Quantitative Detection of Pericardial Adhesions Using Four-Dimensional Computed Tomography: A Novel Motion-Based Analysis Framework

Objective: Pericardial adhesions can unexpectedly occur prior to cardiac surgery or catheter ablation, even in patients without known risk factors, potentially increasing procedural risks. This study proposed and validated a novel, quantitative, and noninvasive method for detecting pericardial adhes...

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Main Authors: Tong Ren, Shuo Wang, Nan Cheng, Zekun Feng, Menglu Li, Li Zhang, Rong Wang
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Bioengineering
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Online Access:https://www.mdpi.com/2306-5354/12/3/224
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author Tong Ren
Shuo Wang
Nan Cheng
Zekun Feng
Menglu Li
Li Zhang
Rong Wang
author_facet Tong Ren
Shuo Wang
Nan Cheng
Zekun Feng
Menglu Li
Li Zhang
Rong Wang
author_sort Tong Ren
collection DOAJ
description Objective: Pericardial adhesions can unexpectedly occur prior to cardiac surgery or catheter ablation, even in patients without known risk factors, potentially increasing procedural risks. This study proposed and validated a novel, quantitative, and noninvasive method for detecting pericardial adhesions using four-dimensional computed tomography (4D CT). Methods: We evaluated preoperative 4D CT datasets from 20 patients undergoing cardiac surgery with and without pericardial adhesions. Our novel approach integrates expert-guided pericardial segmentation, symmetric diffeomorphic registration, and motion disparity analysis. The method quantifies tissue motion differences by computing the displacement fields between the pericardium and epicardial adipose tissue (EAT), with a particular focus on the left anterior descending (LAD) region. Results: Statistical analysis revealed significant differences between adhesion and non-adhesion groups (<i>p</i> < 0.01) using two newly developed metrics: peak ratio (PR) and distribution width index (DWI). Adhesion cases demonstrated characteristic high PR values (>100) with low DWI values (<0.3), while non-adhesion cases showed moderate PR values (<50) with higher DWI values (>0.4). Conclusions: This proof-of-concept study validated a novel quantitative framework for assessing pericardial adhesions using 4D CT imaging and provides an objective and computationally efficient tool for preoperative assessment in clinical settings. These findings suggest the potential clinical utility of this framework in surgical planning and risk assessment.
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spelling doaj-art-a52d7ece02d14efd926054f959e7fc7c2025-08-20T02:11:21ZengMDPI AGBioengineering2306-53542025-02-0112322410.3390/bioengineering12030224Quantitative Detection of Pericardial Adhesions Using Four-Dimensional Computed Tomography: A Novel Motion-Based Analysis FrameworkTong Ren0Shuo Wang1Nan Cheng2Zekun Feng3Menglu Li4Li Zhang5Rong Wang6Department of Adult Cardiac Surgery, Senior Department of Cardiology, The Six Medical Center of PLA General Hospital, Fucheng Road, Haidian District, Beijing 100048, ChinaKey Laboratory of Particle and Radiation Imaging, Department of Engineering Physics, Ministry of Education, Tsinghua University, Beijing 100084, ChinaDepartment of Adult Cardiac Surgery, Senior Department of Cardiology, The Six Medical Center of PLA General Hospital, Fucheng Road, Haidian District, Beijing 100048, ChinaDepartment of Adult Cardiac Surgery, Senior Department of Cardiology, The Six Medical Center of PLA General Hospital, Fucheng Road, Haidian District, Beijing 100048, ChinaDepartment of Diagnostic Radiology, The Six Medical Center of PLA General Hospital, Fucheng Road, Haidian District, Beijing 100048, ChinaKey Laboratory of Particle and Radiation Imaging, Department of Engineering Physics, Ministry of Education, Tsinghua University, Beijing 100084, ChinaDepartment of Adult Cardiac Surgery, Senior Department of Cardiology, The Six Medical Center of PLA General Hospital, Fucheng Road, Haidian District, Beijing 100048, ChinaObjective: Pericardial adhesions can unexpectedly occur prior to cardiac surgery or catheter ablation, even in patients without known risk factors, potentially increasing procedural risks. This study proposed and validated a novel, quantitative, and noninvasive method for detecting pericardial adhesions using four-dimensional computed tomography (4D CT). Methods: We evaluated preoperative 4D CT datasets from 20 patients undergoing cardiac surgery with and without pericardial adhesions. Our novel approach integrates expert-guided pericardial segmentation, symmetric diffeomorphic registration, and motion disparity analysis. The method quantifies tissue motion differences by computing the displacement fields between the pericardium and epicardial adipose tissue (EAT), with a particular focus on the left anterior descending (LAD) region. Results: Statistical analysis revealed significant differences between adhesion and non-adhesion groups (<i>p</i> < 0.01) using two newly developed metrics: peak ratio (PR) and distribution width index (DWI). Adhesion cases demonstrated characteristic high PR values (>100) with low DWI values (<0.3), while non-adhesion cases showed moderate PR values (<50) with higher DWI values (>0.4). Conclusions: This proof-of-concept study validated a novel quantitative framework for assessing pericardial adhesions using 4D CT imaging and provides an objective and computationally efficient tool for preoperative assessment in clinical settings. These findings suggest the potential clinical utility of this framework in surgical planning and risk assessment.https://www.mdpi.com/2306-5354/12/3/224pericardial adhesions4D CTepicardial adipose tissuecardiac surgerymotion quantification
spellingShingle Tong Ren
Shuo Wang
Nan Cheng
Zekun Feng
Menglu Li
Li Zhang
Rong Wang
Quantitative Detection of Pericardial Adhesions Using Four-Dimensional Computed Tomography: A Novel Motion-Based Analysis Framework
Bioengineering
pericardial adhesions
4D CT
epicardial adipose tissue
cardiac surgery
motion quantification
title Quantitative Detection of Pericardial Adhesions Using Four-Dimensional Computed Tomography: A Novel Motion-Based Analysis Framework
title_full Quantitative Detection of Pericardial Adhesions Using Four-Dimensional Computed Tomography: A Novel Motion-Based Analysis Framework
title_fullStr Quantitative Detection of Pericardial Adhesions Using Four-Dimensional Computed Tomography: A Novel Motion-Based Analysis Framework
title_full_unstemmed Quantitative Detection of Pericardial Adhesions Using Four-Dimensional Computed Tomography: A Novel Motion-Based Analysis Framework
title_short Quantitative Detection of Pericardial Adhesions Using Four-Dimensional Computed Tomography: A Novel Motion-Based Analysis Framework
title_sort quantitative detection of pericardial adhesions using four dimensional computed tomography a novel motion based analysis framework
topic pericardial adhesions
4D CT
epicardial adipose tissue
cardiac surgery
motion quantification
url https://www.mdpi.com/2306-5354/12/3/224
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