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Böttcher B, Zsarnoczay E, Varga-Szemes A, Schoepf UJ, Meinel FG, van Assen M, De Cecco CN. Dual-Energy Computed Tomography in Cardiac Imaging. Radiol Clin North Am 2023; 61:995-1009. [PMID: 37758366 DOI: 10.1016/j.rcl.2023.05.004] [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: 10/03/2023]
Abstract
Dual-energy computed tomography (DECT) acquires images using two energy spectra and offers a variation of reconstruction techniques for improved cardiac imaging. Virtual monoenergetic images decrease artifacts improving coronary plaque and stent visualization. Further, contrast attenuation is increased allowing significant reduction of contrast dose. Virtual non-contrast reconstructions enable coronary artery calcium scoring from contrast-enhanced scans. DECT provides advanced plaque imaging with detailed analysis of plaque components, indicating plaque stability. Extracellular volume assessment using DECT offers noninvasive detection of myocardial fibrosis. This review aims to outline the current cardiac applications of DECT, summarize recent literature, and discuss their findings.
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Affiliation(s)
- Benjamin Böttcher
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Road NE, Suite D112, Atlanta, GA 30322, USA; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Strasse 6, 18057 Rostock, Germany
| | - Emese Zsarnoczay
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Center, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA
| | - Uwe Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA
| | - Felix G Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Strasse 6, 18057 Rostock, Germany
| | - Marly van Assen
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Road NE, Suite D112, Atlanta, GA 30322, USA
| | - Carlo N De Cecco
- Division of Cardiothoracic Imaging and Imaging Informatics, Department of Radiology and Imaging Sciences, Emory University Hospital, Emory Healthcare, Inc. 1365 Clifton Road NE, Suite - AT503, Atlanta, GA 30322, USA.
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Meloni A, Cademartiri F, Positano V, Celi S, Berti S, Clemente A, La Grutta L, Saba L, Bossone E, Cavaliere C, Punzo B, Maffei E. Cardiovascular Applications of Photon-Counting CT Technology: A Revolutionary New Diagnostic Step. J Cardiovasc Dev Dis 2023; 10:363. [PMID: 37754792 PMCID: PMC10531582 DOI: 10.3390/jcdd10090363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/28/2023] Open
Abstract
Photon-counting computed tomography (PCCT) is an emerging technology that can potentially transform clinical CT imaging. After a brief description of the PCCT technology, this review summarizes its main advantages over conventional CT: improved spatial resolution, improved signal and contrast behavior, reduced electronic noise and artifacts, decreased radiation dose, and multi-energy capability with improved material discrimination. Moreover, by providing an overview of the existing literature, this review highlights how the PCCT benefits have been harnessed to enhance and broaden the diagnostic capabilities of CT for cardiovascular applications, including the detection of coronary artery calcifications, evaluation of coronary plaque extent and composition, evaluation of coronary stents, and assessment of myocardial tissue characteristics and perfusion.
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Affiliation(s)
- Antonella Meloni
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.M.); (V.P.); (A.C.); (E.M.)
- Unità Operativa Complessa di Bioingegneria, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
| | - Filippo Cademartiri
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.M.); (V.P.); (A.C.); (E.M.)
| | - Vicenzo Positano
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.M.); (V.P.); (A.C.); (E.M.)
- Unità Operativa Complessa di Bioingegneria, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
| | - Simona Celi
- BioCardioLab, Fondazione G. Monasterio CNR-Regione Toscana, 54100 Massa, Italy;
| | - Sergio Berti
- Diagnostic and Interventional Cardiology Department, Fondazione G. Monasterio CNR-Regione Toscana, 54100 Massa, Italy;
| | - Alberto Clemente
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.M.); (V.P.); (A.C.); (E.M.)
| | - Ludovico La Grutta
- Department of Radiology, University Hospital “P. Giaccone”, 90127 Palermo, Italy;
| | - Luca Saba
- Department of Radiology, University Hospital of Cagliari, 09042 Monserrato, CA, Italy;
| | - Eduardo Bossone
- Department of Cardiology, Ospedale Cardarelli, 80131 Naples, Italy;
| | - Carlo Cavaliere
- Department of Radiology, Istituto di Ricerca e Cura a Carattere Scientifico SynLab-SDN, 80131 Naples, Italy; (C.C.); (B.P.)
| | - Bruna Punzo
- Department of Radiology, Istituto di Ricerca e Cura a Carattere Scientifico SynLab-SDN, 80131 Naples, Italy; (C.C.); (B.P.)
| | - Erica Maffei
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.M.); (V.P.); (A.C.); (E.M.)
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D’Angelo T, Martin S, Micari A, Booz C, Steyer A, Blandino A, Lanzafame LR, Koch V, Ascenti G, Mazziotti S. Coronary angiography using spectral detector dual-energy CT: is it the time to assess myocardial first-pass perfusion? Eur Radiol Exp 2022; 6:60. [PMID: 36480065 PMCID: PMC9732170 DOI: 10.1186/s41747-022-00313-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/30/2022] [Indexed: 12/13/2022] Open
Abstract
Coronary computed tomography angiography (CCTA) represents a common approach to the diagnostic workup of patients with suspected coronary artery disease. Technological development has recently allowed the integration of conventional CCTA information with spectral data. Spectral CCTA used in clinical routine may allow for improving CCTA diagnostic performance by measuring myocardial iodine distribution as a marker of first-pass perfusion, thus providing additional functional information about coronary artery disease.
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Affiliation(s)
- Tommaso D’Angelo
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy ,grid.5645.2000000040459992XDepartment of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Simon Martin
- grid.411088.40000 0004 0578 8220Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Antonino Micari
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Christian Booz
- grid.411088.40000 0004 0578 8220Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Alexandra Steyer
- grid.411088.40000 0004 0578 8220Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Alfredo Blandino
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Ludovica R. Lanzafame
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Vitali Koch
- grid.411088.40000 0004 0578 8220Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Giorgio Ascenti
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Silvio Mazziotti
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
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Tang X, Zhang Y, Wang T, Ma Y, Shi H, Yin R, Zou P, Cao J, Pan C. Image quality and diagnostic accuracy of different dosages of iodixanol in computed tomography angiography and perfusion of overweight patients with coronary artery stenosis: A feasibility study. Med Eng Phys 2022; 110:103818. [PMID: 35618562 DOI: 10.1016/j.medengphy.2022.103818] [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: 02/23/2022] [Revised: 04/11/2022] [Accepted: 05/09/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Iodixanol contrast media with different doses using computed tomography angiography (CTA) and perfusion (CTP) to diagnose coronary artery disease (CAD) in overweight patients lacks assessment. Our study compared iodixanol 320 mg I/ml and 270 mg I/ml on image quality and accuracy of CTA combined CTP (CTA-CTP) to diagnose CAD. METHODS Overweight patients with suspected of CAD were randomized into iodixanol 270 group (received iodixanol 270 mg I/ml) and iodixanol 320 group (received iodixanol 320 mg I/ml). Based on these characteristics data, receiver operating characteristic (ROC) curve and corresponding area under the curve (AUC) were plotted to assess the sensitivity and specificity of the two administrations. RESULTS The subjective definition score, signal to noise ratio, and CT value of aorta in iodixanol 320 group were higher than iodixanol 270 group. In iodixanol 270 group: the image exhibited a normal state of both vessels and myocardial perfusion; and the AUC, specificity, and sensitivity were 0.376, 66.67, and 80.46, respectively. In iodixanol 320 group: the image exhibited a diameter stenosis in right coronary artery and myocardial infarction of inferior wall and proximal inferior wall septum, as well as myocardial perfusion defects; and the AUC, specificity, and sensitivity in iodixanol 320 group were 0.824, 75.00, and 89.87, respectively. CONCLUSION Accuracy and image quality of iodixanol 320 mg I/ml in the diagnosis of CAD with CTA-CTP was higher than using iodixanol 270 mg I/ml.
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Affiliation(s)
- Xiaoqiang Tang
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Yong Zhang
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Tao Wang
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Yi Ma
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Haifeng Shi
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Ruohan Yin
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Ping Zou
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Jian Cao
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Changjie Pan
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China.
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Khalique OK, Veillet-Chowdhury M, Choi AD, Feuchtner G, Lopez-Mattei J. Cardiac computed tomography in the contemporary evaluation of infective endocarditis. J Cardiovasc Comput Tomogr 2021; 15:304-312. [PMID: 33612424 DOI: 10.1016/j.jcct.2021.02.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/11/2021] [Accepted: 02/09/2021] [Indexed: 01/20/2023]
Abstract
Increasing data have accumulated on the role of Cardiac Computed Tomography (CCT) in infective endocarditis (IE) with high accuracy for large vegetations, perivalvular complications and for exclusion of coronary artery disease to avoid invasive angiography. CCT can further help to clarify the etiology of infective prosthetic valve dysfunction (e.g. malposition, abscess, leak, vegetation or mass). Structural interventions have increased the relevance of CCT in valvular heart disease and have amplified its use. CCT may be ideally integrated into a multimodality approach that incorporates a central role of transesophageal echocardiography (TEE) with 18-FDG PET and/or cardiac magnetic resonance in individually selected cases, guided by the Heart Team. The coronavirus-19 (COVID-19) pandemic has resulted in renewed attention to CCT as a safe alternative or adjunct to TEE in selected patients. This review article provides a comprehensive, contemporary review on CCT in IE to include scan optimization, characteristics of common IE findings on CCT, published data on the diagnostic accuracy of CCT, multimodality imaging comparison, limitations and future technical advancements.
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Affiliation(s)
- Omar K Khalique
- Structural Heart and Valve Center, Division of Cardiology, Columbia University Medical Center, New York, NY, USA
| | - Mahdi Veillet-Chowdhury
- Advanced Cardiovascular Imaging, Division of Cardiology, Wellspan Health System, York, PA, USA
| | - Andrew D Choi
- Division of Cardiology and Department of Radiology, The George Washington University School of Medicine, USA
| | - Gudrun Feuchtner
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Juan Lopez-Mattei
- Department of Cardiology, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Thoracic Imaging, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Ji X, Zhang R, Li K, Chen GH. Dual Energy Differential Phase Contrast CT (DE-DPC-CT) Imaging. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:3278-3289. [PMID: 32340940 PMCID: PMC7584735 DOI: 10.1109/tmi.2020.2990347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
When more than two elemental materials are present in a given object, material quantification may not be robust and accurate when the routine two-material decomposition scheme in current dual energy CT imaging is employed. In this work, we present an innovative scheme to accomplish accurate three-material decomposition with measurements from a dual energy differential phase contrast CT (DE-DPC-CT) acquisition. A DE-DPC-CT system was constructed using a grating interferometer and a photon counting CT imaging system with two energy bins. The DE-DPC-CT system can simultaneously measure both the imaginary and the real part of the complex refractive index to enable a three-material decomposition. Physical phantom with 21 material inserts were constructed and measured using DE-DPC-CT system. Results demonstrated excellent accuracy in elemental material quantification. For example, relative root-mean-square errors of 4.5% for calcium and 5.2% for iodine were achieved using the proposed three-material decomposition scheme. Biological tissues with iodine inserts were used to demonstrate the potential utility of the proposed spectral CT imaging method. Experimental results showed that the proposed method correctly differentiates the bony structure, iodine, and the soft tissue in the biological specimen samples. A triple spectra CT scan was also performed to benchmark the performance of the DE-DPC-CT scan. Results demonstrated that the material decomposition from the DE-DPC-CT has a much lower quantification noise than that from the triple spectra CT scan.
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Tao L, Xianhao B, Yuxi Z, Ziwen L, Ziyi X, Zhaoxiang Z, Mingwei W, Yiming L, Ding X, Jiaxuan F, Rui F, Jian Z, Zaiping J. Thoracic aortic computed tomography angiography in swine: establishment of a baseline for endovascular evaluation of the ascending aorta. Interact Cardiovasc Thorac Surg 2020; 31:248-253. [PMID: 32500150 DOI: 10.1093/icvts/ivaa077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/09/2020] [Accepted: 03/18/2020] [Indexed: 12/19/2022] Open
Abstract
AbstractOBJECTIVESOur goal was to establish a baseline of computed tomography (CT) angiographic data for the porcine ascending thoracic aorta for endovascular evaluation of animal experiments and device development.METHODSThoracic aortic CT angiography was conducted on 49 pigs with an average body weight of 60–65 kg. The CT angiographic scans were done on an imaging reconstruction workstation to obtain the specific aortic geometric data, including the diameters of the planes, the heights among the planes and the clock positions of target arteries.RESULTSFourteen important planes were defined in the study for endograft customizing reference. The diameters of the planes were measured, and the heights among the planes were recorded. For endograft fenestrations, the right coronary artery ostium clock position was 100.11 ± 7.29°, and the brachiocephalic trunk ostium clock position was 74.72 ± 6.45°. The best projection angle of the tangent position of the left coronary artery was the right anterior oblique 17 ± 7° position. A pig with a rare congenital giant dilated aorta was found among the candidate experimental animals.CONCLUSIONSFor experimental porcine models, CT angiography has proved to be a suitable imaging technique. The established baseline angiography of the swine can provide reference values for future animal experiments and device development.
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Affiliation(s)
- Li Tao
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Bao Xianhao
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Zhao Yuxi
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Li Ziwen
- Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Xu Ziyi
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
- Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Zeng Zhaoxiang
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Wu Mingwei
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Li Yiming
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Xu Ding
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Feng Jiaxuan
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
- Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Feng Rui
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
- Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Zhou Jian
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
- Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Jing Zaiping
- Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Changhai Hospital, Navy Medical University, Shanghai, China
- Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
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Choi JW, van Rosendael AR, Bax AM, van den Hoogen IJ, Gianni U, Baskaran L, Andreini D, De Cecco CN, Earls J, Ferencik M, Hecht H, Leipsic JA, Maurovich-Horvat P, Nicol E, Pontone G, Raman S, Schoenhagen P, Arbab-Zadeh A, Choi AD, Feuchtner G, Weir-McCall J, Chinnaiyan K, Whelton S, Min JK, Villines TC, Al’Aref SJ. The Journal of Cardiovascular Computed Tomography year in review – 2019. J Cardiovasc Comput Tomogr 2020; 14:107-117. [DOI: 10.1016/j.jcct.2020.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/08/2020] [Indexed: 12/20/2022]
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