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European Radiology
Published in: European Radiology 3/2018

01-03-2018 | Cardiac

Late iodine enhancement computed tomography with image subtraction for assessment of myocardial infarction

Authors: Yuki Tanabe, Teruhito Kido, Akira Kurata, Takanori Kouchi, Naoki Fukuyama, Takahiro Yokoi, Teruyoshi Uetani, Natsumi Yamashita, Masao Miyagawa, Teruhito Mochizuki

Published in: European Radiology | Issue 3/2018

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Abstract

Objective

To evaluate the feasibility of image subtraction in late iodine enhancement CT (LIE-CT) for assessment of myocardial infarction (MI).

Methods

A comprehensive cardiac CT protocol and late gadolinium enhancement MRI (LGE-MRI) was used to assess coronary artery disease in 27 patients. LIE-CT was performed after stress CT perfusion (CTP) and CT angiography. Subtraction LIE-CT was created by subtracting the mask volume of the left ventricle (LV) cavity from the original LIE-CT using CTP dataset. The %MI volume was quantified as the ratio of LIE to entire LV volume, and transmural extent (TME) of LIE was classified as 0%, 1–24%, 25–49%, 50–74% or 75–100%. These results were compared with LGE-MRI using the Spearman rank test, Bland-Altman method and chi-square test.

Results

One hundred twenty-five (29%) of 432 segments were positive on LGE-MRI. Correlation coefficients for original and subtraction LIE-CT to LGE-MRI were 0.79 and 0.85 for %MI volume. Concordances of the 5-point grading scale between original and subtraction LIE-CT with LGE-MRI were 75% and 84% for TME; concordance was significantly improved using the subtraction technique (p <0.05).

Conclusion

Subtraction LIE-CT allowed more accurate assessment of MI extent than the original LIE-CT.

Key Points

• Subtraction LIE-CT allows for accurate assessment of the extent of myocardial infarction.
• Subtraction LIE-CT shows a close correlation with LGE-MRI in %MI volume.
• Subtraction LIE-CT has significantly higher concordance with TME assessment than original LIE-CT.
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Metadata
Title
Late iodine enhancement computed tomography with image subtraction for assessment of myocardial infarction
Authors
Yuki Tanabe
Teruhito Kido
Akira Kurata
Takanori Kouchi
Naoki Fukuyama
Takahiro Yokoi
Teruyoshi Uetani
Natsumi Yamashita
Masao Miyagawa
Teruhito Mochizuki
Publication date
01-03-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5048-9

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