Quantitative myocardial perfusion with stress dual-energy CT: iodine concentration differences between normal and ischemic or necrotic myocardium. Initial experience

Abstract

• DECT-S allows for determination of myocardial iodine concentration as a quantitative perfusion parameter. • A high interobserver correlation exists in measuring myocardial iodine concentration with DECT-S. • Myocardial iodine concentration may be useful in the assessment of patients with CAD.

Differentiation of myocardial ischemia and infarction assessed by dynamic computed tomography perfusion imaging and comparison with cardiac magnetic resonance and single-photon emission computed tomography

“…In myocardial CTP imaging, single-phase static CTP and dynamic CTP have been used for assessment of myocardial ischemia in patients with CAD [8][9][10][11][12][13][14][15][16][17][18][19]. The former is easier and allows for reducing radiation exposure, providing a potential of good diagnostic performance if the optimal scan timing could be obtained described by Hurber et al [18].…”

“…1 Study analysis flow chart. CTP, computed tomography perfusion; SPECT, single-photon emission computed tomography; CMR, cardiac magnetic resonance; PCI, percutaneous coronary intervention; CABG, coronary artery bypass graft Heart Association class IV symptomatic congestive heart failure, (8) coronary artery bypass grafting, (9) hypotension (systolic blood pressure < 90 mmHg), (10) severe chronic obstructive pulmonary disease, (11) chronic kidney disease (serum creatinine > 1.5 mg/dL), (12) pregnancy, (13) known history of hyperthyroidism and bronchial asthma, (14) known allergic reaction to contrast media, and (15) patients having segments with poor image quality on CTP and CMR (SPECT). Patients were instructed to avoid caffeine and anti-anginal drugs for at least 24 h before each pharmacological stress MPI examination.…”

“…Recently, stress myocardial CT perfusion (CTP) imaging is reported to be a promising option for detecting myocardial ischemia [8][9][10][11][12][13][14][15][16][17][18][19]. Dynamic CTP imaging allows for quantitative assessment of myocardial perfusion with myocardial blood flow (MBF) by analyzing the myocardial time attenuation curve (TAC) [13][14][15][16][17][18][19].…”

Diagnostic accuracy of coronary CT angiography combined with dual-energy myocardial perfusion imaging for detection of myocardial infarction

“…For the evaluation of myocardial iodine content, images from the same raw data set were then automatically reconstructed into three image datasets (100 and 140 kVp, and an average weighted image set, M_0.3) merging 70% of the 100 kVp and 30% of the 140 kVp information. For the evaluation of myocardial iodine distribution with dual-energy software, additional images from the same raw data set were reconstructed with 1.0-mm thick slices, at 0.75-mm increments, using a dedicated dual-energy convolution D30f kernel (21). Further post-processing was performed on a commercially available workstation (Syngo MMWP, VA36; Siemens AG) using the dedicated DE heart-PBV application to obtain myocardial ‘iodine maps’ in the short and long axes, and four chamber views.…”

Locally advanced gastric cancer: total iodine uptake to predict the response of primary lesion to neoadjuvant chemotherapy

“…With the injection of an iodinated contrast agent, qualitative and quantitative DECT iodine concentration maps can provide an approximation of tissue physiology (Stiller et al 2015;Yeh et al 2009). Iodine uptake (IU), which is derived from the iodine concentration map, has been used as a quantitative perfusion parameter in the myocardium (Sánchez-Gracián et al 2015). In addition, IU may be regarded as a functional parameter or a more robust response parameter to evaluate the response of the tumor to therapy by reflecting the accumulation of contrast medium (Apfaltrer et al 2012;Uhrig et al 2013).…”