Feasibility of 64-slice gadolinium-enhanced cardiac CT for the evaluation of obstructive coronary artery disease

Carrascosa, Patrícia; Capuñay, Carlos; Deviggiano, Alejandro; Bettinotti, Marcelo; Goldsmit, Alejandro; Tajer, Carlos; Carrascosa, Jorge; García, Mario J.

doi:10.1136/hrt.2009.183699

Cited by 14 publications

(11 citation statements)

References 24 publications

(14 reference statements)

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“…The material used to generate contrast for CT is usually in the core of the particle. The contrast‐generating element used is most frequently iodine , gold or bismuth , but the use of various elements such as bromine , tantalum , platinum , ytterbium , yttrium , gadolinium , tungsten and others has been reported. The core is coated with a polymer, lipid, protein, silica or other compounds that yield solubility in biological media and biocompatibility.…”

Section: Introductionmentioning

confidence: 99%

Nanoparticle contrast agents for computed tomography: a focus on micelles

Cormode

Naha

Fayad

2014

Contrast Media & Molecular

284

234

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Computed tomography (CT) is an X-ray based whole body imaging technique that is widely used in medicine. Clinically approved contrast agents for CT are iodinated small molecules or barium suspensions. Over the past seven years there has been a great increase in the development of nanoparticles as CT contrast agents. Nanoparticles have several advantages over small molecule CT contrast agents, such as long blood-pool residence times, and the potential for cell tracking and targeted imaging applications. Furthermore, there is a need for novel CT contrast agents, due to the growing population of renally impaired patients and patients hypersensitive to iodinated contrast. Micelles and lipoproteins, a micelle-related class of nanoparticle, have notably been adapted as CT contrast agents. In this review we discuss the principles of CT image formation and the generation of CT contrast. We discuss the progress in developing non-targeted, targeted and cell tracking nanoparticle CT contrast agents. We feature agents based on micelles and used in conjunction with spectral CT. The large contrast agent doses needed will necessitate careful toxicology studies prior to clinical translation. However, the field has seen tremendous advances in the past decade and we expect many more advances to come in the next decade.

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Section: Introductionmentioning

confidence: 99%

Nanoparticle contrast agents for computed tomography: a focus on micelles

Cormode

Naha

Fayad

2014

Contrast Media & Molecular

284

234

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“…As discussed in the first limitation, additional study with routine low dose gadolinium based contrast agent is needed to assess the image quality of gadolinium-enhanced CTPA. Of note, gadolinium based contrast agent has been shown to be safe in doses up to 0.4-0.5 mmol/kg in healthy subjects without adverse effect on renal function [24,27,28]. Third, our results are limited by small sample size.…”

Section: Discussionmentioning

confidence: 83%

“…Gadolinium-based contrast media has been used as an alternative to iodinated contrast agents for patients with contraindications to iodinated contrast media [17][18][19][20]. Gadolinium-enhanced CT has been used to detect nearly all cardiovascular abnormalities, such as in the aorta, pulmonary circulation, coronary artery, and circle of Willis, with diagnostic image quality and no significant side effects [21][22][23][24][25][26]. Our hypothesis is that gadolinium based contrast agent can be used as an alternative to iodinated contrast agent in dual energy CT pulmonary angiography to assess pulmonary artery and lung parenchyma perfusion in patients with suspected pulmonary embolism but with contraindication to iodinated contrast medium.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of gadolinium-enhanced dual energy CT pulmonary angiography: a pilot study in rabbits

Zhang

Wang

Lü

et al. 2010

Int J Cardiovasc Imaging

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The purpose of this study was to evaluate the feasibility of gadolinium-enhanced dual energy CT pulmonary angiography (CTPA) to detect pulmonary embolism (PE) in rabbits. Dual energy CT was performed on phantoms composed of different dilution of gadolinium and iodinated contrast agents, CT numbers of the phantoms were measured at different tube voltages. Ten rabbits, which were subdivided into two groups receiving 3 or 5 ml/kg of gadolinium based contrast agent (n = 5 for each group), underwent baseline gadolinium-enhanced dual energy CTPA. The CT numbers of pulmonary arteries were measured. The following day, sponge gelatin was injected into femoral vein of 6 rabbits to create pulmonary emboli. The rabbit were re-imaged 2 h after sponge gelatin injection. Histopathology analysis of the lung lobes was performed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Serum creatinine levels were measured on day 1 before gadolinium contrast media injection, and on day 2 prior to PE creation. The phantoms and animal study showed that the CT numbers of gadolinium-based contrast agent and pulmonary arteries at 80 kVp were higher than those at 140 kVp and average weighted 120 kVp. In 6 rabbits, CTPA showed bilateral pulmonary artery emboli, and the reconstructed gadolinium maps showed decreased pulmonary perfusion in the corresponding lung lobes. With the histopathology results as the reference standards, CTPA and Blood flow imaging (BFI) detected PE in 14 and 14 of the 14 pulmonary lobes, 26, 24 lobes without PE, respectively, corresponding to sensitivities of 100 and 100%, and specificities of 100 and 92%, respectively. Serum creatinine level increased by 6.7 and 20.6% in the rabbits receiving 3 and 5 ml/kg gadolinium based contrast medium respectively. Histopathological analysis found no significant tubular necrosis at either gadolinium dose. Gadolinium-enhanced dual energy CT pulmonary angiography is feasible and it can simultaneously provide information on pulmonary artery and lung perfusion in a rabbit model of PE.

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“…Carrascosa et al did not observe severe reactions; there were, however, mild ones such as flushing, itching, rash and nausea 1. Although these were more common in the iodine group than in the gadolinium group, a study15 of 32 659 patients receiving gadolinium reported 51(0.16%) acute adverse reactions of which 43 were mild, six were moderate and two were severe (anaphylaxis).…”

Section: Adverse Reactionsmentioning

confidence: 93%

“…In this issue of Heart , Carrascosa et al report on the feasibility of gadolinium-enhanced coronary computed tomography angiography (CTA) ( see page ) 1. Gadolinium attenuates x-rays and appears hyperdense on CTA 2.…”

mentioning

confidence: 99%