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impaginato corretto fullone_Layout 1 13/10/15 12.09 Pagina 75 Department of Engineering, ICT and Technologies for Energy and Transport Patent Title Title Procedure and system for the determination of Procedure and system for the determination of epicardial fat volume from tomographic images, and epicardial fat volume from tomographic images, and related computer program. related computer program. Ref. CNR 10167 Ref. CNR 10167 Assignee(s): CNR CNR Institute(s): ISTI IFC Main Inventor: D. Moroni –G. Coppini Countries: IT, FR, UK, DE, NL Priority date: 17/01/2012 Abstract Abstract Epicardial fat quantification allows to obtain an independent and objective parameter that can be useful Epicardial fat quantification allows to obtain an independent and objective parameter that can be useful for prognostic stratification and longitudinal assessment of cardiovascular risk. This is well documented for prognostic stratification and longitudinal assessment of cardiovascular risk. This is well documented in the literature and shown in several clinical trials. To date, there are no reliable and reproducible in the literature and shown in several clinical trials. To date, there are no reliable and reproducible methods for the measurement of epicardial fat volume that can be applied in clinical practice by making methods for the measurement of epicardial fat volume that can be applied in clinical practice by making use of standard computed tomography scans. use of standard computed tomography scans. The present invention fills this lack by providing an easy-to-use procedure that allows an accurate and The present invention fills this lack by providing an easy to use procedure that allows an accurate and reproducible measurement of epicardial fat volume from volumetric images, such as tomographic reproducible measurement of epicardial fat volume from volumetric images, such as tomographic images acquired with or without contrast agent administration, including those obtained in computed images acquired with or without contrast agent administration, including those obtained in computed tomography angiography. tomography angiography. Background Background Pericardial fat, like other visceral fat depots, is related to major cardiovascular and metabolic diseases and is Pericardial fat, like other visceral fat depots, is related to major cardiovascular and metabolic diseases and is considered to be a significant marker of the associated risk factors. Several clinical studies have considered to be a significant marker of the associated risk factors. Several clinical studies have demonstrated the importance of quantification of epicardial fat, which allows to obtain an independent and demonstrated the importance of quantification of epicardial fat, which allows to obtain an independent and objective parameter useful for prognostic stratification and longitudinal assessment of cardiovascular risk. objective parameter useful for prognostic stratification and longitudinal assessment of cardiovascular risk. Technology Technology The invention makes use of a conventional computed tomography angiography to obtain an estimate of The invention makes use of a conventional computed tomography angiography to obtain an estimate of the epicardial surface by means of a three-dimensional model generated from a series expansion of the epicardial surface by means of a three dimensional model generated from a series expansion of vector spherical harmonics. Then, the volume of cardiac fat is computed on the basis of the voxels located vector spherical harmonics. Then, the volume of cardiac fat is computed on the basis of the voxels located within the epicardial surface and having an attenuation level in the characteristic range of adipose tissue. within the epicardial surface and having an attenuation level in the characteristic range of adipose tissue. Advantages and Applicatons Advantages and Applications The procedure makes possible the measurement of epicardial fat volume requiring a minimum interaction The procedure makes possible the measurement of epicardial fat volume requiring a minimum interaction with the user and is characterized by high repeatability, low inter- and intra-observer variability and good with the user and is characterized by high repeatability, low inter and intra observer variability and good execution speed. It can be used in clinical practice, even by non-medical personnel, allowing the study of execution speed. It can be used in clinical practice, even by non medical personnel, allowing the study of cardiovascular and metabolic diseases over large populations. cardiovascular and metabolic diseases over large populations. Development stage Development stage A software package has been designed and developed. Thanks to a graphic user interface, it allows to A software package has been designed and developed. Thanks to a graphic user interface, it allows to carry out the entire processing and analysis pipeline. The software is ready to be integrated with existing carry out the entire processing and analysis pipeline. The software is ready to be integrated with existing 75 standard-based ICT infrastructure for health such as RIS and PACS. standard based ICT infrastructure for health such as RIS and PACS.