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Dual Energy CT Imaging for the Assessment of Coronary Artery Stenosis

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Dual-Energy CT in Cardiovascular Imaging

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Abstract

Computed tomography coronary angiography (CTCA) has emerged as an accurate means to evaluate coronary atherosclerosis, not only the lumen but the vessel wall as well. In fact, CTCA is more closely related to intravascular ultrasound than to invasive angiography. Conventional CTCA remains limited by a number of technical, patient-related, or lesion specific issues that preclude the accurate extrapolation of the overall well established diagnostic performance of CTCA to the real world scenario. These limitations include the complex discrimination between calcified plaques and luminal opacification that hamper the precise quantification of densely calcified lesions. Dual energy CT has emerged as a novel approach that aims to evaluate coronary artery disease with a more accurate assessment of plaque thus potentially improving the overall diagnostic performance. DECT has the potential to analyze the information using two different approaches: (1) monochromatic evaluation; and (2) material decomposition. The present chapter discusses the available evidence in this regard among different scenarios including evaluation of de novo lesions, plaque characterization, triage of patients with acute chest pain, and evaluation of patients with previous percutaneous or surgical revascularization.

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Authors and Affiliations

  1. Department of CT and MR, Diagnóstico Maipú, Av. Maipu 1668 Vicente López, Buenos Aires, 1602, Argentina

    Gastón A. Rodriguez-Granillo MD, PhD & Patricia M. Carrascosa MD, PhD, FSSCT

  2. Cardiology Department, Montefiore Einstein Center for Heart and Vascular Care Center, New York, NY, USA

    Mario J. García MD, FACC

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  1. Gastón A. Rodriguez-Granillo MD, PhD
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  2. Patricia M. Carrascosa MD, PhD, FSSCT
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  3. Mario J. García MD, FACC
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Correspondence to Gastón A. Rodriguez-Granillo MD, PhD .

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Editors and Affiliations

  1. Diagnostico Maipú, Buenos Aires, Argentina

    Patricia M. Carrascosa

  2. Miami Cardiac and Vascular Institute and Baptist Health South Florida, Miami, Florida, USA

    Ricardo C. Cury

  3. Montefiore Einstein Center for Heart and Vascular Care Center, New York, New York, USA

    Mario J. García

  4. Providence Health Care, Vancouver, British Columbia, Canada

    Jonathon A. Leipsic

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Rodriguez-Granillo, G.A., Carrascosa, P.M., García, M.J. (2015). Dual Energy CT Imaging for the Assessment of Coronary Artery Stenosis. In: Carrascosa, P., Cury, R., García, M., Leipsic, J. (eds) Dual-Energy CT in Cardiovascular Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-21227-2_11

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