Pixel-wise statistical analysis of myocardial injury in STEMI patients with delayed enhancement MRI
ObjectivesMyocardial injury assessment from delayed enhancement magnetic resonance images is routinely limited to global descriptors such as size and transmurality. Statistical tools from computational anatomy can drastically improve this characterization, and refine the assessment of therapeutic pr...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1136760/full |
| _version_ | 1797802619964489728 |
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| author | Nicolas Duchateau Nicolas Duchateau Magalie Viallon Magalie Viallon Lorena Petrusca Patrick Clarysse Nathan Mewton Loic Belle Pierre Croisille Pierre Croisille |
| author_facet | Nicolas Duchateau Nicolas Duchateau Magalie Viallon Magalie Viallon Lorena Petrusca Patrick Clarysse Nathan Mewton Loic Belle Pierre Croisille Pierre Croisille |
| author_sort | Nicolas Duchateau |
| collection | DOAJ |
| description | ObjectivesMyocardial injury assessment from delayed enhancement magnetic resonance images is routinely limited to global descriptors such as size and transmurality. Statistical tools from computational anatomy can drastically improve this characterization, and refine the assessment of therapeutic procedures aiming at infarct size reduction. Based on these techniques, we propose a new characterization of myocardial injury up to the pixel resolution. We demonstrate it on the imaging data from the Minimalist Immediate Mechanical Intervention randomized clinical trial (MIMI: NCT01360242), which aimed at comparing immediate and delayed stenting in acute ST-Elevation Myocardial Infarction (STEMI) patients.MethodsWe analyzed 123 patients from the MIMI trial (62 ± 12 years, 98 male, 65 immediate 58 delayed stenting). Early and late enhancement images were transported onto a common geometry using techniques inspired by statistical atlases, allowing pixel-wise comparisons across population subgroups. A practical visualization of lesion patterns against specific clinical and therapeutic characteristics was also proposed using state-of-the-art dimensionality reduction.ResultsInfarct patterns were roughly comparable between the two treatments across the whole myocardium. Subtle but significant local differences were observed for the LCX and RCA territories with higher transmurality for delayed stenting at lateral and inferior/inferoseptal locations, respectively (15% and 23% of myocardial locations with a p-value <0.05, mainly in these regions). In contrast, global measurements were comparable for all territories (no statistically significant differences for all-except-one measurements before standardization / for all after standardization), although immediate stenting resulted in more subjects without reperfusion injury.ConclusionOur approach substantially empowers the analysis of lesion patterns with standardized comparisons up to the pixel resolution, and may reveal subtle differences not accessible with global observations. On the MIMI trial data as illustrative case, it confirmed its general conclusions regarding the lack of benefit of delayed stenting, but revealed subgroups differences thanks to the standardized and finer analysis scale. |
| first_indexed | 2024-03-13T05:09:25Z |
| format | Article |
| id | doaj.art-ecc66467fcfc41408f2052d7aedf3cf2 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-13T05:09:25Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-ecc66467fcfc41408f2052d7aedf3cf22023-06-16T06:10:07ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-06-011010.3389/fcvm.2023.11367601136760Pixel-wise statistical analysis of myocardial injury in STEMI patients with delayed enhancement MRINicolas Duchateau0Nicolas Duchateau1Magalie Viallon2Magalie Viallon3Lorena Petrusca4Patrick Clarysse5Nathan Mewton6Loic Belle7Pierre Croisille8Pierre Croisille9Univ Lyon, CREATIS, INSA, CNRS UMR 5220, INSERM U1294, Université Lyon 1, UJM Saint-Etienne, Lyon, FranceInstitut Universitaire de France (IUF), Paris, FranceUniv Lyon, CREATIS, INSA, CNRS UMR 5220, INSERM U1294, Université Lyon 1, UJM Saint-Etienne, Lyon, FranceDepartment of Radiology, Hôpital Nord, University Hospital of Saint-Étienne, Saint-Étienne, FranceUniv Lyon, CREATIS, INSA, CNRS UMR 5220, INSERM U1294, Université Lyon 1, UJM Saint-Etienne, Lyon, FranceUniv Lyon, CREATIS, INSA, CNRS UMR 5220, INSERM U1294, Université Lyon 1, UJM Saint-Etienne, Lyon, FranceDepartment of Cardiology, Clinical Investigation Center, INSERM 1407, Hôpital Cardiovasculaire Louis Pradel, Lyon, FranceDepartment of Cardiology, Centre Hospitalier Annecy-Genevois, Annecy, FranceUniv Lyon, CREATIS, INSA, CNRS UMR 5220, INSERM U1294, Université Lyon 1, UJM Saint-Etienne, Lyon, FranceDepartment of Radiology, Hôpital Nord, University Hospital of Saint-Étienne, Saint-Étienne, FranceObjectivesMyocardial injury assessment from delayed enhancement magnetic resonance images is routinely limited to global descriptors such as size and transmurality. Statistical tools from computational anatomy can drastically improve this characterization, and refine the assessment of therapeutic procedures aiming at infarct size reduction. Based on these techniques, we propose a new characterization of myocardial injury up to the pixel resolution. We demonstrate it on the imaging data from the Minimalist Immediate Mechanical Intervention randomized clinical trial (MIMI: NCT01360242), which aimed at comparing immediate and delayed stenting in acute ST-Elevation Myocardial Infarction (STEMI) patients.MethodsWe analyzed 123 patients from the MIMI trial (62 ± 12 years, 98 male, 65 immediate 58 delayed stenting). Early and late enhancement images were transported onto a common geometry using techniques inspired by statistical atlases, allowing pixel-wise comparisons across population subgroups. A practical visualization of lesion patterns against specific clinical and therapeutic characteristics was also proposed using state-of-the-art dimensionality reduction.ResultsInfarct patterns were roughly comparable between the two treatments across the whole myocardium. Subtle but significant local differences were observed for the LCX and RCA territories with higher transmurality for delayed stenting at lateral and inferior/inferoseptal locations, respectively (15% and 23% of myocardial locations with a p-value <0.05, mainly in these regions). In contrast, global measurements were comparable for all territories (no statistically significant differences for all-except-one measurements before standardization / for all after standardization), although immediate stenting resulted in more subjects without reperfusion injury.ConclusionOur approach substantially empowers the analysis of lesion patterns with standardized comparisons up to the pixel resolution, and may reveal subtle differences not accessible with global observations. On the MIMI trial data as illustrative case, it confirmed its general conclusions regarding the lack of benefit of delayed stenting, but revealed subgroups differences thanks to the standardized and finer analysis scale.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1136760/fullacute myocadial infarctiondelayed enhancement MRIstatistical atlasinfarct sizemicrovascular obstruction |
| spellingShingle | Nicolas Duchateau Nicolas Duchateau Magalie Viallon Magalie Viallon Lorena Petrusca Patrick Clarysse Nathan Mewton Loic Belle Pierre Croisille Pierre Croisille Pixel-wise statistical analysis of myocardial injury in STEMI patients with delayed enhancement MRI Frontiers in Cardiovascular Medicine acute myocadial infarction delayed enhancement MRI statistical atlas infarct size microvascular obstruction |
| title | Pixel-wise statistical analysis of myocardial injury in STEMI patients with delayed enhancement MRI |
| title_full | Pixel-wise statistical analysis of myocardial injury in STEMI patients with delayed enhancement MRI |
| title_fullStr | Pixel-wise statistical analysis of myocardial injury in STEMI patients with delayed enhancement MRI |
| title_full_unstemmed | Pixel-wise statistical analysis of myocardial injury in STEMI patients with delayed enhancement MRI |
| title_short | Pixel-wise statistical analysis of myocardial injury in STEMI patients with delayed enhancement MRI |
| title_sort | pixel wise statistical analysis of myocardial injury in stemi patients with delayed enhancement mri |
| topic | acute myocadial infarction delayed enhancement MRI statistical atlas infarct size microvascular obstruction |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1136760/full |
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