Aquino Gilberto J, O'Doherty Jim, Schoepf U Joseph, Ellison Benjamin, Byrne Jordan, Fink Nicola, Zsarnoczay Emese, Wolf Elias V, Allmendinger Thomas, Schmidt Bernhard, Flohr Thomas, Baruah Dhiraj, Suranyi Pal, Varga-Szemes Akos, Emrich Tilman
From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260 (G.J.A., U.J.S., B.E., J.B., N.F., E.Z., E.V.W., D.B., P.S., A.V.S., T.E.); Department of Radiology, Upstate University Hospital, Syracuse, NY (G.J.A.); Siemens Medical Solutions, Malvern, Pa (J.O.); Department of Radiology, University Hospital LMU Munich, Munich, Germany (N.F.); Siemens Healthineers, Forchheim, Germany (T.A., B.S., T.F.); Department of Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany (T.E.); and German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany (T.E.).
Radiology. 2023 Apr;307(2):e222030. doi: 10.1148/radiol.222030. Epub 2023 Jan 31.
Background Photon-counting detector (PCD) CT provides comprehensive spectral data with every acquisition, but studies evaluating myocardial extracellular volume (ECV) quantification with use of PCD CT compared with an MRI reference remain lacking. Purpose To compare ECV quantification for myocardial tissue characterization between a first-generation PCD CT system and cardiac MRI. Materials and Methods In this single-center prospective study, adults without contraindication to iodine-based contrast media underwent same-day cardiac PCD CT and MRI with native and postcontrast T1 mapping and late gadolinium enhancement for various clinical indications for cardiac MRI (the reference standard) between July 2021 and January 2022. Global and midventricular ECV were assessed with use of three methods: single-energy PCD CT, dual-energy PCD CT, and MRI T1 mapping. Quantitative comparisons among all techniques were performed. Correlation and reliability between different methods of ECV quantification were assessed with use of the Pearson correlation coefficient () and the intraclass correlation coefficient. Results The final sample included 29 study participants (mean age ± SD, 54 years ± 17; 15 men). There was a strong correlation of ECV between dual- and single-energy PCD CT ( = 0.91, < .001). Radiation dose was 40% lower with dual-energy versus single-energy PCD CT (volume CT dose index, 10.1 mGy vs 16.8 mGy, respectively; < .001). In comparison with MRI, dual-energy PCD CT showed strong correlation ( = 0.82 and 0.91, both < .001) and good to excellent reliability (intraclass correlation coefficients, 0.81 and 0.90) for midventricular and global ECV quantification, but it overestimated ECV by approximately 2%. Single-energy PCD CT showed similar relationship with MRI but underestimated ECV by 3%. Conclusion Myocardial tissue characterization with photon-counting detector CT-based quantitative extracellular volume analysis showed a strong correlation to MRI. © RSNA, 2023
背景 光子计数探测器（PCD）CT每次采集都能提供全面的光谱数据，但与MRI参考值相比，评估使用PCD CT定量心肌细胞外容积（ECV）的研究仍然缺乏。目的 比较第一代PCD CT系统与心脏MRI在心肌组织特征ECV定量方面的差异。材料与方法 在这项单中心前瞻性研究中，2021年7月至2022年1月期间，对无碘对比剂禁忌证的成年人进行了当日心脏PCD CT和MRI检查，包括平扫及增强后T1 mapping以及钆延迟强化成像，用于心脏MRI的各种临床指征（参考标准）。使用三种方法评估整体和心室中部的ECV：单能量PCD CT、双能量PCD CT和MRI T1 mapping。对所有技术进行了定量比较。使用Pearson相关系数（）和组内相关系数评估不同ECV定量方法之间的相关性和可靠性。结果 最终样本包括29名研究参与者（平均年龄±标准差，54岁±17岁；15名男性）。双能量和单能量PCD CT之间的ECV有很强的相关性（=0.91，<.001）。双能量PCD CT的辐射剂量比单能量PCD CT低40%（容积CT剂量指数分别为10.1 mGy和16.8 mGy；<.001）。与MRI相比，双能量PCD CT在心室中部和整体ECV定量方面显示出很强的相关性（=0.82和0.91，均<.001）和良好至极好的可靠性（组内相关系数分别为0.81和0.90），但它高估了ECV约2%。单能量PCD CT与MRI显示出相似的关系，但低估了ECV 3%。结论 基于光子计数探测器CT的定量细胞外容积分析对心肌组织特征的评估与MRI有很强的相关性。©RSNA，2023
