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Myocardial Characterization with Extracellular Volume Mapping with a First-Generation Photon-counting Detector CT

Gilberto J Aquino¹, Jim O'Doherty¹, U Joseph Schoepf¹

¹From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260 (G.J.A., U.J.S., B.E., J.B., N.F., E.Z., E.V.W., D.B., P.S., A.V.S., T.E.); Department of Radiology, Upstate University Hospital, Syracuse, NY (G.J.A.); Siemens Medical Solutions, Malvern, Pa (J.O.); Department of Radiology, University Hospital LMU Munich, Munich, Germany (N.F.); Siemens Healthineers, Forchheim, Germany (T.A., B.S., T.F.); Department of Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany (T.E.); and German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany (T.E.).

|January 31, 2023

Summary

Photon-counting detector CT accurately quantifies myocardial extracellular volume (ECV), showing strong correlation with MRI. Dual-energy PCD CT offers a lower radiation dose for reliable ECV assessment.

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Area of Science:

Cardiovascular Imaging
Radiology
Medical Physics

Background:

Photon-counting detector CT (PCD CT) offers spectral data but its utility for myocardial extracellular volume (ECV) quantification against MRI is understudied.
Accurate ECV measurement is crucial for myocardial tissue characterization.

Purpose of the Study:

To compare ECV quantification between a first-generation PCD CT system and cardiac MRI.
To evaluate the diagnostic accuracy and reliability of PCD CT for myocardial ECV assessment.

Main Methods:

Prospective single-center study involving 29 adults undergoing same-day cardiac PCD CT and cardiac MRI.
ECV assessed using single-energy PCD CT, dual-energy PCD CT, and MRI T1 mapping.
Quantitative comparisons, correlation (Pearson's r), and reliability (intraclass correlation coefficient) analyses were performed.

Main Results:

Strong correlation between dual-energy and single-energy PCD CT for ECV (r=0.91).
Dual-energy PCD CT showed strong correlation (r=0.82-0.91) and good reliability with MRI for ECV, with a 2% overestimation.
Dual-energy PCD CT achieved a 40% lower radiation dose compared to single-energy PCD CT.

Conclusions:

PCD CT-based ECV analysis demonstrates strong correlation with cardiac MRI for myocardial tissue characterization.
Dual-energy PCD CT provides a reliable and lower-dose alternative for ECV quantification compared to single-energy PCD CT.