Synthetic hematocrit from virtual non-contrast images for myocardial extracellular volume evaluation with photon-counting detector CT.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2024-12-01 Epub Date: 2024-06-27 DOI:10.1007/s00330-024-10865-7

Victor Mergen, Nicolas Ehrbar, Lukas J Moser, Johannes C Harmes, Robert Manka, Hatem Alkadhi, Matthias Eberhard

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Abstract

Objectives: To assess the accuracy of a synthetic hematocrit derived from virtual non-contrast (VNC) and virtual non-iodine images (VNI) for myocardial extracellular volume (ECV) computation with photon-counting detector computed tomography (PCD-CT).

Materials and methods: Consecutive patients undergoing PCD-CT including a coronary CT angiography (CCTA) and a late enhancement (LE) scan and having a blood hematocrit were retrospectively included. In the first 75 patients (derivation cohort), CCTA and LE scans were reconstructed as VNI at 60, 70, and 80 keV and as VNC with quantum iterative reconstruction (QIR) strengths 2, 3, and 4. Blood pool attenuation (BP_mean) was correlated to blood hematocrit. In the next 50 patients (validation cohort), synthetic hematocrit was calculated using BP_mean. Myocardial ECV was computed using the synthetic hematocrit and compared with the ECV using the blood hematocrit as a reference.

Results: In the derivation cohort (49 men, mean age 79 ± 8 years), a correlation between BP_mean and blood hematocrit ranged from poor for VNI of CCTA at 80 keV, QIR2 (R² = 0.12) to moderate for VNI of LE at 60 keV, QIR4; 70 keV, QIR3 and 4; and VNC of LE, QIR3 and 4 (all, R² = 0.58). In the validation cohort (29 men, age 75 ± 14 years), synthetic hematocrit was calculated from VNC of the LE scan, QIR3. Median ECV was 26.9% (interquartile range (IQR), 25.5%, 28.8%) using the blood hematocrit and 26.8% (IQR, 25.4%, 29.7%) using synthetic hematocrit (VNC, QIR3; mean difference, -0.2%; limits of agreement, -2.4%, 2.0%; p = 0.33).

Conclusion: Synthetic hematocrit calculated from VNC images enables an accurate computation of myocardial ECV with PCD-CT.

Clinical relevance statement: Virtual non-contrast images from cardiac late enhancement scans with photon-counting detector CT allow the calculation of a synthetic hematocrit, which enables accurate computation of myocardial extracellular volume.

Key points: Blood hematocrit is mandatory for conventional myocardial extracellular volume computation. Synthetic hematocrit can be calculated from virtual non-iodine and non-contrast photon-counting detector CT images. Synthetic hematocrit from virtual non-contrast images enables computation of the myocardial extracellular volume.

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用光子计数探测器 CT 从虚拟非对比图像中合成血细胞比容，用于心肌细胞外容积评估。

目的评估通过光子计数探测器计算机断层扫描（PCD-CT）计算心肌细胞外容积（ECV）时从虚拟非对比（VNC）和虚拟非碘图像（VNI）得出的合成血细胞比容的准确性：回顾性纳入接受 PCD-CT 包括冠状动脉 CT 血管造影（CCTA）和晚期增强（LE）扫描且有血细胞比容的连续患者。在前 75 名患者（衍生队列）中，CCTA 和 LE 扫描在 60、70 和 80 keV 下重建为 VNI，在量子迭代重建（QIR）强度 2、3 和 4 下重建为 VNC。血池衰减（BPmean）与血细胞比容相关。在接下来的 50 名患者（验证队列）中，使用 BPmean 计算合成血细胞比容。使用合成血细胞比容计算心肌ECV，并与使用血液血细胞比容作为参考的ECV进行比较：在推导队列（49 名男性，平均年龄为 79 ± 8 岁）中，BPmean 与血液血细胞比容之间的相关性从 80 keV、QIR2 的 CCTA VNI（R2 = 0.12）的较差到 60 keV、QIR4、70 keV、QIR3 和 4 的 LE VNI 以及 QIR3 和 4 的 LE VNC（全部，R2 = 0.58）的中等不等。在验证队列（29 名男性，年龄为 75 ± 14 岁）中，根据 LE 扫描的 VNC（QIR3）计算合成血细胞比容。使用血液血细胞比容计算的中位 ECV 为 26.9%（四分位距 (IQR)，25.5%，28.8%），使用合成血细胞比容计算的中位 ECV 为 26.8%（四分位距 (IQR)，25.4%，29.7%）（VNC，QIR3；平均差异，-0.2%；差异范围，-2.4%，2.0%；P = 0.33）：结论：根据 VNC 图像计算的合成血细胞比容能准确计算 PCD-CT 的心肌 ECV：临床意义：使用光子计数探测器 CT 进行心脏晚期增强扫描获得的虚拟非对比图像可以计算合成血细胞比容，从而准确计算心肌细胞外容积：要点：血细胞比容是常规心肌细胞外容积计算的必备条件。虚拟非碘和非对比度光子计数探测器 CT 图像可计算合成血细胞比容。通过虚拟非对比度图像合成的血细胞比容可以计算心肌细胞外容积。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.