kensuke Yokoi ◽  
Masatoki Yoshida ◽  
Isamu Mizote ◽  
...  
Keyword(s):  
Computed Tomography ◽  
At Risk ◽  
Heart Disease ◽  
Coronary Artery ◽  
Cardiac Computed Tomography ◽  
Myocardial Mass ◽  
Non Invasive ◽  
Vessel Disease ◽  
Single Vessel ◽  
Single Vessel Disease

Background: The myocardial mass at risk (MMAR), representing volume of myocardium distal to culprit lesion, is one of important factors for predicting adverse cardiac event in ischemic heart disease. However, current non-invasive cardiac imaging fails to quantify MMAR in patients with stable coronary artery disease. We have developed a new software calculating MMAR of any designated coronary artery by reconstructing the 3-dimensional-volume-data of cardiac computed tomography (CCT). The novel index, ratio of MMAR to whole left ventricular volume (%LV-MMAR), calculated with this software would be appealing to obtain MMAR objectively. This study aims to compare the %LV-MMAR with Bypass Angioplasty Revascularization Investigation (BARI) and modified Albert Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) scores, both of which are invasive angiographic methods widely used to estimate MMAR, in patients with single-vessel disease. Methods: Between April 2008 and March 2014, patients suspected of effort angina pectoris without history of previous myocardial infarction were assessed with CCT and invasive coronary angiography. Of those, 48 patients who were revealed single-vessel disease (left anterior descending artery (LAD): n=22, left circumflex artery (LCX): n=11 and right coronary artery (RCA): n=15) were included in this study. %LV-MMAR was calculated on the software. BARI and modified APPROACH score were calculated and compared with %LV-MMAR. Results: Mean %LV-MMAR was 27.6 [18.2-37.1] %. BARI and APPROACH scores showed a significant correlation (r=0.92, p<0.0001). Also, a significant correlation was observed between %LV-MMAR versus BARI and %LV-MMAR versus APPROACH (r=0.95, p<0.0001 and r=0.9, p<0.0001, respectively). %LV-MMAR showed significant correlation with BARI and APPROACH scores in all vessels; LAD (r=0.95, p<0.0001 and r=0.91, p<0.0001, respectively), LCX (r=0.91, p=0.0001 and r=0.83, p=0.0002, respectively) and RCA (r=0.92, p<0.0001 and r=0.85, p<0.0001, respectively). Conclusions: This study revealed %LV-MMAR, calculated from CCT data on novel software, to be a promising index for estimating perfusion territory noninvasively in good agreement with BARI and modified APPROACH score.

scholarly journals The Functional Severity Assessment of Coronary Stenosis Using Coronary Computed Tomography Angiography-Based Myocardial Mass at Risk and Minimal Lumen Diameter

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Kenji Sadamatsu ◽  
Kazuhiro Nagaoka ◽  
Yasuaki Koga ◽  
Kotaro Kagiyama ◽  
Kohei Muramatsu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Computed Tomography Angiography ◽  
Predictive Value ◽  
Coronary Stenosis ◽  
Coronary Computed Tomography Angiography ◽  
Quantitative Coronary Angiography ◽  
Myocardial Mass ◽  
Coronary Computed Tomography ◽  
Minimal Lumen Diameter

Background. We investigated whether or not the addition of myocardial mass at risk (MMAR) to quantitative coronary angiography was useful for diagnosing functionally significant coronary stenosis in the daily practice. Methods. We retrospectively enrolled 111 consecutive patients with 149 lesions who underwent clinically indicated coronary computed tomography angiography and subsequent elective coronary angiography with fractional flow reserve (FFR) measurement. MMAR was calculated using a workstation-based software program with ordinary thin slice images acquired for the computed tomography, and the minimal lumen diameter (MLD) and the diameter stenosis were measured with quantitative coronary angiography. Results. The MLD and MMAR were significantly correlated with the FFR, and the MMAR-to-MLD ratio (MMAR/MLD) showed a good correlation. The area under the receiver operating characteristic curve (AUC) of MMAR/MLD for FFR ≤ 0.8 was 0.746, and the sensitivity, specificity, positive predictive value, and negative predictive value were 60%, 83%, 68%, and 77%, respectively, at a cut-off value of 29.5 ml/mm. The addition of MMAR/MLD to diameter stenosis thus made it possible to further discriminate lesions with FFR ≤ 0.8 (AUC = 0.750). For the proximal left coronary artery lesions, in particular, MMAR/MLD showed a better correlation with the FFR, and the AUC of MMAR/MLD for FFR ≤ 0.8 was 0.919 at a cut-off value of 31.7 ml/mm. Conclusions. The index of MMAR/MLD correlated well with the physiological severity of coronary stenosis and showed good accuracy for detecting functional significance. The MMAR/MLD might be a useful parameter to consider when deciding the indication for revascularization.

scholarly journals Machine Learning–Enabled Automated Determination of Acute Ischemic Core From Computed Tomography Angiography

Stroke ◽  
2019 ◽  
Vol 50 (11) ◽  
pp. 3093-3100 ◽  
Author(s):  
Sunil A. Sheth ◽  
Victor Lopez-Rivera ◽  
Arko Barman ◽  
James C. Grotta ◽  
Albert J. Yoo ◽  
...  
Keyword(s):  
Machine Learning ◽  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Ischemic Core ◽  
Automated Determination

Computed tomography angiography accuracy in brain death diagnosis

2020 ◽  
Vol 133 (4) ◽  
pp. 1220-1228
Author(s):  
Sergio Brasil ◽  
Edson Bor-Seng-Shu ◽  
Marcelo de-Lima-Oliveira ◽  
Fabio Silvio Taccone ◽  
Gabriel Gattás ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Brain Death ◽  
Computed Tomography Angiography ◽  
Circulatory Arrest ◽  
Cerebral Veins ◽  
Clinical Trial Registration ◽  
Bilateral Absence ◽  
Internal Cerebral Veins ◽  
Cerebral Circulatory Arrest

OBJECTIVEThe present study was designed to answer several concerns disclosed by systematic reviews indicating no evidence to support the use of computed tomography angiography (CTA) in the diagnosis of brain death (BD). Therefore, the aim of this study was to assess the effectiveness of CTA for the diagnosis of BD and to define the optimal tomographic criteria of intracranial circulatory arrest.METHODSA unicenter, prospective, observational case-control study was undertaken. Comatose patients (Glasgow Coma Scale score ≤ 5), even those presenting with the first signs of BD, were included. CTA scanning of arterial and venous vasculature and transcranial Doppler (TCD) were performed. A neurological determination of BD and consequently determination of case (BD group) or control (no-BD group) was conducted. All personnel involved with assessing patients were blinded to further tests results. Accuracy of BD diagnosis determined by using CTA was calculated based on the criteria of bilateral absence of visualization of the internal cerebral veins and the distal middle cerebral arteries, the 4-point score (4PS), and an exclusive criterion of absence of deep brain venous drainage as indicated by the absence of deep venous opacification on CTA, the venous score (VS), which considers only the internal cerebral veins bilaterally.RESULTSA total of 106 patients were enrolled in this study; 52 patients did not have BD, and none of these patients had circulatory arrest observed by CTA or TCD (100% specificity). Of the 54 patients with a clinical diagnosis of BD, 33 met the 4PS (61.1% sensitivity), whereas 47 met the VS (87% sensitivity). The accuracy of CTA was time related, with greater accuracy when scanning was performed less than 12 hours prior to the neurological assessment, reaching 95.5% sensitivity with the VS.CONCLUSIONSCTA can reliably support a diagnosis of BD. The criterion of the absence of deep venous opacification, which can be assessed by use of the VS criteria investigated in this study, can confirm the occurrence of cerebral circulatory arrest.Clinical trial registration no.: 12500913400000068 (clinicaltrials.gov)

Reproducibility and clinical potential of myocardial mass at risk calculated by a novel software utilizing cardiac computed tomography information

2015 ◽  
Vol 31 (3) ◽  
pp. 218-225 ◽  
Author(s):  
Satoru Sumitsuji ◽  
Seiko Ide ◽  
Patrick T. Siegrist ◽  
Youssef Salah ◽  
Kensuke Yokoi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
At Risk ◽  
Cardiac Computed Tomography ◽  
Myocardial Mass ◽  
Clinical Potential
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