An approach to evaluate myocardial perfusion defect assessment for projection-based DECT: A phantom study
- Authors
- Han, Donghee; Shah, Sunny; Lee, Ji Hyun; Elmore, Kimberly; Gransar, Heidi; Danad, Ibrahim; Kumar, Vidhya; Raman, Subha; Hartaigh, Bríain Ó; Dunham, Simon; Lin, Fay Y; Min, James K.
- Issue Date
- Jul-2020
- Publisher
- ELSEVIER SCIENCE INC
- Keywords
- Computed tomography; Dual energy; Material decomposition; Monochromatic; Myocardial perfusion imaging; Phantom
- Citation
- CLINICAL IMAGING, pp.10 - 15
- Indexed
- SCIE
SCOPUS
- Journal Title
- CLINICAL IMAGING
- Start Page
- 10
- End Page
- 15
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/191571
- DOI
- 10.1016/j.clinimag.2019.09.016
- ISSN
- 0899-7071
- Abstract
- Introduction: Dual-energy CT (DECT) can improve the accuracy of myocardial perfusion CT with projection-based monochromatic (DECT-MCE) and quantification of myocardial iodine in material decomposition (DECT-MD) reconstructions. However, evaluation of multiple reconstructions is laborious and the optimal reconstruction to detect myocardial perfusion defects is unknown. Methods: Left ventricular (LV) phantoms with artificial perfusion defects were scanned using DECT and single energy cardiac computed tomography angiography (SECT). Reconstructions of DECT-MCE at 40, 70, 100 and 140 keV, DECT-MD pairs of water, iodine, iron and fat, and SECT were evaluated using a 17-segment myocardial model. The diagnostic performance of each reconstruction was calculated on a per-segment basis and compared across DECT reconstructions. Results: Over 34 phantoms with artificial perfusion defects were found in 64/578 (11%) of segments, the sensitivity of DECT-MCE at 40, 70, 100, and 140 keV was 100% (95% confidence interval (CI): 93–100), 100% (95% CI: 93–100), 71% (95% CI: 56–83), and 25% (95% CI: 14–40), respectively, with a significant decline between 70 keV and 100 keV (p < 0.001). The specificity of DECT-MCE was 100% at all energies (95% CI: 99–100). As a group, the DECT-MD iodine background reconstructions had significantly lower sensitivity than the remaining modes (2.1% [95% CI, 0.05–11.1], vs. 100% [95% CI, 92.6–100], p < 0.001). Specificity of all material pair modes remained 100%. Conclusions: Using LV phantom models, the approach with the best sensitivity and specificity to assess myocardial perfusion defects with DECT are reconstructions of DECT-MCE at 40 or 70 KeV and DECT-MD without iodine background.
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