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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.).
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.
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.
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