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Published on: February 16, 2016
Dynamic Quantitative Iodine Myocardial Perfusion Imaging with Dual-Layer CT using a Porcine Model
Kai Scherer1,2, Johannes Hammel3,4, Thorsten Sellerer4
1Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, 81675, München, Germany. kai.scherer@tum.de.
Insights
Dual-energy CT enhances myocardial perfusion imaging for assessing heart disease. This study demonstrates quantitative iodine-based analysis in a porcine model, improving accuracy and potentially reducing radiation and contrast agent doses.
Area of Science:
- Cardiovascular imaging
- Radiology
- Medical physics
Background:
- Ischemic heart disease is a leading global cause of mortality.
- Conventional CT angiography has limitations in assessing myocardial functional hemodynamics.
- Dual-energy CT offers advanced solutions for overcoming these limitations.
Purpose of the Study:
- To perform a quantitative, iodine-based analysis of myocardial dynamics using dual-layer spectral CT.
- To evaluate the potential for dose and contrast agent reduction in myocardial CT perfusion imaging.
- To establish a sensitive tool for assessing and monitoring early myocardial ischemia.
Main Methods:
- Utilized dual-layer spectral CT for myocardial perfusion imaging in a porcine model.
- Employed quantitative measurements of peak enhancement, perfusion, time to peak, and iodine volume.
- Implemented a two-shot acquisition approach to assess dose and contrast reduction.
Main Results:
- Achieved quantitative measurements of myocardial dynamics: peak enhancement (0.92 mg/ml), perfusion (0.085 mg/ml/s), time to peak (17.12 s), and iodine volume (29.89 mg/ml*s).
- Demonstrated the feasibility of reducing radiation dose to 18 mGy and contrast volume to 30 mL.
- Measured in-vivo myocardial iodine concentrations as low as 1 mg/ml.
Conclusions:
- Dual-layer spectral CT enables robust, quantitative iodine-based myocardial perfusion imaging.
- This technique shows significant potential for reducing radiation dose and contrast agent volume.
- Dynamic quantitative iodine perfusion imaging is a promising tool for early myocardial ischemia detection and management.
Abstract:
Ischemic heart disease is the globally leading cause of death. When using coronary CT angiography, the functional hemodynamics within the myocardium remain uncertain. In this study myocardial CT perfusion imaging using iodine contrast agent demonstrated to strongly improve the assessment of myocardial disorders. However, a retrieval of such dynamics using Hounsfield units from conventional CT poses concerns with respect to beam-hardening effects and low contrast-to-noise ratio (CNR). Dual-energy CT offers novel approaches to overcome aforementioned limitations. Quantitative peak enhancement, perfusion, time to peak and iodine volume measurements inside the myocardium were determined resulting in 0.92 mg/ml, 0.085 mg/ml/s 17.12 s and 29.89 mg/ml*s, respectively. We report on the first extensive quantitative and iodine-based analysis of myocardial dynamics in a healthy porcine model using a dual-layer spectral CT. We further elucidate on the potential of reducing the radiation dose from 135 to 18 mGy and the contrast agent volume from 60 to 30 mL by presenting a two-shot acquisition approach and measuring iodine concentrations in the myocardium in-vivo down to 1 mg/ml, respectively. We believe that dynamic quantitative iodine perfusion imaging may be a highly sensitive tool for the precise functional assessment and monitoring of early myocardial ischemia.
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