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An approach to evaluate myocardial perfusion defect assessment for projection-based DECT: A phantom study
Donghee Han1, Sunny Shah2, Ji Hyun Lee2
1Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medicine, New York, NY, USA; Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Clinical Imaging
|March 3, 2020
Summary
Dual-energy CT (DECT) myocardial perfusion imaging is enhanced by specific reconstructions. DECT-MCE at 40 or 70 keV and DECT-MD without iodine background offer the best sensitivity and specificity for detecting perfusion defects.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Physics
Background:
- Dual-energy CT (DECT) offers improved accuracy for myocardial perfusion CT (DECT-MCE) and myocardial iodine quantification (DECT-MD).
- Evaluating multiple DECT reconstructions is time-consuming.
- The optimal DECT reconstruction for detecting myocardial perfusion defects remains unclear.
Purpose of the Study:
- To evaluate and compare the diagnostic performance of various DECT reconstructions for detecting myocardial perfusion defects.
- To determine the optimal DECT reconstruction parameters for accurate myocardial perfusion assessment.
Main Methods:
- Left ventricular (LV) phantoms with artificial perfusion defects were scanned using DECT and single-energy CT (SECT).
- DECT-MCE reconstructions at 40, 70, 100, and 140 keV, DECT-MD reconstructions (water, iodine, iron, fat pairs), and SECT were analyzed.
- Diagnostic performance (sensitivity, specificity) was assessed using a 17-segment myocardial model.
Main Results:
- DECT-MCE at 40 and 70 keV demonstrated 100% sensitivity and 100% specificity for detecting perfusion defects.
- Sensitivity significantly declined at 100 keV (71%) and 140 keV (25%) for DECT-MCE.
- DECT-MD iodine background reconstructions showed significantly lower sensitivity (2.1%) compared to other modes, while all modes maintained 100% specificity.
Conclusions:
- DECT-MCE reconstructions at 40 or 70 keV provide optimal sensitivity and specificity for assessing myocardial perfusion defects.
- DECT-MD reconstructions without iodine background also show high diagnostic performance.
- These findings guide the selection of optimal DECT reconstruction techniques for clinical myocardial perfusion imaging.
