Cardiac visualization systems for displaying 3-D images of cardiac voxel intensity distributions with optional physician interactive boundary tracing tools

• US 8,103,073 B2
• Filed: 02/17/2011
• Issued: 01/24/2012
• Est. Priority Date: 02/02/2006
• Status: Expired due to Fees

• Current Assignee: Wake Forest University Health Sciences
• Original Assignee: Wake Forest University Health Sciences
• Inventors: Hundley, William Gregory, Hamilton, Craig A., D'Agostino, Ralph B.
• Primary Examiner(s): Fitzpatrick, Atiba O
• Application Number:
  US13/029,380
• Publication Number:
  US 20110164796A1
• Time in Patent Office: 341 Days
• Field of Search: 382128-134, 128920-925, 356 39- 49, 600407-414, 600424-426, 345581-618
• US Class Current: 382/128
• 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 cardiotoxicity or cardiac injury evaluation signal processor circuit, comprising:

a cardiac image generator module configured to generate at least one 3-D image of a population of intensity voxels of a patient'"'"'s 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,

wherein the circuit is configured to selectively present a 2-D compartmental model of the heart on the display, the 2-D compartmental model having a plurality of adjacent compartments in at least two of the following;

apical, mid and basal short axis slices of the heart, wherein voxel data from the histograms are used to populate the compartments of the model with measures of voxel intensity to provide visual data to allow a clinician to identify cell injury, cell death, fibrosis, cardiac injury and/or predict a likelihood of a negative cardiac event.

2. A circuit according to claim 1, further comprising an electronic boundary tracing tool in communication with a display and a cardiotoxicity evaluation circuit in communication with the cardiac image generator module, wherein 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 the at least one target region of interest associated with the user defined boundary.

3. A circuit according to claim 2, 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 of the regions of interest.

4. A circuit according to claim 2, wherein the electronic boundary tracing tool is configured to accept user input to define epi and endo cardial boundaries of a left ventricle myocardium.

5. A circuit according to claim 2, wherein the medical image is a CMR image comprising voxel intensity data, wherein the at least one 3-D image of the heart is a plurality of color scale 3-D images, wherein histograms define voxel data used to generate the 3-D images of the heart.

6. A circuit according to claim 2, 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 identified by the electronic boundary tracing tool.

7. A circuit according to claim 2, 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.

8. A circuit according to claim 2, 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.

9. A circuit workstation according to claim 2, 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 when the patient is continued on a current chemotherapy regimen.

10. A method of evaluating cardiac images, comprising:

displaying a medical image of the patient'"'"'s heart on a display associated with a clinician workstation;

receiving user input from an electronic boundary tracing tool in communication with the display to allow a user to electronically draw an annulus encompassing a left ventricle myocardium as two separate closed curves on the image on the display such that an inner boundary line is drawn about an endocardial surface and an outer boundary line is drawn about an epicardial surface, to define region of interest of the left ventricle myocardium in the medical image; and

electronically associating voxels residing in the drawn boundaries to the region of interest.

11. A method according to claim 10, 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 one or more of the boundaries drawn with user input.

12. A method according to claim 10, 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.

13. A method according to claim 10, further comprising electronically drawing a region of interest in air on the display associated with background noise.

14. A method according to claim 10, electronically drawing a region of interest outside the medical image of the patient by accepting user input to select a location and/or to draw the region of interest.

15. A method according to claim 10, wherein a shape and size of a background region of interest is automatically sized to be similar to shape and size of a target region of interest in the myocardium.

16. A method according to claim 10, further comprising generating a difference histogram of voxel intensity using data from a background region of interest.

17. A method according to claim 10, wherein the medical image is a CMR or CT X-ray image.

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

a non-transient 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 at least one 3-D image of intensities of a population of voxels across the heart;

computer readable program code configured to present a 2-D compartmental model of the heart, the 2-D compartmental model having a plurality of adjacent compartments in at least two of the following;

apical, mid and basal short axis slices of the heart, wherein voxel data from histograms are used to populate the compartments of the model with measures of voxel intensity to provide visual data to allow a clinician to identify cell injury, cell death, fibrosis, cardiac injury and/or predict a likelihood of a negative cardiac event; and

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

19. A computer program product according to claim 18, wherein the medical image is obtained after administration of a contrast agent to the patient.

20. A computer program product according to claim 18, 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, and wherein the computer readable program code configured to generate the at least one 3-D image of intensities of a population of voxels across the heart uses the correlated voxel intensity values and coordinates.

21. A computer program product according to claim 18, further comprising:

computer readable program code configured to obtain a region of interest outside the heart; 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.

22. A computer program product according to claim 18, further comprising computer readable program code configured to visually map intensity voxel data to different model compartments of the 2-D compartmental model of the heart.

23. A computer program product according to claim 22, 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.

24. 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;

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 generate a 2-D compartmental model of the heart on the display, the 2-D compartmental model having a plurality of adjacent compartments in at least two of the following;

apical, mid and basal short axis slices of the heart, wherein voxel data from histograms are used to populate the compartments of the model with measures of voxel intensity to provide visual data to allow a clinician to identify cell injury, cell death, fibrosis, cardiac injury and/or predict a likelihood of a negative cardiac event.

25. A system according to claim 24, wherein the signal processor circuit is configured to electronically generate 3-D color scale images of the patient'"'"'s heart, and wherein the signal processor circuit is further configured to perform at least one of the following:

(i) electronically determine a likelihood of cardiac injury due to cardiotoxicity or (ii) identify at least one of cell injury, cell death, fibrosis, cardiac injury and/or predict a likelihood of a negative cardiac event using at least one of (a) histogram data, (b) the 2-D compartmental model or (c) at least one of the 3-D images.