“It Is Only With the Heart That One Can See Rightly”
A research team including scientists from Uniklinik RWTH Aachen develops groundbreaking high-resolution 3D imaging of the human heart.
Researchers from Uniklinik RWTH Aachen (UKA), University College London (UCL), and the European Synchrotron Radiation Facility (ESRF) have created a comprehensive atlas of the human heart, mapping it from the cellular level to the whole organ. For the first time, the team has used hierarchical phase contrast tomography (HiP-CT) to capture 3D images of human heart tissue at the cellular level. The findings have been published in the prestigious journal Radiology.
Typically, doctors rely on clinical imaging methods – such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) – to examine the heart. While these techniques are well-suited for diagnosing cardiovascular disease, they do not reveal the heart's structural changes at different levels of detail. For higher resolution, histology is used to examine tissue biopsies in cross-sections. Although histology provides intricate information, it only offers a limited field of view.
The newly developed method, known as hierarchical phase contrast tomography (HiP-CT), now allows researchers to bypass these limitations, generating comprehensive, highly detailed three-dimensional images of the entire adult human heart.
“HiP-CT enables a complete view of whole organs at unprecedented resolutions, bridging the gap between standard imaging and histology,”
The Aachen research team, participating in an international collaboration between the European Synchrotron Source ESRF in Grenoble, France, and a number of leading institutions, has used the HiP-CT imaging method at the ESRF's BM18 beamline to capture high-resolution 3D scans of two human hearts – one healthy and one diseased – down to the cellular level.
Key members of this collaborative effort include researchers from University College London (UCL), Wellcome Sanger Institute, Siemens Healthineers, Great Ormond Street Hospital, Hannover Medical School, Helios University Hospital Wuppertal, the University Medical Center of the Johannes Gutenberg University Mainz, and the Laboratoire d'anatomie des Alpes Françaises (LADAF).
A major advantage of the HiP-CT technique is its ability to generate a complete, three-dimensional view of the organ at an exceptional resolution of 20 micrometers – approximately 20 times better than a clinical CT scanner. Furthermore, the researchers can zoom in to visualize cellular-level details at a resolution of 2 micrometers, providing histological-quality insights without the need for physical sectioning of the sample. This breakthrough imaging approach allows for the hierarchical mapping of entire organs, revealing previously unknown anatomical details and connectivity.
Unprecedented Detail Unlocks New Insights
One of the study’s key findings is the highly detailed mapping of the cardiac conduction system, responsible for generating and transmitting the electrical signals that control the heart’s pumping action. By virtually segmenting this conduction system, researchers could examine both its vascular supply and the connections between heart nodes and neighboring structures. The level of detail achieved for the adult heart’s entire conduction system surpasses what previous imaging technologies could accomplish.
Enhanced Understanding of Cardiac Arrhythmias
Unlike traditional X-ray imaging, which relies on X-ray absorption, phase-contrast imaging leverages the refraction of specific X-ray wavelengths that penetrate tissues, achieving significantly higher contrast and resolution. This is particularly beneficial for visualizing soft tissues and intricate structures within the heart, without the need for contrast agents.
“This technology holds tremendous potential for advancing new treatments,” “Cardiac arrhythmias are one example: with current methods, accurately interpreting the anatomy underlying these arrhythmias is extremely challenging. Our results will help improve understanding of arrhythmia development and enhance the precision of ablation techniques to treat these disorders,”
The study’s results also allow scientists to measure variations in the thickness of atrial sublayers, including the epicardial fat between the heart’s outer surface and its surrounding protective sac. This insight could be pivotal for refining cryoablation treatments through heart walls in arrhythmia cases. Beyond arrhythmias, HiP-CT could also provide valuable information about other cardiovascular diseases.
Human Organ Atlas
This study contributes to the Human Organ Atlas project, which aims to build an open-access image database of all human organs in both health and disease. For more information on the Human Organ Atlas project, video clips on the project are available at mecheng.ucl.ac.uk/HOAHub/ and bit.ly/HiP-CT-Heart. The project is co-funded by the Chan Zuckerberg Initiative (CZI).
Reference
Brunet J, Cook AC, Walsh CL, Cranley J, Tafforeau P, Engel K, Arthurs O, Berruyer C, Burke O'Leary E, Bellier A, Torii R, Werlein C, Jonigk DD, Ackermann M, Dollman K, Lee PD. Multidimensional Analysis of the Adult Human Heart in Health and Disease Using Hierarchical Phase-Contrast Tomography.