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European Radiology
Published in: European Radiology 6/2014

01-06-2014 | Cardiac

Evaluation of monoenergetic late iodine enhancement dual-energy computed tomography for imaging of chronic myocardial infarction

Authors: Julian L. Wichmann, Ruta Arbaciauskaite, J. Matthias Kerl, Claudia Frellesen, Boris Bodelle, Thomas Lehnert, Nadejda Monsefi, Thomas J. Vogl, Ralf W. Bauer

Published in: European Radiology | Issue 6/2014

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Abstract

Objectives

To evaluate image quality and diagnostic accuracy of selective monoenergetic reconstructions of late iodine enhancement (LIE) dual-energy computed tomography (DECT) for imaging of chronic myocardial infarction (CMI).

Methods

Twenty patients with a history of coronary bypass surgery underwent cardiac LIE-DECT and late gadolinium enhancement (LGE) magnetic resonance imaging (MRI). LIE-DECT images were reconstructed as selective monoenergetic spectral images with photon energies of 40, 60, 80, and 100 keV and the standard linear blending setting (M_0.6). Images were assessed for late enhancement, transmural extent, signal characteristics and subjective image quality.

Results

Seventy-nine myocardial segments (23 %) showed LGE. LIE-DECT detected 76 lesions. Images obtained at 80 keV and M_0.6 showed a high signal-to-noise ratio (15.9; 15.1), contrast-to-noise ratio (4.2; 4.0) and sensitivity (94.9 %; 92.4 %) while specificity was identical (99.6 %). Differences between these series were not statistically significant. Transmural extent of LIE was overestimated in both series (80 keV: 40 %; M_0.6: 35 %) in comparison to MRI. However, observers preferred 80 keV in 13/20 cases (65 %, κ = 0.634) over M_0.6 (4/20 cases) regarding subjective image quality.

Conclusions

Post-processing of LIE-DECT data with selective monoenergetic reconstructions at 80 keV significantly improves subjective image quality while objective image quality shows no significant difference compared to standard linear blending.

Key Points

• Late enhancement dual-energy CT allows for detection of chronic myocardial infarction.
• Monoenergetic reconstructions at 80 keV significantly improve subjective image quality.
• 80 keV and standard linear blending reconstructions show no significant differences.
• Extent of CMI detected with LIE-DECT is overestimated compared with MRI.
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Metadata
Title
Evaluation of monoenergetic late iodine enhancement dual-energy computed tomography for imaging of chronic myocardial infarction
Authors
Julian L. Wichmann
Ruta Arbaciauskaite
J. Matthias Kerl
Claudia Frellesen
Boris Bodelle
Thomas Lehnert
Nadejda Monsefi
Thomas J. Vogl
Ralf W. Bauer
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3126-9

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