CARDIAC VISUALIZATION SYSTEMS FOR DISPLAYING 3-D IMAGES OF CARDIAC VOXEL INTENSITY DISTRIBUTIONS WITH OPTIONAL PHYSICIAN INTERACTIVE BOUNDARY TRACING TOOLS

• US 20070236491A1
• Filed: 01/25/2007
• Published: 10/11/2007
• Est. Priority Date: 02/02/2006
• Status: Active Grant

• Current Assignee: Wake Forest University Health Sciences
• Original Assignee: Wake Forest University Health Sciences
• Inventors: Hamilton, Craig, D'Agostino, Ralph, Hundley, William
• Granted Patent: US 7,907,759 B2
• Time in Patent Office: Days
• US Class Current: 345/418
• CPC Class Codes: A61B 5/0044 for the heart
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/466 adapted to display 3D data
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 6/504 for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: G01R 33/283 Intercom or optical viewing arrangements, structurally associated with NMR apparatus
• CPC Class Codes: G01R 33/546 Interface between the MR system and the user, e.g. for controlling the operation of the MR system or for the design of pulse sequences
• CPC Class Codes: G06T 2207/10088 Magnetic resonance imaging [MRI]
• CPC Class Codes: G06T 2207/20104 Interactive definition of region of interest [ROI]
• CPC Class Codes: G06T 2207/30048 Heart; Cardiac
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics
• CPC Class Codes: Y10S 128/921 Diet management
• CPC Class Codes: Y10S 128/922 including image analysis
• CPC Class Codes: Y10S 128/923 by comparison of patient data to other data
• CPC Class Codes: Y10S 128/924 using artificial intelligence

Abstract

Physician interactive workstations with global cardiac voxel distribution visualization may also include one or more of a 3-D color scale image of a population of voxel in the heart and/or an electronic boundary-tracing tool configured to accept user input to electronically define at least one boundary of a target region of a heart in a medical image of a patient on a display. The workstation may be configured to evaluate intensity of voxels associated with tissue within the defined boundary of the target region of the heart whereby cardiotoxicity is evaluated.

Claims

1. A physician interactive workstation, comprising:

a display with a 3-D diagnostic image of a patient'"'"'s heart illustrating substantially an entire population of voxels illustrating measures of voxel intensity in color scale.

2. A workstation according to claim 1, wherein the display is configured to display a plurality of voxel intensity histograms in a plurality of regions of interest in the heart, the voxel intensity histograms defining voxel data used to generate the 3-D image of the heart, the plurality of voxel intensity histograms being selectively viewable by a clinician.

3. A workstation according to claim 1, wherein the workstation is configured to display a CMR medical image of the patient'"'"'s heart, and wherein the workstation further comprises an electronic boundary tracing tool configured to accept user input to electronically define at least one boundary of a target region of a heart in the medical image of the patient on the display.

4. A workstation according to claim 3, wherein the workstation is configured to evaluate intensity of voxels associated with tissue within the defined boundary of the target region of the heart whereby cardiotoxicity is evaluated.

5. A workstation according to claim 4, wherein the electronic boundary tracing tool is configured to accept user input to define a plurality of adjacent regions of interest in a left ventricle myocardium, and wherein the workstation is configured to analyze a chemotherapeutic induced cardiotoxicity state of the patient based on intensity voxel data associated with the regions of interest.

6. A workstation according to claim 3, wherein the electronic boundary tracing tool is configured to allow a user to trace at least one of endo- and epicardial boundaries of a left ventricle myocardium in a CMR image.

7. A workstation according to claim 3, wherein the electronic boundary tracing tool is configured to accept user input to define a region of interest associated with background noise in the air, whereby voxel intensity data from the background noise region of interest is subtracted from voxel intensity data associated with the left ventricle.

8. A workstation according to claim 3 wherein the electronic boundary tracing tool comprises a graphic user interface (GUI).

9. A workstation according to claim 8, wherein the GUI is configured to accept freehand input of a user whereby the electronic tool traces the boundary based on the freehand manual input of the user.

10. A workstation according to claim 8, wherein the GUI is configured to provide at least one electronically selectable line or curve that can overlay a boundary of the target region of the heart, the electronically selectable line or curve having an electronically adjustable shape and/or size.

11. A workstation according to claim 8, wherein the line or curve comprises at least one electronically selectable closed spline curve that is electronically adjustable in shape and size using electronic control handles.

12. A workstation according to claim 8, wherein the GUI is configured to provide electronically selectable points that can be electronically placed along the boundary of the target region, wherein when the points have been positioned by the user on tissue associated with the target region in the heart, the system electronically connects the points to define the boundary.

13. A workstation according to claim 3, wherein the electronic tool is configured to trace regions of interest associated with a left ventricle myocardium in a left ventricular short axis CMR (cardio Magnetic Resonance) image view.

14. A workstation according to claim 1, wherein the display is in communication with a 2-D visualization compartment model of the heart module, wherein intensity voxel data in different compartments is derived from region of interest histograms of voxel intensity data and is spatially allocated to and visually illustrated in the visualization of a corresponding standardized compartment.

15. A workstation according to claim 1, wherein the display is in communication with a cardiotoxicity status module that indicates whether an oncology patient has or is likely to have cardiotoxicity induced cardiac injury based on voxel intensity data associated with the 3-D image.

16. A workstation according to claim 15, wherein the cardiotoxicity status module is configured to predict a likelihood of cardiac injury associated with an intensity and location of voxel intensity data associated with a future predicted decrease in LVEF if chemotherapy continues as currently administered.

17. A cardiotoxicity or cardiac injury evaluation signal processor circuit, comprising:

a cardiac image generator module configured to generate a 3-D image of the population of intensity voxels of the heart in communication with a display; and

a histogram module in communication with the cardiac image generator module configured to generate a plurality of histograms of voxel intensity data associated with regions of interest in the heart.

18. A circuit according to claim 17, further comprising an electronic boundary tracing tool in communication with a display and the cardiotoxicity evaluation circuit, the electronic boundary tracing tool is configured to accept user input to electronically define a boundary of at least one target region of interest of a heart in a medical image of a patient on the display, and wherein voxel data for at least one of the histograms is associated with a region of interest based on the user defined boundary of the at least one target region of interest.

19. A circuit according to claim 18, further comprising a cardiotoxicity evaluation circuit in communication with the image generator module and the histogram module, wherein the cardiotoxicity circuit is configured to evaluate a patient'"'"'s cardiotoxicity status based on intensity data associated with at least one region of interest.

20. A circuit according to claim 18, wherein the electronic boundary tracing tool is configured to accept user input to define epi and endo cardial boundaries of a left ventricle myocardium.

21. A circuit according to claim 18, wherein the medical image is a CMR image comprising voxel intensity data.

22. A circuit according to claim 18, wherein the cardiotoxicity evaluation circuit is configured to electronically register voxel data of first and second images of the patient'"'"'s left ventricle myocardium, taken from temporally spaced apart image acquisitions, using boundary data from the user-defined boundaries of the regions of interest of the left ventricle myocardium defined by the electronic tool.

23. A circuit according to claim 18, further comprising a 2-D cardiac visualization module configured to electronically generate a standardized compartment model of the heart, and wherein intensity voxel data from different compartments of the heart are visually represented in the respective model compartment based on boundary data from the electronic boundary tracing tool.

24. A circuit according to claim 18, wherein the cardiotoxicity evaluation circuit is configured to electronically generate a report that indicates whether the patient has or is likely to have cardiotoxicity induced cardiac injury from chemotherapy.

25. A circuit workstation according to claim 18, wherein the cardiotoxicity evaluation circuit is configured to determine a likelihood of cardiac injury associated with an increase in intensity of voxel data associated with a future projected decrease in LVEF if the patient is continued on a current chemotherapy regimen.

33. A method according to claim 24, wherein the medical image is a CMR or CT X-ray image.

26. A method of evaluating cardiac images, comprising:

receiving user input to electronically draw at least one boundary of a target region of interest of a left ventricle myocardium in a medical image on a display; and

electronically associating voxels residing in the drawn boundary to the region of interest defined within the drawn boundary.

27. A method according to claim 26, further comprising electronically generating at least one histogram of intensity data of at least one region of interest in the left ventricle myocardium using voxel data within the boundary drawn with user input.

28. A method according to claim 26, further comprising electronically assigning voxel intensity data to a region of interest based on epi or endo cardial boundaries drawn by the accepting user input step.

29. A method according to claim 26, further comprising electronically drawing a region of interest in the air on the display associated with background noise.

30. A method according to claim 29, wherein the electronically drawing a region of interest outside the patient comprises accepting user input to select a location and/or to draw the region of interest.

31. A method according to claim 29, wherein a shape and size of the background region of interest is automatically sized to be similar to the shape and size of a region of interest in the myocardium.

32. A method according to claim 29, further comprising generating a difference histogram of voxel intensity using data from the background region of interest.

34. A method to present global injury data to a clinician, comprising:

generating a 3-D image of a heart on a display, the image visually illustrating in color, different intensities of a population of voxels the image.

35. A method according to claim 34, further comprising generating a visual 2-D compartmental model of the heart illustrating the different intensities of the population of voxels within respective compartments of the heart.

36. A computer program product for evaluating cardiotoxicity or cardiac injury in a patient, comprising:

a computer readable medium having computer readable program code embodied therein, the computer readable program code comprising;

computer readable program code configured to accept user input to electronically draw a boundary line associated with at least one target region of interest in a left ventricle myocardium of a medical image of a patient on a display;

computer readable program code configured to generate a histogram of voxel intensity of the at least one region of interest with voxels within the region of interest defined by the drawn boundary;

computer readable program code configured to generate a 3-D image of intensities of a population of voxels across the heart; and

computer readable program code configured to determine a likelihood of cardiac injury associated with cardiotoxicity due to chemotherapy.

37. A computer program product according to claim 36, wherein the medical image is obtained after administration of a contrast agent to the patient.

38. A computer program product according to claim 36, wherein the medical image is a CMR image, the computer product further comprising computer readable program code configured to correlate voxel intensity values of regions of interest in the image with x, y and z coordinates.

39. A computer program product according to claim 36, further comprising:

computer readable program code configured to obtain a region of interest outside the heart corresponding to the first cardiac image; and

computer readable program code configured to generate a difference histogram of adjusted intensity values of voxels in the at least one cardiac image using the region of interest outside the heart.

40. A computer program product according to claim 36, further comprising computer readable program code configured to generate an electronic standardized 2-D compartment model of the heart, and computer readable program code configured to visually map intensity voxel data to different model compartments.

41. A computer program product according to claim 40, wherein the computer program that is configured to visually map uses boundary information to allocate voxels to regions of interest from the boundary drawn by the user input based electronically drawn boundary line.

42. A system for non-invasively evaluating cardiac injury:

a graphic user interface (GUI) in communication with a display for accepting user input to draw at least one boundary about at least one target region of interest in a left ventricle myocardium in an MRI or CT image of a patient; and

a signal processor circuit configured to;

(a) electronically generate at least one histogram of intensities of voxels/pixels in the MRI or CT image of the at least one region of interest based on boundary data from the boundary drawn with the GUI.

43. A system according to claim 42, wherein the signal processor circuit is further configured to (b) electronically determine a likelihood of cardiac injury due to cardiotoxicity based on data from the at least one histogram.

44. A system for non-invasively evaluating cardiac injury due to cardiotoxicity:

a signal processor circuit configured to generate a 3-D image of voxel data of a patient'"'"'s heart that visually illustrates differences in intensity of voxels associated with the heart and locations and intensity of clusters of voxels with similar intensity across at least a major portion of a population of voxels obtained from a CMR or CT image of a patient'"'"'s heart, wherein voxels of intensity representing cell injury and cell death are visualized.

45. A system according to claim 44, wherein the signal processor circuit is further configured to:

electronically generate at least one histogram of intensities of voxels/pixels in the MRI or CT image of the at least one region of interest based on boundary data from the boundary drawn with the GUI; and

electronically determine a likelihood of cardiac injury due to cardiotoxicity based on data from the at least one histogram.