• International journal of advanced smart convergence
• /
• v.13 no.2
• /
• pp.187-194
• /
• 2024

For precise cardiac diagnostics and treatment, we introduce a novel method for patient-specific mapping between myocardial and coronary anatomy, leveraging local variations in myocardial thickness. This complex system integrates and automates multiple sophisticated components, including left ventricle segmentation, myocardium segmentation, long-axis estimation, coronary artery tracking, and advanced geodesic Voronoi distance mapping. It meticulously accounts for variations in myocardial thickness and precisely delineates the boundaries between coronary territories according to the conventional 17-segment myocardial model. Each phase of the system provides a step-by-step approach to automate coronary artery mapping onto the myocardium. This innovative method promises to transform cardiac imaging by offering highly precise, automated, and patient-specific analyses, potentially enhancing the accuracy of diagnoses and the effectiveness of therapeutic interventions for various cardiac conditions.

• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.3
• /
• pp.174-178
• /
• 2009

Many radiopharmaceuticals have been developed and wildy used in the imaging cardiac function. Myocardial perfusion imaging (MPI) is a well established noninvasive method of assessing coronary blood flow and has been widely used in patients diagnosed or suspected with coronary artery diseases. The innovation of radiopharmaceuticals used in the cardiac imaging is one of the most important contributors to the development of nuclear cardiology. Thallium-201 and various technetium-99m agents have been globally used for myocardial perfusion SPEG, and N-13 ammonia (13NH3), rubidium-82 (82Rb), 0-15 water (H2150) for myocardial perfusion PET. As well as the cardiac perfusion studies, new radiopharmaceuticals that visualize fat metabolism or receptors of the sympathetic nervous system have successfully been applied to clinical practice. Useful information can be obtained for diagnosing coronary artery disease, evaluating patients' condition, or assessing therapeutic effects. In this review, we describe the characteristics and clinical usefulness of radiopharmaceuticals used for cardiac SPEG and PET.

• Korean Journal of Radiology
• /
• v.25 no.4
• /
• pp.331-342
• /
• 2024

The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.

• Journal of Chest Surgery
• /
• v.41 no.3
• /
• pp.360-362
• /
• 2008

An adequate location of the reimplanted coronary arteries is one of the most important prognostic factors for an arterial switch operation for treating TGA (transposition of great arteries). We report here on a case of malposition of the reimplanted coronary artery in a 14-year-old boy who had undergone an arterial switch operation. He had chest pain and dyspnea on exertion. The imaging study showed that the ostium of the left main coronary artery, which was between the neo-pulmonary artery and the neo-aorta, was compressed by the great arteries. We excised the left main coronary artery with a button incision from the aorta and reimplanted it on the left lateral side of the aorta. The patency of the left main coronary artery os after the operation was good and it was not compressed by the surrounding arteries.

• Korean Journal of Optics and Photonics
• /
• v.26 no.1
• /
• pp.1-8
• /
• 2015

The most common cause of a heart attack is known as coronary artery disease, which narrows the arteries and reduces the blood flow to the heart. To treat coronary artery stenosis, percutaneous coronary intervention (PCI) (a nonsurgical procedure to install a stent, which holds the artery wall open) is performed. Intracoronary optical coherence tomography (OCT) is a catheter-based, invasive optical imaging system. To determine whether PCI is appropriate, and to perform stent evaluation in a catheterization laboratory, OCT examinations are carried out. This review details the fundamental principles and technological status of intracoronary OCT imaging, and discusses the ongoing clinical applications to determine the benefits of OCT-guided PCI.

• The Korean Journal of Nuclear Medicine
• /
• v.39 no.2
• /
• pp.107-113
• /
• 2005

Pharmacologic stress testing for myocardial perfusion imaging is a widely used noninvasive method for the evaluation of known or suspected coronary artery disease. The use of exercise for cardiac stress has been practiced for over 60 years and clinicians are familial with its using. However, there are inevitabe situations in which exorcise stress is inappropriate. A large number of patients with cardiac problems are unable to exercise to their full potential due to comorbidity such as osteoarthritis, vascular disease and pulmonary disease and a standard exercise stress test for myocardial perfusion imaging is suboptimal means for assessment of coronary artery disease. This problem has led to the development of the pharmacologic stress test and to a great increase in its popularity. All of the currently used pharmacologic agents have well-documented diagnostic value. This review deals the physiological actions, clinical protocols, safety, nuclear imaging applications of currently available stress agents and future development of new vasodilating agents.

• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.3
• /
• pp.222-228
• /
• 2009

Risk stratification and assessment of prognosis in patients with known or suspected CAD is of crucial important for the practice of contemporary medicine. Noninvasive testing such as myocardial perfusion scintigraphy, coronary artery calcium scoring or CT coronary angiography is increasingly being used to determine the need for aggressive medical therapy and to select patients for catheterization. The integrated anatomic and functional information may provide more additional information for the cardiologist or other clinician by the improved risk stratification and diagnostic accuracy of integrated techniques. The development of SPECT/CT or PET/CT hybrid systems is therefore of important value for the nuclear cardiology.

• Korean Journal of Radiology
• /
• v.22 no.10
• /
• pp.1597-1608
• /
• 2021

Cardiovascular computed tomography (CT) is among the most active fields with ongoing technical innovation related to image acquisition and analysis. Artificial intelligence can be incorporated into various clinical applications of cardiovascular CT, including imaging of the heart valves and coronary arteries, as well as imaging to evaluate myocardial function and congenital heart disease. This review summarizes the latest research on the application of deep learning to cardiovascular CT. The areas covered range from image quality improvement to automatic analysis of CT images, including methods such as calcium scoring, image segmentation, and coronary artery evaluation.

• Korean Journal of Radiology
• /
• v.22 no.1
• /
• pp.97-105
• /
• 2021

Objective: The present study aimed to investigate the association between myocardial blood flow (MBF) quantified by dynamic CT myocardial perfusion imaging (CT-MPI) and the increments in heart rate (HR) after stress in patients without obstructive coronary artery disease. Materials and Methods: We retrospectively included 204 subjects who underwent both dynamic CT-MPI and coronary CT angiography (CCTA). Patients with more than minimal coronary stenosis (diameter ≥ 25%), history of myocardial infarction/revascularization, cardiomyopathy, and microvascular dysfunction were excluded. Global MBF at stress was measured using hybrid deconvolution and maximum slope model. Furthermore, the HR increments after stress were recorded. Results: The median radiation dose of dynamic CT-MPI plus CCTA was 5.5 (4.5-6.8) mSv. The median global MBF of all subjects was 156.4 (139.8-180.4) mL/100 mL/min. In subjects with HR increment between 10 to 19 beats per minute (bpm), the global MBF was significantly lower than that of subjects with increment between 20 to 29 bpm (153.3 mL/100 mL/min vs. 171.3 mL/100 mL/min, p = 0.027). This difference became insignificant when the HR increment further increased to ≥ 30 bpm. Conclusion: The global MBF value was associated with the extent of increase in HR after stress. Significantly higher global MBF was seen in subjects with HR increment of ≥ 20 bpm.

• Journal of Chest Surgery
• /
• v.32 no.8
• /
• pp.693-701
• /
• 1999

Recently non-invasive diagnostic imaging replaced the invasive catheter angiography in the diagnosis of vascular disease. Catheter methods are now almost confined to the purpose of intervention. Coronary artery or coronary artery bypass graft still needs catheter technique because of small diameter and the cardiac motion. The last challenge for radiologists in this domain is to obtain a non-invasive imaging. Electron beam tomography(EBT) for high temporal resolution is able to obtain a coronary arteriogram or coronary artery bypass graft (CABG), of which CABG imaging is quite useful for the evaluation of patency. In our experience as well as others, the accuracy of EBT angiogram in evaluating CABG patency revealed that the accuracy of patency of saphenous vein grafts(SVG) is high due to relatively wide lumen, short and straight course and less influence from cardiac motion. The sensitivity and specificity of patency of SVGs were 92%, 97% respectively in the prospective evaluat on and 100% each in the retrospective evaluation. A false positive and a false negative case are rudimentary errors in the initial learing period. In contrast the analysis of left internal mammary artery(LIMA) graft was difficult due to the inherent small size and the adjacent surgical clips provoking beam-hardening artifact; therefore, the method of combining 3 dimensional reconstruction and flow mode study was important in improving the accuracy of LIMA patency. The sensitivity and specificity of LIMA patency were 100% and 80% in both prospective and retrospective evaluation. Therefore, EBT angiography is an accurate non-invasive diagnostic modality for evaluating the patency of CABG, particularly in SVGs. The accuracy can be improved with the improvement of the EBT and the development of the image reconstruction software.