Imaging techniques for evaluating cardiovascular disease have evolved rapidly over the past decade, in particular three-dimensional (3D) tomographic imaging techniques such as multi-detector computed tomography (MDCT), magnetic resonance imaging (MRI) and positron emission tomography (PET). However, current visualization and analysis techniques reduce these 3D modalities to only 2 dimensions (e.g. stacks of images, bullseye plots). We believe that 3D visualization and analysis provide a more appropriate and intuitive framework for evaluating cardiovascular disease, as the heart is an inherently 3D structure. Thus, we endeavor to develop and validate such tools. Studies have shown that recovery of function after coronary revascularization depends upon the extent of viable myocardium in the left ventricle (LV). Tomographic imaging techniques such MRI and PET are often used to assess myocardial viability for the purpose of planning coronary revascularization. However, the success of imaging as a tool to aid revascularization planning depends upon the accuracy of associations between regions of myocardium and a patient's coronary anatomy. Currently, population-based LV models are used to make this association. However, the coronary anatomy of many patients will deviate from models. Hypothesis: 3D visualization tools which enable simultaneous multi-modality display of imaging data can accurately depict the relationship between coronary anatomy and myocardial viability in the individual patient. To test this hypothesis, we will pursue the following specific aims: (1) To develop and evaluate patient-specific coronary distribution maps based on noninvasive tomographic imaging; (2) Develop and evaluate patient-specific parametric maps of myocardial viability, derived from MRI and PET images; (3) Spatial co-registration of multi-modality imaging studies. If successful, this proposal could enhance visualization of the effects of coronary artery disease in individual patients, thus enabling optimized revascularization planning tailored to the individual's anatomy.
