Reproducibility of myocardial extracellular volume quantification using dual-energy computed tomography in patients with cardiac amyloidosis.

Journal of cardiovascular computed tomography Pub Date : 2024-10-04 DOI:10.1016/j.jcct.2024.09.011

Yoshito Kadoya, Mehmet Onur Omaygenc, Benjamin Chow, Gary R Small

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Abstract

Background: Quantifying myocardial extracellular volume (ECV) using computed tomography (CT) has been shown to be useful in the evaluation of cardiac amyloidosis. However, the reproducibility of CT measurements for myocardial ECV, is not well-established in patients with proven cardiac amyloidosis.

Methods: This prospective single-center study enrolled cardiac amyloidosis patients to undergo dual-energy CT for myocardial fibrosis assessment. Delayed imaging at 7 and 8 min post-contrast and independent evaluations by two blinded cardiologists were performed for ECV quantification using 16-segment (ECV_global) and septal sampling (ECV_septal). Inter- and intraobserver variability and test-retest reliability were measured using Spearman's rank correlation, Bland-Altman analysis, and intraclass correlation coefficients (ICC).

Results: Among the 24 participants (median age = 78, 67 % male), CT ECV_global and ECV_septal showed median values of 53.6 % and 49.1 % at 7 min, and 53.3 % and 50.1 % at 8 min, respectively. Inter- and intraobserver variability and test-retest reliability for CT ECV_global (ICC = 0.798, 0.912, and 0.894, respectively) and ECV_septal (ICC = 0.791, 0.898, and 0.852, respectively) indicated good reproducibility, with no evidence of systemic bias between observers or scans.

Conclusions: Dual-energy CT-derived ECV measurements demonstrated good reproducibility in patients with proven cardiac amyloidosis, suggesting potential utility as a repeatable imaging biomarker for this disease.

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使用双能计算机断层扫描对心脏淀粉样变性患者的心肌细胞外体积进行量化的再现性。

背景：使用计算机断层扫描（CT）量化心肌细胞外容积（ECV）已被证明有助于评估心脏淀粉样变性。然而，在已证实患有心脏淀粉样变性的患者中，CT 测量心肌细胞外容积的重现性尚未得到充分证实：这项前瞻性单中心研究招募了心脏淀粉样变性患者接受双能 CT 进行心肌纤维化评估。在对比后 7 分钟和 8 分钟进行延迟成像，并由两名双盲心脏病专家进行独立评估，使用 16 节段（ECVglobal）和室间隔取样（ECVseptal）进行心肌体积量化。使用斯皮尔曼等级相关性、布兰-阿尔特曼分析和类内相关系数（ICC）测量观察者之间和观察者内部的变异性以及测试-重复测试的可靠性：在 24 名参与者（中位年龄 = 78 岁，67% 为男性）中，7 分钟时 CT ECVglobal 和 ECVseptal 的中位值分别为 53.6% 和 49.1%，8 分钟时分别为 53.3% 和 50.1%。CT ECVglobal（ICC 分别为 0.798、0.912 和 0.894）和 ECVseptal（ICC 分别为 0.791、0.898 和 0.852）的观察者间和观察者内变异性以及测试-再测可靠性显示了良好的再现性，没有证据表明观察者或扫描之间存在系统性偏差：结论：双能 CT 导出的 ECV 测量结果在已证实患有心脏淀粉样变性的患者中显示出良好的可重复性，这表明它有可能成为该疾病的可重复成像生物标记物。

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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Journal of cardiovascular computed tomography

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