A Dynamic Solution for Streamlining Cardiac Diagnosis
Dr. Olivier Ghekiere is a global expert in the field of cardiac imaging. He works with both cardiac CT and MRI at the Radiology Department of Jessa Hospital, Hasselt, Belgium. In the past 10 years, his research has included exploration of the technical shortfalls in cardiac CT Angiography (CTA). Now, the Dynamic Myocardial Perfusion application with Canon Medical’s Vitrea Advanced Visualisation closes a gap in diagnostic possibilities in cardiac CT and enables significantly streamlined workflows.
Boosting cardiac diagnostics
Coronary CTA requires additional functional evaluation for stenosis to guide therapeutic management. Much of the research that Dr. Ghekiere has carried out has investigated options for the non-invasive management of intermediate coronary stenosis, including quantitative coronary CTA and stress perfusion cardiac Magnetic Resonance (CMR). He was awarded Magna cum laude for his scientific work entitled: “Technical Pitfalls in cardiac CT angiography: What the radiologist should know.” at the 2012 ESCR annual scientific meeting, held in Barcelona, Spain, and at the 25th anniversary 2019 ECR congress in Vienna, Austria.
“CTA is poor in predicting ischemia, mainly in intermediate coronary artery stenoses. However, the presence or not of ischemia determines treatment and whether that is by medication or by revascularisation,” he explained. “CT Dynamic Myocardial Perfusion gives an additional functional assessment of the coronary stenosis on top of the anatomical information (CTA). It enables us to offer a ‘one-stop-shop’ in CT for the patient – a single CT examination with anatomic and functional information to guide treatment. This means that the patient doesn’t have to come to the hospital twice for diagnosis.”
The standardisation of the application and workflow of Vitrea’s CT Dynamic Myocardial Perfusion leads to low inter user variability. The automated results for Myocardial Blood flow (MBF) for stress and rest and Coronary Flow Reserve (CFR) enable the clinician to make the clinical decision between revascularisation versus medical treatment in a patient with an obstructive coronary artery stenosis.
“CTA is poor in predicting ischemia, mainly in intermediate coronary artery stenoses. However, the presence or not of ischemia determines treatment and whether that is by medication or by revascularisation,” he explained. “CT Dynamic Myocardial Perfusion gives an additional functional assessment of the coronary stenosis on top of the anatomical information (CTA). It enables us to offer a ‘one-stop-shop’ in CT for the patient – a single CT examination with anatomic and functional information to guide treatment. This means that the patient doesn’t have to come to the hospital twice for diagnosis.”
The standardisation of the application and workflow of Vitrea’s CT Dynamic Myocardial Perfusion leads to low inter user variability. The automated results for Myocardial Blood flow (MBF) for stress and rest and Coronary Flow Reserve (CFR) enable the clinician to make the clinical decision between revascularisation versus medical treatment in a patient with an obstructive coronary artery stenosis.
VISIONS spoke with Dr. Olivier Ghekiere, a global expert in the field of cardiac imaging. He works with both cardiac CT and MRI at the Radiology Department of Jessa Hospital, Hasselt, Belgium.
“We appreciate Vitrea Advanced Visualisation particularly, because of its quick workflow, robustness and good centerline tracking of the vessels.”
Dr. Olivier Ghekiere, Global expert cardiac imaging, Radiology Department of Jessa Hospital, Hasselt, Belgium.
Dr. Olivier Ghekiere
Dr. Ghekiere graduated as doctor in 2001 at the KU Leuven, Belgium and obtained his specialisation as a radiologist in 2006 at the UCL St.-Luc, Belgium. He further specialised in cardiac imaging and obtained, among other things, the LEVEL 1 and LEVEL 2 diploma from the American College of Cardiology (ACC) for Coronary CT Angiography (CVCTA Education, San Francisco). In 2018, he obtained the European Diploma in Cardiovascular Radiology (European Board of Cardiovascular Radiology).
Dr. Ghekiere has worked at the Radiology Department of Jessa Hospital, Hasselt, Belgium, since January 2015. He has specific skills in cardiac imaging (CT
and MRI).
Since 2018, he has also given guest lectures at Hasselt University, and since 2021, has been guest professor at the Hasselt University, Belgium.
Since 2012, he has been actively involved in the cardiological support of the Lotto-Belisol and Lotto-Soudal cycling teams, and since 2017 with the Trek Baloise cycling team. He organised various conferences on sports cardiology in collaboration with these cycling teams since 2014.
Dr. Ghekiere is the author of more than 20 scientific publications in international journals and has given numerous scientific presentations on various cardiac topics at national and international conferences.
He received a Magna cum laude for best scientific poster at the European Society of Cardiac Radiology (ESCR) congress in Barcelona 2012 and Milan 2017, and at the European Congress of Radiology in Vienna 2019.
Professional memberships:
Board member of the Belgian Society of Radiology (BVR) since 2012.
Charmain of Working Group Medical Imaging of the Technical Medical Council of the RIZIV/INAMI, Brussels since 2020.
Member of the Technical Medical Council of the RIZIV/INAMI, Brussels since 2013.
Member of the Belgian Medical Imaging Platform (BELMIP), FPS Public Health, Brussels since 2011.
Board member of the Belgian Association of Physicians Syndicates (BVAS) since 2015.
Advanced suite
Jessa Hospital has invested in a suite of advanced CT equipment from Canon Medical including an Aquilion ONE ViSION, Aquilion Lightning SP with Advanced intelligent Clear-IQ Engine (AiCE), powered by Altivity (Canon Medical’s AI suite of technologies). Vitrea Advanced Visualisation is currently used for cardiac examinations.
“Canon’s systems are robust, and bring us easier and faster workflow,” said Dr. Ghekiere.“Optimal workflow is a necessity for our department and patient care, especially to ensure that complex examinations receive the best diagnostic evaluation.”
“We appreciate Vitrea Advanced Visualisation particularly, because of its quick workflow, robustness and good centerline tracking of the vessels,” he continued. “There’s a good standardisation of the application and an easy workflow. This leads to a low variation between different operators.”
“Canon’s systems are robust, and bring us easier and faster workflow,” said Dr. Ghekiere.“Optimal workflow is a necessity for our department and patient care, especially to ensure that complex examinations receive the best diagnostic evaluation.”
“We appreciate Vitrea Advanced Visualisation particularly, because of its quick workflow, robustness and good centerline tracking of the vessels,” he continued. “There’s a good standardisation of the application and an easy workflow. This leads to a low variation between different operators.”
Next steps
The next challenges in Cardiac CT are the integration of artificial intelligence and further improvements in temporal and spatial resolution for similar image quality of conventional coronary angiography and less radiation dose.
Combined with the increase in computing power, AI might help speed up treatment and patient management and deliver essential information for the interpretation of CCTA exams. //
Combined with the increase in computing power, AI might help speed up treatment and patient management and deliver essential information for the interpretation of CCTA exams. //
What is Vitrea’s solution?
CT Dynamic Myocardial Perfusion enables the visualisation and analysis of perfusion deficits in the myocardium.
It features:
- Automatic stress and rest series recognition.
- Multiple review layouts.
- Accurate calculation of multiple parameters, including myocardial blood flow (MBF).
- Multiple polar map options including AHA vessel segments and AHA 17 segment maps. Overlay polar maps with coronary tree and vessel territory for anatomical referencing when assessing perfusion defects.
- Import coronary snapshots from other Vitrea applciations, allowing the accurate analysis of the coronary arteries and myocardium.
- Coronary arteries can be projected onto poler map. This enables visualisation of the myocardial region correlated with supplying coronary arteries on polar map.
- Vessel marking function - Vessel marking on a coronary artery provides the myocardial region correlated with supplying coronary artery from the marked point to distal on polar map. By specifying this point on coronary artery, it is also possible to calculate the partial myocardial mass of the region involved.
- Fusion View. Fusion of perfusion map onto 3D heart and coronary tree images.
- Batch saving (3D, MPR).
Its key benefits are:
- Automatic left ventricle and myocardium segmentation.
- Quantifiable results of the MBF and Coronary Flow Reserve (CFR).
- Polar map plots of Stress and rest MBF and CFR highlighting potential myocardium defects.
- Ability to calculate the partial myocardial mass affected by a diseased coronary vessel.
- Fusion view of coronary vessel branches on the polar maps.
- Fusion of the polar maps on the 3D heart rendering.
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