Myocardial perfusion imaging with dual energy CT

Kwang Nam Jin; Carlo N De Cecco; Damiano Caruso; Christian Tesche; Adam Spandorfer; Akos Varga-Szemes; U Joseph Schoepf

doi:10.1016/j.ejrad.2016.06.023

Myocardial perfusion imaging with dual energy CT

Eur J Radiol. 2016 Oct;85(10):1914-1921. doi: 10.1016/j.ejrad.2016.06.023. Epub 2016 Jun 30.

Authors

Kwang Nam Jin¹, Carlo N De Cecco², Damiano Caruso³, Christian Tesche⁴, Adam Spandorfer², Akos Varga-Szemes², U Joseph Schoepf⁵

Affiliations

¹ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
² Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
³ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza", Rome, Italy.
⁴ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany.
⁵ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA. Electronic address: schoepf@musc.edu.

PMID: 27427412
DOI: 10.1016/j.ejrad.2016.06.023

Abstract

Dual-energy CT (DECT) enables simultaneous use of two different tube voltages, thus different x-ray absorption characteristics are acquired in the same anatomic location with two different X-ray spectra. The various DECT techniques allow material decomposition and mapping of the iodine distribution within the myocardium. Static dual-energy myocardial perfusion imaging (sCTMPI) using pharmacological stress agents demonstrate myocardial ischemia by single snapshot images of myocardial iodine distribution. sCTMPI gives incremental values to coronary artery stenosis detected on coronary CT angiography (CCTA) by showing consequent reversible or fixed myocardial perfusion defects. The comprehensive acquisition of CCTA and sCTMPI offers extensive morphological and functional evaluation of coronary artery disease. Recent studies have revealed that dual-energy sCTMPI shows promising diagnostic accuracy for the detection of hemodynamically significant coronary artery disease compared to single-photon emission computed tomography, invasive coronary angiography, and cardiac MRI. The aim of this review is to present currently available DECT techniques for static myocardial perfusion imaging and recent clinical applications and ongoing investigations.

Keywords: Coronary CT angiography; Coronary artery disease; Dual-energy CT; Myocardial ischemia; Myocardial perfusion imaging.

Publication types

Review

MeSH terms

Computed Tomography Angiography / methods*
Coronary Angiography / methods*
Coronary Artery Disease / diagnostic imaging*
Humans
Radiography, Dual-Energy Scanned Projection / methods*
Sensitivity and Specificity