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Emory Toolbox™ - provides advanced cardiovascular quantification for both SPECT and PET studies with 2D/3D image displays which provides fast, automatic interpretation. Justifications are tracked so the clinician can agree or not. EmoryToolbox quantifies and displays myocardial perfusion, function, and LV dyssynchrony studies in a single, configurable system.
The VISION-CRT trial sponsored by the International Atomic Energy Agency (IAEA), a branch of the United Nations, involves heart failure patients in nine countries: Italy, Algeria, South Africa, Pakistan, India, Colombia, Brazil, Mexico, and Vietnam. SyncTool will be used as part of the nuclear cardiology imaging protocol for the diagnosis of heart failure. This study will include phase analysis for LV Dyssynchrony.
"Of all heart failure patients, about two-thirds of the patients getting CRT will benefit from that treatment yet one-third will not. Phase analysis of left ventricular dyssynchrony can help with two critical issues: First, how to select the right patient for CRT; and second, where to put the left ventricular lead."
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Emory University nuclear cardiology researchers have been at the forefront of research evaluating SPECT MPI versus Speckle Tracking Echocardiology (STE) for the diagnosis of heart failure. Studies show that patients respond more favorably if the left ventricular lead is positioned in the right place. The technology for SyncTool is based on multi-harmonic phase analysis research originally developed by E.V. Garcia and J. Chen at Emory University.
--Ji Chen, PhD, Associate Professor of Radiology and Nuclear Cardiology R&D at Emory University
Emory Toolbox is the only imaging software system on the market for evaluating two different avenues of heart failure and quantitatively providing a more accurate diagnosis of the disease.
SyncTool is a phase analysis software tool that analyzes the benefits of cardiac resynchronization therapy (CRT) in heart failure patients. It has been proven to be more sensitive than TDI Echo to analyze LV Dyssynchrony. SyncTool analysis takes just seconds and uses the same data from perfusion studies. The reporting process can also be applied to any Gated SPECT MPI data set or previously stored image, and provides prognostic information from the 3D perfusion images about the presence and location of scar tissue. In addition to myocardial perfusion SPECT and PET studies, SyncTool can also be used with FDG-PET studies for patients with ischemic cardiomyopathy.
This screen displays the results of phase analysis of the gated stress and rest studies. For each study the following items are shown:
A phase polar map
A histogram plotting the frequency of occurrence of each possible phase (0-360) within the polar map
The raw polar map shown twice. The rightmost one will contain an animation of the wave of contraction when the Animation control's Play button is left-clicked.
A list of calculated values that characterize the phase histogram
SyncTool is proven to be more sensitive than TDI Echo to analyze LV Dyssynchrony and the benefits of cardiac resynchronization therapy (CRT)
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A tool to analyze SPECT images acquired using 123I AdreView, a radiopharmaceutical for imaging myocardial innervation. There are several tools for assessing AdreView uptake:
Quantifying AdreView uptake relative to normal.
Determination of uptake of AdreView in the heart relative to uptake of a perfusion agent such as tetrofosmin or sestamibi.
Calculation of heart-to-mediastinum ratio from transaxial AdreView images.
AdreView Tools for SPECT studies performing quantitative analysis and display of SPECT I-123 mlBG data sets, is a new advance for the diagnosis of heart failure. With AdreView Tools clinicians now have a quantitative, numeric score to help identify mortality risk and aid in the diagnosis of congestive heart failure. Studies have shown that abnormal myocardial sympathetic innervation is associated with increased mortality and morbidity rates in patients with heart failure*. Nuclear imaging techniques can be used to provide detailed information for the detection of early phase heart failure, as well as, for monitoring the effects of new therapeutic interventions.
*Leimbach WVN Jr., Wallin BG, Victor RG, Aylward PE, Sundlof G, Mark AL. "Direct evidence from intraneural recordings for increased central sympathetic outflow in patients with heart failure." Circulation 1986; 73:913-9.
†AdreView Tools is a trademark of the General Electric Company.
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For each study, a cine of the dynamic images is available on the left side of the display, polar maps of the corresponding perfusion and absolute blood flow are displayed in the middle, and graphs of the time activity curves of the blood and myocardial tissue (broken into LAD, LCx and RCA territories) are shown on the right side. A quality control chart is displayed at the bottom left showing whether each study passed several different measures of QC, with green indicating no problems, yellow indicating possible problems and red indicating definite problems.
Diagnose the reduction of hyperemic flow in endothelial disease
Diagnose balanced flow reductions in triple vessel disease
Compute absolute blood flow and coronary flow reserve from dynamic PET studies
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Coronary Artery Calcium Scoring is an integrated feature of the Emory Toolbox for processing CT images to quantify calcifications that have developed within a patient’s heart. In addition to allowing for the visualization of CT images, users can select suspected calcified regions, assign label classifications to those regions, and obtain a report of the selections.
Amyloidosis Analysis is an integrated feature of the Emory Cardiac Toolbox designed to assist in the evaluation of cardiac transthyretin amyloidosis (ATTR) by quantifying the degree of myocardial uptake with Tc-99m PYP (Pyrophosphate), Tc-99m DPD (diphosphono propanodicarboxylic acid) and Tc-99m HMDP (hydroxymethylene diphosphonate) images. Cardiac TTR amyloidosis is an under‐diagnosed cause of heart failure. The majority of individuals with cardiac amyloidosis have myocardial amyloid deposits formed from misfolded light chain (AL) or transthyretin (TTR) proteins. Diagnosis of amyloidosis and differentiation between the types is important for prognosis, therapy, and genetic counseling.
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- 99mTechnetium Pyrophosphate Imaging’
This tool provides a method for fusing a 3-dimensional myocardial map, derived from a PET study, with a 3-dimensional image of a coronary artery tree. Data files expected for HeartFusion include one or two short axis datasets and one or two coronary model files.
HeartFusion details anatomical and functional information of the coronary vasculature by combining both the CT angiography data and PET data into one fused image.
The software program provides more accurate views through an interactive display that matches the anatomical lesions with the functional defect.
HeartFusion has static and cine displays for easy viewing of the information.
3D Polar maps are enhanced with an accurate correlation of the vasculature.
The end result is greater detail about perfusion. The normal limits for NH3, Rb82, and FDG protocols help determine the severity of the disease.
HeartFusion™ fuses CT angiography images with PET functional data to provide more comprehensive assessments of coronary artery disease, monitors vascular response to treatment, defines more aggressive preventive therapies for every patient and provides more cost-effective healthcare.
The software program provides more accurate views through an interactive display that matches the anatomical lesions with the functional defect.
HeartFusion has static and cine displays for easy viewing of the information.
3D Polar maps are enhanced with an accurate correlation of the vasculature.
When assessing coronary artery disease, HeartFusion™ fuses CT angiography images with PET functional data. The result is a more comprehensive evaluation of heart function.
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Used to monitor vascular response to treatment and personalize medical treatment plans
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