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Title: The Use of a Computerized Coronary Artery Segmentation-Perfusion Territories Model for Assessing Differential Regional Myocardial Perfusion in Tc-99m Tetrofosmin Stress and Rest Heart Studies to Enhance Detection of Ischemia
Authors: Ibrahim B. I. Alrekhais 
Supervisor: Dr. Issa Loutfi
Keywords: Coronary Artery
Issue Date: 2018
Publisher:  Kuwait university - college of graduate studies
Abstract: Myocardial perfusion imaging (MPI) studies have been used for diagnosis of ischemic heart disease (IHD). Interpretation is usually by visual inspection for myocardial perfusion defects for diagnosis of ischemia or scar. Also, diversion of the radiotracer from a blocked vessel to adjacent territories supplied by patent coronary artery branches may occur, which would create areas containing more radioactivity than would be normally present when no such diversion exist. The study objective was to evaluate differential regional myocardial perfusion (DRMP) as a novel parameter for its usefulness in aiding detection of flow diversion and hence myocardial ischemia. The study was retrospective of 50 patients who had MPI studies for evaluation of IHD. Standard processing protocols were used for generating images of the myocardial perfusion. In addition, special processing for the DRMP in various coronary artery territories was done using a coronary vascular model and the Corridor 4DM software for uptake in the left anterior descending (LAD), left circumflex (LCX) and right coronary (RCA) territories and in their sub-territories (two for each the LAD, LCX & RCA). The results of the visual analysis showed a high proportion of abnormal studies (48%). The average values of the DRMP from 4 region pairs ranged from 3-7% for the stress & rest studies. A DRMP score based on the percentiles of DRMP observed gave lower scores for DRMP values less than 5% and higher scores that would indicate flow diversion for DRMP more than 5%. Cross-correlation of the perfusion visual interpretation and the DRMP did not show a clear-cut statistically significant relationship which would indicate independent performance of the two for evaluation of IHD. In conclusion, the DRMP parameter could provide additional data on the regional coronary circulation that would assist in the detection of ischemia.
Appears in Programs:0555 Nuclear Medicine (M.Sc.)

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