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D D Watson

Publications and source records attributed to D D Watson.

133 records · Page 8Linked to original sources

Method for the quantitation of myocardial perfusion during myocardial contrast two-dimensional echocardiography.

This article describes the hardware and software components of two systems designed for quantitative analysis of data obtained during myocardial contrast two-dimensional echocardiography. One system is meant for off-line analysis of data, whereas the other is designed for on-line analysis, especially in the operating room. The algorithms used for data transfer, selection of appropriate frames, data alignment, derivation of time-intensity plots, and curve-fitting and parameter generation are described in some detail. It is hoped that this information will be of use to others who work in the field of myocardial perfusion imaging.

Algorithms↗

Optimal timing for initial and redistribution technetium 99m-N-NOET image acquisition.

BACKGROUND: Bis (N-ethoxy, N-ethyl dithiocarbamato) nitrido technetium-99m (V) (Tc-99m-N-NOET) is a new Tc-99m-labeled myocardial perfusion imaging agent that redistributes. We sought to determine the optimal timing for acquiring initial and delayed images to maximize sensitivity for the detection of coronary stenoses. METHODS: Twelve anesthetized dogs with critical stenoses of the left anterior descending coronary artery were infused with adenosine (250 microg/kg/min) or MRE-0470, an adenosine A2a agonist (0.6 microg/kg/min x 10 minutes), and Tc-99m-N-NOET (8 mCi; 296 MBq) was injected intravenously at peak flow. Myocardial and lung Tc-99m-N-NOET activities were determined by serial quantitative imaging and arterial blood sampling was performed over 2 hours. RESULTS: Left anterior descending/left circumflex artery defect count ratios showed rapid redistribution during the first 10 minutes after Tc-99m-N-NOET injection (0.66 +/- 0.02 at 2 minutes to 0.73 +/- 0.01 at 10 minutes; P < .01). Redistribution was nearly complete by 120 minutes (defect ratio = 0.87 +/- 0.03; P < or = .01 vs 2 minutes). Lung activity fell significantly during the first 10 minutes from a heart/lung activity ratio of 1.07 +/- 0.05 (2 minutes) to 1.44 +/- 0.09 (10 minutes; P < or = .01). CONCLUSION: Initial stress Tc-99m-N-NOET images should be acquired within 10 minutes after injection, whereas delayed images can be obtained as early as 2 hours later. Lung activity clears rapidly, permitting acquisition of good-quality poststress cardiac images. These Tc-99m-N-NOET uptake and redistribution kinetics after vasodilator stress provide important information for designing clinical imaging protocols for optimal identification of inducible ischemia.

Animals↗

Quantitative gated single photon emission computed tomography imaging: a counts-based method for display and measurement of regional and global ventricular systolic function.

BACKGROUND: Gated single photon emission computed tomography imaging allows simultaneous determination of myocardial perfusion and function. Quantitative perfusion measurements can be based on regional tracer uptake, but function measurements ordinarily require endocardial and epicardial edge detection, which is problematic because of the inherently low spatial resolution and image noise in single photon emission computed tomography images. This article presents methods for quantification of both function and perfusion that do not require edge detection. METHODS AND RESULTS: In SPECT imaging the partial volume effect causes changes in myocardial wall thickness to be reflected as changes in pixel counts in pixels representing the myocardial wall. This effect allows an estimation of changes in myocardial wall thickness by comparing pixel counts in end-systolic images with corresponding pixel counts in end-diastolic images. This article first describes a standard method to quantify myocardial perfusion by sampling myocardial tracer activity at rest and stress. The same method is then used to sample tracer activity in diastolic and systolic images. A new method is developed to convert the diastolic and systolic samples into quantitative estimates of regional wall thickening. A method is then developed to convert the regional wall thickening fractions into a global left ventricular ejection fraction. A normal database is presented. Receiver operating characteristic analysis is used to establish normal limits. CONCLUSION: This method requires no edge detection or geometric boundary estimates. Computer results are presented in a simple and intuitive format, which is uniform for parameters of both perfusion and function. The method is robust and produces relatively few false-positive results.

Databases as Topic↗

Validation of a new counts-based gated single photon emission computed tomography method for quantifying left ventricular systolic function: comparison with equilibrium radionuclide angiography.

BACKGROUND: Because myocardial wall thickness is smaller than the spatial resolution of single photon emission computed tomography (SPECT) imaging, changes in myocardial wall thickness are related to changes in maximum pixel counts via the partial volume effect, allowing for quantification of regional systolic wall thickening. We have developed a new gated SPECT method for computing the global left ventricular ejection fraction (LVEF) based entirely on changes in maximum regional myocardial counts during systolic contraction. This new method is independent of endocardial edge detection or other geometric measurements. METHODS AND RESULTS: In 23 patients the gated SPECT method was validated by comparison with radionuclide angiography. The correlation between computed LVEFs was excellent (slope = 0.97, r = 0.91). The measurement of LVEF by gated SPECT was highly reproducible, with minimal intraoperator (slope = 0.97, r = 0.97) or interoperator (slope = 1.00, r = 0.97) variability. Measurements of regional thickening indexes were also reproducible, with a mean intraoperator correlation coefficient of 0.89 +/- 0.05 (range 0.79 to 0.95) for the 14 myocardial regions. Finally, the measurement of LVEF was not significantly influenced by changes in reconstruction filter parameters over a range of cutoff frequencies from 0.16 to 0.28. CONCLUSIONS: This new counts-based gated SPECT method for measuring global left ventricular systolic function correlates well with radionuclide angiography, is highly reproducible, and has theoretic advantages over geometric methods.

Adult↗

Tc-99m sestamibi defect magnitude predicts the amount of viable myocardium after coronary reperfusion despite the presence of severe residual stenosis.

BACKGROUND: Whether technetium-99m-labeled methoxyisobutyl isonitrile (Tc-99m sestamibi) imaging early after reperfusion can detect the amount of salvaged viable myocardium in the presence of a severe residual stenosis remains controversial. METHODS AND RESULTS: Nine dogs underwent total left anterior descending coronary artery (LAD) occlusion for 40 to 180 minutes followed by reperfusion through a flow-limiting stenosis. They were divided into 2 groups based on infarct size (group 1, <15% of risk area; group 2, > or =15%). Triphenyl tetrazolium chloride infarct size was measured by planimetry, and regional flow was quantified by radiolabeled microspheres. Mean infarct size was 9.3% +/- 3.0% of risk area in group 1 versus 51.1% +/- 4.8% in group 2 (P <.01). Tc-99m sestamibi was injected 30 minutes after reperfusion, when the LAD flows were comparable for group 1 (9 +/- 2 mL. min(-1)) and group 2 (9 +/- 1 mL. min(-1)). Left circumflex coronary artery flows were 33 +/- 5 and 32 +/- 9 mL. min(-1) for groups 1 and 2, respectively. Despite administration of Tc-99m sestamibi during diminished residual LAD flow after reperfusion, defect magnitude on ex vivo images in group 1 was significantly less severe than that in group 2, which had larger infarcts (0.71 +/- 0.02 vs 0.42 +/- 0.05, P <.01). This reflects greater salvage and more viability in group 1. CONCLUSION: Resting perfusion imaging with Tc-99m sestamibi accurately determined viability of the infarct zone despite reperfusion through a residual stenosis. Tc-99m sestamibi imaging may prove useful in the clinical setting for the prediction of the amount of salvaged myocardium.

Animals↗