Dual-contrast agent photon-counting computed tomography of the heart: initial experience

Rolf Symons, Tyler E. Cork, Manu N. Lakshmanan, Robert Evers, Cynthia Davies-Venn, Kelly A. Rice, Marvin L. Thomas, Chia Ying Liu, Steffen Kappler, Stefan Ulzheimer, Veit Sandfort, David A. Bluemke, Amir Pourmorteza

Research output: Contribution to journalArticle

Abstract

To determine the feasibility of dual—contrast agent imaging of the heart using photon-counting detector (PCD) computed tomography (CT) to simultaneously assess both first-pass and late enhancement of the myocardium. An occlusion-reperfusion canine model of myocardial infarction was used. Gadolinium-based contrast was injected 10 min prior to PCD CT. Iodinated contrast was infused immediately prior to PCD CT, thus capturing late gadolinium enhancement as well as first-pass iodine enhancement. Gadolinium and iodine maps were calculated using a linear material decomposition technique and compared to single-energy (conventional) images. PCD images were compared to in vivo and ex vivo magnetic resonance imaging (MRI) and histology. For infarct versus remote myocardium, contrast-to-noise ratio (CNR) was maximal on late enhancement gadolinium maps (CNR 9.0 ± 0.8, 6.6 ± 0.7, and 0.4 ± 0.4, p < 0.001 for gadolinium maps, single-energy images, and iodine maps, respectively). For infarct versus blood pool, CNR was maximum for iodine maps (CNR 11.8 ± 1.3, 3.8 ± 1.0, and 1.3 ± 0.4, p < 0.001 for iodine maps, gadolinium maps, and single-energy images, respectively). Combined first-pass iodine and late gadolinium maps allowed quantitative separation of blood pool, scar, and remote myocardium. MRI and histology analysis confirmed accurate PCD CT delineation of scar. Simultaneous multi-contrast agent cardiac imaging is feasible with photon-counting detector CT. These initial proof-of-concept results may provide incentives to develop new k-edge contrast agents, to investigate possible interactions between multiple simultaneously administered contrast agents, and to ultimately bring them to clinical practice.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalInternational Journal of Cardiovascular Imaging
DOIs
StateAccepted/In press - Mar 13 2017
Externally publishedYes

Fingerprint

Gadolinium
Photons
Contrast Media
Iodine
Tomography
Noise
Myocardium
Cicatrix
Histology
Magnetic Resonance Imaging
Reperfusion
Canidae
Motivation
Myocardial Infarction

Keywords

  • Cardiac imaging techniques
  • Computed tomography
  • Contrast media
  • Myocardial infarction
  • Photon-counting CT
  • Spectral CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Symons, R., Cork, T. E., Lakshmanan, M. N., Evers, R., Davies-Venn, C., Rice, K. A., ... Pourmorteza, A. (Accepted/In press). Dual-contrast agent photon-counting computed tomography of the heart: initial experience. International Journal of Cardiovascular Imaging, 1-9. https://doi.org/10.1007/s10554-017-1104-4

Dual-contrast agent photon-counting computed tomography of the heart : initial experience. / Symons, Rolf; Cork, Tyler E.; Lakshmanan, Manu N.; Evers, Robert; Davies-Venn, Cynthia; Rice, Kelly A.; Thomas, Marvin L.; Liu, Chia Ying; Kappler, Steffen; Ulzheimer, Stefan; Sandfort, Veit; Bluemke, David A.; Pourmorteza, Amir.

In: International Journal of Cardiovascular Imaging, 13.03.2017, p. 1-9.

Research output: Contribution to journalArticle

Symons, R, Cork, TE, Lakshmanan, MN, Evers, R, Davies-Venn, C, Rice, KA, Thomas, ML, Liu, CY, Kappler, S, Ulzheimer, S, Sandfort, V, Bluemke, DA & Pourmorteza, A 2017, 'Dual-contrast agent photon-counting computed tomography of the heart: initial experience', International Journal of Cardiovascular Imaging, pp. 1-9. https://doi.org/10.1007/s10554-017-1104-4
Symons, Rolf ; Cork, Tyler E. ; Lakshmanan, Manu N. ; Evers, Robert ; Davies-Venn, Cynthia ; Rice, Kelly A. ; Thomas, Marvin L. ; Liu, Chia Ying ; Kappler, Steffen ; Ulzheimer, Stefan ; Sandfort, Veit ; Bluemke, David A. ; Pourmorteza, Amir. / Dual-contrast agent photon-counting computed tomography of the heart : initial experience. In: International Journal of Cardiovascular Imaging. 2017 ; pp. 1-9.
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