Estimation of myocardial fibrosis in humans with dual energy CT

Quantification of myocardial fibrosis using noninvasive T2‐mapping magnetic resonance imaging: Preclinical models of aging and pressure overload

“…Noninvasive medical imaging modalities such as computerized tomography (CT), 9 single photon emission computed tomography (SPECT), positron emission tomography (PET), 10 and magnetic resonance imaging (MRI) may be used to evaluate myocardial fibrosis and remodeling. Recently, dual‐energy CT has shown promise in analyzing myocardial fibrosis with a correct classification rate of 89.3% compared with late gadolinium enhancement MRI (LGE‐MRI) 9 . Several radiotracers and collagen‐targeted gadolinium‐chelates designed for molecular imaging have been utilized to detect excessive collagen deposition in multiple murine studies by SPECT, PET, and MRI 11–15 .…”

Multimodality imaging in cardiac amyloidosis: State‐of‐the‐art review

“…Myocardial attenuation on delayed acquisition and the relative attenuation index (variation of myocardial attenuation between delayed and first‐pass acquisitions) was higher in CA when compared to controls, supporting the concept that MDCT‐LIE may be useful for the diagnosis of CA 77 . Subsequent work reported that contrast‐enhanced equilibrium‐phase cardiac MDCT could be used to accurately measure ECV, and that MDCT‐measured ECV could be used to discriminate healthy from diseased myocardium in different cardiomyopathies, yielding results comparable to CMR 73,78–84 . Two methods of myocardial MDCT‐ECV measurement have been reported, yielding equivalent results: the subtraction‐derived method based on standard single‐energy MDCT, and the iodine density‐derived method based on dual‐energy MDCT (DECT) 79 …”

“…77 Subsequent work reported that contrastenhanced equilibrium-phase cardiac MDCT could be used to accurately measure ECV, and that MDCT-measured ECV could be used to discriminate healthy from diseased myocardium in different cardiomyopathies, yielding results comparable to CMR. 73,[78][79][80][81][82][83][84] Two methods of myocardial MDCT-ECV measurement have been reported, yielding equivalent results: the subtraction-derived method based on standard single-energy MDCT, and the iodine density-derived method based on dual-energy MDCT (DECT). 79 Myocardial iodine concentration is able to distinguish CA from other cardiomyopathies with a reported sensitivity and specificity as high as 100% and 92%, respectively.…”

The Potential Role of Cardiac CT in the Evaluation of Patients With Known or Suspected Cardiomyopathy: From Traditional Indications to Novel Clinical Applications

“…More precisely, in 2020, Ohta et al reported that strong correlations were seen between CT-ECV and MR-ECV at postcontrast CT images in 23 patients (51). Similarly, in 2019 Kumar et al (52) reported that multienergy CT in 21 subjects, when compared with a singleenergy approach, better discriminate the presence or absence of myocardial fibrosis severity when compared with CMR, with correct classification rates of 89 and 71%, respectively; similarly, the multi energy CT better discriminates normal from elevated ECV, with a correct classification in 89% of patients vs. correct distinction of normal vs. elevated ECV in only 70% using single energy CT. Recently, radiomics models with an artificial intelligence approach achieved a good diagnostic accuracy (AUC: 0.78, 95% CI: 0.75-0.81) on a per-segment basis for the identification of myocardial fibrosis with CCR vs. MRI (53).…”