Clinical application of quantitative analysis in real-time MCE

Area of Science:

• Cardiovascular Imaging
• Medical Technology
• Echocardiography

Background:

• Advancements in microbubble contrast agents and technology enable quantitative microvascular damage assessment via myocardial contrast echocardiography (MCE).
• Accurate measurement of myocardial perfusion is crucial for diagnosing and managing coronary artery disease.

Purpose of the Study:

• To evaluate the accuracy and reliability of Qontrast, a novel software system for quantitative measurements using MCE.
• To compare the performance of parametric MCE with a reference method (SPELT) in patients with myocardial infarction.

Main Methods:

• Qontrast software, featuring physiological filters and tracking algorithms, was tested on pigs with induced coronary artery stenosis using sulphur hexafluoride microbubbles.
• The reference standard used was fluorescent microspheres.
• Parametric MCE was compared to SPELT in 119 myocardial segments from 12 patients with recent myocardial infarction.

Main Results:

• A high correlation (approximately 0.9) was observed between Qontrast's risk area/control area ratio (SI x beta) and the microsphere reference method across different ultrasound equipment.
• Agreement between parametric MCE and SPELT was 83% (kappa: 0.53-0.55).
• Sensitivity and specificity for detecting abnormal perfusion were 67-70% for peak SI and 70-87% for SI x beta.

Conclusions:

• Qontrast software provides accurate and reliable quantitative measurements of microvascular damage using MCE.
• Parametric MCE demonstrates potential as a valuable imaging technique for assessing myocardial perfusion in patients with coronary artery disease.