P381Retrospective registration can provide good concordance between perfusion data from 3D nuclear imaging and electrophysiological data from EnSite Velocity mapping system
Notice bibliographique
Résumé
Introduction: Catheter ablation of scar-related ventricular tachycardia (VT) remain challenging partly due to the difficulty of accurate identification of scar tissue. Improvement of arrhythmogenic substrate characterization could be achieved through myocardial perfusion imaging (SPECT/CT) and voltage mapping (VM) integration. Purpose: This study describes the concordance between SPECT/CT and VM characterization of ventricular scar and heathy myocardium post procedure and assesses the role of different landmarks in the retrospective 3D surface registration process. Methods: Ischemic VT subjects underwent SPECT/CT imaging prior to left ventricular electroanatomical mapping (EAM) with EnSite Velocity cardiac mapping system. Post-procedure, the SPECT/CT, VM data and ablation lesions went through a retrospective co-registeration in the EnSite system (Fig A) and exported for supplemantary analysis. Perfusion data were scored from 0 (> 70% perfusion, healthy myocardium) to 4 (≤ 40%, myocardial scar). The voltage data were scored between 0 (> 2.5 mV, healthy myocardium) and 4 (< 0.5 mV, myocardial scar). Then both perfusion and voltage scores were grouped into each of the 17 segments and two scar percentages were computed for each segment, one using the perfusion scores and the second using the voltage scores. Percentages above a threshold of 50 were assumed to be scar segments. Segments corresponding to endocardial regions of the left ventricle where no voltage recordings were made with the catheter were discarded. Concordance (scar and healthy segments correctly matched overall segments), sensitivity (proportion of scar segments correctly matched) and specificity (proportion of healthy segments correctly matched) between the two modalities was evaluated (Fig B). Results: Seven subjects (100% male, 67 ± 7 years old, LVEF 26 ± 10%) underwent voltage mapping and SPECT/CT integration. Through retrospective registration at least 60% of the segments classified as scar by the perfusion data was correctly matched with the voltage mapping results. In 3/7 patients voltage mapping lead to a 30% overestimation of the scar area. A concordance of 70.0% was found among all subjects between VM and SPECT/CT for identification of CSeg as scar or healthy with VM showing a 81.6% sensitivity and 60.9% specificity when using SPECT/CT as a gold standard. 94% of the applied ablation lesions were located in CSeg identified as scar by SPECT/CT. Conclusion: Following retrospective registration concordance between SPECT/CT and voltage mapping data is possible for VT scar identification. The registration process as well as the asymetry in the endocardial mapping resolution (i.e. high around the VT scar and low in healthy cardiac tissue) may explain why sensitivity is better than specificity. Value of VM-SPECT/CT integration will be evaluated prospectively in a new series of ischemic VT ablation procedures. Abstract P381 Figure.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».