Skip to main content
Top
Published in: European Radiology 2/2014

01-02-2014 | Cardiac

Accuracy of dual-energy computed tomography for the measurement of iodine concentration using cardiac CT protocols: validation in a phantom model

Authors: James D. Koonce, Rozemarijn Vliegenthart, U. Joseph Schoepf, Bernhard Schmidt, Amy E. Wahlquist, Paul J. Nietert, Gorka Bastarrika, Thomas G. Flohr, Felix G. Meinel

Published in: European Radiology | Issue 2/2014

Login to get access

Abstract

Purpose

To assess the accuracy of dual-energy CT (DECT) for the quantification of iodine concentrations in a thoracic phantom across various cardiac DECT protocols and simulated patient sizes.

Materials and methods

Experiments were performed on first- and second-generation dual-source CT (DSCT) systems in DECT mode using various cardiac DECT protocols. An anthropomorphic thoracic phantom was equipped with tubular inserts containing known iodine concentrations (0–20 mg/mL) in the cardiac chamber and up to two fat-equivalent rings to simulate different patient sizes. DECT-derived iodine concentrations were measured using dedicated software and compared to true concentrations. General linear regression models were used to identify predictors of measurement accuracy

Results

Correlation between measured and true iodine concentrations (n = 72) across CT systems and protocols was excellent (R = 0.994–0.997, P < 0.0001). Mean measurement errors were 3.0 ± 7.0 % and −2.9 ± 3.8 % for first- and second-generation DSCT, respectively. This error increased with simulated patient size. The second-generation DSCT showed the most stable measurements across a wide range of iodine concentrations and simulated patient sizes.

Conclusion

Overall, DECT provides accurate measurements of iodine concentrations across cardiac CT protocols, strengthening the case for DECT-derived blood volume estimates as a surrogate of myocardial blood supply.

Key Points

• Dual-energy CT provides new opportunities for quantitative assessment in cardiac imaging.
• DECT can quantify myocardial iodine as a surrogate for myocardial perfusion.
• DECT measurements of iodine concentrations are overall very accurate.
• The accuracy of such measurements decreases as patient size increases.
Literature
1.
go back to reference Flohr TG, McCollough CH, Bruder H et al (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16:256–268PubMedCrossRef Flohr TG, McCollough CH, Bruder H et al (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16:256–268PubMedCrossRef
2.
go back to reference Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517PubMedCrossRef Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517PubMedCrossRef
3.
go back to reference Ko SM, Choi JW, Song MG et al (2011) Myocardial perfusion imaging using adenosine-induced stress dual-energy computed tomography of the heart: comparison with cardiac magnetic resonance imaging and conventional coronary angiography. Eur Radiol 21:26–35PubMedCrossRef Ko SM, Choi JW, Song MG et al (2011) Myocardial perfusion imaging using adenosine-induced stress dual-energy computed tomography of the heart: comparison with cardiac magnetic resonance imaging and conventional coronary angiography. Eur Radiol 21:26–35PubMedCrossRef
4.
go back to reference Ruzsics B, Lee H, Zwerner PL, Gebregziabher M, Costello P, Schoepf UJ (2008) Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience. Eur Radiol 18:2414–2424PubMedCrossRef Ruzsics B, Lee H, Zwerner PL, Gebregziabher M, Costello P, Schoepf UJ (2008) Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience. Eur Radiol 18:2414–2424PubMedCrossRef
5.
go back to reference Schwarz F, Ruzsics B, Schoepf UJ et al (2008) Dual-energy CT of the heart–principles and protocols. Eur J Radiol 68:423–433PubMedCrossRef Schwarz F, Ruzsics B, Schoepf UJ et al (2008) Dual-energy CT of the heart–principles and protocols. Eur J Radiol 68:423–433PubMedCrossRef
6.
go back to reference Wang R, Yu W, Wang Y et al (2011) Incremental value of dual-energy CT to coronary CT angiography for the detection of significant coronary stenosis: comparison with quantitative coronary angiography and single photon emission computed tomography. Int J Cardiovasc Imaging 27:647–656PubMedCrossRef Wang R, Yu W, Wang Y et al (2011) Incremental value of dual-energy CT to coronary CT angiography for the detection of significant coronary stenosis: comparison with quantitative coronary angiography and single photon emission computed tomography. Int J Cardiovasc Imaging 27:647–656PubMedCrossRef
7.
go back to reference Vliegenthart R, Henzler T, Moscariello A et al (2012) CT of coronary heart disease: Part 1, CT of myocardial infarction, ischemia, and viability. AJR Am J Roentgenol 198:531–547PubMedCrossRef Vliegenthart R, Henzler T, Moscariello A et al (2012) CT of coronary heart disease: Part 1, CT of myocardial infarction, ischemia, and viability. AJR Am J Roentgenol 198:531–547PubMedCrossRef
8.
go back to reference Ravenel JG, Leue WM, Nietert PJ, Miller JV, Taylor KK, Silvestri GA (2008) Pulmonary nodule volume: effects of reconstruction parameters on automated measurements–a phantom study. Radiology 247:400–408PubMedCrossRef Ravenel JG, Leue WM, Nietert PJ, Miller JV, Taylor KK, Silvestri GA (2008) Pulmonary nodule volume: effects of reconstruction parameters on automated measurements–a phantom study. Radiology 247:400–408PubMedCrossRef
9.
go back to reference Primak AN, Ramirez Giraldo JC, Liu X, Yu L, McCollough CH (2009) Improved dual-energy material discrimination for dual-source CT by means of additional spectral filtration. Med Phys 36:1359–1369PubMedCrossRef Primak AN, Ramirez Giraldo JC, Liu X, Yu L, McCollough CH (2009) Improved dual-energy material discrimination for dual-source CT by means of additional spectral filtration. Med Phys 36:1359–1369PubMedCrossRef
10.
go back to reference Karlo C, Lauber A, Gotti RP et al (2011) Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study. Eur Radiol 21:385–392PubMedCrossRef Karlo C, Lauber A, Gotti RP et al (2011) Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study. Eur Radiol 21:385–392PubMedCrossRef
11.
go back to reference Schenzle JC, Sommer WH, Neumaier K et al (2010) Dual energy CT of the chest: how about the dose? Invest Radiol 45:347–353PubMed Schenzle JC, Sommer WH, Neumaier K et al (2010) Dual energy CT of the chest: how about the dose? Invest Radiol 45:347–353PubMed
12.
go back to reference Zhang LJ, Peng J, Wu SY, Yeh BM, Zhou CS, Lu GM (2010) Dual source dual-energy computed tomography of acute myocardial infarction: correlation with histopathologic findings in a canine model. Invest Radiol 45:290–297PubMed Zhang LJ, Peng J, Wu SY, Yeh BM, Zhou CS, Lu GM (2010) Dual source dual-energy computed tomography of acute myocardial infarction: correlation with histopathologic findings in a canine model. Invest Radiol 45:290–297PubMed
13.
go back to reference Vliegenthart R, Pelgrim GJ, Ebersberger U, Rowe GW, Oudkerk M, Schoepf UJ (2012) Dual-energy CT of the heart. AJR Am J Roentgenol 199:S54–S63PubMedCrossRef Vliegenthart R, Pelgrim GJ, Ebersberger U, Rowe GW, Oudkerk M, Schoepf UJ (2012) Dual-energy CT of the heart. AJR Am J Roentgenol 199:S54–S63PubMedCrossRef
14.
go back to reference Ruzsics B, Schwarz F, Schoepf UJ et al (2009) Comparison of dual-energy computed tomography of the heart with single photon emission computed tomography for assessment of coronary artery stenosis and of the myocardial blood supply. Am J Cardiol 104:318–326PubMedCrossRef Ruzsics B, Schwarz F, Schoepf UJ et al (2009) Comparison of dual-energy computed tomography of the heart with single photon emission computed tomography for assessment of coronary artery stenosis and of the myocardial blood supply. Am J Cardiol 104:318–326PubMedCrossRef
15.
go back to reference So A, Hsieh J, Imai Y et al (2012) Prospectively ECG-triggered rapid kV-switching dual-energy CT for quantitative imaging of myocardial perfusion. JACC Cardiovasc Imaging 5:829–836PubMedCrossRef So A, Hsieh J, Imai Y et al (2012) Prospectively ECG-triggered rapid kV-switching dual-energy CT for quantitative imaging of myocardial perfusion. JACC Cardiovasc Imaging 5:829–836PubMedCrossRef
16.
go back to reference Ko SM, Choi JW, Hwang HK, Song MG, Shin JK, Chee HK (2012) Diagnostic performance of combined noninvasive anatomic and functional assessment with dual-source CT and adenosine-induced stress dual-energy CT for detection of significant coronary stenosis. AJR Am J Roentgenol 198:512–520PubMedCrossRef Ko SM, Choi JW, Hwang HK, Song MG, Shin JK, Chee HK (2012) Diagnostic performance of combined noninvasive anatomic and functional assessment with dual-source CT and adenosine-induced stress dual-energy CT for detection of significant coronary stenosis. AJR Am J Roentgenol 198:512–520PubMedCrossRef
17.
go back to reference Arnoldi E, Lee YS, Ruzsics B et al (2011) CT detection of myocardial blood volume deficits: dual-energy CT compared with single-energy CT spectra. J Cardiovasc Comput Tomogr 5:421–429PubMedCrossRef Arnoldi E, Lee YS, Ruzsics B et al (2011) CT detection of myocardial blood volume deficits: dual-energy CT compared with single-energy CT spectra. J Cardiovasc Comput Tomogr 5:421–429PubMedCrossRef
18.
19.
go back to reference Graser A, Becker CR, Staehler M et al (2010) Single-phase dual-energy CT allows for characterization of renal masses as benign or malignant. Invest Radiol 45:399–405PubMed Graser A, Becker CR, Staehler M et al (2010) Single-phase dual-energy CT allows for characterization of renal masses as benign or malignant. Invest Radiol 45:399–405PubMed
20.
go back to reference Chandarana H, Megibow AJ, Cohen BA et al (2011) Iodine quantification with dual-energy CT: phantom study and preliminary experience with renal masses. AJR Am J Roentgenol 196:W693–W700PubMedCrossRef Chandarana H, Megibow AJ, Cohen BA et al (2011) Iodine quantification with dual-energy CT: phantom study and preliminary experience with renal masses. AJR Am J Roentgenol 196:W693–W700PubMedCrossRef
21.
go back to reference Song KD, Kim CK, Park BK, Kim B (2011) Utility of iodine overlay technique and virtual unenhanced images for the characterization of renal masses by dual-energy CT. AJR Am J Roentgenol 197:W1076–W1082PubMedCrossRef Song KD, Kim CK, Park BK, Kim B (2011) Utility of iodine overlay technique and virtual unenhanced images for the characterization of renal masses by dual-energy CT. AJR Am J Roentgenol 197:W1076–W1082PubMedCrossRef
22.
go back to reference De Cecco CN, Darnell A, Rengo M et al (2012) Dual-energy CT: oncologic applications. AJR Am J Roentgenol 199:S98–S105PubMedCrossRef De Cecco CN, Darnell A, Rengo M et al (2012) Dual-energy CT: oncologic applications. AJR Am J Roentgenol 199:S98–S105PubMedCrossRef
23.
go back to reference Meinel FG, Graef A, Thieme SF et al (2013) Assessing pulmonary perfusion in emphysema: automated quantification of perfused blood volume in dual-energy CTPA. Invest Radiol 48:79–85PubMedCrossRef Meinel FG, Graef A, Thieme SF et al (2013) Assessing pulmonary perfusion in emphysema: automated quantification of perfused blood volume in dual-energy CTPA. Invest Radiol 48:79–85PubMedCrossRef
24.
go back to reference Meinel FG, Graef A, Bamberg F et al (2013) Effectiveness of automated quantification of pulmonary perfused blood volume using dual-energy CTPA for the Severity assessment of acute pulmonary embolism. Invest Radiol. doi:10.1097/RLI.0b013e3182879482 Meinel FG, Graef A, Bamberg F et al (2013) Effectiveness of automated quantification of pulmonary perfused blood volume using dual-energy CTPA for the Severity assessment of acute pulmonary embolism. Invest Radiol. doi:10.​1097/​RLI.​0b013e3182879482​
Metadata
Title
Accuracy of dual-energy computed tomography for the measurement of iodine concentration using cardiac CT protocols: validation in a phantom model
Authors
James D. Koonce
Rozemarijn Vliegenthart
U. Joseph Schoepf
Bernhard Schmidt
Amy E. Wahlquist
Paul J. Nietert
Gorka Bastarrika
Thomas G. Flohr
Felix G. Meinel
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-3040-6

Other articles of this Issue 2/2014

European Radiology 2/2014 Go to the issue