Effect of contrast material injection protocol on first-pass myocardial perfusion assessed by dual-energy dual-layer computed tomography

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License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_448A745DD1A3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effect of contrast material injection protocol on first-pass myocardial perfusion assessed by dual-energy dual-layer computed tomography
Journal
Quantitative Imaging in Medicine and Surgery
Author(s)
Boccalini Sara, Si-Mohamed Salim, Matzuzzi Maxime, Tillier Manon, Rotzinger David C., Revel Didier, Boussel Loic, Douek Philippe
ISSN
2223-4292
2223-4306
Publication state
Published
Issued date
07/2022
Peer-reviewed
Oui
Volume
12
Number
7
Pages
3903-3916
Language
english
Abstract
Background: Dual-energy dual-layer computed tomography (CT) scanners can provide useful tools, such as iodine maps and virtual monochromatic images (VMI), for the evaluation of myocardial perfusion defects. Data about the influence of acquisition protocols and normal values are still lacking.
Methods: Clinically indicated coronary CT-angiographies performed between January-October 2018 in a single university hospital with dual-energy dual-layer CT (DE-DLCT) and different injection protocols were retrospectively evaluated. The two protocols were: 35 mL in patients <80 kg and 0.5 mL/kg in patients >80 kg at 2.5 mL/sec (group A) or double contrast dose at 5 mL/sec (group B). Patients with coronary stenosis >50% were excluded. Regions of interest were manually drawn on 16 myocardial segments and iodine concentration was measured in mg/mL. Signal-to-noise, contrast-to-noise ratios (CNR) and image noise were measured on conventional images and VMI.
Results: A total of 30 patients were included for each protocol. With iodine concentrations of 1.38 +/- 0.41 mg/mL for protocol A and 2.07 +/- 0.73 mg/mL for protocol B, the two groups were significantly different (P<0.001). No significant iodine concentration differences were found between the 16 segments (P=0.47 and P=0.09 for group A and B respectively), between basal, mid and apical segments for group A and B (P=0.28 and P=0.12 for group A and B respectively) and between wall regions for group A (P=0.06 on normalised data). In group B, iodine concentration was significantly different between three wall regions [highest values for the lateral wall, median =2.03 (1.06) mg/mL]. Post-hoc analysis showed highest contrast-to-noise and signal-to-noise in VMI at 40 eV (P<0.05).
Conclusions: Iodine concentration in left ventricular myocardium of patients without significant coronary artery stenosis varied depending on the injection protocol and appeared more heterogeneous in different wall regions at faster injection rate and greater iodine load. Signal-to-noise and contrast-to-noise gradually improved when decreasing VMI energy, although at the expenses of higher noise, demonstrating the potential of DE-DLCT to enhance objective image quality.
Keywords
Radiology, Nuclear Medicine and imaging
Pubmed
Web of science
Open Access
Yes
Create date
05/06/2022 10:25
Last modification date
07/07/2022 6:09
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