Image Fusion of Coronary CT Angiography and Cardiac Perfusion MRI: A Pilot Study
OBJECTIVES: To develop a tool for the image fusion of computed tomography coronary angiography (CTCA) and cardiac magnetic resonance imaging (CMR).
METHODS: Surface representations and volume-rendered images from fused CTCA/CMR data of five patients with significant coronary artery disease (CAD) on CTCA and perfusion deficits on CMR were generated using a newly developed software prototype. The spatial relationship of significant coronary artery stenosis at CTCA and myocardial defects at CMR was evaluated.
RESULTS: Registration of CTCA and CMR images was possible in all patients. The comprehensive three-dimensional visualisation of fused CTCA and CMR data accurately demonstrated the relationship between coronary artery stenoses and myocardial defects in all patients.
CONCLUSIONS: The introduced tool enables image fusion of CTCA and CMR data sets and allows for correct superposition of the coronary arteries derived from CTCA onto the corresponding myocardial segments derived from CMR. The method facilitates the comprehensive assessment of the functionally relevant CAD by the exact allocation of culprit coronary stenoses to corresponding myocardial defects at a low radiation dose.
PMID: 20204639
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Phillip M. Young, MD on March 17th, 2010
As the various modalities employed for cardiac imaging – echocardiography, nuclear imaging, CT, and MR – develop and are used in complex patients, software which facilitates correlation of the modalities or co-registration of data in order to interpret findings may play an important role in diagnostic interpretation. This is an interesting development in the area.
Paul Schoenhagen, MD on March 18th, 2010
See also:
Combined non-invasive anatomical and functional assessment with MSCT and MRI for the detection of significant coronary artery disease in patients with an intermediate pre-test likelihood.
Jacob M van Werkhoven, Mark W Heijenbrok, Joanne D Schuijf, J Wouter Jukema, Ernst E van der Wall, Joop H M Schreur, Jeroen J Bax.
Heart 2010;96 425-431.
PMID: 19858134
Jacobo Kirsch, MD on March 22nd, 2010
Although this pilot study was performed in a very small number of subjects, it is important to keep pushing the limits of imaging. Intuitively, fusion of perfusion MRI images and anatomical CTA may be more relevant clinically than the fusion of LGE and CTA images. Further studies will tell.