Skip to Main content Skip to Navigation
Master Thesis

Détection et quantification de l'hétérogénéité spatiale de perfusion myocardique par analyse markovienne de la tomoscintigraphie monophotonique au Thallium deux cent un‎ : étude clinique preuve de concept à partir de 125 patients

Abstract : Background: Myocardial perfusion heterogeneity (MPH) is a surrogate marker of coronary endothelial dysfunction and of future cardiovascular events (CVE). We addressed the ability of 201Thallium single photon emission tomography (SPECT) to evidence and quantify MPH (MPH index = Hi) based on Markovian analysis of perfusion images. Methods: 39 diabetic and 21 control patients were included to determine the optimal imaging parameters to assess MPH. A separate cohort of 46 diabetic and 19 control patients was used to validate Hi diagnostic and prognostic values. Results: Diabetes (p=0.003), Butteworth filter parameters (p=0.0001), and body weight (p=0.002) were associated to Hi variations. Stress images applying a Butterworth filter with cut-off/roll-off values of 0.3/20 offered the best compromise between MPH detection and image quality: Hi=0.53+0.10 in diabetic versus 0.64+0.09 in control patients (p=0.0004); area under the ROC-curve = 0.77+0.06 for identifying diabetic from control subjects. In the validation cohort, Hi was also lower in diabetic (0.55+0.01) than in control subjects (0.66+0.02, p=0.003), and accurately identified the 2 populations with an area under the ROC-curve of 0.78±0.06. At follow-up (13+4 months), CVEs occurred in 4/46 diabetic patients. Hi was 0.41+0.01 in patients with CVEs versus 0.56+0.09 in patients without CVEs (p=0.005). The occurrence of future events was 4/16 (25%) and 0/30 (0%) in patients with Hi<0.50 and Hi>0.50 respectively (p=0.02). Conclusion: Our results first demonstrate that Markovian analysis of 201Thallium-SPECT stress images (with 0.3/20 Butterworth filter) allows detection and quantification of MPH. This technique seems promising for diagnosis and prognosis purpose in selected high-risk subjects.
Document type :
Master Thesis
Complete list of metadata

Cited literature [39 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-00747868
Contributor : Jean-Hugues Morneau <>
Submitted on : Friday, November 2, 2012 - 2:20:36 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
Long-term archiving on: : Sunday, February 3, 2013 - 3:36:55 AM

Identifiers

  • HAL Id : dumas-00747868, version 1

Citation

Alix Martin. Détection et quantification de l'hétérogénéité spatiale de perfusion myocardique par analyse markovienne de la tomoscintigraphie monophotonique au Thallium deux cent un‎ : étude clinique preuve de concept à partir de 125 patients. Human health and pathology. 2011. ⟨dumas-00747868⟩

Share

Metrics

Record views

132

Files downloads

640