Comparison of Dual-Energy Computed Tomography of the Heart With Single Photon Emission Computed Tomography for Assessment of Coronary Artery Stenosis and of the Myocardial Blood Supply

Ruzsics, Balázs; Schwarz, Florian; Schoepf, U. Joseph; Lee, Yeong Shyan; Bastarrika, Gorka; Chiaramida, Salvatore A.; Costello, Philip; Zwerner, Peter L.

doi:10.1016/j.amjcard.2009.03.051

Cited by 165 publications

(97 citation statements)

References 29 publications

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“…Mapping the iodine distribution within the left ventricular myocardium is possible with DECT. Accordingly, DECT-based iodine maps highlight areas of decreased iodine in the left ventricular myocardium [15][16][17]. The present results are in accordance with our previous stress DECT-MPI studies.…”

Section: Discussionsupporting

confidence: 82%

“…DECT-based colorcoded iodine distribution maps were superimposed onto grayscale multiplanar reformats of the left ventricular myocardium in the short-and long-axis views (5-mm slice thickness and no intersection gap) using the dual-energy image post-processing software application of the Syngo-Multi-Modality Workplace (syngoDualEnergy; Siemens, Forchheim, Germany). Perfusion defects were defined as contiguous, circumscribed areas of reduced or absent iodine content within the left ventricular myocardium relative to remote normal-appearing myocardium, as described previously [17]. The stress DECT-MPI and resting CTP obtained using CCTA were read side by side in the shortaxis view to distinguish stress-induced perfusion defects from artifacts or myocardial infarction.…”

Section: Stress Dect-mpimentioning

confidence: 99%

“…Dual-energy computed tomography (DECT) has recently emerged as a novel method for assessing myocardial perfusion. Based on the specific absorption characteristics of iodine for different X-ray energies, DECT allows mapping of intra-myocardial iodine extent and distribution, and small sample studies have demonstrated the feasibility of this technique to detect myocardial perfusion deficits [15][16][17]. However, large-scale studies examining stress DECT-MPI are lacking [18,19].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Stress Dual-Energy Computed Tomography-Myocardial Perfusion Imaging to Identify Coronary Artery Stenoses Causing Ischemia: A Direct Comparison between Invasive Coronary Angiography and Cardiac Magnetic Resonance-Myocardial Perfusion Imaging

Song

Hwang

et al. 2017

Cardiovasc Imaging Asia

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Objective:We determined the diagnostic performance of stress dual-energy computed tomography-myocardial perfusion imaging (DECT-MPI) for diagnosing coronary artery stenoses causing ischemia. Materials and Methods:Institutional review board approval and informed patient consent were obtained before patient enrollment in the study. One hundred ninety-two consecutive patients (135 males, 63.1±8.0 years) underwent coronary computed tomography angiography (CCTA), stress DECT-MPI, and a combined invasive coronary angiography (ICA)/cardiac magnetic resonance-myocardial perfusion imaging (CMR-MPI) for further comparison. Stress DECT-MPI and CMR-MPI were evaluated for perfusion deficits, whereas CCTA and ICA were evaluated for coronary stenosis ≥50%. The primary endpoint was the diagnostic performance of combined CCTA/stress DECT-MPI compared with combined ICA/CMR-MPI at the per-vessel level. Individual direct comparisons of CCTA to ICA and stress DECT-MPI to CMR-MPI were explored. Results:One hundred forty-four (75%) patients and 257 (45%) vascular territories manifested ischemia-causing coronary stenoses based on combined ICA/CMR-MPI. Per-vessel sensitivity, specificity, positive predictive value, and negative predictive value of combined CCTA/stress DECT-MPI were 88, 82, 79, and 89%, respectively, compared with combined ICA/ CMR-MPI. The values for CCTA alone were 95, 45, 63, and 94%, respectively, and the values for stress DECT-MPI alone were 91, 75, 75, and 92%, respectively. The area under the receiver operating characteristics curve for combined CCTA/stress DECT-MPI was higher than that for CCTA alone (0.85 vs. 0.75, p=0.001). Conclusion:When compared with combined ICA/CMR-MPI, combined CCTA/stress DECT-MPI improved the predictive value for coronary stenoses causing ischemia compared with CCTA, but only mildly improved the diagnostic performance of stress DECT-MPI alone.

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Section: Discussionsupporting

confidence: 82%

Section: Stress Dect-mpimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stress Dual-Energy Computed Tomography-Myocardial Perfusion Imaging to Identify Coronary Artery Stenoses Causing Ischemia: A Direct Comparison between Invasive Coronary Angiography and Cardiac Magnetic Resonance-Myocardial Perfusion Imaging

Song

Hwang

et al. 2017

Cardiovasc Imaging Asia

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“…Dual-energy CT technology may provide image acquisition using more than a single energy X-ray spectrum (30,31). Dual-energy CT represents a promising technique for the integrative analysis of coronary artery morphology and myocardial blood supply; furthermore Dual-energy CT is in good agreement with invasive coronary angiography and SPECT (30).…”

Section: Ct Technical Notesmentioning

confidence: 83%

“…Dual-energy CT represents a promising technique for the integrative analysis of coronary artery morphology and myocardial blood supply; furthermore Dual-energy CT is in good agreement with invasive coronary angiography and SPECT (30). Dual-energy technology enables mapping the myocardial iodine distribution, according to the absorption of X-ray spectra at different energy levels.…”

Section: Ct Technical Notesmentioning

confidence: 93%

Infarct characterization using CT

Grutta

Toia

Maffei

et al. 2017

Cardiovasc. Diagn. Ther.

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Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination.Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contrast media, but may characterize MI with overlapping imaging findings due to the similar kinetics and tissue distribution of gadolinium and iodinated contrast media. CCT may detect first-pass perfusion defects, dynamic perfusion after pharmacological stress, and delayed enhancement (DE) of non-viable territories.

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Optimal virtual monoenergetic image in “TwinBeam” dual‐energy CT for organs‐at‐risk delineation based on contrast‐noise‐ratio in head‐and‐neck radiotherapy

Wang

Ghavidel

Beitler

et al. 2019

J Applied Clin Med Phys

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PurposeDual‐energy computed tomography (DECT) using TwinBeam CT (TBCT) is a new option for radiation oncology simulators. TBCT scanning provides virtual monoenergetic images which are attractive in treatment planning since lower energies offer better contrast for soft tissues, and higher energies reduce noise. A protocol is needed to achieve optimal performance of this feature. In this study, we investigated the TBCT scan schema with the head‐and‐neck radiotherapy workflow at our clinic and selected the optimal energy with best contrast‐noise‐ratio (CNR) in organs‐at‐risks (OARs) delineation for head‐and‐neck treatment planning.Methods and materialsWe synthesized monochromatic images from 40 keV to 190 keV at 5 keV increments from data acquired by TBCT. We collected the Hounsfield unit (HU) numbers of OARs (brainstem, mandible, spinal cord, and parotid glands), the HU numbers of marginal regions outside OARs, and the noise levels for each monochromatic image. We then calculated the CNR for the different OARs at each energy level to generate a serial of spectral curves for each OAR. Based on these spectral curves of CNR, the mono‐energy corresponding to the max CNR was identified for each OAR of each patient.ResultsComputed tomography scans of ten patients by TBCT were used to test the optimal monoenergetic image for the CNR of OAR. Based on the maximized CNR, the optimal energy values were 78.5 ± 5.3 keV for the brainstem, 78.0 ± 4.2 keV for the mandible, 78.5 ± 5.7 keV for the parotid glands, and 78.5 ± 5.3 keV for the spinal cord. Overall, the optimal energy for the maximum CNR of these OARs in head‐and‐neck cancer patients was 80 keV.ConclusionWe have proposed a clinically feasible protocol that selects the optimal energy level of the virtual monoenergetic image in TBCT for OAR delineation based on the CNR in head‐and‐neck OAR. This protocol can be applied in TBCT simulation.

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Comparison of Dual-Energy Computed Tomography of the Heart With Single Photon Emission Computed Tomography for Assessment of Coronary Artery Stenosis and of the Myocardial Blood Supply

Cited by 165 publications

References 29 publications

Stress Dual-Energy Computed Tomography-Myocardial Perfusion Imaging to Identify Coronary Artery Stenoses Causing Ischemia: A Direct Comparison between Invasive Coronary Angiography and Cardiac Magnetic Resonance-Myocardial Perfusion Imaging

Stress Dual-Energy Computed Tomography-Myocardial Perfusion Imaging to Identify Coronary Artery Stenoses Causing Ischemia: A Direct Comparison between Invasive Coronary Angiography and Cardiac Magnetic Resonance-Myocardial Perfusion Imaging

Infarct characterization using CT

Optimal virtual monoenergetic image in “TwinBeam” dual‐energy CT for organs‐at‐risk delineation based on contrast‐noise‐ratio in head‐and‐neck radiotherapy

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