Multidimensional Analysis of the Adult Human Heart in Health and Disease Using Hierarchical Phase-Contrast Tomography.
Joseph BrunetAndrew C CookClaire L WalshJames CranleyPaul TfforeauKlaus EngelOwen John ArthursCamille BerruyerEmer Burke O'LearyAlexandre BellierRyo ToriiChristopher WerleinDanny D JonigkMaximilian AckermannKathleen N DollmanPeter David LeePublished in: Radiology (2024)
Background Current clinical imaging modalities such as CT and MRI provide resolution adequate to diagnose cardiovascular diseases but cannot depict detailed structural features in the heart across length scales. Hierarchical phase-contrast tomography (HiP-CT) uses fourth-generation synchrotron sources with improved x-ray brilliance and high energies to provide micron-resolution imaging of intact adult organs with unprecedented detail. Purpose To evaluate the capability of HiP-CT to depict the macro- to microanatomy of structurally normal and abnormal adult human hearts ex vivo. Materials and Methods Between February 2021 and September 2023, two adult human donor hearts were obtained, fixed in formalin, and prepared using a mixture of crushed agar in a 70% ethanol solution. One heart was from a 63-year-old White male without known cardiac disease, and the other was from an 87-year-old White female with a history of multiple known cardiovascular pathologies including ischemic heart disease, hypertension, and atrial fibrillation. Nondestructive ex vivo imaging of these hearts without exogenous contrast agent was performed using HiP-CT at the European Synchrotron Radiation Facility. Results HiP-CT demonstrated the capacity for high-spatial-resolution, multiscale cardiac imaging ex vivo, revealing histologic-level detail of the myocardium, valves, coronary arteries, and cardiac conduction system across length scales. Virtual sectioning of the cardiac conduction system provided information on fatty infiltration, vascular supply, and pathways between the cardiac nodes and adjacent structures. HiP-CT achieved resolutions ranging from gross (isotropic voxels of approximately 20 µm) to microscopic (approximately 6.4-µm voxel size) to cellular (approximately 2.3-µm voxel size) in scale. The potential for quantitative assessment of features in health and disease was demonstrated. Conclusion HiP-CT provided high-spatial-resolution, three-dimensional images of structurally normal and diseased ex vivo adult human hearts. Whole-heart image volumes were obtained with isotropic voxels of approximately 20 µm, and local regions of interest were obtained with resolution down to 2.3-6.4 µm without the need for sectioning, destructive techniques, or exogenous contrast agents. Published under a CC BY 4.0 license Supplemental material is available for this article. See also the editorial by Bluemke and Pourmorteza in this issue.
Keyphrases
- contrast enhanced
- dual energy
- image quality
- computed tomography
- high resolution
- endothelial cells
- magnetic resonance imaging
- atrial fibrillation
- magnetic resonance
- heart failure
- left ventricular
- healthcare
- single molecule
- positron emission tomography
- public health
- cardiovascular disease
- coronary artery disease
- induced pluripotent stem cells
- pluripotent stem cells
- diffusion weighted imaging
- coronary artery
- blood pressure
- systematic review
- mental health
- randomized controlled trial
- mass spectrometry
- young adults
- type diabetes
- machine learning
- squamous cell carcinoma
- cardiovascular risk factors
- radiation therapy
- aortic valve
- acute coronary syndrome
- social media
- neoadjuvant chemotherapy
- optical coherence tomography
- transcatheter aortic valve replacement
- human health
- rectal cancer
- early stage
- childhood cancer
- locally advanced
- climate change