Myocardial extracellular volume fraction with dual-energy equilibrium contrast-Enhanced cardiac ct in nonischemic cardiomyopathy: A prospective comparison with cardiac MR imaging

Hye Jeong Lee, Dong Jin Im, Jong Chan Youn, Suyon Chang, Young Joo Suh, Yoo Jin Hong, Young Jin Kim, Jin Hur, Byoung Wook Choi

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Abstract

To evaluate the feasibility of equilibrium contrast material-enhanced dual-energy cardiac computed tomography (CT) to determine extracellular volume fraction (ECV) in nonischemic cardiomyopathy (CMP) compared with magnetic resonance (MR) imaging. Materials and Methods: This study was approved by the institutional review board; informed consent was obtained. Seven healthy subjects and 23 patients (six with hypertrophic CMP, nine with dilated CMP, four with amyloidosis, and four with sarcoidosis) (mean age ± standard deviation, 57.33 years ± 14.82; 19 male participants [63.3%]) were prospectively enrolled. Twelve minutes after contrast material injection (1.8 mL/kg at 3 mL/sec), dualenergy cardiac CT was performed. ECV was measured by two observers independently. Hematocrit levels were compared between healthy subjects and patients with the Mann-Whitney U test. In per-subject analysis, interobserver agreement for CT was assessed with the intraclass correlation coefficient (ICC), and intertest agreement between MR imaging and CT was assessed with Bland-Altman analysis. In per-segment analysis, Student t tests in the linear mixed model were used to compare ECV on CT images between healthy subjects and patients. Results: Hematocrit level was 43.44% ± 1.80 for healthy subjects and 41.23% ± 5.61 for patients with MR imaging (P = .16) and 43.50% ± 1.92 for healthy subjects and 41.35% ± 5.92 for patients with CT (P = .15). For observer 1 in per-subject analysis, ECV was 34.18% ± 8.98 for MR imaging and 34.48% ± 8.97 for CT. For observer 2, myocardial ECV was 34.42% ± 9.03 for MR imaging and 33.98% ± 9.05 for CT. Interobserver agreement for ECV at CT was excellent (ICC = 0.987). Bland- Altman analysis between MR imaging and CT showed a small bias (20.06%), with 95% limits of agreement of 21.19 and 1.79. Compared with healthy subjects, patients with hypertrophic CMP, dilated CMP, amyloidosis, and sarcoidosis had significantly higher myocardial ECV at dual-energy equilibrium contrast- enhanced cardiac CT (all P< .01) in per-segment analysis. Conclusion: Myocardial ECV with dual-energy equilibrium contrast-enhanced CT showed good agreement with MR imaging findings, suggesting the potential of myocardial tissue characterization with CT.

Original languageEnglish
Pages (from-to)49-57
Number of pages9
JournalRadiology
Volume280
Issue number1
DOIs
Publication statusPublished - 2016 Jul

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Cardiomyopathies
Tomography
Magnetic Resonance Imaging
Healthy Volunteers
Hypertrophic Cardiomyopathy
Dilated Cardiomyopathy
Amyloidosis
Sarcoidosis
Hematocrit
Contrast Media
Research Ethics Committees
Nonparametric Statistics
Informed Consent
Linear Models
Students

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Lee, Hye Jeong ; Im, Dong Jin ; Youn, Jong Chan ; Chang, Suyon ; Suh, Young Joo ; Hong, Yoo Jin ; Kim, Young Jin ; Hur, Jin ; Choi, Byoung Wook. / Myocardial extracellular volume fraction with dual-energy equilibrium contrast-Enhanced cardiac ct in nonischemic cardiomyopathy : A prospective comparison with cardiac MR imaging. In: Radiology. 2016 ; Vol. 280, No. 1. pp. 49-57.
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title = "Myocardial extracellular volume fraction with dual-energy equilibrium contrast-Enhanced cardiac ct in nonischemic cardiomyopathy: A prospective comparison with cardiac MR imaging",
abstract = "To evaluate the feasibility of equilibrium contrast material-enhanced dual-energy cardiac computed tomography (CT) to determine extracellular volume fraction (ECV) in nonischemic cardiomyopathy (CMP) compared with magnetic resonance (MR) imaging. Materials and Methods: This study was approved by the institutional review board; informed consent was obtained. Seven healthy subjects and 23 patients (six with hypertrophic CMP, nine with dilated CMP, four with amyloidosis, and four with sarcoidosis) (mean age ± standard deviation, 57.33 years ± 14.82; 19 male participants [63.3{\%}]) were prospectively enrolled. Twelve minutes after contrast material injection (1.8 mL/kg at 3 mL/sec), dualenergy cardiac CT was performed. ECV was measured by two observers independently. Hematocrit levels were compared between healthy subjects and patients with the Mann-Whitney U test. In per-subject analysis, interobserver agreement for CT was assessed with the intraclass correlation coefficient (ICC), and intertest agreement between MR imaging and CT was assessed with Bland-Altman analysis. In per-segment analysis, Student t tests in the linear mixed model were used to compare ECV on CT images between healthy subjects and patients. Results: Hematocrit level was 43.44{\%} ± 1.80 for healthy subjects and 41.23{\%} ± 5.61 for patients with MR imaging (P = .16) and 43.50{\%} ± 1.92 for healthy subjects and 41.35{\%} ± 5.92 for patients with CT (P = .15). For observer 1 in per-subject analysis, ECV was 34.18{\%} ± 8.98 for MR imaging and 34.48{\%} ± 8.97 for CT. For observer 2, myocardial ECV was 34.42{\%} ± 9.03 for MR imaging and 33.98{\%} ± 9.05 for CT. Interobserver agreement for ECV at CT was excellent (ICC = 0.987). Bland- Altman analysis between MR imaging and CT showed a small bias (20.06{\%}), with 95{\%} limits of agreement of 21.19 and 1.79. Compared with healthy subjects, patients with hypertrophic CMP, dilated CMP, amyloidosis, and sarcoidosis had significantly higher myocardial ECV at dual-energy equilibrium contrast- enhanced cardiac CT (all P< .01) in per-segment analysis. Conclusion: Myocardial ECV with dual-energy equilibrium contrast-enhanced CT showed good agreement with MR imaging findings, suggesting the potential of myocardial tissue characterization with CT.",
author = "Lee, {Hye Jeong} and Im, {Dong Jin} and Youn, {Jong Chan} and Suyon Chang and Suh, {Young Joo} and Hong, {Yoo Jin} and Kim, {Young Jin} and Jin Hur and Choi, {Byoung Wook}",
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pages = "49--57",
journal = "Radiology",
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Myocardial extracellular volume fraction with dual-energy equilibrium contrast-Enhanced cardiac ct in nonischemic cardiomyopathy : A prospective comparison with cardiac MR imaging. / Lee, Hye Jeong; Im, Dong Jin; Youn, Jong Chan; Chang, Suyon; Suh, Young Joo; Hong, Yoo Jin; Kim, Young Jin; Hur, Jin; Choi, Byoung Wook.

In: Radiology, Vol. 280, No. 1, 07.2016, p. 49-57.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Myocardial extracellular volume fraction with dual-energy equilibrium contrast-Enhanced cardiac ct in nonischemic cardiomyopathy

T2 - A prospective comparison with cardiac MR imaging

AU - Lee, Hye Jeong

AU - Im, Dong Jin

AU - Youn, Jong Chan

AU - Chang, Suyon

AU - Suh, Young Joo

AU - Hong, Yoo Jin

AU - Kim, Young Jin

AU - Hur, Jin

AU - Choi, Byoung Wook

PY - 2016/7

Y1 - 2016/7

N2 - To evaluate the feasibility of equilibrium contrast material-enhanced dual-energy cardiac computed tomography (CT) to determine extracellular volume fraction (ECV) in nonischemic cardiomyopathy (CMP) compared with magnetic resonance (MR) imaging. Materials and Methods: This study was approved by the institutional review board; informed consent was obtained. Seven healthy subjects and 23 patients (six with hypertrophic CMP, nine with dilated CMP, four with amyloidosis, and four with sarcoidosis) (mean age ± standard deviation, 57.33 years ± 14.82; 19 male participants [63.3%]) were prospectively enrolled. Twelve minutes after contrast material injection (1.8 mL/kg at 3 mL/sec), dualenergy cardiac CT was performed. ECV was measured by two observers independently. Hematocrit levels were compared between healthy subjects and patients with the Mann-Whitney U test. In per-subject analysis, interobserver agreement for CT was assessed with the intraclass correlation coefficient (ICC), and intertest agreement between MR imaging and CT was assessed with Bland-Altman analysis. In per-segment analysis, Student t tests in the linear mixed model were used to compare ECV on CT images between healthy subjects and patients. Results: Hematocrit level was 43.44% ± 1.80 for healthy subjects and 41.23% ± 5.61 for patients with MR imaging (P = .16) and 43.50% ± 1.92 for healthy subjects and 41.35% ± 5.92 for patients with CT (P = .15). For observer 1 in per-subject analysis, ECV was 34.18% ± 8.98 for MR imaging and 34.48% ± 8.97 for CT. For observer 2, myocardial ECV was 34.42% ± 9.03 for MR imaging and 33.98% ± 9.05 for CT. Interobserver agreement for ECV at CT was excellent (ICC = 0.987). Bland- Altman analysis between MR imaging and CT showed a small bias (20.06%), with 95% limits of agreement of 21.19 and 1.79. Compared with healthy subjects, patients with hypertrophic CMP, dilated CMP, amyloidosis, and sarcoidosis had significantly higher myocardial ECV at dual-energy equilibrium contrast- enhanced cardiac CT (all P< .01) in per-segment analysis. Conclusion: Myocardial ECV with dual-energy equilibrium contrast-enhanced CT showed good agreement with MR imaging findings, suggesting the potential of myocardial tissue characterization with CT.

AB - To evaluate the feasibility of equilibrium contrast material-enhanced dual-energy cardiac computed tomography (CT) to determine extracellular volume fraction (ECV) in nonischemic cardiomyopathy (CMP) compared with magnetic resonance (MR) imaging. Materials and Methods: This study was approved by the institutional review board; informed consent was obtained. Seven healthy subjects and 23 patients (six with hypertrophic CMP, nine with dilated CMP, four with amyloidosis, and four with sarcoidosis) (mean age ± standard deviation, 57.33 years ± 14.82; 19 male participants [63.3%]) were prospectively enrolled. Twelve minutes after contrast material injection (1.8 mL/kg at 3 mL/sec), dualenergy cardiac CT was performed. ECV was measured by two observers independently. Hematocrit levels were compared between healthy subjects and patients with the Mann-Whitney U test. In per-subject analysis, interobserver agreement for CT was assessed with the intraclass correlation coefficient (ICC), and intertest agreement between MR imaging and CT was assessed with Bland-Altman analysis. In per-segment analysis, Student t tests in the linear mixed model were used to compare ECV on CT images between healthy subjects and patients. Results: Hematocrit level was 43.44% ± 1.80 for healthy subjects and 41.23% ± 5.61 for patients with MR imaging (P = .16) and 43.50% ± 1.92 for healthy subjects and 41.35% ± 5.92 for patients with CT (P = .15). For observer 1 in per-subject analysis, ECV was 34.18% ± 8.98 for MR imaging and 34.48% ± 8.97 for CT. For observer 2, myocardial ECV was 34.42% ± 9.03 for MR imaging and 33.98% ± 9.05 for CT. Interobserver agreement for ECV at CT was excellent (ICC = 0.987). Bland- Altman analysis between MR imaging and CT showed a small bias (20.06%), with 95% limits of agreement of 21.19 and 1.79. Compared with healthy subjects, patients with hypertrophic CMP, dilated CMP, amyloidosis, and sarcoidosis had significantly higher myocardial ECV at dual-energy equilibrium contrast- enhanced cardiac CT (all P< .01) in per-segment analysis. Conclusion: Myocardial ECV with dual-energy equilibrium contrast-enhanced CT showed good agreement with MR imaging findings, suggesting the potential of myocardial tissue characterization with CT.

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