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Title: A framework to measure myocardial extracellular volume fraction using dual-phase low dose CT images

Purpose: Myocardial extracellular volume fraction (ECVF) is a surrogate imaging biomarker of diffuse myocardial fibrosis, a hallmark of pathologic ventricular remodeling. Low dose cardiac CT is emerging as a promising modality to detect diffuse interstitial myocardial fibrosis due to its fast acquisition and low radiation; however, the insufficient contrast in the low dose CT images poses great challenge to measure ECVF from the image. Methods: To deal with this difficulty, the authors present a complete ECVF measurement framework including a point-guided myocardial modeling, a deformable model-based myocardium segmentation, nonrigid registration of pre- and post-CT, and ECVF calculation. Results: The proposed method was evaluated on 20 patients by two observers. Compared to the manually delineated reference segmentations, the accuracy of our segmentation in terms of true positive volume fraction (TPVF), false positive volume fraction (FPVF), and average surface distance (ASD), were 92.18% ± 3.52%, 0.31% ± 0.10%, 0.69 ± 0.14 mm, respectively. The interobserver variability measured by concordance correlation coefficient regarding TPVF, FPVF, and ASD were 0.95, 0.90, 0.94, respectively, demonstrating excellent agreement. Bland-Altman method showed 95% limits of agreement between ECVF at CT and ECVF at MR. Conclusions: The proposed framework demonstrates its efficiency, accuracy, and noninvasiveness in ECVF measurement and dramatically advances the ECVFmore » at cardiac CT toward its clinical use.« less
Authors:
; ;  [1] ; ; ;  [2] ;  [3]
  1. Clinical Image Processing Service, Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, Maryland 20892 (United States)
  2. Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, Maryland 20892-1182 and Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, NIH Clinical Center, Bethesda, Maryland 20892 (United States)
  3. Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, Maryland 20892-1182 (United States)
Publication Date:
OSTI Identifier:
22251870
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 40; Journal Issue: 10; Other Information: (c) 2013 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; BIOLOGICAL MARKERS; COMPUTERIZED TOMOGRAPHY; CORRELATIONS; FIBROSIS; IMAGE PROCESSING; IMAGES; MANUALS; MYOCARDIUM; PATIENTS; RADIATION DOSES