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High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals

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Late enhancement using multidetector row computer tomography: a feasibility study with low dose 80 kV protocol.

Anja J Reimann¹, Axel Kuettner, Bernhard Klumpp

¹Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.

European Journal of Radiology

|September 14, 2007

Summary

This study validates a low-dose computed tomography (CT) protocol for detecting coronary artery late enhancement. The method is feasible and shows promising results for identifying hemodynamically relevant stenoses.

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Area of Science:

Cardiovascular imaging
Radiology
Medical physics

Background:

Multidetector row computer tomography (MDCT) is a feasible non-invasive method for detecting coronary artery stenoses.
Determining the hemodynamic relevance of stenosis remains a challenge.
Late enhancement (LE) imaging can provide crucial information about myocardial scar and viability.

Purpose of the Study:

To validate the feasibility of a low-dose MDCT protocol using 80 kV for detecting late enhancement.
To assess the diagnostic performance of this low-dose protocol compared to magnetic resonance imaging (MRI).

Main Methods:

An Alderson-Rando Phantom was used to evaluate the effective dose of the low-dose LE protocol.
Ten patients with known coronary artery disease underwent CT-angiography (CTA) followed by a low-dose LE scan (80 kV, 400 mAs max, ECG pulsed) 1 day prior to MRI.
Phantom dose measurements indicated an effective dose of 1.19 mSv (male) and 1.61 mSv (female).

Main Results:

Fifty-six percent (5/9) of patients showed late enhancement on MRI.
The low-dose CT protocol correctly identified three transmural late enhancements and four negative findings.
Diagnostic performance included a sensitivity of 78%, specificity of 100%, negative predictive value (NPV) of 100%, and positive predictive value (PPV) of 97%.

Conclusions:

The low-dose MDCT protocol for detecting late enhancement is feasible.
Preliminary results suggest promising accuracy for identifying myocardial scar and viability.
This approach may aid in assessing the hemodynamic relevance of coronary artery stenoses.