Non-invasive imaging for determination of global tissue characteristics

• US 8,532,739 B2
• Filed: 01/24/2008
• Issued: 09/10/2013
• Est. Priority Date: 02/06/2004
• 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., Lane, Kimberly, Morgan, Tim, Torti, Frank
• Primary Examiner(s): MEHTA, PARIKHA SOLANKI
• Application Number:
  US12/019,457
• Publication Number:
  US 20080119718A1
• Time in Patent Office: 2,056 Days
• Field of Search: 600/407, 600/410, 600/420, 600/411, 600/425, 600/427, 382128-132, 382/154, 382/181, 382/190, 382/195, 382/254, 382/274, 382/276, 345/589, 345/629
• US Class Current: 600/411
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/42 Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems A61B1/00, A61B5/4857, A61B5/486, A61B5/4866, A61B5/4869 take precedence
• CPC Class Codes: A61B 5/4519 Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• 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: G01R 33/281 Means for the use of in vitro contrast agents G01R33/282 takes precedence; involving use of a contrast agent in MR imaging G01R33/5601; in vivo contrast agents A61K49/0002
• CPC Class Codes: G01R 33/56 Image enhancement or correction, e.g. subtraction or averaging techniques , e.g. improvement of signal-to-noise ratio and resolution
• CPC Class Codes: G06T 2200/24 involving graphical user interfaces [GUIs]
• CPC Class Codes: G06T 2207/10088 Magnetic resonance imaging [MRI]
• CPC Class Codes: G06T 2207/30048 Heart; Cardiac
• CPC Class Codes: G06T 7/0014 using an image reference approach
• CPC Class Codes: G06T 7/41 based on statistical description of texture

Abstract

Evaluating tissue characteristics including identification of injured tissue or alteration of the ratios of native tissue components such as shifting the amounts of normal myocytes and fibrotic tissue in the heart, identifying increases in the amount of extracellular components or fluid (like edema or extracellular matrix proteins), or detecting infiltration of tumor cells or mediators of inflammation into the tissue of interest in a patient, such as a human being, is provided by obtaining a first image of tissue including a region of interest from a first acquisition, and obtaining a second image of the tissue including the region of interest during a second, subsequent acquisition. The subsequent acquisition may be obtained after a period of time to determine if injury has occurred during that period of time. Such a comparison may include comparison of mean, average characteristics, histogram shape, such as skew and kurtosis, or distribution of intensities within the histogram.

Claims

1. A method of evaluating a potential of a global injury of tissue of a patient, comprising:

electronically registering a region of interest in a first image with a corresponding region of interest in a second image obtained subsequent to the first image;

electronically determining a global intensity characteristic of the region of interest based on image data from the first and second images, wherein the determining the global intensity characteristic comprises evaluating at least one of skew, kurtosis, or standard deviation of at least one property of pixels/voxels of the region of interest and/or at least one of a shape or distribution of at least one pixel/voxel intensity histogram associated with the region of interest;

electronically applying an autocorrelation statistic (I) to determine a relationship between a pattern of pixel parameters within a three dimensional tissue volume of a ROI (region of interest) to evaluate whether the pattern is clustered or randomly distributed or diffuse; and

electronically displaying to a user a likelihood of at least one of an actual or a potential for a global injury of tissue in the region of interest based on the determined global intensity characteristic, wherein the global injury is due to a change in tissue composition and/or function that is in a scattered, diffuse and/or randomly distributed pattern in the region of interest.

2. The method of claim 1, wherein the first and the second images comprise at least one of Magnetic Resonance Imaging (MRI) images, X-ray computed tomography (CT) images, ultrasound images, single photon emission computed tomography (SPECT) images and/or positron emission tomography (PET) images.

3. The method of claim 1, wherein each of the first and second images comprise a plurality of MM slices.

4. The method of claim 1, wherein at least one of the first and second images comprises MRI slices, and wherein electronically determining the global intensity characteristic includes electronically evaluating the shape or distribution of at least one pixel/voxel intensity histogram.

5. The method of claim 1, wherein the tissue includes at least one of heart, blood, muscle, brain, nerve, skeletal, skeletal muscle, liver, kidney, lung, pancreas, endocrine, gastrointestinal and/or genitourinary tissue.

6. The method of claim 1, wherein the images are cardiac MRI images, wherein the electronically determining step that determines the likelihood of at least one of an actual or a potential for a global injury determines the likelihood of a future onset of global cardiac injury including at least one of viral cardiomyopathy, alcoholic cardiomyopathy, postpartum cardiomyopathy, idiopathic dilated cardiomyopathy, cardiac necrosis, cardiac edema or cardiac fibrosis, and wherein the electronically displaying is carried out to display the likelihood of the future onset of global cardiac injury to a workstation having a display associated with a clinician or other user.

7. The method of claim 6, wherein the first and second images are cardiac images, wherein at least one of the first image and the second images comprise a Magnetic Resonance Imaging (MRI) image, and wherein at least the second image is taken after administration of a cytotoxic chemotherapeutic drug to the patient.

8. The method of claim 7, wherein the chemotherapeutic drug is for treating cancer, and wherein the method further comprises obtaining images at intervals prior to or after a planned chemotherapeutic drug to evaluate whether myocellular necrosis is likely to result in a drop in LVEF (left ventricular ejection fraction).

9. The method of claim 7, further comprising obtaining the second image after administration of doxorubicin to evaluate whether myocellular necrosis is likely to result in a drop in LVEF (left ventricular ejection fraction).

10. The method of claim 7, further comprising obtaining the second and at least one subsequent image after administration of anthracycline to evaluate whether myocellular necrosis is likely to result in a drop in LVEF (left ventricular ejection fraction).

11. The method of claim 6, further comprising electronically determining whether a distribution pattern of voxel or pixels of high intensity in a left ventricle myocardium is distributed rather than clustered to predict whether a myocellular injury secondary to cytotoxic chemotherapy is likely to be associated with a fall in LVEF (left ventricular ejection fraction).

12. The method of claim 1, wherein the images are cardiac MRI images of a plurality of slices of a patient'"'"'s heart, and wherein the global injury is associated with myocardial edema, fibrosis or necrosis that is not visually detectable at a resolution of the cardiac MRI images.

13. A method of evaluating a potential of a global cardiac injury of tissue of a patient, comprising:

electronically evaluating intensity and associated x, y, z coordinates of pixels/voxels in a plurality of cardiac MR (Magnetic Resonance) image slices of a three dimensional tissue volume of a left ventricle of the patient of a region of interest in a first image and a corresponding region of interest in a second image obtained after the first image;

electronically applying an autocorrelation statistic (I) to determine a relationship between a pattern of pixel/voxel intensity within each image slice of the three dimensional tissue volume of the left ventricle to evaluate whether the pattern is clustered or distributed;

electronically determining if there is a scattered or distributed pattern or a clustered pattern of high intensity pixels/voxels in the region of interest using the autocorrelation statistic; and

outputting to a display associated with a user a prediction or evaluation of global injury

to tissue in the region of interest based on the determined pattern of high intensity data,

wherein the global injury is associated with a diffuse, scattered or distributed pattern of high intensity pixels/voxels rather than a clustered pattern.

14. A method according to claim 13, further comprising evaluating a global intensity characteristic of the region of interest based on data from the first and second images, wherein evaluating the global intensity characteristic comprises evaluating at least one of skew, kurtosis, or standard deviation of at least one property of pixels/voxels of the region of interest and/or at least one of a shape or distribution of at least one pixel/voxel intensity histogram associated with the region of interest.

15. A system for predicting, evaluating and/or detecting global injury in a patient, comprising:

at least one processor configured to (i) identify intensity and x, y, z coordinates of each voxel in 3-dimensional space to determine a global intensity characteristic of a region of interest based on data from first and second MR (Magnetic Resonance) images, wherein the global intensity characteristic comprises evaluating at least one of skew, kurtosis, or standard deviation of at least the intensity of pixels/voxels in the region of interest and/or at least one of a shape or distribution of at least one pixel/voxel intensity histogram associated with the region of interest and (ii) apply an autocorrelation measure/statistic (I) to determine a relationship between a pattern of high intensity pixels within each image slice to determine if there is pattern clustering within a ROI (region of interest) or a random or diffuse pattern.

16. The system of claim 15, wherein the first image and the second image comprise cardiac Magnetic Resonance Imaging (MRI) images if a left ventricle.

17. A system of evaluating an actual or potential of a global injury of tissue of a patient, comprising:

a circuit with at least one processor configured to;

(i) compare image data derived from a region of interest in a first image of tissue with image data derived from a corresponding region of interest in a second image of tissue obtained after the first image and identify image intensity of each voxel and coordinates in three dimensional space;

(ii) determine if there is a distributed or scattered pattern of high intensity voxels and/or pixels in the region of interest by applying an autocorrelation statistic (I) to determine a relationship between a pattern of high intensity pixels within each slice, to evaluate whether the pattern is clustered or randomly distributed or diffuse; and

(iii) output to a display a prediction or evaluation of a global injury to tissue in the region of interest to a user based on the determined pattern of high intensity data, wherein the global injury is due to a change in tissue composition and/or function that is in a random or diffuse distributed pattern and not a clustered pattern and/or in a pattern that is not visually detectable at a resolution of the images.

18. The system of claim 17, wherein the first and second images of the region of interest are images of at least one of heart, blood, muscle, brain, nerve, skeletal, skeletal muscle, liver, kidney, lung, pancreas, endocrine, gastrointestinal and/or genitourinary tissue.

19. The system of claim 17, wherein the first and second images comprise at least one of a Magnetic Resonance Imaging (MRI) image, and/or an X-ray computed tomography image, an ultrasound image, a single photon emission computed tomography (SPECT) image and/or positron emission tomography (PET) image.

20. A system according to claim 17, wherein the first and second images comprise cardiac MR images including image slices of a left ventricle, and wherein the at least one processor is configured to output to the display histogram data associated with image intensity data of the region of interest derived from the first and second images.

21. A system of non-invasively evaluating a patient for injury or abnormality, comprising:

a circuit that comprises at least one processor configured to a ply an to determine if there is a pattern of a defined at least one voxel characteristic within a three dimensional (3-D) tissue volume of a ROI (region of interest) and analyze the at least one characteristic of voxels of MRI image slices to detect a global injury, global abnormal tissue, or global abnormal accumulation of materials not found in normal ratios within native tissue, even when the characteristic of those voxels is in a random pattern or in a pattern that is not visually detectable at a resolution of the MRI image slices, wherein the global injury, global abnormal tissue or global accumulation is identified when there is a determined pattern that is scattered, diffuse and/or randomly distributed in the 3-D volume of the region of interest; and

a display in communication with the circuit that provides an output of the analysis.

22. The system of claim 21, wherein the region of interest is the heart, wherein the circuit is configured to analyze a global cardiac injury as the global injury, and wherein the circuit analyzes histograms for skew or kurtosis to identify the global cardiac injury.

23. The system of claim 21, wherein the circuit is configured to define associated x, y and z voxel coordinates of each voxel in the region of interest.

24. The system of claim 21, wherein the region of interest is the heart, and wherein the MRI image slices comprise perfusion images acquired using blood oxygenation level dependent (BOLD) cardiac imaging.

25. The system of claim 21, wherein the circuit is configured to detect a global cardiac injury associated with at least one of cardiomyopathy, edema or fibrosis.

26. The system of claim 21, wherein the circuit is configured to apply an autocorrelation statistic (I) to carry out the autocorrelation to determine if there is a pattern of high intensity pixels within each image slice, to assess whether a determined pattern is distributed or clustered in the 3-D volume of the region of interest.