Patient-Specific Mappings between Myocardial and Coronary Anatomy

Abstract

The segmentation of the myocardium based on the 17-segment model as recommended by the American Heart Association is widely used in medical practice. The patient-specific coronary anatomy does not play a role in this model. Due to large variations in coronary anatomy among patients, this can result in an inaccurate mapping between myocardial segments and coronary arteries. We present two approaches to include the patient-specific coronary anatomy in this mapping. The first approach adapts the 17-segment model to fit the patient. The second approach generates a less constrained mapping that does not necessarily conform to this model. Both approaches are based on a Voronoi diagram computation of the primary coronary arteries using geodesic distances along the epicardium in three-dimensional space. We demonstrate both our approaches with several patients and show how our first approach can also be used to fit volume data to the 17-segment model. Our technique gives detailed insight into the coronary anatomy in a single diagram. Based on the feedback provided by clinical experts we conclude that it has the potential to provide a more accurate relation between deficiencies in the myocardium and the supplying coronary arteries.