Tetsuya Matsuda

Assessment of regional and global left ventricular function by reinjection Tl-201 and rest Tc-99m sestamibi ECG-gated SPECT: Comparison with three-dimensional magnetic resonance imaging

OBJECTIVESnThe purpose of this study was to test the ability of reinjection thallium-201 and rest technetium-99m sestamibi ECG (electrocardiographic)-gated SPECT (i.e., reinjection-g-SPECT [single-photon emission computed tomography] and MIBI-g-SPECT) to determine regional and global functional parameters.nnnBACKGROUNDnThe ECG-gated perfusion SPECT was reported to provide accurate left ventricular ejection fraction (LVEF) using an automated algorithm. We hypothesized that other various functional data may be obtained using reinjection-g-SPECT and MIBI-g-SPECT.nnnMETHODSnReinjection-g-SPECT, MIBI-g-SPECT, and three-dimensional magnetic resonance imaging (3DMRI) were conducted in 20 patients with coronary artery disease. Regional wall motion (RWM) and wall thickening (RWT) were analyzed using semiquantitative visual scoring by each g-SPECT and 3DMRI. The left ventricular end-systolic and end-diastolic volumes (EDV, ESV) and LVEF estimated by reinjection- and MIBI-g-SPECT were compared with the results of 3DMRI.nnnRESULTSnA high degree of agreement in RWM and RWT assessment was observed between each g-SPECT and 3DMRI (kappa >.70, p < .001). The LVEF values by reinjection- and MIBI-g-SPECT correlated and agreed well with those by 3DMRI (reinjection: r = .92, SEE = 5.9%, SD of differences = 5.7%; sestamibi: r = .94, SEE = 4.4%, SD of differences = 5.1%). The same also pertained to EDV (reinjection: r = .85, SEE = 18.7 ml, SD of differences = 18.4 ml; sestamibi: r = .92, SEE = 13.1 ml, SD of differences = 13.0 ml) and ESV (reinjection: r = .94, SEE = 10.3 ml, SD of differences = 10.3 ml; sestamibi: r = .97, SEE = 6.7 ml [p < .05 vs. reinjection by F test], SD of differences = 6.6 ml [p < .05 vs. reinjection by F test]).nnnCONCLUSIONSnReinjection- and MIBI-g-SPECT provide clinically satisfactory various functional data. These functional data in combination with the perfusion information will improve diagnostic and prognostic accuracy without an increase in cost or the radiation dose to the patients.

Use of technetium-99m sestamibi ECG-gated single-photon emission tomography for the evaluation of left ventricular function following coronary artery bypass graft : comparison with three-dimensional magnetic resonance imaging

Abstract. In patients who had undergone cardiac surgery (coronary artery bypass graft) and whose hearts showed abnormal movement during the cardiac cycle, we studied the accuracy of functional assessment using ECG-gated single-photon emission tomography (SPET) and the automated software developed by Germano et al. by comparing the findings with magnetic resonance (MR) images acquired three-dimensionally. Sixteen patients who had undergone cardiac surgery underwent 99mTc-sestamibi gated SPET (MIBI-g-SPET) and MRI on the same day. Left ventricular end-diastolic and end-systolic volumes (EDV, ESV) and ejection fraction (LVEF) were measured using MIBI-g-SPET and the aforementioned algorithm. Regional wall thickening was assessed using a four-point scale on MIBI-g-SPET and cine MRI. There was a good correlation between MIBI-g-SPET and MRI in respect of EDV (r=0.89), ESV (r=0.93) and LVEF (r=0.89). A high degree of agreement was found between the wall thickening scores obtained by MIBI-g-SPET and MRI in total segments (κ=0.62) and in septal segments (κ=0.67). It is concluded that ECG-gated perfusion SPET can provide regional and global functional information, including absolute volumes, in patients following cardiac surgery.

Absolute quantitation of regional myocardial blood flow of rats using dynamic pinhole SPECT

PET and SPECT have been widely used to investigate the physiological function of animals in vivo. However, little efforts have been done to estimate absolute physiological parameters, i.e. blood flow of small animals. The present study was aimed at the absolute quantitation of myocardial blood flow of rats by means of the dynamic SPECT fitted with a pinhole collimator with a careful determination of the arterial input function (IF). The center-of-rotation was carefully aligned to the center of the field-of-view of a fixed gamma camera with the accuracy < 0.05 mm. A rat was placed on a rotating device that fixes the rat in a stand position. The arterial blood samples were frequently collected and their radioactivity concentration was measured using a well counter cross-calibrated to the SPECT images. Dynamic SPECT (the step-and-shoot mode) was initiated at 5 min after the injection of 201TlCl into the tail vein. Acquisition period was 10 sec at each rotation angle, and 120 view projection data were obtained. The 360-degree complete data sets were obtained at approximately 20 min interval for 5 time frames. Images were reconstructed by filtered-back projection technique with Feldkamp algorithm. The cross-calibration factor was determined using a cylindrical phantom of 5 cm diameter filled with the 201TlCl solution. Regions-of-interest were placed on the left ventricular wall to generate the tissue time activity curve (TTAC). TTAC and IF were fitted to the previously validated single-tissue compartment model to estimate the regional myocardial blood flow (rMBF) and volume of distribution (Vd) of thallium. The present system provided clear images of myocardial uptake of 201TlCl, and the time-dependent change of the tissue radioactivity concentration in regional basis, which was statistically sufficient for applying the compartment model analysis. The kinetic analysis yielded the rMBF of approximately 0.77 ml/min/g, which appeared to be an acceptable value with a consideration of contribution of partial volume effect and other error sources. Vd of approximately 91.9 ml/ml was also consistent with the know value of the potassium potential across the cell membrane. These results strongly suggested the potential of the dynamic pinhole SPECT as a tool for absolute quantitation of physiological parameters in small animals.

Visualization of human prenatal development by magnetic resonance imaging (MRI).

It is essential to visualize the structures of embryos and their internal organs three‐dimensionally to analyze morphogenesis; this used to rely solely on serial histological sectioning and solid reconstruction, which were tedious and time‐consuming. We have applied imaging with a magnetic resonance (MR) microscope equipped with a 2.35 T superconducting magnet to visualize human embryos; we were successful in acquiring high‐resolution sectional images and in identifying the detailed structures of major organs. The imaging process was facilitated by using a super‐parallel MR microscope. A dataset of MR images of more than 1,000 human embryos, now collected, will be important for future biomedical research and for education.

Measurement of in vivo local shear modulus using MR elastography multiple-phase patchwork offsets

Magnetic resonance elastography (MRE) is a method that can visualize the propagating and standing shear waves in an object being measured. The quantitative value of a shear modulus can be calculated by estimating the local shear wavelength. Low-frequency mechanical motion must be used for soft, tissue-like objects because a propagating shear wave rapidly attenuates at a higher frequency. Moreover, a propagating shear wave is distorted by reflections from the boundaries of objects. However, the distortions are minimal around the wave front of the propagating shear wave. Therefore, we can avoid the effect of reflection on a region of interest (ROI) by adjusting the duration of mechanical vibrations. Thus, the ROI is often shorter than the propagating shear wavelength. In the MRE sequence, a motion-sensitizing gradient (MSG) is synchronized with mechanical cyclic motion. MRE images with multiple initial phase offsets can be generated with increasing delays between the MSG and mechanical vibrations. This paper proposes a method for measuring the local shear wavelength using MRE multiple initial phase patchwork offsets that can be used when the size of the object being measured is shorter than the local wavelength. To confirm the reliability of the proposed method, computer simulations, a simulated tissue study and in vitro and in vivo studies were performed.

Keyhole method for high-speed human cardiac cine MR imaging.

Although electrocardiographic (ECG)‐gated magnetic resonance (MR) imaging is widely used for cardiac imaging, it has several disadvantages, such as long imaging time, respiratory artifacts, and motion artifacts induced by arrhythmia. An MR image can be acquired within about 0.3 seconds by using a fast gradient‐echo imaging method. When this method is continuously applied, only two to three images can be obtained during a single cardiac cycle. The goal of this study is to obtain cine MR images in a single cardiac cycle using fast gradient‐echo imaging combined with the “keyhole” method. The optimal conditions for the keyhole method for cardiac cine imaging were obtained by computer simulation based on a simplified cardiac model. When the read‐out direction was set parallel to the cardiac short axis, left ventricular motion was almost correctly reproduced by the keyhole method with acquisition time reduced to one‐fourth. J. Magn. Reson. Imaging 1999;10:778–783.

Magnetic resonance elastography: in vivo measurements of elasticity for human tissue

Elasticity is an important physical property of material. In the clinical practice, elasticity is used for physical examination in several ways, such as palpation or percussion. Differences in elasticity can help facilitate the diagnosis of tumors and their extent. Elasticity is an essential property in the diagnosis of liver cirrhosis, or soft degeneration in tissue necrosis. In addition, information of tissue elasticity is utilized in virtual reality systems such as telepalpation and computer assisted surgery. It was difficult to obtain such properties in vivo by using conventional measurement methods. To overcome this problem, magnetic resonance elastography (MRE) has been developed that provides noninvasive in vivo measurements of elasticity for human tissue. We summarize this MRE method in this paper. When an object is oscillated from the surface in a known frequency, acoustic strain waves propagate into the material and one can calculate the physical constants of a material elasticity by the wave velocity. In MRE measurements, a cyclic micromotion caused by the acoustic strain waves is obtained as an MR image that is synchronized to the oscillation. By measuring the local wavelength of the strain waves, we can obtain the elasticity constants. Several examples of MRE image including in vivo measurements are provided as well as several methods to estimate the local wavelength from MRE images are described.

System design and development of a pinhole SPECT system for quantitative functional imaging of small animals

Recently, small animal imaging by pinhole SPECT has been widely investigated by several researchers. We developed a pinhole SPECT system specially designed for small animal imaging. The system consists of a rotation unit for a small animal and a SPECT camera attached with a pinhole collimator. In order to acquire complete data of the projections, the system has two orbits with angles of 90° and 45° with respect to the object. In this system, the position of the SPECT camera is kept fixed, and the animal is rotated in order to avoid misalignment of the center of rotation (COR). We implemented a three dimensional OSEM algorithm for the reconstruction of data acquired by the system from both the orbitals. A point source experiment revealed no significant COR misalignment using the proposed system. Experiments with a line phantom clearly indicated that our system succeeded in minimizing the misalignment of the COR. We performed a study with a rat and99mTc-HMDP, an agent for bone scan, and demonstrated a dramatic improvement in the spatial resolution and uniformity achieved by our system in comparison with the conventional Feldkamp algorithm with one set of orbital data.

Haptic reproduction and interactive visualization of a beating heart for cardiovascular surgery simulation

This paper aims to achieve haptic reproduction and real-time visualization of a beating heart for cardiac surgery simulation. Unlike most forgoing approaches, the authors focus on time series datasets and propose a new framework for interactive simulation of active tissues. The framework handles both detection and response of collisions between a manipulator and a beating virtual heart. Physics-based force feedback of autonomous cardiac motion is also produced based on a stress-pressure model, which is adapted to elastic objects filled with fluid. Time series datasets of an adult man were applied to an integrated simulation system with a force feedback device. The system displays multi-dimensional representation of a beating heart and provides a basic training environment for surgical palpation. Finally, results of measurement and medical assessment confirm the achieved quality and performance of the presented framework.

Combining Volumetric Soft Tissue Cuts for Interventional Surgery Simulation

This paper proposes a framework to simulate soft tissue cuts for interventional surgery simulation. A strained status of soft tissues is modeled as internal tension between adjacent vertices in a particle based model. Both remodeling particle systems and an adaptive scheme in tetrahedral subdivision provide volumetric and smooth cuts on large virtual objects. 3D MRI datasets are applied to a developed system with a force feedback device. Measurement of the calculation time and visualization of simulation quality confirms that the framework contributes to surgical planning and training with tissue cutting.