C Arm Ct Imaging Of Myocardial Necrotic Tissue During An Interventional Procedure

Cardiac C-arm CT is a valuable imaging modality that can provide three-dimensional images of the heart during an interventional procedure. As the technology advances to provide better image quality and faster acquisition times, the potential clinical uses increase. Visualization of myocardial defects could directly impact the guidance, procedure time, and outcome of various interventional procedures. In this work, I developed protocols to optimize low-contrast detectability for cardiac C-arm CT and performed in vivo studies to validate using C-arm CT for imaging myocardial necrosis during a cardiac interventional procedure. Initial in vivo investigations were used to evaluate the contrast injection protocol for ideal timing, dilution, catheter type, and injection location. Additionally, x-ray parameters including filtration, kVp, dose, and collimation were optimized for low-contrast detectability and minimization of artifacts. A 4 sweep x 5 s, ECG-gated imaging protocol using low energy (70-90 kVp) and high dose (1.2 [mu]Gy/projection) optimizes low contrast detectability, while collimation around the heart improves SNR by reducing scatter. Images acquired both in vivo and in a slab phantom show that tight collimation and beam filtration result in improved SNR and a reduction of shading artifacts. Visualization of radiofrequency ablation lesions using contrast enhanced C-arm CT during the procedure provides a direct assessment of adequate lesion formation and may circumvent complications associated with cardiac ablation procedures. An in vivo validation study was completed in 9 swine by comparing lesion dimensions measured in C-arm CT images and pathology specimens. All ablation lesions were visualized and lesion dimensions, as measured on C-arm CT, correlated well with postmortem tissue measurements using triphenyltetrazolium chloride (TTC) staining (mean difference 1D dimensions: 0.09 ± 1.04 mm, area: -0.71 ± 5.86 mm2). C-arm CT visualization of myocardial infarction (MI) in the catheterization lab could furnish early prognostic information for risk stratification as well as provide 3D images for guidance of stem cell or ablation therapies. A porcine model using balloon occlusion in the coronary artery was used to study visualization of acute and subacute MI in 12 swine. Contrast enhanced C-arm CT imaging was performed the day of infarct creation or 4 weeks after infarct creation and the volume of the infarct was compared against pathology to validate the visualization of infarction. Acute MI is best visualized at 1 minute post contrast injection as a region of combined hyper- and hypoenhancement whereas subacute MI appears as a region of hyperenhancement with peak contrast enhancement at 5 minutes post contrast injection. C-arm CT infarct volumes compared well with TTC staining (mean difference acute: -0.5 cm3, subacute: -0.7cm3). In conclusion, cardiac C-arm CT with contrast and imaging protocols optimized for low-contrast detectability has been established as a consistent and reliable technique for imaging myocardial necrotic tissue in the interventional suite.

Recent years have seen a marked increase in cardiovascular computed tomography (CT) imaging, with the technique now integrated into many imaging guidelines, such as those published by ESC and NICE. Rapid clinical and technological progress has created a need for guidance on the practical aspects of CT image acquisition, analysis and interpretation. The Oxford Specialist Handbook of Cardiovascular CT, now revised for the second edition by practising international experts with many years of hands-on experience, is designed to fulfil this need. The Handbook is a practical guide on performing, analysing and interpreting cardiovascular CT scans, covering all aspects from patient safety to optimal image acquisition to differential diagnoses of tricky images. It takes an international approach to both accreditation and certification, highlighting British, European, and American examinations and courses. The format is designed to be accessible and is laid out in easy to navigate sections. It is meant as a quick-reference guide, to live near the CT scanner, workstation, or on the office shelf. The Handbook is aimed at all cardiovascular CT users (Cardiologists, Radiologists and Radiographers), particularly those new to cardiovascular CT, although even the advanced user should find useful tips and tricks within.

Advances in Heart Research and Application / 2012 Edition is a ScholarlyEditions™ eBook that delivers timely, authoritative, and comprehensive information about Heart. The editors have built Advances in Heart Research and Application / 2012 Edition on the vast information databases of ScholarlyNews.™ You can expect the information about Heart in this eBook to be deeper than what you can access anywhere else, as well as consistently reliable, authoritative, informed, and relevant. The content of Advances in Heart Research and Application / 2012 Edition has been produced by the world’s leading scientists, engineers, analysts, research institutions, and companies. All of the content is from peer-reviewed sources, and all of it is written, assembled, and edited by the editors at ScholarlyEditions™ and available exclusively from us. You now have a source you can cite with authority, confidence, and credibility. More information is available at http://www.ScholarlyEditions.com/.

This cross-disciplinary book documents the key research challenges in the mathematical sciences and physics that could enable the economical development of novel biomedical imaging devices. It is hoped that the infusion of new insights from mathematical scientists and physicists will accelerate progress in imaging. Incorporating input from dozens of biomedical researchers who described what they perceived as key open problems of imaging that are amenable to attack by mathematical scientists and physicists, this book introduces the frontiers of biomedical imaging, especially the imaging of dynamic physiological functions, to the educated nonspecialist. Ten imaging modalities are covered, from the well-established (e.g., CAT scanning, MRI) to the more speculative (e.g., electrical and magnetic source imaging). For each modality, mathematics and physics research challenges are identified and a short list of suggested reading offered. Two additional chapters offer visions of the next generation of surgical and interventional techniques and of image processing. A final chapter provides an overview of mathematical issues that cut across the various modalities.

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

With the contribution from more than one hundred CNS neurotrauma experts, this book provides a comprehensive and up-to-date account on the latest developments in the area of neurotrauma including biomarker studies, experimental models, diagnostic methods, and neurotherapeutic intervention strategies in brain injury research. It discusses neurotrauma mechanisms, biomarker discovery, and neurocognitive and neurobehavioral deficits. Also included are medical interventions and recent neurotherapeutics used in the area of brain injury that have been translated to the area of rehabilitation research. In addition, a section is devoted to models of milder CNS injury, including sports injuries.

This issue reviews the latest advances in the use of magnetic resonance to assist in performing interventional procedures. Biopsy and aspiration, radiofrequency and laser ablation, and focused ultrasound are all covered. Also included are articles on biliary, prostate, and breast interventions.

This fully updated new edition is a comprehensive guide to interventional radiology (IR) for medical students, residents, early career attendings, nurse practitioners and physician assistants. The IR Playbook includes procedures, new and updated data, and new images, to stay on the cutting edge of IR. As a specialty, IR is constantly changing and evolving to apply newer technologies and techniques to a breadth of disease pathologies. This book addresses the growing need for a reference for trainees and early career professionals to gain a solid foundation. Let this book serve as your only resource from the first day you find out about IR to the day you take your certifying exam. One and done. The textbook is divided into two main sections, with many images and key point boxes throughout that offer high-yield pearls along with the specific How To's necessary for practice. The first section is designed to give readers an introduction to IR, including radiation safety, commonly used devices, patient care, and anatomy. The second portion is divided by procedure. These chapters cover pathophysiology, indications for treatment, as well as alternative treatments before delving into interventional therapy. This new edition has been fully updated throughout including several brand-new procedures and divided chapters to allow a more in depth look at several disease pathologies. IR Playbook gives medical students, residents, and trainees a full perspective of interventional radiology.

This open access book gives a complete and comprehensive introduction to the fields of medical imaging systems, as designed for a broad range of applications. The authors of the book first explain the foundations of system theory and image processing, before highlighting several modalities in a dedicated chapter. The initial focus is on modalities that are closely related to traditional camera systems such as endoscopy and microscopy. This is followed by more complex image formation processes: magnetic resonance imaging, X-ray projection imaging, computed tomography, X-ray phase-contrast imaging, nuclear imaging, ultrasound, and optical coherence tomography.

Nuclear cardiology is one of the most widely used non-invasive techniques for the assessment of coronary artery disease and other cardiovascular conditions. It has proved to be a cost effective tool for the evaluation and management of cardiac patients and usually has a decisive role for diagnosis, prognosis and risk stratification. In particular, radionuclide myocardial perfusion imaging (MPI) is used extensively worldwide for the evaluation of known or suspected coronary artery disease, with an estimated 15-20 million procedures performed annually. This publication provides a detailed analysis of all the steps involved in the delivery of nuclear cardiology services, from referrals to reporting, and is intended to serve as guidance for the implementation, homogenization and enhancement of MPI practice in those Member States where the technique is under development.