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Updated: Nov 11, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Myocardial Late Iodine Enhancement and Extracellular Volume Quantification with Dual-Layer Spectral Detector
Seitaro Oda1, Takafumi Emoto1, Takeshi Nakaura1
1Departments of Diagnostic Radiology (S.O., T.N., M.K., D.U., Y.N., Y.Y.), Medical Physics (Y.F.), Cardiology (S.T., K.T.), and Neurology (M.U., T.Y., Y.A.), Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan; and Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan (T.E.).
Purpose:
To explore the usefulness of myocardial late iodine enhancement (LIE) and extracellular volume (ECV) quantification by using dual-energy cardiac CT.
Materials And Methods:
In this single-center retrospective study, a total of 40 patients were evaluated with LIE CT by using a dual-layer spectral detector CT system. Among these, 21 also underwent cardiac MRI. Paired image sets were created by using standard imaging at 120 kVp, virtual monochromatic imaging (VMI) at 50 keV, and iodine density imaging. The contrast-to-noise ratio and image quality were then compared. Two observers assessed the presence of LIE and calculated the interobserver agreements. Agreement between CT and cardiac MRI when detecting late-enhancing lesions and calculating the ECV was also assessed.
Results:
The contrast-to-noise ratio was significantly higher by using VMI than by using standard 120-kVp imaging, and the mean visual image quality score was significantly higher by using VMI than by using either standard or iodine density imaging. For interobserver agreement of visual detection of LIE, the agreement for VMI was excellent and the κ value (κ, 0.87) was higher than that for the standard 120-kVp (κ, 0.70) and iodine density (κ, 0.83) imaging. For detecting late-enhancing lesions, agreement with cardiac MRI was excellent by using VMI (κ, 0.90) and iodine density imaging (κ, 0.87) but was only good by using standard 120-kVp imaging (κ, 0.66). Quantitative comparisons of the ECV calculations by using CT and cardiac MRI showed excellent correlation (r = 0.94).
Conclusion:
Dual-energy cardiac CT can assess myocardial LIE and quantify ECV, with results comparable to those obtained by using cardiac MRI.© RSNA, 2019See also the commentary by Litt in this issue.
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