Non-linear blending of dual-energy CT data improves depiction of late iodine enhancement in chronic myocardial infarction

Wichmann, Julian L.; Hu, Xiaohan; Kerl, J. Matthias; Schulz, Boris; Bodelle, Boris; Frellesen, Claudia; Lehnert, Thomas; Vogl, Thomas J.; Bauer, Ralf W.

doi:10.1007/s10554-014-0440-x

Cited by 15 publications

(8 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Wichmann et. al also used nonlinear blending but employed 100kVp/140kVp tube voltages in a patient study 13 . The present study provides a more comprehensive assessment of spectral reconstruction methods, including conventional and noise optimized monoenergetic images.…”

Section: Discussionmentioning

confidence: 99%

Optimized energy of spectral CT for infarct imaging: Experimental validation with human validation

Sandfort

Palanisamy

Symons

et al. 2017

Journal of Cardiovascular Computed Tomography

View full text Add to dashboard Cite

Objectives Late contrast enhancement visualizes myocardial infarction, but the contrast to noise ratio (CNR) is low using conventional CT. The aim of this study was to determine if spectral CT can improve imaging of myocardial infarction. Materials and Methods A canine model of myocardial infarction was produced in 8 animals (90-minute occlusion, reperfusion). Later, imaging was performed after contrast injection using CT at 90kVp/150kVpSn. The following reconstructions were evaluated: Single energy 90 kVp, mixed, iodine map, multiple monoenergetic conventional and monoenergetic noise optimized reconstructions. Regions of interest were measured in infarct and remote regions to calculate contrast to noise ratio (CNR) and Bhattacharya distance (a metric of the differentiation between regions). Blinded assessment of image quality was performed. The same reconstruction methods were applied to CT scans of four patients with known infarcts. Results For animal studies, the highest CNR for infarct vs. myocardium was achieved in the lowest keV (40 keV) VMo images (CNR 4.42, IQR 3.64–5.53), which was superior to 90 kVp, mixed and iodine map (p=0.008, p=0.002, p<0.001, respectively). Compared to 90 kVp and iodine map, the 40 keV VMo reconstructions showed significantly higher histogram separation (p=0.042 and p<0.0001, respectively). The VMo reconstructions showed the highest rate of excellent quality scores. A similar pattern was seen in human studies, with CNRs for infarct maximized at the lowest keV optimized reconstruction (CNR 4.44, IQR 2.86–5.94). Conclusions Dual energy in conjunction with noise-optimized monoenergetic post-processing improves CNR of myocardial infarct delineation by approximately 20 – 25%.

show abstract

Section: Discussionmentioning

confidence: 99%

Optimized energy of spectral CT for infarct imaging: Experimental validation with human validation

Sandfort

Palanisamy

Symons

et al. 2017

Journal of Cardiovascular Computed Tomography

View full text Add to dashboard Cite

show abstract

“…One study compared nonlinear and linear blending of cardiac dual-energy computed tomography (DECT) for optimal visualization of late iodine enhancement (LIE) in patients with chronic myocardial infarction (CMI). [79] LIE-DECT data from 20 patients with known CMI were retrospectively analyzed. Images were reconstructed using non-linear blending center and width settings in the range of 0-500.…”

Section: Computed Tomography Componentmentioning

confidence: 99%

Cardiovascular imaging 2014 in the International Journal of Cardiovascular Imaging

Bezerra¹,

Costa²,

Reiber³

et al. 2015

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

“…Due to higher signal of gadolinium contrast and lower noise levels automatic segmentation of infarcts was shown to be feasible in delayed enhancement MRI 18, 19 although visual assessment is frequently used. Using improved image reconstructions and dual energy CT, the signal to noise ratio can be increased 5, 20-22 but infarct imaging using CT remains technically challenging. Using dual energy CT, Wichmann et al 5 report CNR between myocardium and infarct of (74.6/26.7 = ∼3) but the CNR between infarct and blood pool even with optimized dual energy CT was only about (33.2/29.6 = 1.2).…”

Section: Discussionmentioning

confidence: 99%

“…Compared with single-energy CT, dual-energy CT can improve CNR to some extent. 5, 6 To maximize infarct conspicuity, late contrast enhancement CT is performed after intravenous administration of 40-50 g iodine. High iodine loads improve the contrast to noise ratio of the enhancing infarct compared to normal myocardium.…”

Section: Introductionmentioning

confidence: 99%

Automatic high-resolution infarct detection using volumetric multiphase dual-energy CT

Sandfort

Kwan

Elumogo

et al. 2017

Journal of Cardiovascular Computed Tomography

View full text Add to dashboard Cite

Objectives Late contrast enhancement CT (LCE-CT) visualizes the presence of myocardial infarcts. Differentiation of the contrast-enhanced infarct from blood pool is challenging. We developed a novel method using data from first pass CT angiography (CTA) imaging to enable automatic infarct detection. Materials and Methods A canine model of myocardial infarction was produced in 11 animals. Two months later, first pass CTA (90 kVp) and LCE-CT (dual energy 90 kVp/150 kVp tin filtered) were performed. Late gadolinium enhancement MRI was used as reference standard. The CTA and LCE-CT were co-registered using a fully automatic non-rigid method based on curved B-splines. The method allowed for limited elastic deformation and the considerable differences in attenuation between first-pass and delayed image. The blood pool was easily identified on the CTA image by high attenuation. Because CTA and LCE-CT were registered, the blood pool segmentation can be directly transferred to the LCE-CT – thereby solving the key problem of infarct/blood pool differentiation. The remaining segmentation of infarcted vs. noninfarcted myocardium was performed using a threshold. Automatic and MRI-guided expert segmentations of LCE-CT infarcts were compared to each other on volume and area basis (intraclass correlation coefficient, ICC) and on voxel basis (dice similarity coefficient, DSC between automatic and expert CT segmentation). CT infarct volumes were compared with the reference standard MRI. Results The infarcts were mainly subendocardial (81 %) and relatively small (median MRI infarct mass 7.4 gram). The automatic segmentation showed excellent agreement with expert segmentation on volume and area measurements (ICC = 0.96 and 0.87, respectively). DSC showed moderately good agreement (DSC =0.47). Compared to MRI there was modest agreement (ICC = 0.62) and excellent correlation (R=0.9). Manual interaction was less than 1 minute per exam. Conclusion We propose an automatic method for infarct segmentation on LCE-CT using multiphase CT information, which showed excellent agreement with expert readers and favorable correlation with MRI.

show abstract

Non-linear blending of dual-energy CT data improves depiction of late iodine enhancement in chronic myocardial infarction

Cited by 15 publications

References 25 publications

Optimized energy of spectral CT for infarct imaging: Experimental validation with human validation

Optimized energy of spectral CT for infarct imaging: Experimental validation with human validation

Cardiovascular imaging 2014 in the International Journal of Cardiovascular Imaging

Automatic high-resolution infarct detection using volumetric multiphase dual-energy CT

Contact Info

Product

Resources

About