Investigation of myocardial extracellular volume fraction in heart failure patients using iodine map with rapid-kV switching dual-energy CT: Segmental comparison with MRI T1 mapping.

Ohta Y, Kishimoto J, Kitao S, Yunaga H, Mukai-Yatagai N, Fujii S, Yamamoto K, Fukuda T, Ogawa T

Journal of cardiovascular computed tomography

Jan 1, 2020

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Abstract

PURPOSE: To measure myocardial extracellular volume fraction (ECV) for each region or segment using iodine density image (IDI) with single-source dual-energy computed tomography (DECT) and compare the results with an MRI T1 mapping approach. MATERIALS AND METHODS: For this prospective study, 79 consecutive heart failure patients referred for MRI were included and 23 patients (14 men, 63 ± 14 years) who underwent both MRI and late contrast enhancement DECT following coronary CT angiography were evaluated. CT-ECV was computed from IDI using late acquisition projection data. MR-ECV was computed from native and post-contrast T1 maps using non-rigid image registration for segments with evaluable image quality from 3.0-T MRI. Regional CT-ECV and MR-ECV were measured based on 16-segment models. CT-ECV and MR-ECV were compared using Pearson correlations. Agreement among methods was assessed using Bland-Altman comparisons. RESULTS: In the 368 segments, although all segments were evaluable on IDI, 37 segments were rated as non-evaluable on T1 maps. Overall, 331 segments were analyzed. Mean CT-ECV and MR-ECV were 31.6 ± 9.1 and 33.2 ± 9.1, respectively. Strong correlations were seen between CT-ECV and MR-ECV for each region, as follows: all segments, r = 0.837; septal, r = 0.871; mid-septal, r = 0.895; anterior, r = 0.869; inferior, r = 0.793; and lateral, 0.864 (all p < 0.001). Differences between CT-ECV and MR-ECV were as follows: all segments, 1.13 ± 4.98; septal, -1.51 ± 4.37; mid-septal, -1.85 ± 4.22; anterior, 2.54 ± 4.89; inferior, 1.2 ± 5.78; and lateral, 2.65 ± 3.98. CONCLUSION: ECV using DECT and from cardiac MRI showed a strong correlation on regional and segmental evaluations. DECT is useful for characterizing myocardial ECV changes as well as MRI.

Affiliation

Division of Radiology, Department of Pathophysiological Therapeutic Science, Tottori University Faculty of Medicine, Yonago City, Tottori, 683-8504, Japan; National Cerebral and Cardiovascular Center, Suita City, Osaka, 565-8565, Japan. Electronic address: [email protected].