4.7 Article

Quantification of the myocardial area at risk using coronary CT angiography and Voronoi algorithm-based myocardial segmentation

Journal

EUROPEAN RADIOLOGY
Volume 25, Issue 1, Pages 49-57

Publisher

SPRINGER
DOI: 10.1007/s00330-014-3388-2

Keywords

Area at risk; Coronary artery disease; CT angiography; Computed tomography; Myocardial ischemia

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Objectives The purpose of this study was to estimate the myocardial area at risk (MAAR) using coronary computed tomography angiography (CTA) and Voronoi algorithm-based myocardial segmentation in comparison with single-photon emission computed tomography (SPECT). Methods Thirty-four patients with coronary artery disease underwent 128-slice coronary CTA, stress/rest thallium-201 SPECT, and coronary angiography (CAG). CTA-based MAAR was defined as the sum of all CAG stenosis (>50 %) related territories (the ratio of the left ventricular volume). Using automated quantification software (17-segment model, 5-point scale), SPECT-based MAAR was defined as the number of segments with a score above zero as compared to the total 17 segments by summed stress score (SSS), difference (SDS) score map, and comprehensive SPECT interpretation with either SSS or SDS best correlating CAG findings (SSS/SDS). Results were compared using Pearson's correlation coefficient. Results Forty-nine stenoses were observed in 102 major coronary territories. Mean value of CTA-based MAAR was 28.3 +/- 14.0 %. SSS-based, SDS-based, and SSS/SDS-based MAAR was 30.1 +/- 6.1 %, 20.1 +/- 15.8 %, and 26.8 +/- 15.7 %, respectively. CTA-based MAAR was significantly related to SPECT-based MAAR (r=0.531 for SSS; r=0.494 for SDS; r=0.814 for SSS/SDS; P<0.05 in each). Conclusions CTA-based Voronoi algorithm myocardial segmentation reliably quantifies SPECT-based MAAR.

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