Feasibility of extracellular volume fraction calculation using myocardial CT delayed enhancement with low contrast media administration |
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Institution: | 1. The Ohio State University Davis Heart and Lung Research Institute, 473 W. 12th Ave, Columbus, OH, 43210, USA;2. University of Maryland School of Public Health, Department of Epidemiology and Biostatistics, College Park, MD, 20742, USA |
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Abstract: | BackgroundMyocardial extracellular volume fraction (ECV) derived from CT delayed enhancement (CTDE) may allow assessment of diffuse myocardial fibrosis. However, the amount of contrast medium required for ECV estimation has not been established. Since ECV estimation by CT is typically performed in combination with coronary CT angiography (CCTA) in clinical settings, we aimed to investigate whether reliable ECV estimation is possible using the contrast dose optimized for CCTA without additional contrast administration.MethodsTwenty patients with known or suspected coronary artery disease who underwent CTDE with a dual-source scanner using two protocols (Protocols A and B) within 2 years were retrospectively enrolled. In Protocol A, CTDE was obtained with 0.84 ml/kg of iopamidol (370 mgI/ml) injected for CCTA. In Protocol B, stress CT perfusion imaging, which requires 40 ml of contrast medium, was added to Protocol A. ECV values calculated from the two protocols were compared.ResultsDespite the different contrast doses, no significant difference in mean myocardial ECV was seen between Protocols A and B at the patient level (28.7 ± 4.3% vs. 28.7 ± 4.4%, respectively, P = 0.868). Excellent correlations in ECV were seen between the two protocols (r = 0.942, P < 0.001). Bland-Altman analysis showed slight bias (+0.06%), within a 95% limit of agreement of ?2.9% and 3.0%. The coefficient of variation was 5.2%.ConclusionReliable ECV estimation can be achieved with the contrast doses optimized for CCTA. Despite the differing contrast administration schemes and doses, ECV values calculated from the two protocols showed excellent agreement, indicating the robustness of ECV estimation by CT. |
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Keywords: | Myocardial CT delayed enhancement Contrast media dosing Extracellular volume fraction Coronary CT angiography Dual-source CT CT"} {"#name":"keyword" "$":{"id":"kwrd0040"} "$$":[{"#name":"text" "_":"computed tomography MRI"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"magnetic resonance imaging CCT"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"coronary CT angiography CTP"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"myocardial CT perfusion CTDE"} {"#name":"keyword" "$":{"id":"kwrd0080"} "$$":[{"#name":"text" "_":"CT delayed enhancement ECV"} {"#name":"keyword" "$":{"id":"kwrd0090"} "$$":[{"#name":"text" "_":"xtracellular volume fraction HU"} {"#name":"keyword" "$":{"id":"kwrd0100"} "$$":[{"#name":"text" "_":"Hounsfield units LV"} {"#name":"keyword" "$":{"id":"kwrd0110"} "$$":[{"#name":"text" "_":"left ventricular CoV"} {"#name":"keyword" "$":{"id":"kwrd0120"} "$$":[{"#name":"text" "_":"coefficient of variation LOA"} {"#name":"keyword" "$":{"id":"kwrd0130"} "$$":[{"#name":"text" "_":"limits of agreement |
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