Current Projects
The Cardiac Imaging Research Team (CIRT) is dedicated to fighting heart disease by developing powerful new diagnostic methods that can recognize at-risk individuals and evaluate atherosclerosis years or even decades before catastrophic events can occur.
CURRENT STUDIES:
PROJECT DESCRIPTIONS:
Cardiac Imaging Research Registry
Principal Investigator: Daniel S. Berman, MD
IRB Approval Number: 1752
Contact: Nancy Zambrana (310) 423-3763
Status: Active - Enrolling
The Cardiac Imaging Research Registry is an organized system of information derived from historical, demographical, clinical, imaging, and outcomes data from patients undergoing cardiac imaging procedures including nuclear cardiology SPECT and PET, cardiac CT, and cardiac magnetic resonance imaging at Cedars-Sinai Medical Center for use in ongoing and future research that will help advance the field of cardiac imaging focused around the following general aims:
1) to investigate technical questions such as issues related to the acquisition parameters, image processing, and quantitative analysis,
2) to investigate diagnostic capabilities to detect disease and assess risk compared to other assessments,
3) to investigate prognostic value to predict adverse outcomes of cardiovascular disease (CVD) and all cause mortality, and
4) to investigate the usefulness of the testing to guide clinical decision making and monitor therapy with the goal of preventing adverse outcomes.
CT-Based Coronary Plaque Feature Detection for Predicting Myocardial Ischemia (NIH funded)
Principal Investigator: Victor Cheng, MD
IRB Approval Number: 21458
Contact: Nancy Zambrana (310) 423-3763
Status: Active - Enrollment on hold
The purpose of this research study is to evaluate whether the appearance of coronary artery plaque (collection of cholesterol, cells, and debris) predicts changes in blood flow to the heart muscle.
There is evidence indicating that processes contributing to loss of blood flow to the heart may change the appearance of plaque on diagnostic imaging. Improving our ability to identify changes caused by these processes can help doctors better identify important coronary artery blockages and learn why some blockages cause more loss of blood flow than others. Information obtained from this study can potentially help heart doctors improve use of diagnostic tests and treatment options for coronary artery disease.
Subjects invited to take part in this study will have had a non-invasive coronary computed tomographic angiography (CCTA) that showed a significant blockage from plaque in at least one coronary artery, and are scheduled to undergo catheter-based (invasive) coronary angiography with fractional flow reserve measurement (measurement of fluid pressure in the coronary artery) for possible angioplasty. Prior to angiography, each subject will undergo PET myocardial perfusion imaging used to measure blood flow delivery to the heart muscle. During the angiography, blood will be collected from the aortic root to evaluate blood fat, cholesterol, and viscosity (a measure of "stickiness") levels, all factors that can affect blood flow to the heart muscle.
Principal Investigator: Daniel S. Berman, MD
IRB Approval Number: 22066
Contact: Rhona Littman (310) 423-4387
Status: Active - Data analysis only
This is a minimal risk, multi center trial to validate the use of a low-dose cardiac imaging protocol with a high-efficiency cardiac dedicated camera (D-SPECT) to detect myocardial perfusion (blood flow) abnormalities during myocardial perfusion single photon emission computed tomography (SPECT).
The standard SPECT procedure is performed with the Anger scintillation camera (A-SPECT) and requires the patient to lie immobilized on a table for 10-20 minutes and requires separate rest and stress images, taking 3-4 hours of patient time. The D-SPECT camera, a new nuclear imaging camera design allows very rapid images to be obtained. Shortening imaging time and reducing patient radiation exposure have become important challenges of nuclear cardiology over recent years.
Patients undergoing clinically indicated A-SPECT will be asked to have an additional ultra-low dose D-SPECT imaging study. Images from the two cameras will be compared with respect to presence/extent of perfusion defects and image quality.
Principal Investigator: Daniel S. Berman, MD
IRB Approval Number: 24593
Contact: Nancy Zambrana (310) 423-3763
Status: Active - Enrolling
The purpose of this study is to evaluate the use and safety profile of flurpiridaz F-18 imaging injection, in patients with a history of or suspected CAD, to determine if flurpiridaz F-18 injection PET imaging is better than the single photon emission computed tomography (SPECT) imaging currently used for this purpose. Flurpiridaz F-18 represents a new generation cardiac perfusion (blood flow) imaging agent that may have superior characteristics to currently used agents.
Participants in this study have had, or are scheduled to have, a clinical coronary angiogram, the gold standard for the detection of significant coronary artery disease. Research procedures include a screening visit and an imaging visit during which the subject will undergo rest/stress PET cardiac imaging using Flurpiridaz F-18.
PET has several technical advantages over SPECT that may account for improved image quality leading to increased diagnostic certainty when evaluating for coronary artery disease.
EISNER: Early Identification of Subclinical Atherosclerosis using NoninvasivE Imaging Program
Principal Investigator: Daniel S. Berman, MD
IRB Approval Number: 3351/3974/3355
Contact: Nancy Zambrana (310) 423-3763
Status: Active - Data analysis only
Cardiac CT scanning has been shown to be useful in detecting subclinical coronary atherosclerosis, however the relative usefulness of cardiac CT findings, clinical, and biochemical assessments in predicting outcomes in coronary artery disease has not been fully explored. The Early Identification of Subclinical Atherosclerosis using NoninvasivE Imaging Research (EISNER) Study integrates the imaging (cardiac CT and nuclear cardiology), preventive cardiology, and basic cardiology aspects to improve the outcomes for coronary artery disease.
Study 1: CSMC Community (IRB# 3351)
The primary purpose of this prospective, randomized study is to determine if a particular combination of assessments (medical history and risk factor information, clinical and biochemical tests, and a cardiac CT scan) can predict future clinical outcomes (e.g. progression of atherosclerosis, heart surgery) in patients who have had no symptoms of coronary artery disease or other heart disease.
Study 2: Patients with Nuclear Cardiology Studies (IRB# 3974)
The primary purpose of this study is to determine if the information from a coronary calcium CT scan adds value to the information from a nuclear cardiology study in helping physicians make medical decisions.
Automated Quantitative Plaque Characterization with Coronary CT Angiography
Principal Investigator: Damini Dey, PhD
IRB Approval Number: 19424
Contact: Damini Dey, PhD (310) 423-1517
Status: Active - Data analysis only
The investigators have developed a preliminary fully automatic volumetric analysis capable of accurate, rapid quantitation and characterization of atherosclerotic plaque lesions from standard coronary CT angiography and propose to refine, validate and evaluate the prognostic value of this approach. This goal will be accomplished through two specific aims: 1) validation of the developed methods by comparison to expert human observers and invasive “gold standard” modalities; and 2) assessment of the prognostic value in prediction of cardiac death.
Optimization of Image Quality and Radiation Dose in CT Angiography and CCS
Co-Principal Investigators: Daniel S. Berman, MD; Damini Dey, PhD
IRB Approval Number: 23737
Contact: Damini Dey, PhD (310) 423-1517
Status: Active - Data analysis only
Recent developments in CT technology have made imaging of the coronary arteries possible at high resolution and speed. Strategies to reduce the radiation dose, while maintaining diagnostic image quality, are imperative for cardiac CT. The overall aim of this proposal is to improve image quality and minimize radiation dose for cardiac CT with the dual-source CT (DSCT) Siemens Definition scanner, currently operational at the Cedars-Sinai Medical Center.
Our specific aims are 1) to optimize radiation dose for coronary calcium scoring by combining lower x-ray tube voltage and tube current and 2) to optimize radiation dose in cardiac CT using new iterative reconstruction techniques.
The results of this research can be directly applied to clinical practice. Although developed for the dual-source CT scanner, results can be generalized to other CT scanners.
National PET Registry Analysis
Principal Investigator: Daniel S. Berman, MD
IRB Approval Number: 23712
Contact: Lisa Miranda-Peats (310) 423-6753
Status: Active - Data analysis only
Principal Investigator: Daniel S. Berman, MD
IRB Approval Number: 23737
Contact: Lisa Miranda-Peats (310) 423-6753
Status: Active - Data analysis only
Principal Investigator: Daniel S. Berman, MD
IRB Approval Number: 25448
Contact: Rhona Littman (310) 423-4387
Status: Active - Data analysis only
Principal Investigator: Daniel S. Berman, MD
IRB Approval Number:
Contact: Rhona Littman (310) 423-4387
Status: Active - Data analysis only
Principal Investigator: Daniel S. Berman, MD
IRB Approval Number: 26082
Contact: Nancy Zambrana (310) 423-3763
Status: Approval pending
