PubMed Health⌕ Search

Biomedical subjects

Hiroshi Higashino

Publications and source records attributed to Hiroshi Higashino.

14 recordsLinked to original sources

Cardiac imaging using 256-detector row four-dimensional CT: preliminary clinical report.

PURPOSE: Along with the increase of detector rows on the z-axis and a faster gantry rotation speed, the spatial and temporal resolutions of the multislice computed tomography (CT) have been improved for noninvasive coronary artery imaging. We investigated the feasibility of the second specification prototype 256-detector row four-dimensional CT for assessing coronary artery and cardiac function. MATERIALS AND METHODS: The subjects were five patients with coronary artery disease. Contrast medium (40-60 ml) was intravenously administered at the rate of 3-4 ml/s. The patient's whole heart was scanned for 1.5 s to cover at least one cardiac cycle during breathholding without electrocardiographic gating. Parameters used were 0.5 mm slice thickness, 0.5 s/rotation, 120 Kv, and 350 mA, with a half-scan reconstruction algorithm (temporal resolution 250 ms). Twenty-six transaxial datasets were reconstructed at intervals of 50 ms. RESULTS: The assessability of the coronary arteries in AHA segments 1, 2, 3, 5, 6, 7, 9, and 11 was visually evaluated, resulting in 29 of 32 (90.9%) segments being assessable. Functional assessment was also performed using animated movies without banding artifacts in all cases. CONCLUSIONS: The 256-detector row four-dimensional CT can assess the coronary artery and cardiac function using data during 1.5 s without banding artifacts.

Aged↗

Assessment of left ventricular wall motion using 16-channel multislice computed tomography: comparison with left ventriculography.

PURPOSE: Using the raw data from coronary computed tomography (CT) angiography, multislice CT (MSCT) can be used to evaluate cardiac function. However, the accuracy of left ventricular (LV) wall motion assessment by MSCT has not been thoroughly investigated. We investigated whether 16-channel MSCT could accurately assess LV wall motion by comparing its results with those of conventional biplane left ventriculography (LVG). MATERIALS AND METHODS: The study included 20 patients with various kinds of heart disease. All patients underwent both contrast-enhanced MSCT and biplane LVG. Using a retrospective electrocardiography-gating technique, 10 phases over one cardiac cycle were extracted. The left ventricle was divided into seven segments according to the American Heart Association classification. Wall motion was scored as follows: 1, normal; 2, mild to moderate hypokinesis; 3, severe hypokinesis; 4, akinesis; 5, dyskinesis; and 6, aneurysm. The scores obtained by MSCT were compared with those obtained by LVG. The wall motion scores were analyzed using the chi-squared independence test (6 x 6 contingency table). RESULTS: Wall motion could be assessed in all segments of the 20 patients using interactive multiplanar animation. Among a total of 140 segments in 20 patients, scores in 118 were concordant between MSCT and LVG (118/140, 84.3%). CONCLUSION: The 16-MSCT can accurately assess LV wall motion.

Adult↗

Image fusion of coronary tree and regional cardiac function image using multislice computed tomography.

BACKGROUND: Although trials of image fusion, such as positron emission computed tomography and multislice spiral computed tomography (MSCT), have already demonstrated clinical usefulness, fusion of the coronary artery image and functional image by MSCT alone has not been reported yet. Here, a new idea of data analysis is proposed in which both regional cardiac function and the responsible coronary arteries can be assessed by a fused image. METHODS AND RESULTS: The study group comprised 5 patients with coronary artery disease. At the first procedure, 3 dimensional (D) volume rendering coronary artery (3D-CTA) was extracted. At the second procedure, the systolic regional wall thickening was calculated and the color 3D functional surface map of systolic wall thickening (3D-SWT) was generated. At the final procedure, 3D-SWT was superimposed on the left ventricular surface with 3D-CTA using a transparency. In all 5 patients, image fusion of the coronary tree and cardiac function was correctly generated. Image fusion can be displayed as clear 3D images, offering better orientation to help assess both the coronary artery and regional function. CONCLUSIONS: Image fusion of coronary computed tomography angiography and the functional map by MSCT is potentially a new method of assessing both the coronary artery and cardiac function.

Coronary Angiography↗

Giant congenital coronary artery fistula to left brachial vein clearly detected by multidetector computed tomography.

Coronary artery fistulas (CAF) are a rare anomaly in which there is communication between a coronary artery and a cardiac chamber or another vascular structure. A giant congenital CAF to the left brachial vein was identified clearly by multidetector computed tomography (MDCT) in an 84-year-old woman who presented with orthopnea and continuous murmur. Electrocardiogram was almost normal, but chest X-ray showed marked cardiomegaly with pulmonary congestion. Transthoracic echocardiography showed that the wall motion of the left ventricle (LV) was normal, but with an abnormal cavity behind the LV. CAF was suspected and coronary angiography revealed that the CAF originated from the right coronary artery (RCA), connected to the giant vessel. However, because the drainage site was not clearly detected, MDCT was performed and it became clear that the CAF originated from the RCA. The left circumflex artery flowed into the giant vessel, and drained to the left brachial vein.

Aged, 80 and over↗

Assessment of reperfused acute myocardial infarction with two-phase contrast-enhanced helical CT: prediction of left ventricular function and wall thickness.

PURPOSE: To investigate whether two-phase contrast material-enhanced computed tomographic (CT) findings serve as predictors of changes in left ventricular (LV) function and wall thickness (WT) after acute myocardial infarction (MI) and successful angioplasty. MATERIALS AND METHODS: Ethics committee approval and informed consent were obtained. In 58 patients (51 men and seven women; mean age, 62 years +/- 12 [standard deviation]) who had experienced an acute MI and undergone successful angioplasty, two-phase (acquisitions at 45 seconds and 7 minutes) contrast-enhanced CT was performed in the acute (mean interval between treatment and CT, 37 hours +/- 4) and intermediate (mean interval, 28 days +/- 4) periods and for long-term (mean interval, 12 months +/- 4) follow-up. CT images were reviewed for an early perfusion defect (ED) at 45 seconds and for late enhancement (LE) and a residual perfusion defect (RD) at 7 minutes. Myocardial enhancement patterns and WT were assessed, and LV ejection fraction (LVEF) and percentage decrease in WT were calculated. The patient group was subdivided into three groups according to enhancement pattern: Group 1 included patients with LE but no ED or RD; group 2, patients with ED and LE but no RD; and group 3, patients with ED, LE, and RD. Fisher exact testing was used to measure categorical response. Paired and unpaired t tests were used for comparison between two groups (points); Tukey-Kramer multiple comparison and repeated-measures analysis of variance were used for comparisons between the three groups. P < .05 was considered to indicate a significant difference. RESULTS: In group 3 (n = 36), WT in infarcted area was significantly reduced at the intermediate and long-term CT examinations (P < .001). At the intermediate and long-term examinations, percentage decrease in WT was greater in group 2 (n = 10) than in group 1 (n = 12) (P < .05 for intermediate and P < .001 for long-term examination) and was greatest in group 3 (P < .001 for both examinations). LVEF was poorest in group 3 and best in group 1. CONCLUSION: Two-phase contrast-enhanced CT proved useful in predicting LV functional recovery and WT in patients who had experienced acute MI and undergone successful angioplasty.

Aged↗

A study on attenuation correction using Tc-99m external TCT source in Tc-99m GSA liver SPECT.

PURPOSE: In attenuation correction of ECT images by transmission CT (TCT) with an external 99mTc gamma-ray source, simultaneous TCT/ECT data acquisition is difficult, when the same radionuclide such as 99mTc-tetrofosmin or 99mTc-GSA is used as the tracer. In this case, TCT is usually acquired before administration of the tracer, and ECT is acquired separately after the tracer injection. However, misregistration may occur between the TCT and ECT images, and the repetition of examinations add to the mental and physical stress of the patients. In this study, to eliminate this problem, we evaluated whether attenuation correction of ECT images can be achieved by acquiring TCT and ECT simultaneously, then acquiring ECT alone, and preparing an attenuation map by subtracting the latter from the former using 99mTc-GSA liver ECT. METHOD: The ECT system used was a three-head gamma camera equipped with one cardiac fan beam collimator and two parallel beam collimators. External gamma-ray source for TCT of 99mTc was 740 MBq, and ECT of 99mTc-GSA was 185 MBq. First, pure TCT data were acquired for the original TCT-map, then, ECT/TCT data were acquired for the subtracted TCT-map, and finally, pure ECT data were acquired. The subtracted attenuation map was produced by subtracting the pure ECT image from the TCT/ECT image, and attenuation correction of the ECT image was done using both this subtracted TCT map and attenuation map from pure TCT. These two attenuation corrected images and non-corrected images were compared. Hot rods phantom, a liver phantom with a defect, and 10 patients were evaluated. RESULTS: Attenuation corrected ECT values using the subtraction attenuation map showed an error of about 5% underestimation compared with ECT values of the images corrected by original attenuation map at the defect in the liver phantom. A good correlation of y = 22.65 + 1.06x, r = 0.958 was observed also in clinical evaluation. CONCLUSION: By means of the method proposed in this study, it is possible to perform simultaneous TCT/ECT data acquisition for attenuation correction using Tc-99m external source in Tc-99m GSA liver SPECT. Moreover, it is thought that this method decreases the mental and physical stress of the patients.

Algorithms↗

Segmented attenuation correction for myocardial SPECT.

PURPOSE: One of the main factors contributing to the accuracy of attenuation correction for SPECT imaging using transmission computed tomography (TCT) with an external gamma-ray source is the radionuclide count. To reduce deterioration of TCT images due to inadequate radionuclide counts, a correction method, segmented attenuation correction (SAC), in which TCT data are transformed into several components (segments) such as water, lungs and spine, providing a satisfactory attenuation correction map with less counts, has been developed. The purpose of this study was to examine the usefulness of SAC for myocardial SPECT with attenuation correction. METHODS: A myocardial phantom filled with Tc-99m was scanned with a triple headed SPECT system, equipped with one cardiac fan beam collimator for TCT and two parallel hole collimators for ECT. As an external gamma-ray source for TCT, 740 MBq of Tc-99m was also used. Since Tc-99m was also used for ECT, the TCT and ECT data were acquired separately. To make radionuclide counts, the TCT data were acquired in the sequential repetition mode, in which a 3-min-rotation was repeated 7 times followed by a 10-min-rotation 4 times (a total of 61 minutes). The TCT data were reconstructed by adding some of these rotations to make TCT maps with various radionuclide counts. Three types of SAC were used: (a) 1-segment SAC in which the body structure was regarded as water, (b) 2-segment SAC, in which the body structure was regarded as water and lungs, and (c) 3-segment SAC, in which the body structure was regarded as water, lungs and spine. We compared corrected images obtained with non-segmentation methods, and with 1- to 3-segment SACs. We also investigated the influence of radionuclide counts of TCT (3, 6, 9, 12, 15, 18, 21, 31, 41, 51, 61 min acquisition) on the accuracy of the attenuation correction. RESULTS: Either 1-segment or 2-segment SAC was sufficient to correct the attenuation. When non-segmentation TCT attenuation methods were used, rotations of at least 31 minutes were required to obtain sufficiently large counts for TCT. When the 3-segment SAC was used, the minimal acquisition time for a satisfactory TCT map was 7 min. CONCLUSION: The 3-segment SAC was effective for attenuation correction, requiring fewer counts (about 1/5 of the value for non-segmentation TCT), or less radiation for TCT.

Adult↗

Assessment of coronary artery and cardiac function using multidetector CT.

Multidetector CT is able to reconstruct artifact-less cardiac images due to improved temporal resolution. In this article, we review the potential benefits of the cardiac application of multidetector CT in the assessment of coronary artery and cardiac function, such as wall motion and systolic thickening. By applying retrospective ECG-gating, 10 phases throughout 1 cardiac cycle are extracted for functional analysis. Animated movies are generated by paging through these 2D and 3D images in cardiac phase order. Left ventricular end-diastolic volume, end-systolic volume, and ejection fraction can also be generated. Using the data acquired during a single breath hold, coronary artery and cardiac function can be assessed by multidetector CT.

Contrast Media↗

Truncation correction of fan beam transmission data for attenuation correction using parallel beam emission data on a 3-detector SPECT system.

BACKGROUND: When the simultaneous transmission computed tomography (TCT)/single photon emission CT (SPECT) acquisition protocol is applied to myocardial studies using a 3-detector SPECT, the narrow effective field of view of a fan beam collimator used for TCT acquisition may cause truncation artifacts on TCT images. In this paper, we propose a new method of correcting for the truncation of TCT. METHODS: The truncated parts of the TCT projection data are corrected using quadratic functions, based on the properties that the integral of non-truncated TCT projection data is constant at any projection angle and the position of the centre of gravity is focused on a fixed point. The usefulness of our method was investigated in phantom and human studies using a 3-detector SPECT equipped with one cardiac fan beam collimator for TCT and two parallel beam collimators for SPECT. We used Tl as a tracer for SPECT and Tc as an external source for TCT. RESULTS: The phantom and human studies showed that our method can adequately correct for the truncation of TCT data acquired using a fan beam collimator in a 3-detector SPECT, as long as there is no truncation in SPECT data. CONCLUSION: Our method appears to be useful for improving the SPECT images obtained using simultaneous TCT/SPECT acquisition in a 3-detector SPECT. However, further studies will be necessary to establish the clinical usefulness of this method.

Algorithms↗

Evaluation of the number of SPECT projections in the ordered subsets-expectation maximization image reconstruction method.

Filtered back projection (FBP) method, maximum likelihood-expectation maximization(ML-EM) method, and ordered subsets-expectation maximization (OS-EM) method are currently used for reconstruction of SPECT images in clinical studies. In the ML-EM method, images of good quality can be reconstructed even with a small sampling number of projection data, when compared with FBP. Shorter acquisition time and less radionuclide dose are preferable in the clinical setting if image quality is the same. In this study, we attempted to find optimal conditions for reconstruction of OS-EM images with commonly used sampling numbers of 30, 60 and 120 (step angles: 12 degrees, 6 degrees, and 3 degrees, respectively), with acquisition counts/projection of 30, 60, 120 and 240 each. We adjusted the pixel counts of reconstructed images to be constant, by setting combination of sampling number and counts/projection (120 sampling number for 30 counts/projection, 60 for 60, and 30 for 120). Among the 3 acquisition conditions, the small sampling number of 30 had large acquisition counts per direction, resulting in low signal to noise ratio. Under this condition, the resolution was slightly low, but the uniformity of images was high. The combination of OS-EM and smaller sampling projection number may be clinically useful with reduction of the examination time, which is also beneficial to reduce dead time for gamma-camera rotation.

Adult↗

Clinical usefulness of the cardiac multi-detector-row CT.

Along with improvement of the temporal and special resolution, multi-detector-row CT has become able to generate artifact-less heart images. We discuss the potential benefits of the newly developed cardiac application, demonstrating informative cases.Two- and three-dimensional (2D and 3D) cardiac images were produced throughout one cardiac cycle. By paging 2D and 3D images in cardiac cycle order, animated movies were generated. Cardiac imaging with multi-detector-row CT, acquired during a single breath hold, provides information about: (1) clear morphology of heart chambers and myocardium, (2) wall motion and systolic thickening, (3) myocardial perfusion, (4) volume assessment, and (5) coronary anatomy and pathophysiology.

Female↗

Ischemic "memory image" in acute myocardial infarction of 123I-BMIPP after reperfusion therapy: a comparison with 99mTc-pyrophosphate and 201Tl dual-isotope SPECT.

Ischemic "memory image" is a phenomenon of 123I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) in which an area at risk of acute myocardial infarction (AMI), could be detected as a defect in a couple of weeks even after successful reperfusion therapy. The purpose of this study was to clarify the incidence of the ischemic "memory image" of 123I-BMIPP in patients with AMI by comparing 99mTc-PYP and 201Tl dual-isotope SPECT. Materials consisted of 14 patients with successfully reperfused AMI and 20 patients with old myocardial infarction (OMI). All AMI patients underwent PYP/Tl dual-isotope SPECT within 1 week after the onset of AMI, and BMIPP SPECT was performed within 1 week after the PYP/Tl dual-isotope SPECT. The extent and severity of the defect of BMIPP and Tl were visually scored into four grades: 0 = no defect to 3 = large or severe defect. These scores were compared. PYP positive AMI lesions were concordant with BMIPP defects (13/14). In AMI, both the extent and severity scores of BMIPP were higher than 201Tl (p < 0.001). Differences (BMIPP - Tl) of extent and severity scores were greater in AMI than in OMI (p < 0.001). In conclusion, the ischemic "memory image" obtained by means of the BMIPP is a common phenomenon (13/14) in AMI, and helpful in evaluating the area at risk.

Aged↗

Attenuation correction of myocardial SPECT images with X-ray CT: effects of registration errors between X-ray CT and SPECT.

PURPOSE: Attenuation correction with an X-ray CT image is a new method to correct attenuation on SPECT imaging, but the effect of the registration errors between CT and SPECT images is unclear. In this study, we investigated the effects of the registration errors on myocardial SPECT, analyzing data from a phantom and a human volunteer. METHODS: Registerion (fusion) of the X-ray CT and SPECT images was done with standard packaged software in three dimensional fashion, by using linked transaxial, coronal and sagittal images. In the phantom study, an X-ray CT image was shifted 1 to 3 pixels on the x, y and z axes, and rotated 6 degrees clockwise. Attenuation correction maps generated from each misaligned X-ray CT image were used to reconstruct misaligned SPECT images of the phantom filled with 201Tl. In a human volunteer, X-ray CT was acquired in different conditions (during inspiration vs. expiration). CT values were transferred to an attenuation constant by using straight lines; an attenuation constant of 0/cm in the air (CT value = -1,000 HU) and that of 0.150/cm in water (CT value = 0 HU). For comparison, attenuation correction with transmission CT (TCT) data and an external gamma-ray source (99mTc) was also applied to reconstruct SPECT images. RESULTS: Simulated breast attenuation with a breast attachment, and inferior wall attenuation were properly corrected by means of the attenuation correction map generated from X-ray CT. As pixel shift increased, deviation of the SPECT images increased in misaligned images in the phantom study. In the human study, SPECT images were affected by the scan conditions of the X-ray CT. CONCLUSION: Attenuation correction of myocardial SPECT with an X-ray CT image is a simple and potentially beneficial method for clinical use, but accurate registration of the X-ray CT to SPECT image is essential for satisfactory attenuation correction.

Artifacts↗