Yao Jingting, Tridandapani S, Auffermann W F, Wick C A, Bhatti P T
School of Electrical and Computer EngineeringGeorgia Institute of TechnologyAtlantaGA30332USA.
Department of RadiologyThe University of Alabama at BirminghamBirminghamAL35294USA.
IEEE J Transl Eng Health Med. 2018 Oct 8;6:1900611. doi: 10.1109/JTEHM.2018.2869141. eCollection 2018.
To more accurately trigger data acquisition and reduce radiation exposure of coronary computed tomography angiography (CCTA), a multimodal framework utilizing both electrocardiography (ECG) and seismocardiography (SCG) for CCTA prospective gating is presented. Relying upon a three-layer artificial neural network that adaptively fuses individual ECG- and SCG-based quiescence predictions on a beat-by-beat basis, this framework yields a personalized quiescence prediction for each cardiac cycle. This framework was tested on seven healthy subjects (age: 22-48; m/f: 4/3) and eleven cardiac patients (age: 31-78; m/f: 6/5). Seventeen out of 18 benefited from the fusion-based prediction as compared to the ECG-only-based prediction, the traditional prospective gating method. Only one patient whose SCG was compromised by noise was more suitable for ECG-only-based prediction. On average, our fused ECG-SCG-based method improves cardiac quiescence prediction by 47% over ECG-only-based method; with both compared against the gold standard, B-mode echocardiography. Fusion-based prediction is also more resistant to heart rate variability than ECG-only- or SCG-only-based prediction. To assess the clinical value, the diagnostic quality of the CCTA reconstructed volumes from the quiescence derived from ECG-, SCG- and fusion-based predictions were graded by a board-certified radiologist using a Likert response format. Grading results indicated the fusion-based prediction improved diagnostic quality. ECG may be a sub-optimal modality for quiescence prediction and can be enhanced by the multimodal framework. The combination of ECG and SCG signals for quiescence prediction bears promise for a more personalized and reliable approach than ECG-only-based method to predict cardiac quiescence for prospective CCTA gating.
为了更准确地触发数据采集并减少冠状动脉计算机断层扫描血管造影(CCTA)的辐射暴露,本文提出了一种利用心电图(ECG)和心震图(SCG)进行CCTA前瞻性门控的多模态框架。该框架基于一个三层人工神经网络,逐搏自适应融合基于个体ECG和SCG的静息预测,从而为每个心动周期生成个性化的静息预测。该框架在7名健康受试者(年龄:22 - 48岁;男/女:4/3)和11名心脏病患者(年龄:31 - 78岁;男/女:6/5)身上进行了测试。与仅基于ECG的传统前瞻性门控方法相比,18名受试者中有17名从基于融合的预测中受益。只有一名SCG受噪声影响的患者更适合仅基于ECG的预测。平均而言,我们基于ECG - SCG融合的方法比仅基于ECG的方法将心脏静息预测提高了47%;两者均与金标准B型超声心动图进行比较。基于融合的预测也比仅基于ECG或仅基于SCG的预测对心率变异性更具抗性。为了评估临床价值,由一名获得董事会认证的放射科医生使用李克特反应格式对基于ECG、SCG和融合预测得出的静息状态下重建的CCTA容积的诊断质量进行分级。分级结果表明基于融合的预测提高了诊断质量。ECG可能是静息预测的次优模态,多模态框架可以对其进行增强。ECG和SCG信号相结合进行静息预测有望成为一种比仅基于ECG的方法更个性化、更可靠的方法,用于预测前瞻性CCTA门控的心脏静息状态。