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Faga V, Ruiz Cueto M, Viladés Medel D, Moreno-Weidmann Z, Dallaglio PD, Diez Lopez C, Roura G, Guerra JM, Leta Petracca R, Gomez-Hospital JA, Comin Colet J, Anguera I, Di Marco A. Diagnostic and Prognostic Value of Right Ventricular Fat Quantification from Computed Tomography in Arrhythmogenic Right Ventricular Cardiomyopathy. J Clin Med 2024; 13:3674. [PMID: 38999240 PMCID: PMC11242505 DOI: 10.3390/jcm13133674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/15/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
Background: In arrhythmogenic right ventricular cardiomyopathy (ARVC) non-invasive scar evaluation is not included among the diagnostic criteria or the predictors of ventricular arrhythmias (VA) and sudden death (SD). Computed tomography (CT) has excellent spatial resolution and allows a clear distinction between myocardium and fat; thus, it has great potential for the evaluation of myocardial scar in ARVC. Objective: The objective of this study is to evaluate the feasibility, and the diagnostic and prognostic value of semi-automated quantification of right ventricular (RV) fat replacement from CT images. Methods: An observational case-control study was carried out including 23 patients with a definite (19) or borderline (4) ARVC diagnosis and 23 age- and sex-matched controls without structural heart disease. All patients underwent contrast-enhanced cardiac CT. RV images were semi-automatically reconstructed with the ADAS-3D software (ADAS3D Medical, Barcelona, Spain). A fibrofatty scar was defined as values of Hounsfield Units (HU) <-10. Within the scar, a border zone (between -10 HU and -50 HU) and dense scar (<-50 HU) were distinguished. Results: All ARVC patients had an RV scar and all scar-related measurements were significantly higher in ARVC cases than in controls (p < 0.001). The total scar area and dense scar area showed no overlapping values between cases and controls, achieving perfect diagnostic performance (sensitivity and specificity of 100%). Among ARVC patients, 16 (70%) had experienced sustained VA or aborted SD. Among all clinical, ECG and imaging parameters, the dense scar area was the only one with a statistically significant association with VA and SD (p = 0.003). Conclusions: In ARVC, RV myocardial fat quantification from CT is feasible and may have considerable diagnostic and prognostic value.
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Affiliation(s)
- Valentina Faga
- Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
- BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d’Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - María Ruiz Cueto
- Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - David Viladés Medel
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Cardiac Imaging Unit, Hospital de la Creu Blanca, 08034 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | | | - Paolo D. Dallaglio
- Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
- BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d’Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Carles Diez Lopez
- Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
- BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d’Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Gerard Roura
- Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
- BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d’Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Jose M. Guerra
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
- Institut de Recerca Sant Pau, 08041 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Rubén Leta Petracca
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Cardiac Imaging Unit, Hospital de la Creu Blanca, 08034 Barcelona, Spain
| | - Joan Antoni Gomez-Hospital
- Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
- BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d’Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Josep Comin Colet
- Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
- BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d’Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
- Innovation, Research and Universities Department, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, Hospitalet de Llobregat, 08907 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, 08007 Barcelona, Spain
| | - Ignasi Anguera
- Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
- BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d’Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Andrea Di Marco
- Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
- BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d’Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
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Birnbacher L, Braig EM, Pfeiffer D, Pfeiffer F, Herzen J. Quantitative X-ray phase contrast computed tomography with grating interferometry : Biomedical applications of quantitative X-ray grating-based phase contrast computed tomography. Eur J Nucl Med Mol Imaging 2021; 48:4171-4188. [PMID: 33846846 PMCID: PMC8566444 DOI: 10.1007/s00259-021-05259-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/11/2021] [Indexed: 11/25/2022]
Abstract
The ability of biomedical imaging data to be of quantitative nature is getting increasingly important with the ongoing developments in data science. In contrast to conventional attenuation-based X-ray imaging, grating-based phase contrast computed tomography (GBPC-CT) is a phase contrast micro-CT imaging technique that can provide high soft tissue contrast at high spatial resolution. While there is a variety of different phase contrast imaging techniques, GBPC-CT can be applied with laboratory X-ray sources and enables quantitative determination of electron density and effective atomic number. In this review article, we present quantitative GBPC-CT with the focus on biomedical applications.
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Affiliation(s)
- Lorenz Birnbacher
- Physics Department, Munich School of Bioengineering, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Eva-Maria Braig
- Physics Department, Munich School of Bioengineering, Technical University of Munich, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Franz Pfeiffer
- Physics Department, Munich School of Bioengineering, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Julia Herzen
- Physics Department, Munich School of Bioengineering, Technical University of Munich, Munich, Germany.
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Notohamiprodjo S, Treitl KM, Hauke C, Sutter SM, Auweter S, Pfeiffer F, Reiser MF, Hellbach K. Imaging characteristics of intravascular spherical contrast agents for grating-based x-ray dark-field imaging – effects of concentrations, spherical sizes and applied voltage. Sci Rep 2020; 10:9405. [PMID: 32523085 PMCID: PMC7287139 DOI: 10.1038/s41598-020-66395-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 05/14/2020] [Indexed: 11/09/2022] Open
Abstract
AbstractThis study investigates the x-ray scattering characteristics of microsphere particles in x-ray-grating-based interferometric imaging at different concentrations, bubble sizes and tube voltages (kV). Attenuation (ATI), dark-field (DFI) and phase-contrast (PCI) images were acquired. Signal-to-noise (SNR) and contrast-to-noise ratios with water (CNRw) and air as reference (CNRa) were determined. In all modalities, a linear relationship between SNR and microbubbles concentration, respectively, microsphere size was found. A significant gain of SNR was found when varying kV. SNR was significantly higher in DFI and PCI than ATI. The highest gain of SNR was shown at 60 kV for all media in ATI and DFI, at 80 kV for PCI. SNR for all media was significantly higher compared to air and was slightly lower compared to water. A linear relationship was found between CNRa, CNRw, concentration and size. With increasing concentration and decreasing size, CNRa and CNRw increased in DFI, but decreased in PCI. Best CNRa and CNRw was found at specific combination of kV and concentration/size. Highest average CNRa and CNRw was found for microspheres in ATI and PCI, for microbubbles in DFI. Microspheres are a promising contrast-media for grating-based-interferometry, if kV, microsphere size and concentration are appropriately combined.
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Sun M, Lv W, Zhao X, Qin L, Zhao Y, Xin X, Jian J, Chen X, Hu C. Vascular branching geometry relating to portal hypertension: a study of liver microvasculature in cirrhotic rats by X-ray phase-contrast computed tomography. Quant Imaging Med Surg 2020; 10:116-127. [PMID: 31956535 DOI: 10.21037/qims.2019.11.04] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Portal hypertension is one of the major complications of cirrhosis. The changes in hepatic microvasculature are considered as critical pathophysiological characteristics of portal hypertension. X-ray phase-contrast computed tomography (PCCT) is a new imaging technique that can detect liver vessels at a micrometric level without contrast agents. Methods In this study, male Sprague-Dawley rats with liver cirrhosis induced by carbon tetrachloride (CCl4) or bile duct ligation (BDL) were investigated with PCCT. The portal pressures of rats were recorded before euthanasia. The branch angle and Murray's deviation (MD) were measured based on the branching geometry of the three-dimensional (3D) microvasculature of liver cirrhosis in rats. Statistical analyses were performed to determine the correlation between branching geometry and portal pressure in liver fibrosis. Results The results demonstrated that the branch angle and MD significantly increased in the CCl4 model and BDL model compared with their corresponding normal group or sham group. The portal pressure was significantly correlated with the branching morphologic features (all R≥0.761 and P<0.01). Conclusions The branch angle and MD could accurately distinguish portal pressure in cirrhotic rats, suggesting that branching geometric characteristics of the microvasculature may be a promising marker in the prognosis of portal hypertension in liver cirrhosis.
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Affiliation(s)
- Mengyu Sun
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin 300070, China
| | - Wenjuan Lv
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin 300070, China
| | - Xinyan Zhao
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Lili Qin
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin 300070, China
| | - Yuqing Zhao
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin 300070, China
| | - Xiaohong Xin
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin 300070, China
| | - Jianbo Jian
- Radiation Oncology Department, Tianjin Medical University General Hospital, Tianjin 300070, China
| | - Xiaodong Chen
- Key Laboratory of Optoelectronic Information Technology, Ministry of Education (Tianjin University), Tianjin 300072, China
| | - Chunhong Hu
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin 300070, China
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