SBIR Phase I: Transluminal Attenuation Flow Encoding (TAFE) for Rapid and Accurate Assessment of Significant Coronary Artery Disease

The broader impact/commercial potential of this Small Business Innovation Research (SBIR) Phase I project will be the development of a novel non-invasive quantitative computed tomography (CT) imaging-based alternative to existing coronary artery disease (CAD) diagnoses. Over 17 million Americans have coronary artery disease (CAD) and 400,000 Americans die annually from this disease. Current diagnoses of CAD based on nuclear tests are not only complex, costly and involve a high radiation exposure, they have relatively low specificity and lead to over a million unnecessary risky and expensive invasive procedures every year. Invasive tests have higher specificity, but carry the inherent expense and risks of catheterization. The new technology to be developed here (Transluminal Attenuation Flow Encoding-TAFE) will provide rapid and accurate determination of the functional significance of CAD such that appropriate and cost-effective health care can be deployed. TAFE will also lead to a significant reduction in unnecessary invasive catheterization, and in doing so, reduce the costs and patient risks associated with these procedures. The Phase 1 effort is designed to make advancements in TAFE that are key to its development and commercialization. These studies will prepare the groundwork for a TAFE-based software package, and animal and human clinical studies in the future. The proposed project spans the areas of biomechanics, fluid dynamics, imaging and biomedicine. The formation of temporal and spatial gradients in the iodinated contrast that appear during a CTA exam are the result of complex interactions between fluid dynamics and dispersion physics, which is not completely understood. These patterns of contrast have only begun to reveal themselves in the last few years with the availability of CTA scanners with high spatial and temporal resolution. In conducting this research, we will not only break new ground in understanding the physics of blood flow and contrast dispersion in human vasculature; we will also demonstrate that these new-generation scanners can be combined with physics-based algorithms to facilitate optimized, patient-centered evidence-based decision support. The development and use of CTA compatible phantoms which mimic the fluid dynamics, contrast dispersion patterns and imaging attributes of coronary vessels is novel, and it is expected that the current research will help make these standard tools in this arena.