Novel indices representing heterogeneous distributions of myocardial perfusion imaging

IF 2.5 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Misato Chimura, Tomohito Ohtani, Fusako Sera, Rie Higuchi, Kenji Kajitani, Kenichi Nakajima, Yasushi Sakata
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引用次数: 0

Abstract

Introduction

Heterogeneous distribution in myocardial perfusion images (MPI) obtained by scintigraphy is often observed in cardiac diseases with normal myocardial perfusion. However, quantitative assessments of such heterogeneity have not been established. We hypothesized that the heterogeneity in MPI can be quantitatively evaluated through histogram analysis, calculating the standard deviation (SD), the 95% bandwidth (BW95%), and entropy.

Methods

We examined resting 99mTc-MIBI images in 20 healthy subjects and 29 patients with cardiac disease who had none or very-mild reduced myocardial perfusion evaluated as a low summed rest score (0 to 4, the range of the studied healthy subjects). Two nuclear medicine specialists blindly divided them into two groups: non-heterogeneity or heterogeneity group, based solely on their visual assessments of heterogeneity on splash and polar maps generated from single-photon emission computed tomography (SPECT) images. The %uptake was determined by dividing the tracer count of each pixel by the tracer count of the pixel with the highest value in the LV myocardium. SD, BW95%, and entropy from histogram patterns were analyzed from the polar map data array of each %uptake. We investigated whether heterogeneity could be assessed using SD, BW95, and entropy in two groups classified by visual assessments. Additionally, we evaluated the area under the curve (AUC) to identify heterogeneity in the receiver operating characteristic curve analysis.

Results

Based solely on visual assessments, 11 (22%) and 38 (78%) cases were classified into the non-heterogeneity and heterogeneity groups, respectively. The non-heterogeneity group consisted of only healthy subjects, and all patients with cardiac disease were classified into the heterogeneity group. The cases in the heterogeneity group had significantly higher values of heterogeneity indices (SD, BW95%, and entropy) in %uptake than those in the non-heterogeneity group (p < 0.05 for all). The AUCs of the heterogeneity indices were sufficiently high (AUCs > 0.90 for all) in distinguishing cases with visually heterogeneous distribution or patients with cardiac disease.

Conclusions

Heterogeneity in MPI can be evaluated using SD, BW95%, and entropy through histogram analysis. These novel indices may help identify patients with subtle myocardial changes, even in images that show preserved perfusion (345/350).

Abstract Image

代表心肌灌注成像异质性分布的新指数
导言:在心肌灌注正常的心脏病患者中,通过闪烁成像获得的心肌灌注图像(MPI)中经常会观察到异质性分布。然而,对这种异质性的定量评估尚未建立。我们假设 MPI 中的异质性可通过直方图分析进行定量评估,计算标准偏差(SD)、95% 带宽(BW95%)和熵。方法 我们检查了 20 名健康受试者和 29 名心脏病患者的静息 99mTc-MIBI 图像,这些患者的心肌灌注无减少或极轻微减少,静息总分较低(0 至 4,为所研究健康受试者的范围)。两名核医学专家仅根据他们在单光子发射计算机断层扫描(SPECT)图像生成的飞溅图和极坐标图上对异质性的目测评估,将他们盲分为两组:非异质性组和异质性组。摄取%的确定方法是将每个像素的示踪剂计数除以左心室心肌中值最高的像素的示踪剂计数。我们从每个摄取率的极坐标图数据阵列中分析了SD、BW95%和直方图模式的熵。我们研究了是否可以使用 SD、BW95 和熵来评估通过视觉评估划分的两组的异质性。此外,我们还评估了曲线下面积(AUC),以确定接收者操作特征曲线分析中的异质性。结果仅根据视觉评估,11 例(22%)和 38 例(78%)病例分别被分为非异质性组和异质性组。非异质性组仅包括健康受试者,所有心脏病患者均被归入异质性组。异质性组病例摄入百分比的异质性指数(SD、BW95% 和熵)值明显高于非异质性组病例(均为 p <0.05)。异质性指数的 AUC 值很高(所有指数的 AUC 值均为 0.90),足以区分视觉异质性分布的病例或心脏病患者。这些新指标可帮助鉴别有细微心肌变化的患者,即使是在显示灌注保留的图像中(345/350)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Nuclear Medicine
Annals of Nuclear Medicine 医学-核医学
CiteScore
4.90
自引率
7.70%
发文量
111
审稿时长
4-8 weeks
期刊介绍: Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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