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Tore D, Faletti R, Palmisano A, Salto S, Rocco K, Santonocito A, Gaetani C, Biondo A, Bozzo E, Giorgino F, Landolfi I, Menchini F, Esposito A, Fonio P, Gatti M. Cardiac computed tomography with late contrast enhancement: A review. Heliyon 2024; 10:e32436. [PMID: 38933964 PMCID: PMC11200357 DOI: 10.1016/j.heliyon.2024.e32436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 05/19/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Cardiac computed tomography (CCT) has assumed an increasingly significant role in the evaluation of coronary artery disease (CAD) during the past few decades, whereas cardiovascular magnetic resonance (CMR) remains the gold standard for myocardial tissue characterization. The discovery of late myocardial enhancement following intravenous contrast administration dates back to the 1970s with ex-vivo CT animal investigations; nevertheless, the clinical application of this phenomenon for cardiac tissue characterization became prevalent for CMR imaging far earlier than for CCT imaging. Recently the technical advances in CT scanners have made it possible to take advantage of late contrast enhancement (LCE) for tissue characterization in CCT exams. Moreover, the introduction of extracellular volume calculation (ECV) on cardiac CT images combined with the possibility of evaluating cardiac function in the same exam is making CCT imaging a multiparametric technique more and more similar to CMR. The aim of our review is to provide a comprehensive overview on the role of CCT with LCE in the evaluation of a wide range of cardiac conditions.
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Affiliation(s)
- Davide Tore
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Riccardo Faletti
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Anna Palmisano
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Salto
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Katia Rocco
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Ambra Santonocito
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Clara Gaetani
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Andrea Biondo
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Elena Bozzo
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Fabio Giorgino
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Ilenia Landolfi
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Francesca Menchini
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Antonio Esposito
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Fonio
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Marco Gatti
- Radiology Unit, Department of Surgical Sciences, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
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Deneke T, Kutyifa V, Hindricks G, Sommer P, Zeppenfeld K, Carbucicchio C, Pürerfellner H, Heinzel FR, Traykov VB, De Riva M, Pontone G, Lehmkuhl L, Haugaa K. Pre- and post-procedural cardiac imaging (computed tomography and magnetic resonance imaging) in electrophysiology: a clinical consensus statement of the European Heart Rhythm Association and European Association of Cardiovascular Imaging of the European Society of Cardiology. Europace 2024; 26:euae108. [PMID: 38743765 PMCID: PMC11104536 DOI: 10.1093/europace/euae108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
Imaging using cardiac computed tomography (CT) or magnetic resonance (MR) imaging has become an important option for anatomic and substrate delineation in complex atrial fibrillation (AF) and ventricular tachycardia (VT) ablation procedures. Computed tomography more common than MR has been used to detect procedure-associated complications such as oesophageal, cerebral, and vascular injury. This clinical consensus statement summarizes the current knowledge of CT and MR to facilitate electrophysiological procedures, the current value of real-time integration of imaging-derived anatomy, and substrate information during the procedure and the current role of CT and MR in diagnosing relevant procedure-related complications. Practical advice on potential advantages of one imaging modality over the other is discussed for patients with implanted cardiac rhythm devices as well as for planning, intraprocedural integration, and post-interventional management in AF and VT ablation patients. Establishing a team of electrophysiologists and cardiac imaging specialists working on specific details of imaging for complex ablation procedures is key. Cardiac magnetic resonance (CMR) can safely be performed in most patients with implanted active cardiac devices. Standard procedures for pre- and post-scanning management of the device and potential CMR-associated device malfunctions need to be in place. In VT patients, imaging-specifically MR-may help to determine scar location and mural distribution in patients with ischaemic and non-ischaemic cardiomyopathy beyond evaluating the underlying structural heart disease. Future directions in imaging may include the ability to register multiple imaging modalities and novel high-resolution modalities, but also refinements of imaging-guided ablation strategies are expected.
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Affiliation(s)
- Thomas Deneke
- Clinic for Rhythmology at Klinikum Nürnberg Campus Süd, University Hospital of the Paracelsus Medical University, Nuremberg, Germany
| | | | | | | | - Katja Zeppenfeld
- Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | | | - Helmut Pürerfellner
- Department of Clinical Electrophysiology, Ordensklinikum Linz Elisabethinen, Linz, Austria
| | - Frank R Heinzel
- Städtisches Klinikum Dresden, Department of Cardiology, Angiology and Intensive Care Medicine, Dresden, Germany
| | - Vassil B Traykov
- Department of Invasive Electrophysiology and Cardiac Pacing, Acibadem City Clinic Tokuda Hospital, Sofia, Bulgaria
| | - Marta De Riva
- Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Gianluca Pontone
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Lukas Lehmkuhl
- Department of Radiology, Heart Center RHÖN-KLINIKUM Campus Bad Neustadt, Germany
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Sultana S, McCarthy CP, Randhawa M, Cao J, Parakh A, Baliyan V. Role of Computed Tomography in Cardiac Electrophysiology. Radiol Clin North Am 2024; 62:489-508. [PMID: 38553182 PMCID: PMC11088717 DOI: 10.1016/j.rcl.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
With the increasing prevalence of arrhythmias, the use of electrophysiology (EP) procedures has increased. Recent advancements in computed tomography (CT) technology have expanded its use in pre-assessments and post-assessments of EP procedures. CT provides high-resolution images, is noninvasive, and is widely available. This article highlights the strengths and weaknesses of cardiac CT in EP.
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Affiliation(s)
- Sadia Sultana
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Cian P McCarthy
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Mangun Randhawa
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Jinjin Cao
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Anushri Parakh
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Vinit Baliyan
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
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4
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Oyama-Manabe N, Oda S, Ohta Y, Takagi H, Kitagawa K, Jinzaki M. Myocardial late enhancement and extracellular volume with single-energy, dual-energy, and photon-counting computed tomography. J Cardiovasc Comput Tomogr 2024; 18:3-10. [PMID: 38218665 DOI: 10.1016/j.jcct.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/16/2023] [Accepted: 12/14/2023] [Indexed: 01/15/2024]
Abstract
Computed tomography late enhancement (CT-LE) is emerging as a non-invasive technique for cardiac diagnosis with wider accessibility compared to MRI, despite its typically lower contrast-to-noise ratio. Optimizing CT-LE image quality necessitates a thorough methodology addressing contrast administration, timing, and radiation dose, alongside a robust understanding of extracellular volume (ECV) quantification methods. This review summarizes CT-LE protocols, clinical utility, and advances in ECV measurement through both single-energy and dual-energy CT. It also highlights photon-counting detector CT technology as an innovative means to potentially improve image quality and reduce radiation exposure.
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Affiliation(s)
- Noriko Oyama-Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasutoshi Ohta
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hidenobu Takagi
- Department of Advanced Radiological Imaging Collaborative Research, Tohoku University, Sendai, Japan; Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Kakuya Kitagawa
- Department of Radiology, Mie University Hospital, Tsu, Japan.
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Tonet E, Boccadoro A, Micillo M, Cocco M, Cossu A, Pompei G, Giganti M, Campo G. Coronary Computed Tomography Angiography: Beyond Obstructive Coronary Artery Disease. Life (Basel) 2023; 13:1086. [PMID: 37240730 PMCID: PMC10223586 DOI: 10.3390/life13051086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/10/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Nowadays, coronary computed tomography angiography (CCTA) has a role of paramount importance in the diagnostic algorithm of ischemic heart disease (IHD), both in stable coronary artery disease (CAD) and acute chest pain. Alongside the quantification of obstructive coronary artery disease, the recent technologic developments in CCTA provide additional relevant information that can be considered as "novel markers" for risk stratification in different settings, including ischemic heart disease, atrial fibrillation, and myocardial inflammation. These markers include: (i) epicardial adipose tissue (EAT), associated with plaque development and the occurrence of arrhythmias; (ii) late iodine enhancement (LIE), which allows the identification of myocardial fibrosis; and (iii) plaque characterization, which provides data about plaque vulnerability. In the precision medicine era, these emerging markers should be integrated into CCTA evaluation to allow for the bespoke interventional and pharmacological management of each patient.
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Affiliation(s)
- Elisabetta Tonet
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy
| | - Alberto Boccadoro
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy
| | - Marco Micillo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy
| | - Marta Cocco
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy
| | - Alberto Cossu
- Department of Morphology, Surgery and Experimental Medicine, Section of Radiology, University of Ferrara, 44121 Ferrara, Italy
| | - Graziella Pompei
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy
| | - Melchiore Giganti
- Department of Morphology, Surgery and Experimental Medicine, Section of Radiology, University of Ferrara, 44121 Ferrara, Italy
| | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy
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6
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Gama FF, Patel K, Bennett J, Aziminia N, Pugliese F, Treibel T. Myocardial Evaluation in Patients with Aortic Stenosis by Cardiac Computed Tomography. ROFO-FORTSCHR RONTG 2023; 195:506-513. [PMID: 36854383 DOI: 10.1055/a-1999-7271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND Aortic valve stenosis (AVS) is one of the most prevalent pathologies affecting the heart that can curtail expected survival and quality of life if not managed appropriately. CURRENT STATUS Cardiac computed tomography (CT) has long played a central role in this subset, mostly for severity assessment and for procedural planning. Although not as widely accepted as other imaging modalities for functional myocardial assessment [i. e., transthoracic echocardiogram (TTE), cardiac magnetic resonance (CMR)], this technique has recently increased its clinical application in this regard. FUTURE OUTLOOK The ability to provide morphological, functional, tissue, and preprocedural information highlights the potential of the "all-in-one" concept of cardiac CT as a potential reality for the near future for AVS assessment. In this review article, we sought to analyze the current applications of cardiac CT that allow a full comprehensive evaluation of aortic valve disease. KEY POINTS · Noninvasive myocardial tissue characterization stopped being an exclusive feature of cardiac magnetic resonance.. · Emerging acquisition methods make cardiac CT an accurate and widely accessible imaging modality.. · Cardiac CT has the potential to become a "one-stop" exam for comprehensive aortic stenosis assessment.. CITATION FORMAT · Gama FF, Patel K, Bennett J et al. Myocardial Evaluation in Patients with Aortic Stenosis by Cardiac Computed Tomography. Fortschr Röntgenstr 2023; DOI: 10.1055/a-1999-7271.
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Affiliation(s)
- Francisco F Gama
- Cardiology, Hospital Centre of West Lisbon Campus Hospital of Santa Cruz, Lisboa, Portugal.,Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Kush Patel
- Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Jonathan Bennett
- Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Nikoo Aziminia
- Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Francesca Pugliese
- Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Thomas Treibel
- Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
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Ghannam M, Bogun F. Improving Outcomes in Ventricular Tachycardia Ablation Using Imaging to Identify Arrhythmic Substrates. Card Electrophysiol Clin 2022; 14:609-620. [PMID: 36396180 DOI: 10.1016/j.ccep.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Ventricular tachycardia (VT) ablation is limited by modest acute and long-term success rates, in part due to the challenges in accurately identifying the arrhythmogenic substrate. The combination of multimodality imaging along with information from electroanatomic mapping allows for a more comprehensive assessment of the arrhythmogenic substrate which facilitates VT ablation, and the use of preprocedural imaging has been shown to improve long-term ablation outcomes. Beyond regional recognition of the arrhythmogenic substrate, advanced imaging techniques can be used to create tailored ablation strategies preprocedurally. This review will focus on how imaging can be used to guide ablation planning and execution with a focus on clinical applications aimed at improving the outcome of VT ablation procedures.
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Affiliation(s)
- Michael Ghannam
- Division of Cardiovascular Medicine, University of Michigan, 1500 E. Medical Center Dr., SPC5853, Ann Arbor, Michigan 48109-5853, USA.
| | - Frank Bogun
- Division of Cardiovascular Medicine, University of Michigan, 1500 E. Medical Center Dr., SPC5853, Ann Arbor, Michigan 48109-5853, USA
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Nishii T, Kobayashi T, Tanaka H, Kotoku A, Ohta Y, Morita Y, Umehara K, Ota J, Horinouchi H, Ishida T, Fukuda T. Deep Learning-based Post Hoc CT Denoising for Myocardial Delayed Enhancement. Radiology 2022; 305:82-91. [PMID: 35762889 DOI: 10.1148/radiol.220189] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background To improve myocardial delayed enhancement (MDE) CT, a deep learning (DL)-based post hoc denoising method supervised with averaged MDE CT data was developed. Purpose To assess the image quality of denoised MDE CT images and evaluate their diagnostic performance by using late gadolinium enhancement (LGE) MRI as a reference. Materials and methods MDE CT data obtained by averaging three acquisitions with a single breath hold 5 minutes after the contrast material injection in patients from July 2020 to October 2021 were retrospectively reviewed. Preaveraged images obtained in 100 patients as inputs and averaged images as ground truths were used to supervise a residual dense network (RDN). The original single-shot image, standard averaged image, RDN-denoised original (DLoriginal) image, and RDN-denoised averaged (DLave) image of holdout cases were compared. In 40 patients, the CT value and image noise in the left ventricular cavity and myocardium were assessed. The segmental presence of MDE in the remaining 40 patients who underwent reference LGE MRI was evaluated. The sensitivity, specificity, and accuracy of each type of CT image and the improvement in accuracy achieved with the RDN were assessed using odds ratios (ORs) estimated with the generalized estimation equation. Results Overall, 180 patients (median age, 66 years [IQR, 53-74 years]; 107 men) were included. The RDN reduced image noise to 28% of the original level while maintaining equivalence in the CT values (P < .001 for all). The sensitivity, specificity, and accuracy of the original images were 77.9%, 84.4%, and 82.3%, of the averaged images were 89.7%, 87.9%, and 88.5%, of the DLoriginal images were 93.1%, 87.5%, and 89.3%, and of the DLave images were 95.1%, 93.1%, and 93.8%, respectively. DLoriginal images showed improved accuracy compared with the original images (OR, 1.8 [95% CI: 1.2, 2.9]; P = .011) and DLave images showed improved accuracy compared with the averaged images (OR, 2.0 [95% CI: 1.2, 3.5]; P = .009). Conclusion The proposed denoising network supervised with averaged CT images reduced image noise and improved the diagnostic performance for myocardial delayed enhancement CT. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Vannier and Wang in this issue.
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Affiliation(s)
- Tatsuya Nishii
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Takuma Kobayashi
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Hironori Tanaka
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Akiyuki Kotoku
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Yasutoshi Ohta
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Yoshiaki Morita
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Kensuke Umehara
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Junko Ota
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Hiroki Horinouchi
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Takayuki Ishida
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Tetsuya Fukuda
- From the Department of Radiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita 564-8565, Japan (T.N., T.K., H.T., A.K., Y.O., Y.M., H.H., T.F.); Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Japan (T.K., K.U., J.O., T.I.); Medical Informatics Section, QST Hospital (K.U., J.O.), and Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (K.U., J.O.), National Institutes for Quantum Science and Technology, Chiba, Japan
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The Role of Cardiac Computed Tomography in Heart Failure. Curr Heart Fail Rep 2022; 19:213-222. [PMID: 35588344 DOI: 10.1007/s11897-022-00553-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW Cardiac computed tomography (CT) is becoming a more widely applied tool in the diagnosis and management of a variety of cardiovascular conditions, including heart failure. The aim of this narrative review is to examine the role of cardiac CT in patients with heart failure. RECENT FINDINGS Coronary computed tomographic angiography has robust diagnostic accuracy for ruling out coronary artery disease. These data are reflected in updated guidelines from major cardiology organizations. New roles for cardiac CT in myocardial imaging, perfusion scanning, and periprocedural planning, execution, and monitoring are being implemented. Cardiac CT is useful in ruling out coronary artery disease its diagnostic accuracy, accessibility, and safety. It is also intricately linked to invasive cardiac procedures that patients with heart failure routinely undergo.
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Kim MY, Yang DH, Choo KS, Lee W. Beyond Coronary CT Angiography: CT Fractional Flow Reserve and Perfusion. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:3-27. [PMID: 36237355 PMCID: PMC9238199 DOI: 10.3348/jksr.2021.0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/15/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022]
Abstract
심장 전산화단층촬영은 비약적인 기술발전과 다양한 연구 결과를 바탕으로 심혈관위험 계층화와 치료 결정을 위한 관상동맥 질환의 진단과 예후 평가성능이 입증되었다. 전산화단층촬영 관상동맥조영술은 폐쇄성 관상동맥 질환에 대한 음성 예측도가 높아서 침습적 혈관조영술의 빈도를 줄일 수 있는 관상동맥 질환 관련 검사의 관문으로 부상했지만, 진단특이도가 상대적으로 낮다. 하지만 심장 전산화단층촬영을 이용한 분획혈류예비력과 심근관류를 분석하여 관상동맥 질환의 혈역학적 유의성을 확인하는 기능적 평가를 통해 그 한계를 극복할 수 있다. 최근에는 이를 보다 객관적이고 재현 가능하도록 인공지능을 접목하는 연구들이 활발히 진행되고 있다. 본 종설에서는 심장 전산화단층촬영의 기능적 영상화 기법들에 대해 알아보고자 한다.
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Affiliation(s)
- Moon Young Kim
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki Seok Choo
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Whal Lee
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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11
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Manabe O, Oyama-Manabe N, Aikawa T, Tsuneta S, Tamaki N. Advances in Diagnostic Imaging for Cardiac Sarcoidosis. J Clin Med 2021; 10:jcm10245808. [PMID: 34945105 PMCID: PMC8704832 DOI: 10.3390/jcm10245808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/05/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Sarcoidosis is a systemic granulomatous disease of unknown etiology, and its clinical presentation depends on the affected organ. Cardiac sarcoidosis (CS) is one of the leading causes of death among patients with sarcoidosis. The clinical manifestations of CS are heterogeneous, and range from asymptomatic to life-threatening arrhythmias and progressive heart failure due to the extent and location of granulomatous inflammation in the myocardium. Advances in imaging techniques have played a pivotal role in the evaluation of CS because histological diagnoses obtained by myocardial biopsy tend to have lower sensitivity. The diagnosis of CS is challenging, and several approaches, notably those using positron emission tomography and cardiac magnetic resonance imaging (MRI), have been reported. Delayed-enhanced computed tomography (CT) may also be used for diagnosing CS in patients with MRI-incompatible devices and allows acceptable evaluation of myocardial hyperenhancement in such patients. This article reviews the advances in imaging techniques for the evaluation of CS.
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Affiliation(s)
- Osamu Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan; (O.M.); (T.A.)
| | - Noriko Oyama-Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan; (O.M.); (T.A.)
- Correspondence: ; Tel.: +81-48-647-2111
| | - Tadao Aikawa
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan; (O.M.); (T.A.)
| | - Satonori Tsuneta
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo 060-8648, Japan;
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan;
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12
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Palmisano A, Vignale D, Tadic M, Moroni F, De Stefano D, Gatti M, Boccia E, Faletti R, Oppizzi M, Peretto G, Slavich M, Sala S, Montorfano M, Agricola E, Margonato A, De Cobelli F, Gentile F, Robella M, Cortese G, Esposito A. Myocardial Late Contrast Enhancement CT in Troponin-Positive Acute Chest Pain Syndrome. Radiology 2021; 302:545-553. [PMID: 34874200 DOI: 10.1148/radiol.211288] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Acute chest pain with mild troponin rise and inconclusive diagnosis after clinical evaluation represents a diagnostic challenge. Triple-rule-out (TRO) CT may exclude coronary artery disease (CAD), as well as acute aortic syndrome and pulmonary embolism, but cannot help identify other causes of myocardial injury. Purpose To investigate the diagnostic value of a comprehensive CT protocol including both an angiographic and a late contrast enhancement (LCE) scan in participants with troponin-positive acute chest pain. Materials and Methods In this prospective study, consecutive patients with troponin-positive acute chest pain or anginal equivalent and inconclusive diagnosis after clinical evaluation (symptoms, markers, electrocardiography, and echocardiography) who underwent TRO CT between June 2018 and September 2020 were enrolled. TRO CT was performed to evaluate the presence of obstructive CAD (stenosis ≥50%), acute aortic syndrome, and pulmonary embolism. If the findings on the TRO CT scan were negative, an LCE CT scan was acquired after 10 minutes to assess the presence and pattern of scar and quantify the myocardial extracellular volume fraction. CT-based diagnoses were compared with diagnoses obtained with reference standard methods, including invasive coronary angiography, cardiac MRI, and endomyocardial biopsy. Results Eighty-four patients (median age, 69 years [interquartile range, 50-77 years]; 45 men) were enrolled. TRO CT helped identify obstructive CAD in 35 participants (42%), acute aortic syndrome in one (1.2%), and pulmonary embolism in six (7.1%). LCE CT scans were acquired in the remaining 42 participants. The following diagnoses were reached with use of LCE CT: myocarditis (22 of 42 participants [52%]), takotsubo cardiomyopathy (four of 42 [10%]), amyloidosis (three of 42 [7.1%]), myocardial infarction with nonobstructed coronary arteries (three of 42 [7.1%]), dilated cardiomyopathy (two of 42 [4.8%]), and negative or inconclusive findings (eight of 42 [19%]). The addition of LCE CT improved the diagnostic rate of TRO CT from 42 of 84 participants (50% [95% CI: 38.9, 61.1]) to 76 of 84 (90% [95% CI: 82.1, 95.8]) (P < .001). Conclusion A CT protocol including triple-rule-out and late contrast enhancement CT scans improved diagnostic rate in participants presenting with acute chest pain syndrome. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Nagpal and Bluemke in this issue.
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Affiliation(s)
- Anna Palmisano
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Davide Vignale
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Marijana Tadic
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Francesco Moroni
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Domenico De Stefano
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Marco Gatti
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Edda Boccia
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Riccardo Faletti
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Michele Oppizzi
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Giovanni Peretto
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Massimo Slavich
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Simone Sala
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Matteo Montorfano
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Eustachio Agricola
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Alberto Margonato
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Francesco De Cobelli
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Francesco Gentile
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Mattia Robella
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Giancarlo Cortese
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
| | - Antonio Esposito
- From the Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy (A.P., D.V., D.D.S., F.D.C., A.E.); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (A.P., D.V., E.B., F.D.C., A.E.); Department of Cardiology, University Hospital Dr Dragiša Mišović Dedinje, Belgrade, Serbia (M.T.); Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (F.M., M.M.); UOC Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Campus Bio-Medico, Rome, Italy (D.D.S.); Department of Surgical Sciences, Radiology Unit, University of Turin, Turin, Italy (M.G., R.F., F.G., M.R.); Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele University Hospital, Milan, Italy (M.O., M.S., A.M.); Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy (G.P., S.S.); Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (E.A.); and Department of Diagnostic Radiology, Ospedale Maria Vittoria, Turin, Italy (G.C.)
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13
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Conte E, Mushtaq S, Muscogiuri G, Formenti A, Annoni A, Mancini E, Ricci F, Melotti E, Gigante C, Lorenza Z, Guglielmo M, Baggiano A, Maragna R, Giacari CM, Carbucicchio C, Catto V, Pepi M, Andreini D, Pontone G. The Potential Role of Cardiac CT in the Evaluation of Patients With Known or Suspected Cardiomyopathy: From Traditional Indications to Novel Clinical Applications. Front Cardiovasc Med 2021; 8:709124. [PMID: 34595219 PMCID: PMC8476802 DOI: 10.3389/fcvm.2021.709124] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/05/2021] [Indexed: 12/28/2022] Open
Abstract
After 15 years from its advent in the clinical field, coronary computed tomography (CCTA) is now widely considered as the best first-step test in patients with low-to-moderate pre-test probability of coronary artery disease. Technological innovation was of pivotal importance for the extensive clinical and scientific interest in CCTA. Recently, the advent of last generation wide-coverage CT scans paved the way for new clinical applications of this technique beyond coronary arteries anatomy evaluation. More precisely, both biventricular volume and systolic function quantification and myocardial fibrosis identification appeared to be feasible with last generation CT. In the present review we would focus on potential applications of cardiac computed tomography (CCT), beyond CCTA, for a comprehensive assessment patients with newly diagnosed cardiomyopathy, from technical requirements to novel clinical applications.
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Affiliation(s)
- Edoardo Conte
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy.,Department of Biomedical Science for Health, University of Milan, Milan, Italy
| | - Saima Mushtaq
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Giuseppe Muscogiuri
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Alberto Formenti
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Andrea Annoni
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Elisabetta Mancini
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Francesca Ricci
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Eleonora Melotti
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Carlo Gigante
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Zanotto Lorenza
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Marco Guglielmo
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Andrea Baggiano
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy.,Department of Biomedical Science for Health, University of Milan, Milan, Italy
| | - Riccardo Maragna
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Carlo Maria Giacari
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Corrado Carbucicchio
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Valentina Catto
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Mauro Pepi
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Daniele Andreini
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy.,Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Gianluca Pontone
- Centro Cardologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
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14
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Koyanagawa K, Kobayashi Y, Aikawa T, Takeda A, Shiraishi H, Tsuneta S, Oyama-Manabe N, Iwano H, Nagai T, Anzai T. Myocardial T 1-mapping and Extracellular Volume Quantification in Patients and Putative Carriers of Muscular Dystrophy: Early Experience. Magn Reson Med Sci 2021; 20:320-324. [PMID: 32893256 PMCID: PMC8424027 DOI: 10.2463/mrms.bc.2020-0069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
To assess myocardial fibrosis associated with muscular dystrophy, T1-mapping and extracellular volume fraction (ECV) quantification was prospectively performed using cardiovascular MR (CMR) imaging in 6 male patients with muscular dystrophy and 5 female putative carriers of Duchenne or Becker muscular dystrophy. Five patients and all putative carriers had an elevated ECV (>29.5% for men and >35.2% for women), suggesting that ECV has a potential to detect diffuse fibrotic changes in patients and putative carriers of muscular dystrophy.
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Affiliation(s)
- Kazuhiro Koyanagawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Yuta Kobayashi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Tadao Aikawa
- Department of Radiology, Jichi Medical University Saitama Medical Center
| | | | | | - Satonori Tsuneta
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital
| | | | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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15
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Koyanagawa K, Naya M, Aikawa T, Manabe O, Furuya S, Kuzume M, Oyama-Manabe N, Ohira H, Tsujino I, Anzai T. The rate of myocardial perfusion recovery after steroid therapy and its implication for cardiac events in cardiac sarcoidosis and primarily preserved left ventricular ejection fraction. J Nucl Cardiol 2021; 28:1745-1756. [PMID: 31605274 DOI: 10.1007/s12350-019-01916-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/01/2019] [Accepted: 09/23/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Sarcoidosis is a multisystemic disorder of unknown cause characterized by immune granuloma formation in the involved organs. Few studies have reported on the myocardial perfusion changes by immunosuppression therapy in cardiac sarcoidosis (CS). Additionally, the relationship between myocardial perfusion changes and prognosis is unknown. Therefore, this study aimed to clarify myocardial perfusion recovery after steroid therapy and its prognostic value for major adverse cardiac events (MACE) in patients with CS. METHODS AND RESULTS Thirty-eight consecutive patients with CS {median age, 63 [interquartile range (IQR) 51-68] years; 10 men} underwent both 18F-fluorodeoxyglucose positron emission tomography/computed tomography (CT) and electrocardiography-gated single-photon emission CT (SPECT) pre- and post-steroid therapy. Patients with improved or preserved myocardial perfusion after post-therapy were defined as the recovery group and those with worsened myocardial perfusion as the non-recovery group. Twenty-six patients (68%) were categorized as the recovery group. MACE occurred in eight patients. The Kaplan-Meier curves revealed a significantly higher rate of MACE in the non-recovery group (17.4%/y vs 2.9%/y, P = 0.007). CONCLUSIONS Myocardial perfusion was recovered by steroid therapy in 61% and preserved in 8% of patients. Myocardial perfusion recovery after steroid therapy was significantly associated with a low incidence of MACE.
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Affiliation(s)
- Kazuhiro Koyanagawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Masanao Naya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Tadao Aikawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Osamu Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Sho Furuya
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Masato Kuzume
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Noriko Oyama-Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Hiroshi Ohira
- First Department of Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Ichizo Tsujino
- First Department of Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
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16
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Infante T, Francone M, De Rimini ML, Cavaliere C, Canonico R, Catalano C, Napoli C. Machine learning and network medicine: a novel approach for precision medicine and personalized therapy in cardiomyopathies. J Cardiovasc Med (Hagerstown) 2021; 22:429-440. [PMID: 32890235 DOI: 10.2459/jcm.0000000000001103] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The early identification of pathogenic mechanisms is essential to predict the incidence and progression of cardiomyopathies and to plan appropriate preventive interventions. Noninvasive cardiac imaging such as cardiac computed tomography, cardiac magnetic resonance, and nuclear imaging plays an important role in diagnosis and management of cardiomyopathies and provides useful prognostic information. Most molecular factors exert their functions by interacting with other cellular components, thus many diseases reflect perturbations of intracellular networks. Indeed, complex diseases and traits such as cardiomyopathies are caused by perturbations of biological networks. The network medicine approach, by integrating systems biology, aims to identify pathological interacting genes and proteins, revolutionizing the way to know cardiomyopathies and shifting the understanding of their pathogenic phenomena from a reductionist to a holistic approach. In addition, artificial intelligence tools, applied to morphological and functional imaging, could allow imaging scans to be automatically analyzed to extract new parameters and features for cardiomyopathy evaluation. The aim of this review is to discuss the tools of network medicine in cardiomyopathies that could reveal new candidate genes and artificial intelligence imaging-based features with the aim to translate into clinical practice as diagnostic, prognostic, and predictive biomarkers and shed new light on the clinical setting of cardiomyopathies. The integration and elaboration of clinical habits, molecular big data, and imaging into machine learning models could provide better disease phenotyping, outcome prediction, and novel drug targets, thus opening a new scenario for the implementation of precision medicine for cardiomyopathies.
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Affiliation(s)
- Teresa Infante
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Marco Francone
- Department of Radiological, Oncological, and Pathological Sciences, La Sapienza University, Rome
| | | | | | - Raffaele Canonico
- U.O.C. of Dietetics, Sport Medicine and Psychophysical Wellbeing, Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological, and Pathological Sciences, La Sapienza University, Rome
| | - Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania 'Luigi Vanvitelli', Naples, Italy
- IRCCS SDN
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17
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Oyama-Manabe N, Manabe O, Aikawa T, Tsuneta S. The Role of Multimodality Imaging in Cardiac Sarcoidosis. Korean Circ J 2021; 51:561-578. [PMID: 34085435 PMCID: PMC8263295 DOI: 10.4070/kcj.2021.0104] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/21/2021] [Indexed: 12/19/2022] Open
Abstract
The etiology and the progression of sarcoidosis remain unknown. However, cardiac sarcoidosis (CS) is significantly associated with a poor prognosis due to the associated congestive heart failure, arrhythmias (such as an advanced atrioventricular block), and ventricular tachyarrhythmia. Novel imaging modalities are now available to detect CS lesions secondary to active inflammation, granuloma formation, and fibrotic changes. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and cardiac magnetic resonance imaging (CMR) play essential roles in diagnosing and monitoring patients with confirmed or suspected CS. The following focused review will highlight the emerging role of non-invasive cardiac imaging techniques, including FDG PET/CT and CMR.
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Affiliation(s)
- Noriko Oyama-Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
| | - Osamu Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Tadao Aikawa
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan.,Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Japan
| | - Satonori Tsuneta
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
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18
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Rajiah P, Kirsch J, Bolen MA, Batlle JC, Brown RKJ, Francois CJ, Galizia MS, Hanneman K, Inacio JR, Johri AM, Lee DC, Singh SP, Villines TC, Wann S, Zimmerman SL, Abbara S. ACR Appropriateness Criteria® Nonischemic Myocardial Disease with Clinical Manifestations (Ischemic Cardiomyopathy Already Excluded). J Am Coll Radiol 2021; 18:S83-S105. [PMID: 33651982 DOI: 10.1016/j.jacr.2021.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 01/27/2021] [Indexed: 12/13/2022]
Abstract
Nonischemic cardiomyopathies encompass a broad spectrum of myocardial disorders with mechanical or electrical dysfunction without evidence of ischemia. There are five broad variants of nonischemic cardiomyopathies; hypertrophic cardiomyopathy (Variant 1), restrictive or infiltrative cardiomyopathy (Variant 2), dilated or unclassified cardiomyopathy (Variant 3), arrhythmogenic cardiomyopathy (Variant 4), and inflammatory cardiomyopathy (Variant 5). For variants 1, 3, and 4, resting transthoracic echocardiography, MRI heart function and morphology without and with contrast, and MRI heart function and morphology without contrast are the usually appropriate imaging modalities. For variants 2 and 5, resting transthoracic echocardiography and MRI heart function and morphology without and with contrast are the usually appropriate imaging modalities. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | - Jacobo Kirsch
- Panel Chair, Cleveland Clinic Florida, Weston, Florida
| | - Michael A Bolen
- Panel Vice-Chair, Cleveland Clinic, Cleveland, Ohio, Radiology Fellowship Director for Cardiovascular CT/MRI Cleveland Clinic Main Campus
| | - Juan C Batlle
- Miami Cardiac and Vascular Institute and Baptist Health of South Florida, Miami, Florida
| | - Richard K J Brown
- University of Utah, Department of Radiology and Imaging Sciences, Salt Lake City, Utah
| | | | | | - Kate Hanneman
- Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada, Director, Cardiac Imaging Research, Department of Medical Imaging, University of Toronto
| | - Joao R Inacio
- The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Amer M Johri
- Queen's University, Kingston, Ontario, Canada, Cardiology expert
| | - Daniel C Lee
- Northwestern University Feinberg School of Medicine Chicago, Illinois, Society for Cardiovascular Magnetic Resonance, Co-Director, Cardiovascular Magnetic Resonance Imaging, Northwestern University Feinberg School of Medicine
| | | | - Todd C Villines
- University of Virginia Health System, Charlottesville, Virginia, Society of Cardiovascular Computed Tomography
| | - Samuel Wann
- Wisconsin Heart Hospital, Milwaukee, Wisconsin, Nuclear cardiology expert
| | | | - Suhny Abbara
- Specialty Chair, UT Southwestern Medical Center, Dallas, Texas
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19
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Narula J, Chandrashekhar Y, Ahmadi A, Abbara S, Berman DS, Blankstein R, Leipsic J, Newby D, Nicol ED, Nieman K, Shaw L, Villines TC, Williams M, Hecht HS. SCCT 2021 Expert Consensus Document on Coronary Computed Tomographic Angiography: A Report of the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr 2021; 15:192-217. [PMID: 33303384 PMCID: PMC8713482 DOI: 10.1016/j.jcct.2020.11.001] [Citation(s) in RCA: 141] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Jagat Narula
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Y Chandrashekhar
- University of Minnesota and VA Medical Center, Minneapolis, MN, USA
| | - Amir Ahmadi
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Suhny Abbara
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Ron Blankstein
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | | | - David Newby
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - Edward D Nicol
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | | | - Leslee Shaw
- New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Todd C Villines
- University of Virginia Health System, Charlottesville, VA, USA
| | - Michelle Williams
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - Harvey S Hecht
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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20
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Texture analysis of delayed contrast-enhanced computed tomography to diagnose cardiac sarcoidosis. Jpn J Radiol 2021; 39:442-450. [PMID: 33483941 DOI: 10.1007/s11604-020-01086-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/27/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To investigate the diagnostic value of texture analysis to differentiate cardiac sarcoidosis (CS) from other non-ischemic cardiomyopathies (non-CS). MATERIALS AND METHODS Twenty CS patients and 15 non-CS patients who had undergone myocardial CT delayed enhancement (CTDE) were included. A total of 36 texture features were calculated according to the CT attenuation of CTDE. We investigated the diagnostic value to differentiate CS from non-CS. We also assessed the intra- and inter-rater reproducibility for each feature and inter-observer agreement for visual assessment. RESULTS Seven extracted features had significantly higher run length non-uniformity (RLNU) values (5.4 × 102 ± 6.2 × 102 vs. 11.2 × 102 ± 4.9 × 102, p = 0.037) and significantly lower low gray-level zone emphasis (LGZE) values (7.1 × 10-3 ± 8.6 × 10-3 vs. 18.1 × 10-3 ± 16.9 × 10-3, p = 0.017) in CS than in non-CS. Intra- and inter-rater reproducibility of RLNU and LGZE were excellent (ICCs > 0.8), while inter-observer agreement of visual assessment was poor (kappa = 0.19). The accuracies of texture analysis were 69% with RLNU and 71% with LGZE, which were better than that of visual assessment. CONCLUSION Texture analysis of CTDE could differentiate CS from non-CS with high reproducibility.
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21
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Montalto S, Better N. Assessing severity of cardiac sarcoid: Is SUV the answer? J Nucl Cardiol 2020; 27:2011-2016. [PMID: 30483957 DOI: 10.1007/s12350-018-01534-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 11/12/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Stephanie Montalto
- Department of Cardiology, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia
| | - Nathan Better
- Department of Cardiology, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia.
- Department of Nuclear Medicine, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia.
- Department of Medicine, University of Melbourne, Parkville, VIC, 3050, Australia.
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22
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Abstract
The prevalence of heart failure (HF) is approximately 1-2% of the adult population in developed countries, rising to ≥ 10% among people over 70. The common symptoms of HF include shortness of breath, ankle swelling and fatigue, determined by a reduced cardiac output. Multimodality imaging is crucial to define HF etiology, determine prognosis and guiding tailored treatments. Echocardiography is the most widely used imaging modality and maintains a pivotal role in the initial diagnostic work-up and in the follow-up of HF patients. Cardiac magnetic resonance (CMR) may support the morpho-functional assessment provided by echocardiography when the acoustic window is limited or a gold standard evaluation is required. Furthermore, CMR is frequently used due to the unmatched capability to characterize myocardial structure. Coronary computed tomography angiography has become the non-invasive imaging of choice to diagnose or rule-out coronary artery disease, acquiring remarkable importance in the management of HF patients. Moreover, emerging capabilities of CT-based tissue characterization may be useful, especially when CMR is contraindicated. Finally, chest CT may contribute to precisely define the framework of HF patients, revealing new insight about cardiopulmonary pathophysiological interactions with potential high prognostic value.
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23
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Raimondi PM, Lisker J, Rini JN, Vitkovski T, Rahmani N, Kuvin JT, Saba SG. Myocardial hypoattenuation in cardiac sarcoidosis: CT correlation with CMR, PET and SPECT. Clin Imaging 2020; 67:136-142. [PMID: 32622334 DOI: 10.1016/j.clinimag.2020.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/26/2020] [Accepted: 06/12/2020] [Indexed: 10/24/2022]
Abstract
We report a marked abnormality in myocardial attenuation on non-gated contrast-enhanced CT in a patient with multiorgan sarcoidosis and correlate our findings with CMR, PET and SPECT. The noteworthy observation of myocardial hypoattenuation, in correspondence with the multimodality cardiovascular imaging findings, suggests that standard contrast-enhanced CT may provide information regarding tissue characterization. This report also demonstrates the independent clinical utility of CMR and PET in the evaluation and management of cardiac sarcoidosis.
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Affiliation(s)
- Peter M Raimondi
- Department of Cardiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States of America
| | - Jay Lisker
- Department of Cardiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States of America
| | - Josephine N Rini
- Department of Radiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States of America; Multimodality Cardiovascular Imaging Laboratory, North Shore University Hospital, Manhasset, NY 11030, United States of America
| | - Taisia Vitkovski
- Department of Anatomic/Clinical Pathology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States of America
| | - Navid Rahmani
- Department of Radiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States of America; Multimodality Cardiovascular Imaging Laboratory, North Shore University Hospital, Manhasset, NY 11030, United States of America
| | - Jeffrey T Kuvin
- Department of Cardiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States of America
| | - Shahryar G Saba
- Department of Cardiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States of America; Department of Radiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States of America; Multimodality Cardiovascular Imaging Laboratory, North Shore University Hospital, Manhasset, NY 11030, United States of America.
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24
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Tanabe Y, Kurata A, Matsuda T, Yoshida K, Baruah D, Kido T, Mochizuki T, Rajiah P. Computed tomographic evaluation of myocardial ischemia. Jpn J Radiol 2020; 38:411-433. [PMID: 32026226 PMCID: PMC7186254 DOI: 10.1007/s11604-020-00922-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/20/2020] [Indexed: 01/02/2023]
Abstract
Myocardial ischemia is caused by a mismatch between myocardial oxygen consumption and oxygen delivery in coronary artery disease (CAD). Stratification and decision-making based on ischemia improves the prognosis in patients with CAD. Non-invasive tests used to evaluate myocardial ischemia include stress electrocardiography, echocardiography, single-photon emission computed tomography, and magnetic resonance imaging. Invasive fractional flow reserve is considered the reference standard for assessment of the hemodynamic significance of CAD. Computed tomography (CT) angiography has emerged as a first-line imaging modality for evaluation of CAD, particularly in the population at low to intermediate risk, because of its high negative predictive value; however, CT angiography does not provide information on the hemodynamic significance of stenosis, which lowers its specificity. Emerging techniques, e.g., CT perfusion and CT-fractional flow reserve, help to address this limitation of CT, by determining the hemodynamic significance of coronary artery stenosis. CT perfusion involves acquisition during the first pass of contrast medium through the myocardium following pharmacological stress. CT-fractional flow reserve uses computational fluid dynamics to model coronary flow, pressure, and resistance. In this article, we review these two functional CT techniques in the evaluation of myocardial ischemia, including their principles, technology, advantages, limitations, pitfalls, and the current evidence.
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Affiliation(s)
- Yuki Tanabe
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Akira Kurata
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Takuya Matsuda
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Kazuki Yoshida
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Dhiraj Baruah
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
| | - Teruhito Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
- Department of Radiology, I.M. Sechenov First Moscow State Medical University, Bol'shaya Pirogovskaya Ulitsa, Moscow, Russia
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25
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Late iodine enhancement cardiac computed tomography for detection of myocardial scars: impact of experience in the clinical practice. Radiol Med 2019; 125:128-136. [PMID: 31784926 DOI: 10.1007/s11547-019-01108-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Cardiac CT with late iodine enhancement (LIE-CT) may characterize the scarred myocardium, but the role of readers' experience and scar pattern on LIE-CT diagnostic performance is unknown. Aim was to assess the diagnostic performance of LIE-CT according to readers' experience, scar pattern and contrast-to-noise ratio (CNR) using late gadolinium enhancement MRI (LGE-MRI) as reference. METHODS LIE-CT and LGE-MRI images of 40 consecutive patients were analyzed. Two readers with different experience (8 and 2 years) independently analyzed LIE-CT images defining the presence/absence of scar and scar CNR, segmental involvement, transmural pattern and scar etiology. The same parameters were extracted from LGE-MRI by two expert readers in consensus, blinded to the LIE-CT results. RESULTS Scars were identified at LGE-MRI in 29/40 patients and 141/680 segments. Scar burden at LIE-CT versus LGE-MRI correlated better for the most experienced reader than for the least experienced one (ρ = 0.954 and ρ = 0.797, p < 0.001). The most experienced reader missed scars in 2 patients and in 21/141 segments; the least experienced in 5 patients and 53/141 segments. The most experienced reader showed higher accuracy and sensitivity compared to the least experienced in per-patient (accuracy: 95% vs. 88%; sensitivity: 93% vs. 83%) and per-segment analysis (accuracy: 96% vs. 92%; sensitivity: 85% vs. 62%). Specificity was excellent (100% per-patient, 99% per-segment,) regardless of readers' experience. Missed scars had non-ischemic pattern, low scar burden (< 6%) and lower CNR compared to ischemic scars (2.33 vs. 3.54, p = 0.005). CONCLUSION LIE-CT represents an alternative to LGE-MRI, although the impact of readers' experience on sensitivity for small non-ischemic scars should be considered.
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26
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Aikawa T, Takeda A, Oyama-Manabe N, Naya M, Yamazawa H, Koyanagawa K, Ito YM, Anzai T. Progressive left ventricular dysfunction and myocardial fibrosis in Duchenne and Becker muscular dystrophy: a longitudinal cardiovascular magnetic resonance study. Pediatr Cardiol 2019; 40:384-392. [PMID: 30564867 DOI: 10.1007/s00246-018-2046-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/09/2018] [Indexed: 12/18/2022]
Abstract
This study examined the progression of left ventricular dysfunction and myocardial fibrosis in patients with Duchenne muscular dystrophy (DMD) or Becker muscular dystrophy (BMD) to evaluate the effects of angiotensin-converting enzyme inhibitor (ACEI). Ninety-eight cardiovascular magnetic resonance (CMR) studies in 34 consecutive patients with DMD (n = 21) or BMD (n = 13) were retrospectively reviewed. Left ventricular ejection fraction (LVEF) and the extent of myocardial late gadolinium enhancement (LGE) were semiautomatically quantified. During the study period, five patients had already been treated with ACEI at the first CMR; five were started on ACEI at LVEF ≥ 55% and 10 at LVEF < 55%. All patients had hyperenhanced myocardium on LGE images at the first CMR (median extent, 3.3%; interquartile range 0.1-14.3%). A mixed-effects model for longitudinal data of each patient, adjusted for age, type of muscular dystrophy, steroid use, and ACEI use showed that higher age (β = - 1.1%/year; 95% confidence interval [CI], - 1.8% to - 0.4%; p = 0.005) and no use of ACEI (β = - 3.1%; 95% CI, - 5.4% to - 0.8%; p = 0.009) were significantly associated with a lower LVEF. When ACEI use was stratified by time of initiation (LVEF ≥ 55% vs. < 55%), only ACEI initiation at LVEF < 55% had a beneficial effect on LVEF at each imaging examination (β = 3.7%; 95% CI, 0.9-6.4%; p = 0.010). ACEI use or the time of initiation of ACEI did not significantly affect age-related increase in LGE. ACEI attenuated the age-related decline in LVEF only in patients with DMD or BMD and reduced LVEF, suggesting that further investigation on prophylactic use of cardioprotective therapy in these patients is warranted.
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Affiliation(s)
- Tadao Aikawa
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Atsuhito Takeda
- Department of Pediatrics, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Noriko Oyama-Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan.
| | - Masanao Naya
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Hirokuni Yamazawa
- Department of Pediatrics, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Kazuhiro Koyanagawa
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Yoichi M Ito
- Department of Biostatistics, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
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27
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Comparison of the different imaging time points in delayed phase cardiac CT for myocardial scar assessment and extracellular volume fraction estimation in patients with old myocardial infarction. Int J Cardiovasc Imaging 2018; 35:917-926. [DOI: 10.1007/s10554-018-1513-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 12/11/2018] [Indexed: 01/02/2023]
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29
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Kitagawa K, Goto Y, Nakamura S, Takafuji M, Hamdy A, Ishida M, Sakuma H. Dynamic CT Perfusion Imaging: State of the Art. ACTA ACUST UNITED AC 2018. [DOI: 10.22468/cvia.2018.00031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kakuya Kitagawa
- Department of Radiology, Mie University School of Medicine, Tsu, Japan
| | - Yoshitaka Goto
- Department of Radiology, Mie University School of Medicine, Tsu, Japan
| | - Satoshi Nakamura
- Department of Radiology, Mie University School of Medicine, Tsu, Japan
| | - Masafumi Takafuji
- Department of Radiology, Mie University School of Medicine, Tsu, Japan
| | - Ahmed Hamdy
- Department of Radiology, Mie University School of Medicine, Tsu, Japan
| | - Masaki Ishida
- Department of Radiology, Mie University School of Medicine, Tsu, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine, Tsu, Japan
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30
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Abstract
Cardiac computed tomography (CT) is increasingly used in the evaluation of cardiomyopathies, particularly in patients who are not able to undergo other non-invasive imaging tests such as magnetic resonance imaging (MRI) due to the presence of MRI-incompatible pacemakers/defibrillators or other contraindications or due to extensive artifacts from indwelling metallic devices. Advances in scanner technology enable acquisition of CT images with high spatial resolution, good temporal resolution, wide field of view and multi-planar reconstruction capabilities. CT is useful in cardiomyopathies in several ways, particularly in the evaluation of coronary arteries, characterization of cardiomyopathy phenotype, quantification of cardiac volumes and function, treatment-planning, and post-treatment evaluation. In this article, we review the imaging techniques and specific applications of CT in the evaluation of cardiomyopathies.
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Affiliation(s)
- Kevin Kalisz
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Prabhakar Rajiah
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, Texas, USA
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31
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Halliburton SS, Tanabe Y, Partovi S, Rajiah P. The role of advanced reconstruction algorithms in cardiac CT. Cardiovasc Diagn Ther 2017; 7:527-538. [PMID: 29255694 DOI: 10.21037/cdt.2017.08.12] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Non-linear iterative reconstruction (IR) algorithms have been increasingly incorporated into clinical cardiac CT protocols at institutions around the world. Multiple IR algorithms are available commercially from various vendors. IR algorithms decrease image noise and are primarily used to enable lower radiation dose protocols. IR can also be used to improve image quality for imaging of obese patients, coronary atherosclerotic plaques, coronary stents, and myocardial perfusion. In this article, we will review the various applications of IR algorithms in cardiac imaging and evaluate how they have changed practice.
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Affiliation(s)
| | - Yuki Tanabe
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, TX, USA
| | - Sasan Partovi
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Prabhakar Rajiah
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, TX, USA
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32
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Tanabe Y, Kido T, Kurata A, Kouchi T, Fukuyama N, Yokoi T, Uetani T, Yamashita N, Miyagawa M, Mochizuki T. Late iodine enhancement computed tomography with image subtraction for assessment of myocardial infarction. Eur Radiol 2017; 28:1285-1292. [DOI: 10.1007/s00330-017-5048-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/02/2017] [Accepted: 08/22/2017] [Indexed: 01/22/2023]
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33
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Aikawa T, Naya M, Obara M, Oyama-Manabe N, Manabe O, Magota K, Ito YM, Katoh C, Tamaki N. Regional interaction between myocardial sympathetic denervation, contractile dysfunction, and fibrosis in heart failure with preserved ejection fraction: 11C-hydroxyephedrine PET study. Eur J Nucl Med Mol Imaging 2017; 44:1897-1905. [PMID: 28653180 DOI: 10.1007/s00259-017-3760-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 06/12/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE This investigation aimed to identify significant predictors of regional sympathetic denervation quantified by 11C-hydroxyephedrine (HED) positron emission tomography (PET) in patients with heart failure with preserved left ventricular ejection fraction (HFpEF). METHODS Included in the study were 34 patients (age 63 ± 15 years, 23 men) with HFpEF (left ventricular ejection fraction ≥40%) and 11 age-matched volunteers without heart failure. Cardiac magnetic resonance imaging was performed to measure left ventricular size and function, and the extent of myocardial late gadolinium enhancement (LGE). 11C-HED PET was performed to quantify myocardial sympathetic innervation that was expressed as a 11C-HED retention index (RI, %/min). To identify predictors of regional 11C-HED RI in HFpEF patients, we propose a multivariate mixed-effects model for repeated measures over segments with an unstructured covariance matrix. RESULTS Global 11C-HED RI was significantly lower and more heterogeneous in HFpEF patients than in volunteers (P < 0.01 for all). Regional 11C-HED RI was correlated positively with systolic wall thickening (r = 0.42, P < 0.001) and negatively with the extent of LGE (r = -0.43, P < 0.001). Segments in HFpEF patients with a large extent of LGE had the lowest regional 11C-HED RI among all segments (P < 0.001 in post hoc tests). Multivariate analysis demonstrated that systolic wall thickening and the extent of LGE were significant predictors of regional 11C-HED RI in HFpEF patients (both P ≤ 0.001). CONCLUSION Regional sympathetic denervation was associated with contractile dysfunction and fibrotic burden in HFpEF patients, suggesting that regional sympathetic denervation may provide an integrated measure of myocardial damage in HFpEF.
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Affiliation(s)
- Tadao Aikawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Masanao Naya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Masahiko Obara
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Noriko Oyama-Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Osamu Manabe
- Department of Nuclear Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Keiichi Magota
- Division of Medical Imaging and Technology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Yoichi M Ito
- Department of Biostatistics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Chietsugu Katoh
- Department of Biomedical Science and Engineering, Faculty of Health Sciences, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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34
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Manabe O, Naya M, Yoshinaga K, Oyama-Manabe N, Ohira H, Aikawa T, Tamaki N. Assessment of Myocardial Blood Flow and Cardiac FDG Uptake Using Positron Emission Tomography. ACTA ACUST UNITED AC 2017. [DOI: 10.17996/anc.17-00014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Osamu Manabe
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine
| | - Masanao Naya
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Keiichiro Yoshinaga
- Diagnostic and Therapeutic Nuclear Medicine, National Institute of Radiological Science
| | - Noriko Oyama-Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital
| | - Hiroshi Ohira
- First Department of Medicine, Hokkaido University Hospital
| | - Tadao Aikawa
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Nagara Tamaki
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine
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