Automated Quantification of Right Ventricular Fat at Contrast-enhanced Cardiac Multidetector CT in Arrhythmogenic Right Ventricular Cardiomyopathy

Cochet, Hubert; Denis, Arnaud; Komatsu, Yuki; Jadidi, Amir; Ali, Tassadit Aït; Sacher, Frédéric; Derval, Nicolas; Relan, Jatin; Sermesant, Maxime; Corneloup, O.; Hocini, Mélèze; Haı̈ssaguerre, Michel; Laurent, François; Montaudon, Michel; Jaı̈s, Pierre

doi:10.1148/radiol.14141140

Cited by 24 publications

(21 citation statements)

References 24 publications

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“…The method used to segment intramyocardial fat from MDCT is based on previous validation studies demonstrating good correlation with contact mapping data 9 and Task Force criteria. 10 The distribution of RV fat is consistent with previous histological 3,24 and contact mapping studies. 18,25 In the current study, RV substrate was also assessed with the use of MRI.…”

Section: Distribution Of Structural Substrate In Arvcsupporting

confidence: 90%

“…Intramyocardial fat was defined as any myocardial voxel with attenuation less than −10 HU, based on previous validation versus contact mapping. 9 This substrate was segmented using an automated image processing method, as described previously, 9,10 and distributed over a biventricular 16-segment model: the RV and LV free walls comprised 7 segments each (3 segments at basal and midventricular levels-ie, anterior, lateral, and inferiorand 1 segment at the apex), and the septum comprised 2 segments (basal and midventricular). CMR imaging was performed on a 1.5T system (Avanto; Siemens Medical Solutions, Erlangen, Germany).…”

Section: Imagingmentioning

confidence: 99%

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Characterization of the Left-Sided Substrate in Arrhythmogenic Right Ventricular Cardiomyopathy

Berte

Denis

Amraoui

et al. 2015

Circ: Arrhythmia and Electrophysiology

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Background-The correlates of left ventricular (LV) substrate in arrhythmogenic right ventricular (RV) cardiomyopathy are largely unknown. Methods and Results-Thirty-two patients with arrhythmogenic RV cardiomyopathy (47±14 years; 6 women) were included. RV and LV dysplasia were defined from multidetector computed tomography and cardiac magnetic resonance imaging. Arrhythmias were characterized as right-sided or left-sided on 12-lead ECG recordings at baseline and during isoproterenol testing. In 14 patients, the imaging substrate was compared with voltage mapping and local abnormal ventricular activity. Imaging abnormalities were found in 32 (100%) and 21 (66%) patients on the RV and LV, respectively, intramyocardial fat on multidetector computed tomography being the most sensitive feature. LV involvement related to none of the Task Force criteria. Right-sided arrhythmias were more frequent than left-sided arrhythmias (P=0.003) although the latter were more frequent in case of LV involvement (P=0.02). The agreement between low voltage and fat on multidetector computed tomography was high on the RV when using either endocardial unipolar or epicardial bipolar data (κ=0.82 and κ=0.78, respectively) but lower on the LV (κ=0.54 for epicardial bipolar). LV local abnormal ventricular activity was found in all patients with LV involvement, and none of the others. The density of local abnormal ventricular activity within fat areas was similar between the RV and LV (P=0.57). Conclusions-LV substrate is frequent in arrhythmogenic RV cardiomyopathy, but poorly identified by current diagnostic strategies. Left-sided arrhythmias are more frequent in case of LV involvement. LV fat hosts the same density of local abnormal ventricular activity as RV fat, but is less efficiently detected by voltage mapping. These results support the need for alternative diagnostic strategies to identify LV dysplasia. (Circ Arrhythm Electrophysiol.

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Section: Distribution Of Structural Substrate In Arvcsupporting

confidence: 90%

Section: Imagingmentioning

confidence: 99%

Characterization of the Left-Sided Substrate in Arrhythmogenic Right Ventricular Cardiomyopathy

Berte

Denis

Amraoui

et al. 2015

Circ: Arrhythmia and Electrophysiology

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“…CT. Cardiac CT also provides a role in morphologic evaluation of the RV, particularly in patients with implantable cardioverter defibrillators who often cannot undergo MRI examination [80][81][82].…”

Section: Echocardiographymentioning

confidence: 99%

ACR Appropriateness Criteria ® Dyspnea—Suspected Cardiac Origin

Vogel‐Claussen

Elshafee

Kirsch

et al. 2017

Journal of the American College of Radiology

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This article discusses imaging guidelines for five dyspnea variants: (1) dyspnea due to heart failure, ischemia not excluded; (2) dyspnea due to suspected nonischemic heart failure, ischemia excluded; (3) dyspnea due to suspected valvular heart disease, ischemia excluded; (4) dyspnea due to suspected cardiac arrhythmia, ischemia excluded; and (5) dyspnea due to suspected pericardial disease, ischemia excluded. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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“…In patients with ARVC, the substrate was assessed on multidetector CT images by using automatic segmentation of right ventricular intramyocardial fat (18). On MR images, the endocardium and epicardium were segmented manually.…”

Section: Feasibilitymentioning

confidence: 99%

Cardiac Arrythmias: Multimodal Assessment Integrating Body Surface ECG Mapping into Cardiac Imaging

Cochet¹,

Dubois²,

Sacher

et al. 2014

Radiology

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Automated Quantification of Right Ventricular Fat at Contrast-enhanced Cardiac Multidetector CT in Arrhythmogenic Right Ventricular Cardiomyopathy

Cited by 24 publications

References 24 publications

Characterization of the Left-Sided Substrate in Arrhythmogenic Right Ventricular Cardiomyopathy

Characterization of the Left-Sided Substrate in Arrhythmogenic Right Ventricular Cardiomyopathy

ACR Appropriateness Criteria ® Dyspnea—Suspected Cardiac Origin

Cardiac Arrythmias: Multimodal Assessment Integrating Body Surface ECG Mapping into Cardiac Imaging

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