Development of a myocardial perfusion phantom
2019
In the Netherlands, the mortality rate of Coronary Vascular Disease (CVD) is on a declining trend since 1980; 69\% for men and 59\% for woman. Nevertheless, 272,234 men and women have been admitted for CVD related diseases in 2016, in the Netherlands, alone. 31\% (84,912) had to be admitted for a full day, of which 37\% specifically for ischemia. The cause of these admissions can be prevented by a timely diagnosis of possible CVD, especially in high-risk groups (obese, smokers, diabetic, physical inactive).
Myocardial Perfusion Imaging (MPI), or, simply put, the imaging of a tracer (or contrast agent) in the blood, flowing through the heart muscle, plays an important role in diagnosing heart failure and detecting Coronary Artery Disease (CAD). Imaging systems like CT, MRI, PET, or SPECT can visualise such (radioactive) tracer (or contrast agent) in the coronary arteries and in myocardial tissue. The flow of the tracer (or contrast agent) can give an indication of narrowed or blocked blood vessels.
Clinical software is biased towards the shape of the heart and thus require anatomical landmarks. Several previously developed phantoms show interesting characteristics but none are directly compatible with clinical software. Therefore, a new myocardial perfusion phantom, specifically designed for the D-SPECT, has been developed that is directly compatible with clinical software.
The phantom, described in this thesis, is unique as it is the first phantom that is directly compatible with clinical software. Its design resembles a simplified heart, consisting of a centralised cylinder, the left ventricle, with a surrounding myocardium, split into three equal, modular, chambers corresponding to the areas perfused by the three coronary arteries. The primary flow (constant, not pulsatile), i.e. the cardiac output, is generated by a pump whereas the myocardial flow is indirectly regulated by means of flow regulators.
However, in its current state, the phantom, and its set-up, cannot yet be used to validate the D-SPECT or other modalities. The phantom does not trap the tracer in the myocardium, i.e. a true 2-compartment model, and the measurements, taken with our control module, had a low Signal-to-Noise Ratio.
With further development, the myocardial perfusion phantom, as described in this thesis, can be the corner stone for future Myocardial Perfusion phantom validation studies. Not only for the D-SPECTS quantitative perfusion measurements, but also, potentially, for other modalities.
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