Non-contrast estimation of diffuse myocardial fibrosis with dual energy CT: A phantom study |
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| Affiliation: | 1. The Ohio State University Davis Heart and Lung Research Institute, 473 W. 12th Ave, Columbus, OH 43210, USA;2. OSU Department of Physiology and Cell Biology, 473 W. 12th Ave, Columbus, OH 43210, USA;3. Dalio Institute for Cardiovascular Imaging, Weill-Cornell Medical Center, New York, NY 10021, USA;4. University of Maryland School of Public Health, Department of Epidemiology and Biostatistics, College Park, MD 20742, USA;1. Lightbox Radiology Education, Noosaville, Queensland, Australia;2. The Queen Elizabeth Hospital, Woodville Rd, Woodville South, Adelaide, South Australia, Australia 5011;1. Department of Radiology, Duke University Medical Center, 2301 Erwin Road, DUMC Box 3808, Durham, NC 27710, United States;2. Department of Cardiology, Duke University Medical Center, 2400 Pratt St, Box 3850, Durham, NC 27705, United States;3. Department of Cardiology, Duke University Medical Center, 2301 Erwin Rd, Box 7412, Durham, NC 27710, United States;1. St Paul''s Hospital, Vancouver BC, Canada;2. Cardiology Service, Walter Reed National Military Medical Center, Bethesda, MD, USA;3. Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA;4. University of Texas Southwestern Medical Center, Dallas, TX, USA;5. Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA;6. Stanford University School of Medicine, Cardiovascular Institute, Stanford, CA, USA;7. Department of Medicine, Friedrich Alexander Universität Erlangen-Nürnberg, Erlangen, Germany;8. Department of Cardiology, Royal Brompton and Harefield NHS FT, London, UK |
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| Abstract: | BackgroundEstimation of diffuse myocardial fibrosis, substrate for adverse events such as heart failure and arrhythmias in patients with various cardiac disorders, is presently done by histopathology or cardiac magnetic resonance. We sought to develop a non-contrast method to estimate the amount of diffuse myocardial fibrosis leveraging dual energy computed tomography (DECT) in phantoms and a suitable small animal model.Methods and ResultsPhantoms consisted of homogenized bovine myocardium with varying amounts of Type 1 collagen. Fifteen mice underwent sham surgery, no procedure, or transverse aortic constriction (TAC) for 5 or 8 weeks to produce moderate or severe fibrosis, respectively. Phantoms and ex vivo mouse hearts were imaged on a single source, DECT scanner equipped with kVp switching. Monochromatic images were reconstructed at 40–140 keV. Linear discriminant analysis (LDA) was performed on mean myocardial CT numbers derived from single energy (70 keV) images as well as images reconstructed across multiple energies. Classification of myocardial fibrosis severity as low, moderate or severe was more often correct using the multi-energy CT/LDA approach vs. single energy CT/LDA in both phantoms (80.0% vs. 70.0%) and mice (93.3% vs. 33.3%).ConclusionsDECT myocardial imaging with multi-energy analysis better classifies myocardial fibrosis severity compared to a single energy-based approach. Non-contrast DECT can accurately and non-invasively estimate the extent of diffuse myocardial fibrosis in phantom and animal models. These data support further evaluation of this approach for in vivo myocardial fibrosis estimation. |
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| Keywords: | Dual energy computed tomography Myocardial fibrosis |
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