Fused 3-dimensional whole-heart coronary artery, coronary vein and myocardial scar imaging at 3 T: Feasibility in patients with ischemic and non-ischemic cardiomyopathy
Bibliographic record
Abstract
Patients with cardiomyopathy are frequently considered for vascular-based interventions aimed at improving systolic performance. Cardiac Resynchronization Therapy (CRT) and Coronary Artery Revascularization (CAR) are dependent upon the presence of appropriate vascular targets and health of related myocardium for clinical success. A combined evaluation of coronary vascular targets and myocardial scar may benefit the planning of such procedures. 53 consecutive patients were enrolled prior to device (ICD and/or CRT) therapy (N = 42) or CAR (N = 11). All patients had imaging performed using a 3.0 Tesla MRI scanner. A cardiac-gated, 3-D whole-heart inversion-recovery gradient echo pulse sequence with respiratory navigator was used to obtain both a contrast-enhanced coronary MRA (0.2 mmol/kg gadolinium infusion at 0.3 ml/sec) followed in 25 minutes by a late enhancement (scar) dataset. Both datasets were obtained using an isotropic voxel resolution of 1.3 × 1.3 × 1.3 mm. All coronary artery and coronary vein segments were evaluated by consensus opinion for vessel image quality using a standard visual scoring system (score 0 to 4). Contrast to noise (CNR) and signal to noise (SNR) measurements of the proximal coronary artery and vein segments and myocardial scar were performed. Spatially matched datasets were then fused using 3-D segmentation of myocardial scar with fusion to coronary MRA for volume rendered visualization Figure 1 . Figure 1 The mean age was 56.6 ± 14.5 years. Combined coronary MRA and 3D scar imaging was successfully performed in 49 (92%) patients. Of 588 proximal-mid coronary artery and coronary vein segments 570 (97%) were scored as clinically evaluable. The mean quality score of the proximal-mid coronary artery segments and coronary vein segments was 3.1 ± 0.9 and 3.2 ± 0.9, respectively. The SNR and CNR scores were 57.3 ± 35.3 and 48.3 ± 31.6 respectively for the left main coronary artery. The respective vales for the right coronary artery was and 47.2 ± 31.4 and 38.2 ± 28.1, respectively for the right coronary artery. The mean quality score for myocardial scar imaging was 2.90 ± 0.98, with an SNR and CNR of 54.2 ± 29.9 and 49.4 ± 29.3 respectively. Image fusion was successful in all patients with quality scores of 2 or greater. This study demonstrates clinical feasibility of MRI to provide matched isotropic 3-D imaging of coronary anatomy and myocardial scar. This novel fusion technique has the potential to assist in the pre-procedural planning of vascular-based cardiac interventions where myocardial scar is relevant to clinical response.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".