Myocardial scar imaging by standard single-energy and dual-energy late enhancement CT: Comparison with pathology and electroanatomic map in an experimental chronic infarct porcine model. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Myocardial scar is a substrate for ventricular tachycardia and sudden cardiac death. Late enhancement CT imaging can detect scar, but it remains unclear whether newer late enhancement dual-energy (LE-DECT) acquisition has benefit over standard single-energy late enhancement (LE-CT). OBJECTIVE: We aim to compare late enhancement CT using newer LE-DECT acquisition and single-energy LE-CT acquisitions with pathology and electroanatomic map (EAM) in an experimental chronic myocardial infarction (MI) porcine study. METHODS: In 8 pigs with chronic myocardial infarction (59 ± 5 kg), we performed dual-source CT, EAM, and pathology. For CT imaging, we performed 3 acquisitions at 10 minutes after contrast administration: LE-CT 80 kV, LE-CT 100 kV, and LE-DECT with 2 postprocessing software settings. RESULTS: Of the sequences, LE-CT 100 kV provided the best contrast-to-noise ratio (all P ≤ .03) and correlation to pathology for scar (ρ = 0.88). LE-DECT overestimated scar (both P = .02), whereas LE-CT images did not (both P = .08). On a segment basis (n = 136), all CT sequences had high specificity (87%-93%) and modest sensitivity (50%-67%), with LE-CT 100 kV having the highest specificity of 93% for scar detection compared to pathology and agreement with EAM (κ = 0.69). CONCLUSIONS: Standard single-energy LE-CT, particularly 100 kV, matched better to pathology and EAM than dual-energy LE-DECT for scar detection. Larger human trials as well as more technical studies that optimize varying different energies with newer hardware and software are warranted.

authors

  • Truong, Quynh A.
  • Thai, Wai-Ee
  • Wai, Bryan
  • Cordaro, Kevin
  • Cheng, Teresa
  • Beaudoin, Jonathan
  • Xiong, Guanglei
  • Cheung, Jim W.
  • Altman, Robert
  • Min, James K
  • Singh, Jagmeet P
  • Barrett, Conor D
  • Danik, Stephan

publication date

  • March 24, 2015

Research

keywords

  • Body Surface Potential Mapping
  • Cicatrix
  • Myocardial Infarction
  • Myocardial Stunning
  • Radiography, Dual-Energy Scanned Projection
  • Tomography, X-Ray Computed

Identity

PubMed Central ID

  • PMC4475424

Scopus Document Identifier

  • 84930924673

Digital Object Identifier (DOI)

  • 10.1016/j.jcct.2015.03.003

PubMed ID

  • 25977115

Additional Document Info

volume

  • 9

issue

  • 4