Coronary Plaque Detection using Novel Imaging

1. Coronary Plaque detection using
Novel Imaging
DR.TATCHANAAMURRTI
2016

2. Coronary Artery Disease
Coronary artery disease (CAD) is a
condition in which plaque builds up
inside the coronary arteries.
Plaque is made up of fat, cholesterol,
calcium, and other substances found i
n
the blood, and narrows the arteries an
Coronary artery disease (CAD) is a
condition in which plaque builds up
inside the coronary arteries.
Plaque is made up of fat, cholesterol,
calcium, and other substances found i
n
the blood, and narrows the arteries an

3. Statistics
• According to the latest WHO data published in
may 2014 Coronary Heart Disease Deaths in
Malaysia reached 29,363 or 23.10% of total
deaths. The age adjusted Death Rate is 150.11
per 100,000 of population ranks Malaysia #33
in the world.

4. Novel Imaging
• Radicals are thought to believed to be involved in the
early stages of many diseases, including cancer,
inflammatory disease, heart disease and many more.
• Our aim is to design, build and use 'scanners' to show
where these free radicals are within the body, and to
view the response of these free radicals to various
forms of treatment.

5. Invasive & Non-Invasive
• Invasive: An invasive procedures is defined as a
medical procedure which breaks the skin in some
way. Example: Surgery
• Non-Invasive: Non-invasive procedures are also quite
common. These are defined as any medical procedure
which does not break the skin. Example: MRI ,CT

6. Heart attack
Need immediate
treatment

7. Video

8. Angina
• Angina–also sometimes called angina pectoris.
It means that the heart is not getting enough
blood and as a result, not enough oxygen.
This decrease of oxygen being delivered to the
muscle of the heart happens if one or more
coronary arteries are narrowed or blocked, a
condition called atherosclerosis.

10. Imaging Modalities
• Multi Detector Computed Tomography (MDCT) ...
• Magnetic Resonance Imaging (MRI) ...
• SPECT (Single-Photon emission Computed
Tomography)
• PET-CT. ...
• Ultrasound. ...
• X-Ray. ...
• Biomarkers

11. World Class Review
• Evaluation of 64-slice MDCT in the real world
of cardiology: A comparison with
conventional coronary angiography
Author by
Javier Sanz - The Zena and Michael A. Wiener cardiovascular institute, the Marie-José
and Henry R. Kravis cardiovascular health center, Mount Sinai School of
Medicine, New York, USA
Alexander Leber
Department of clinical cardiology and radiology, Ludwig-Maximilians-University,
Munich, Germany.

12. Multi Detector Computed Tomography

14. Cardiac CT

15. Advantages
• Improved spatial resolution.
• Motion artifacts reduced.
• Patient breath hold is much less demanding.
• Imaging larger z-axis volume in less time.
• Less contrast medium required.
• Improved accuracy in needle placement CT
fluoroscopy.

16. Artifacts in Multi-slice scanning
• Motion artifact reduced by faster scanning.
• Stair-step artifacts in 3D reconstruction
reduced by using thinner slices.
• Partial volume artifacts reduced by using
thinner slices

17. NEW CT TECHNOLOGY

18. Cardiac MRI

19. Comparison
Modalities Advantages Limitations
MRI
High Contrast Noise
Ration(CNR) –Image quality
High accuracy
Limited spatial resolution
of MRI in axial direction
(slice thickness)
Low ionizing radiation and
less toxic contrast agent
Higher cost. Longer
scanning time
Highly attractive for
viability imaging
Restriction to patients with
implanted electronic
devices
CT SCAN
Improved spatial resolution High radiation and contrast
dose
Faster/high temporal
resolution
Lower CNR
Greatly reduced slice width Require hardware
development to reduce
motion artifact

20. Basic Medical Image Processing
System
Acquisition
Processing
Visualizing/Reporting
Pre processing
Segmentation
Detection
Analyzing
Diagnosis

21. Preprocessing of Images
• Filtering
• Image Denoising
• Image Registration
• Image enhancement

22. List of algorithms for
Preprocessing
• Median filter
• Mean filter
• Wavelet Based Denoising
• Wavelet based Image registration
• Support Vector Machine

23. Segmentation
•Exactly delimitate objects, once they are detected
-Cardiac Imaging
-Coronary plaque
-Blood clot

24. Detection
• Find the location of objects of interest without
prior knowledge about their location/
existence.
-Right artery
-Left artery

25. Analysis

26. Challenges unique to medical images.
• Compression Algorithms
• Lossy / Lossless
• Medical Images should always be stored in
lossless format.
• Erroneous Diagnostics and its legal
implications.

27. Conclusion
The use of 16-slice CT scanner with 400ms rotation time,
combined with ß-blocking agent has significantly improved the
diagnostic accuracy of MDCT to non-invasive detection of
coronary stenosis.
Fast MDCT is moving fast to become the first screening imaging
technique for detection of coronary artery

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