Quantitative myocardial perfusion with stress dual-energy CT: iodine concentration differences between normal and ischemic or necrotic myocardium. Initial experience.
Eur Radiol
; 26(9): 3199-207, 2016 Sep.
Article
in En
| MEDLINE
| ID: mdl-26699372
ABSTRACT
OBJECTIVES:
To determine whether the quantification of iodine with stress dual-energy computed tomography (DECT-S) allows for the discrimination between a normal and an ischemic or necrotic myocardium using magnetic resonance (MR) as a reference.METHODS:
This retrospective study was approved by the institutional review board, with waiver of informed consent. Thirty-six cardiac MR and DECT-S images from patients with suspected coronary artery disease were evaluated. Perfusion defects were visually determined, and myocardial iodine concentration was calculated by two observers using DECT colour-coded iodine maps. Iodine concentration differences were calculated using parametric tests. Receiver operating characteristic (ROC) curve analysis was conducted to estimate the optimal iodine concentration threshold for discriminating pathologic myocardium.RESULTS:
In total, 576 cardiac segments were evaluated. There were differences in mean iodine concentration (p < 0.001) between normal (2.56 ± 0.66 mg/mL), ischemic (1.98 ± 0.36 mg/dL) and infarcted segments (1.35 ± 0.57 mg/mL). A myocardium iodine concentration of 2.1 mg/mL represented the optimal threshold to discriminate between normal and pathologic myocardium (sensitivity 75 %, specificity 73.6 %, area under the curve 0.806). Excellent agreement was found in measured myocardium iodine concentration (intraclass correlation coefficient 0.814).CONCLUSION:
Cardiac DECT-S with iodine quantification may be useful to differentiate healthy and ischemic or necrotic myocardium. KEY POINTS ⢠DECT-S allows for determination of myocardial iodine concentration as a quantitative perfusion parameter. ⢠A high interobserver correlation exists in measuring myocardial iodine concentration with DECT-S. ⢠Myocardial iodine concentration may be useful in the assessment of patients with CAD.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tomography, X-Ray Computed
/
Iodine
/
Myocardial Infarction
/
Myocardium
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Eur Radiol
Journal subject:
RADIOLOGIA
Year:
2016
Document type:
Article
Affiliation country:
España