Measurement of myocardial extracellular volume fraction in patients with heart failure with preserved ejection fraction using dual-energy computed tomography

Assessment of Myocardial Viability in Chronic Myocardial Infarction Using the Dual-Energy Computed Tomography Myocardial Extracellular Volume Fractionation Technique: A Case Report

“…As well as providing information on coronary artery morphology, cardiac CT with the use of LIE provides information on the presence or absence of myocardial infarction and the location and site of infarction. CT with LIE has also been used in the context of myocardial fibrosis, heart failure, cardiomyopathy, and aortic valve stenosis [5 , 6] .…”

Imaging biomarkers in cardiac CT: moving beyond simple coronary anatomical assessment

“…With DECT or PCD-CT, ECV CT is quantify by measuring the iodine concentration in myocardium and blood pool in the delayed-phase scan only, based on spectral decomposition of the obtained multi-energy datasets [ 110 ]. The acquisition time for the delayed scan phases is not still unanimously shared, ranging from 5 to 12 min [ 114 , 116 ]; CM injection technique could be based on single or double boli (fixed or proportional to patient’s body weight [ 117 – 119 ]) or with slow intravenous infusion [ 109 , 115 ].…”

Myocardial extracellular volume quantification with computed tomography—current status and future outlook

“…For dual-energy-based ECV CT calculation, the timing of late enhancement acquisitions varied between studies as well. For dual source dual-energy CT, the acquisition of late enhancement scans ranged between 5 and 12 min after CM administration [ 18 , 24 , 29 , 30 ], both with prospective and retrospective ECG-triggering, using energy levels at 80 or 90 kV and 140 or 150 kV [ 18 , 29 ]. Otha et al calculated ECV CT using the rapid kV switching technique (80–140 kV) with a late enhancement acquisition performed 7–8 min after CM injection [ 23 ].…”

“…While this CM injection scheme may result in a true steady state of CM distribution between the vascular and extracellular space, it is difficult to apply in clinical practice. More practical CM protocols are reported by Hammer et al [ 26 ] using a fixed bolus of 50–60 mL of iopromide 370, by Scully et al [ 21 ] using a fixed bolus of 90 mL iohexol 300 or by Qi et al [ 24 ] using a bolus of 50 mL iopromide 370 for coronary angiography followed by an additional bolus of 50 mL of iopromide 370 before late enhancement scan acquisition. Other groups adapted the CM volume to body weight reaching a total volume of 1.4–1.8 mL/kg of iopamidol [ 18 , 22 , 23 ] or 1 mL/kg of iohexol [ 27 ].…”

“…In general, myocardial ECV CT assessed with dual-energy CT has an excellent reproducibility and good agreement with ECV MRI in patients with nonischemic cardiomyopathy [ 18 ] and heart failure [ 23 , 38 ]. Moreover, ECV CT is positively correlated with the NYHA classification in patients with non-ischemic heart failure with preserved ejection fraction [ 24 ]. ECV CT may even serve as an early biomarker of cardiotoxicity in patients with cardiac dysfunction after anthracycline chemotherapy [ 39 , 40 ] or chest radiation therapy for esophageal cancer [ 41 ], as elevated ECV CT were observed in these patients.…”