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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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Li G, Dong J, Cao Z, Wang J, Cao D, Zhang X, Zhang L, Lu G. Application of low-dose CT to the creation of 3D-printed kidney and perinephric tissue models for laparoscopic nephrectomy. Cancer Med 2021; 10:3077-3084. [PMID: 33797861 PMCID: PMC8085913 DOI: 10.1002/cam4.3851] [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] [Received: 01/12/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The aim of this study was to explore the feasibility of 3D printing of kidney and perinephric fat based on low-dose CT technology. PATIENTS AND METHODS A total of 184 patients with stage T1 complex renal tumors who underwent laparoscopic nephrectomy were prospectively enrolled and divided into three groups: group A (conventional dose kidney and perinephric fat 3D printing group, n = 62), group B (low-dose kidney and perinephric fat 3D printing, n = 64), and group C (conventional dose merely kidney 3D printing group, n = 58). The effective dose (ED), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were determined. The 3D printing quality was evaluated using a 4-point scale, and interobserver agreement was assessed using the intraclass correlation coefficient (ICC). RESULTS The ED of group B was lower than that of group A, with a decrease of 55.1%. The subjective scores of 3D printing quality in all groups were 3 or 4 points. The interobserver agreement among the three observers in 3D printing quality was good (ICC = 0.84-0.92). The perioperative indexes showed that operation time (OT), warm ischemia time (WIT), estimated blood loss (EBL), and laparoscopic partial nephrectomy (LPN) conversion to laparoscopic radical nephrectomy (LRN) in groups A or B were significantly less than those in group C. LPN was more frequent in group A and group B than in group C (all p < 0.017). There were no significant differences in perioperative indexes between group A and group B (all p > 0.017). CONCLUSION Low-dose CT technology can be effectively applied to 3D printing of kidney and perinephric fat and reduce the patient's radiation dose without compromising 3D printing quality. 3D printing of kidney and perinephric fat can significantly increase the success rate of LPN and decrease OT, WIT, and EBL.
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Affiliation(s)
- Guan Li
- Department of Radiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jie Dong
- Department of Urology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhiqiang Cao
- Department of Urology, General Hospital of Northern Theater Command, Shenyang, China
| | - Jinbao Wang
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Dongbing Cao
- Department of Urology, Cancer Hospital of China Medical University, Shenyang, China
| | - Xin Zhang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Longjiang Zhang
- Department of Radiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guangming Lu
- Department of Radiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Ohta Y, Kishimoto J, Kitao S, Yunaga H, Mukai-Yatagai N, Fujii S, Yamamoto K, Fukuda T, Ogawa T. Investigation of myocardial extracellular volume fraction in heart failure patients using iodine map with rapid-kV switching dual-energy CT: Segmental comparison with MRI T1 mapping. J Cardiovasc Comput Tomogr 2019; 14:349-355. [PMID: 31892473 DOI: 10.1016/j.jcct.2019.12.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/16/2019] [Accepted: 12/20/2019] [Indexed: 01/10/2023]
Abstract
PURPOSE To measure myocardial extracellular volume fraction (ECV) for each region or segment using iodine density image (IDI) with single-source dual-energy computed tomography (DECT) and compare the results with an MRI T1 mapping approach. MATERIALS AND METHODS For this prospective study, 79 consecutive heart failure patients referred for MRI were included and 23 patients (14 men, 63 ± 14 years) who underwent both MRI and late contrast enhancement DECT following coronary CT angiography were evaluated. CT-ECV was computed from IDI using late acquisition projection data. MR-ECV was computed from native and post-contrast T1 maps using non-rigid image registration for segments with evaluable image quality from 3.0-T MRI. Regional CT-ECV and MR-ECV were measured based on 16-segment models. CT-ECV and MR-ECV were compared using Pearson correlations. Agreement among methods was assessed using Bland-Altman comparisons. RESULTS In the 368 segments, although all segments were evaluable on IDI, 37 segments were rated as non-evaluable on T1 maps. Overall, 331 segments were analyzed. Mean CT-ECV and MR-ECV were 31.6 ± 9.1 and 33.2 ± 9.1, respectively. Strong correlations were seen between CT-ECV and MR-ECV for each region, as follows: all segments, r = 0.837; septal, r = 0.871; mid-septal, r = 0.895; anterior, r = 0.869; inferior, r = 0.793; and lateral, 0.864 (all p < 0.001). Differences between CT-ECV and MR-ECV were as follows: all segments, 1.13 ± 4.98; septal, -1.51 ± 4.37; mid-septal, -1.85 ± 4.22; anterior, 2.54 ± 4.89; inferior, 1.2 ± 5.78; and lateral, 2.65 ± 3.98. CONCLUSION ECV using DECT and from cardiac MRI showed a strong correlation on regional and segmental evaluations. DECT is useful for characterizing myocardial ECV changes as well as MRI.
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Affiliation(s)
- Yasutoshi Ohta
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Tottori University Faculty of Medicine, Yonago City, Tottori, 683-8504, Japan; National Cerebral and Cardiovascular Center, Suita City, Osaka, 565-8565, Japan.
| | - Junichi Kishimoto
- Tottori University Hospital, Department of Clinical Radiology, Yonago City, Tottori, 683-8504, Japan
| | - Shinichiro Kitao
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Tottori University Faculty of Medicine, Yonago City, Tottori, 683-8504, Japan
| | - Hiroto Yunaga
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Tottori University Faculty of Medicine, Yonago City, Tottori, 683-8504, Japan
| | - Natsuko Mukai-Yatagai
- Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Yonago City, Tottori, 683-8504, Japan
| | - Shinya Fujii
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Tottori University Faculty of Medicine, Yonago City, Tottori, 683-8504, Japan
| | - Kazuhiro Yamamoto
- Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Yonago City, Tottori, 683-8504, Japan
| | - Tetsuya Fukuda
- National Cerebral and Cardiovascular Center, Suita City, Osaka, 565-8565, Japan
| | - Toshihide Ogawa
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Tottori University Faculty of Medicine, Yonago City, Tottori, 683-8504, Japan; Kurashiki Heisei Hospital, Department of Radiology, Kurashiki City, Okayama, 710-0826, Japan
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Mukai-Yatagai N, Ohta Y, Amisaki R, Sasaki N, Akasaka T, Watanabe T, Kishimoto J, Kato M, Ogawa T, Yamamoto K. Myocardial delayed enhancement on dual-energy computed tomography: The prevalence and related factors in patients with suspicion of coronary artery disease. J Cardiol 2019; 75:302-308. [PMID: 31500962 DOI: 10.1016/j.jjcc.2019.08.004] [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] [Received: 03/01/2019] [Revised: 07/17/2019] [Accepted: 08/03/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND We aimed to assess the prevalence of myocardial delayed enhancement (MDE) in patients with suspected obstructive coronary artery disease (CAD), and to investigate factors related to the presence or absence of MDE. METHODS We retrospectively evaluated 191 consecutive patients who underwent coronary computed tomography angiography (CCTA) with MDE imaging for clinical suspicion of CAD from December 2014 to December 2016. The presence of MDE on iodine-density images using dual-energy CT was assessed by two independent readers. Multivariable logistic regression analyses were used to determine factors associated with the presence of MDE. RESULTS MDE was detected in 58 (30%) patients. Male gender, hypertension, prior heart failure (HF) hospitalization, and CCTA-detected CAD were independent factors related to the presence of MDE. When CCTA-detected CAD was excluded to narrow down the analysis to factors obtainable before CCTA, interventricular septum thickness (IVST) ≥12 mm was added as another independent factor. The combination of the following four factors: female gender, no history of hypertension, no history of prior HF hospitalization, and IVST < 12 mm demonstrated high specificity (98.3%) and positive predictive value (96.2%) for predicting the absence of MDE. CONCLUSIONS Male gender, hypertension, prior HF hospitalization, and CAD were independently associated with the presence of MDE in patients with suspected CAD. The combination of female gender, no history of hypertension, no history of prior HF hospitalization, and IVST < 12 mm is likely to be a helpful predictor in discriminating patients without MDE before CCTA.
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Affiliation(s)
- Natsuko Mukai-Yatagai
- Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan.
| | - Yasutoshi Ohta
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Ryosuke Amisaki
- Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Naoko Sasaki
- Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Toshihiko Akasaka
- Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Tomomi Watanabe
- Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Junichi Kishimoto
- Department of Clinical Radiology, Tottori University Hospital, Yonago, Japan
| | - Masahiko Kato
- Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Toshihide Ogawa
- Division of Radiology, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kazuhiro Yamamoto
- Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan
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Ohta Y, Kitao S, Yunaga H, Watanabe T, Mukai—Yatagai N, Kishimoto J, Yamamoto K, Ogawa T. Quantitative evaluation of non-ischemic dilated cardiomyopathy by late iodine enhancement using rapid kV switching dual-energy computed tomography: A feasibility study. J Cardiovasc Comput Tomogr 2019; 13:148-156. [DOI: 10.1016/j.jcct.2018.10.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/03/2018] [Accepted: 10/26/2018] [Indexed: 10/28/2022]
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Ohta Y, Kitao S, Yunaga H, Fujii S, Mukai N, Yamamoto K, Ogawa T. Myocardial Delayed Enhancement CT for the Evaluation of Heart Failure: Comparison to MRI. Radiology 2018; 288:682-691. [PMID: 29989514 DOI: 10.1148/radiol.2018172523] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To assess the diagnostic performance of dual-energy CT with myocardial delayed enhancement (MDE) in the detection and classification of myocardial scar in patients with heart failure, with late gadolinium enhancement (LGE) MRI as the standard of reference. Materials and Methods MDE CT and LGE MRI were performed in 44 patients with heart failure (30 men; mean patient age, 66 years ± 14) between 2013 and 2016, and images were retrospectively analyzed. The presence and patterns of MDE on iodine-density and virtual monochromatic (VM) images were assessed by two independent readers. Contrast-to-noise ratio (CNR) and percentage signal intensity increase relative to normal myocardium were measured. Diagnostic performance and area under the receiver operating characteristic curve for MDE CT and kappa values for reader agreement were determined. Results Thirty-five of the 44 patients (80%) demonstrated a focal area of LGE, with a nonischemic pattern in 22 of the 44 patients (50%) and an ischemic pattern in 13 (30%). Iodine-density images demonstrated the highest CNR and percentage signal intensity increase on CT images (P < .05), resulting in the highest diagnostic performance in the detection of any MDE CT abnormality (92% sensitivity [195 of 213 segments] and 98% specificity [481 of 491 segments]). The areas under the receiver operating characteristic curve for iodine-density images and 40-keV VM images in the detection of MDE were 0.97 and 0.95, respectively (P < .001). Kappa values for reader agreement were 0.82 for iodine-density images and 0.72 for 40-keV VM images. Conclusion Myocardial delayed enhancement CT enables accurate detection and localization of scar in patients with heart failure when compared with late gadolinium enhancement MRI, the reference standard.
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Affiliation(s)
- Yasutoshi Ohta
- From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Shinichiro Kitao
- From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Hiroto Yunaga
- From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Shinya Fujii
- From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Natsuko Mukai
- From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Kazuhiro Yamamoto
- From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Toshihide Ogawa
- From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
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