Optimal Timing of Image Acquisition for Arterial First Pass CT Myocardial Perfusion Imaging
Highlights • Optimal timing of static, single-shot CT perfusion scans is important to differentiate ischemic from non-ischemic myocardial segments. • Time delay between reaching 150 and 250 HU thresholds in the ascending aorta and optimal contrast in the myocardium are 4 and 2 s, respectively. • Att...
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| Published in | European journal of radiology Vol. 86; pp. 227 - 233 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Elsevier B.V
01.01.2017
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| Abstract | Highlights • Optimal timing of static, single-shot CT perfusion scans is important to differentiate ischemic from non-ischemic myocardial segments. • Time delay between reaching 150 and 250 HU thresholds in the ascending aorta and optimal contrast in the myocardium are 4 and 2 s, respectively. • Attenuation difference of more than 15 HU between normal and ischemic myocardium is present during approximately 8 s. |
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| AbstractList | •Optimal timing of static, single-shot CT perfusion scans is important to differentiate ischemic from non-ischemic myocardial segments.•Time delay between reaching 150 and 250 HU thresholds in the ascending aorta and optimal contrast in the myocardium are 4 and 2s, respectively.•Attenuation difference of more than 15 HU between normal and ischemic myocardium is present during approximately 8s.
To determine the optimal timing of arterial first pass computed tomography (CT) myocardial perfusion imaging (CTMPI) based on dynamic CTMPI acquisitions.
Twenty-five patients (59±8.4years, 14 male)underwent adenosine-stress dynamic CTMPI on second-generation dual-source CT in shuttle mode (30s at 100kV and 300mAs). Stress perfusion magnetic resonance imaging (MRI) was used as reference standard for differentiation of non-ischemic and ischemic segments. The left ventricle (LV) wall was manually segmented according to the AHA 16-segment model. Hounsfield units (HU) in myocardial segments and ascending (AA) and descending aorta (AD) were monitored over time. Time difference between peak AA and peak AD and peak myocardial enhancement was calculated, as well as the, time delay from fixed HU thresholds of 150 and 250 HU in the AA and AD to a minimal difference of 15 HU between normal and ischemic segments. Furthermore, the duration of the 15 HU difference between ischemic and non-ischemic segments was calculated.
Myocardial ischemia was observed by MRI in 10 patients (56.3±9.0years; 8 male). The delay between the maximum HU in the AA and AD and maximal HU in the non-ischemic segments was 2.8s [2.2–4.3] and 0.0s [0.0–2.8], respectively. Differentiation between ischemic and non-ischemic myocardial segments in CT was best during a time window of 8.6±3.8s. Time delays for AA triggering were 4.5s [2.2–5.6] and 2.2s [0–2.8] for the 150 HU and 250 HU thresholds, respectively. While for AD triggering, time delays were 2.4s [0.0–4.8] and 0.0s [−2.2–2.6] for the 150 HU and 250 HU thresholds, respectively.
In CTMPI, the differentiation between normal and ischemic myocardium is best accomplished during a time interval of 8.6±3.8s. This time window can be utilized by a test bolus or bolus tracking in the AA or AD using the time delays identified here. Highlights • Optimal timing of static, single-shot CT perfusion scans is important to differentiate ischemic from non-ischemic myocardial segments. • Time delay between reaching 150 and 250 HU thresholds in the ascending aorta and optimal contrast in the myocardium are 4 and 2 s, respectively. • Attenuation difference of more than 15 HU between normal and ischemic myocardium is present during approximately 8 s. To determine the optimal timing of arterial first pass computed tomography (CT) myocardial perfusion imaging (CTMPI) based on dynamic CTMPI acquisitions. Twenty-five patients (59±8.4years, 14 male)underwent adenosine-stress dynamic CTMPI on second-generation dual-source CT in shuttle mode (30s at 100kV and 300mAs). Stress perfusion magnetic resonance imaging (MRI) was used as reference standard for differentiation of non-ischemic and ischemic segments. The left ventricle (LV) wall was manually segmented according to the AHA 16-segment model. Hounsfield units (HU) in myocardial segments and ascending (AA) and descending aorta (AD) were monitored over time. Time difference between peak AA and peak AD and peak myocardial enhancement was calculated, as well as the, time delay from fixed HU thresholds of 150 and 250 HU in the AA and AD to a minimal difference of 15 HU between normal and ischemic segments. Furthermore, the duration of the 15 HU difference between ischemic and non-ischemic segments was calculated. Myocardial ischemia was observed by MRI in 10 patients (56.3±9.0years; 8 male). The delay between the maximum HU in the AA and AD and maximal HU in the non-ischemic segments was 2.8s [2.2-4.3] and 0.0s [0.0-2.8], respectively. Differentiation between ischemic and non-ischemic myocardial segments in CT was best during a time window of 8.6±3.8s. Time delays for AA triggering were 4.5s [2.2-5.6] and 2.2s [0-2.8] for the 150 HU and 250 HU thresholds, respectively. While for AD triggering, time delays were 2.4s [0.0-4.8] and 0.0s [-2.2-2.6] for the 150 HU and 250 HU thresholds, respectively. In CTMPI, the differentiation between normal and ischemic myocardium is best accomplished during a time interval of 8.6±3.8s. This time window can be utilized by a test bolus or bolus tracking in the AA or AD using the time delays identified here. PURPOSETo determine the optimal timing of arterial first pass computed tomography (CT) myocardial perfusion imaging (CTMPI) based on dynamic CTMPI acquisitions.METHODS AND MATERIALSTwenty-five patients (59±8.4years, 14 male)underwent adenosine-stress dynamic CTMPI on second-generation dual-source CT in shuttle mode (30s at 100kV and 300mAs). Stress perfusion magnetic resonance imaging (MRI) was used as reference standard for differentiation of non-ischemic and ischemic segments. The left ventricle (LV) wall was manually segmented according to the AHA 16-segment model. Hounsfield units (HU) in myocardial segments and ascending (AA) and descending aorta (AD) were monitored over time. Time difference between peak AA and peak AD and peak myocardial enhancement was calculated, as well as the, time delay from fixed HU thresholds of 150 and 250 HU in the AA and AD to a minimal difference of 15 HU between normal and ischemic segments. Furthermore, the duration of the 15 HU difference between ischemic and non-ischemic segments was calculated.RESULTSMyocardial ischemia was observed by MRI in 10 patients (56.3±9.0years; 8 male). The delay between the maximum HU in the AA and AD and maximal HU in the non-ischemic segments was 2.8s [2.2-4.3] and 0.0s [0.0-2.8], respectively. Differentiation between ischemic and non-ischemic myocardial segments in CT was best during a time window of 8.6±3.8s. Time delays for AA triggering were 4.5s [2.2-5.6] and 2.2s [0-2.8] for the 150 HU and 250 HU thresholds, respectively. While for AD triggering, time delays were 2.4s [0.0-4.8] and 0.0s [-2.2-2.6] for the 150 HU and 250 HU thresholds, respectively.CONCLUSIONIn CTMPI, the differentiation between normal and ischemic myocardium is best accomplished during a time interval of 8.6±3.8s. This time window can be utilized by a test bolus or bolus tracking in the AA or AD using the time delays identified here. |
| Author | Slump, C.H Fuller, S.R Nieuwenhuis, E Oudkerk, M Pelgrim, G.J Duguay, T.M van de Geest, R Varga-Szemes, A Schoepf, U.J Vliegenthart, R |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28027752$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1186_s41747_019_0093_6 crossref_primary_10_3348_kjr_2019_0327 crossref_primary_10_22468_cvia_2018_00031 crossref_primary_10_1016_j_ejrad_2021_110139 crossref_primary_10_1080_14779072_2017_1359087 crossref_primary_10_1186_s41747_020_00158_1 crossref_primary_10_1097_MD_0000000000020804 crossref_primary_10_1088_1361_6498_ad1fe1 |
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| Keywords | coronary artery disease magnetic resonance imaging myocardial perfusion imaging MRI left ventricle MPI multiplanar reformat reconstructions invasive coronary angiography LV HU SPECT MPR electrocardiography CCTA Computed tomography Ischemia Tomography Iodine AA ROIs Hounsfield unit AD coronary computed tomography angiography X-Ray Computed ICA regions of interest CAD single photon emission computed tomography ECG time-attenuation curves American Heart Association CT descending aorta TAC AHA ascending aorta Myocardial perfusion imaging X-Ray computed |
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| Snippet | Highlights • Optimal timing of static, single-shot CT perfusion scans is important to differentiate ischemic from non-ischemic myocardial segments. • Time... •Optimal timing of static, single-shot CT perfusion scans is important to differentiate ischemic from non-ischemic myocardial segments.•Time delay between... To determine the optimal timing of arterial first pass computed tomography (CT) myocardial perfusion imaging (CTMPI) based on dynamic CTMPI acquisitions.... PURPOSETo determine the optimal timing of arterial first pass computed tomography (CT) myocardial perfusion imaging (CTMPI) based on dynamic CTMPI... |
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| SubjectTerms | Adenosine Aged Contrast Media Coronary Angiography - methods Female Humans Iodine Ischemia Magnetic Resonance Angiography Male Middle Aged Myocardial Ischemia - diagnostic imaging Myocardial Ischemia - physiopathology Myocardial perfusion imaging Myocardial Perfusion Imaging - methods Myocardial Perfusion Imaging - standards Radiology Reference Standards Retrospective Studies Tomography Tomography, X-Ray Computed - methods X-Ray computed |
| Title | Optimal Timing of Image Acquisition for Arterial First Pass CT Myocardial Perfusion Imaging |
| URI | https://www.clinicalkey.es/playcontent/1-s2.0-S0720048X16303758 https://dx.doi.org/10.1016/j.ejrad.2016.11.024 https://www.ncbi.nlm.nih.gov/pubmed/28027752 https://search.proquest.com/docview/1853745024 |
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