Daniel A. Lorenzatti , Annalisa Filtz , Pamela Piña , Jeirym Miranda , Siddarth Ragupathi , Felipe Contreras Yametti , Andrea Scotti , Winsome Elliott-Bailey , João L. Cavalcante , Thomas Ivanc , Azeem Latib , Mario J. Garcia , Leandro Slipczuk
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引用次数: 0
Abstract
Background
Computed tomography (CT)-derived extracellular volume fraction (ECV) quantifies myocardial fibrosis noninvasively, comparable to cardiovascular magnetic resonance. The conventional subtraction method (ECV-conv) requires dedicated pre- and post-contrast acquisitions, while the dual-energy spectral method (ECV-spec) uses only the post-contrast phase. We aimed to compare these methods in patients undergoing CT planning for transcatheter aortic valve replacement (TAVR).
Methods
We prospectively included patients undergoing CT-TAVR evaluation on a dual-energy dual-layer detector scanner. Baseline pre-contrast and equilibrium delay phase (at 5 min) prospectively ECG-triggered acquisitions were co-registered for ECV-conv calculation. Equilibrium phase spectral iodine maps were derived for ECV-spec measurement and compared with ECV-con maps using a mid-septal and a global mid-ventricular region of interest.
Results
Overall, 78 patients (53 % female, mean age 77 years) were analyzed. There was a minor overestimation in global measurement by ECV-spec (31.8 ± 4.6 % vs 30.3 ± 5.3 %, p = 0.023. However, there were no significant differences between both methods for the mid-septal measurement (ECV-conv = 30.4 ± 5.3 % vs ECV-spec = 31.0 ± 5.6 %, p = 0.196).). Both methods demonstrated comparable 95 % limits of agreement, with a strong correlation for mid-septal (r = 0.75, p < 0.0001) and a moderate correlation for global measurements (r = 0.51, p < 0.0001).
Conclusions
Myocardial CT-ECV estimation using dual-energy spectral maps was comparable to the conventional subtraction method without the need of a pre-contrast acquisition. This approach may help reduce imaging and processing times, as well as minimize radiation exposure.
期刊介绍:
The Journal of Cardiovascular Computed Tomography is a unique peer-review journal that integrates the entire international cardiovascular CT community including cardiologist and radiologists, from basic to clinical academic researchers, to private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our cardiovascular imaging community across the world. The goal of the journal is to advance the field of cardiovascular CT as the leading cardiovascular CT journal, attracting seminal work in the field with rapid and timely dissemination in electronic and print media.