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Prediction of myocardial blood flow under stress conditions by means of a computational model

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Quantification of myocardial blood flow (MBF) and functional assessment of coronary artery disease (CAD) can be achieved through stress myocardial computed tomography perfusion (stress-CTP). This requires an additional scan after the resting coronary computed tomography angiography (cCTA) and administration of an intravenous stressor. This complex protocol has limited reproducibility and non-negligible side effects for the patient. We aim to mitigate these drawbacks by proposing a computational model able to reproduce MBF maps.

Methods

A computational perfusion model was used to reproduce MBF maps. The model parameters were estimated by using information from cCTA and MBF measured from stress-CTP (MBFCTP) maps. The relative error between the computational MBF under stress conditions (MBFCOMP) and MBFCTP was evaluated to assess the accuracy of the proposed computational model.

Results

Applying our method to 9 patients (4 control subjects without ischemia vs 5 patients with myocardial ischemia), we found an excellent agreement between the values of MBFCOMP and MBFCTP. In all patients, the relative error was below 8% over all the myocardium, with an average-in-space value below 4%.

Conclusion

The results of this pilot work demonstrate the accuracy and reliability of the proposed computational model in reproducing MBF under stress conditions. This consistency test is a preliminary step in the framework of a more ambitious project which is currently under investigation, i.e., the construction of a computational tool able to predict MBF avoiding the stress protocol and potential side effects while reducing radiation exposure.

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Author information

Author notes

  1. Simone Di Gregorio and Christian Vergara are contributed equally to this work.

Authors and Affiliations

  1. Dipartimento Di Matematica, MOX, Politecnico Di Milano, Milan, Italy

    Simone Di Gregorio, Giovanni Montino Pelagi, Paolo Zunino & Alfio Quarteroni

  2. LABS, Dipartimento Di Chimica, Materiali E Ingegneria Chimica, Politecnico Di Milano, Milan, Italy

    Christian Vergara

  3. Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCSS, Via C. Parea 4, 20138, Milan, Italy

    Andrea Baggiano, Marco Guglielmo, Laura Fusini, Giuseppe Muscogiuri & Gianluca Pontone

  4. Department of Clinical Science and Community Health, University of Milan, Milan, Italy

    Andrea Baggiano

  5. Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy

    Laura Fusini

  6. Department of Nuclear Medicine, University Hospital, Zurich, Switzerland

    Alexia Rossi

  7. Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland

    Alexia Rossi

  8. Loyola University of Chicago, Chicago, IL, USA

    Mark G. Rabbat

  9. Edward Hines Jr. VA Hospital, Hines, IL, USA

    Mark G. Rabbat

  10. Institute of Mathematics, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland

    Alfio Quarteroni

Authors
  1. Simone Di Gregorio
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  2. Christian Vergara
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Contributions

Conceptualization: Simone Di Gregorio, Christian Vergara, Gianluca Pontone

Methodology: Simone Di Gregorio, Christian Vergara, Paolo Zunino, Giovanni Montino Pelagi

Formal analysis and investigation: Simone Di Gregorio, Giovanni Montino Pelagi

Writing—original draft preparation: Simone Di Gregorio, Christian Vergara

Writing—review and editing: Simone Di Gregorio, Christian Vergara, Andrea Baggiano, Marco Guglielmo, Laura Fusini, Giuseppe Muscogiuri, Alexia Rossi, Mark G Rabbat, Paolo Zunino, Alfio Quarteroni, Gianluca Pontone

Supervision: Gianluca Pontone, Alfio Quarteroni, Christian Vergara

Corresponding author

Correspondence to Gianluca Pontone.

Ethics declarations

Ethical approval

Ethical Review Board approval was obtained (R250/15-CCM 262). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Conflict of interest

Pontone G. declared institutional research grant and/or honorarium as speaker from General Electric, Bracco, Heartflow, Boehringer Ingelheim.

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This article is part of the Topical Collection on Cardiology

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Di Gregorio, S., Vergara, C., Pelagi, G.M. et al. Prediction of myocardial blood flow under stress conditions by means of a computational model. Eur J Nucl Med Mol Imaging 49, 1894–1905 (2022). https://doi.org/10.1007/s00259-021-05667-8

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  • DOI: https://doi.org/10.1007/s00259-021-05667-8

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