Myocardial extracellular volume quantification with computed tomography-current status and future outlook

Area of Science:

• Cardiovascular Imaging
• Radiology
• Cardiac CT

Background:

• Non-invasive quantification of myocardial fibrosis is crucial for evaluating cardiovascular diseases.
• Cardiac magnetic resonance imaging (ECV_MRI) is established for extracellular volume (ECV) quantification.
• ECV_CT presents an accessible, cost-effective, and rapid alternative to ECV_MRI.

Purpose of the Study:

• To summarize the technical principles of myocardial ECV quantification using CT (ECV_CT).
• To review literature comparing ECV_CT with ECV_MRI and histopathology.
• To review the prognostic value of myocardial ECV quantification in various cardiovascular diseases.

Main Methods:

• Review of existing literature on ECV quantification using CT.
• Comparison of ECV_CT with ECV_MRI and histopathological findings.
• Analysis of studies investigating the prognostic implications of ECV_CT.

Main Results:

• ECV_CT demonstrates a high correlation with ECV_MRI.
• ECV_CT offers an alternative for patients with contraindications to MRI.
• ECV_CT provides incremental prognostic information in various cardiovascular conditions.

Conclusions:

• Myocardial ECV quantification with CT is a reliable non-invasive method for assessing cardiac fibrosis.
• ECV_CT is a valuable tool, particularly for patients ineligible for MRI.
• ECV_CT shows strong correlation with ECV_MRI and offers prognostic insights.