An automatic method for quantification of myocardium at risk from myocardial perfusion SPECT in patients with acute coronary occlusion.
BACKGROUND
In order to determine myocardial salvage, accurate quantification of myocardium at risk (MaR) is necessary. We present a validated novel automatic segmentation algorithm for quantification of MaR by myocardial perfusion SPECT (MPS) in patients with acute coronary occlusion.


RESULTS
Twenty-nine patients with coronary occlusion were injected with a perfusion tracer before reperfusion, and underwent rest MPS within 4 hours. The MaR was quantified using the proposed algorithm (Segment software), the software Quantitative Perfusion SPECT (QPS) and by manual segmentation. The Segment MaR algorithm used a threshold of 55% of maximal counts and an a priori model based on normal coronary artery perfusion territories. The MaR was 30 ± 10% left ventricular mass (%LVM) by manual segmentation, 31 ± 12%LVM by Segment, and 36 ± 14%LVM by QPS. There was a good agreement between automatic and manual segmentation for both of the algorithms with a lower bias for Segment (.8 ± 4.0%LVM) than for QPS (5.8 ± 5.8%LVM) when compared to manual segmentation.


CONCLUSIONS
The Segment MaR algorithm can be used to correctly assess MaR from MPS images in patients with acute coronary occlusion without access to tracer-specific normal database. The MaR in relation to final infarct size enables determination of myocardial salvage.
Soneson
Helen
H
Department of Clinical Physiology, Skåne University Hospital, Lund University, 221 85 Lund, Sweden.
Engblom
Henrik
H
Hedström
Erik
E
Bouvier
Frederic
F
Sörensson
Peder
P
Pernow
John
J
Arheden
Håkan
H
Heiberg
Einar
E
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D018570:Risk Assessment; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*