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Myocardial Perfusion by Dual Energy CT

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Dual-Energy CT in Cardiovascular Imaging

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Abstract

Coronary CT angiography (CCTA) in a reliable non-invasive tool for the assessment of coronary artery disease (CAD) in patients with low to intermediate risk of CAD, with a high diagnostic accuracy and an excellent negative predictive value. When a coronary stenosis is present, it’s hemodynamical relevance needs to be determined in order to facilitate the appropriate therapeutic decision. CCTA per se is a poor predictor of the physiologic relevance of a given stenotic lesion

For that reason, both anatomic and functional testing is usually required to correctly identify patients who will benefit from coronary intervention. The evaluation of functional imaging has been done with modalities such as single photon emission computed tomography, Magnetic Resonance Imaging, stress echocardiography, and Positron Emission Tomography.

In recent years multidetector computed tomography (MDCT) started to perform a comprehensive evaluation (anatomical and functional) in a single study, offering a complete evaluation of patient’s ischemic heart disease. To date, there have been several single-center studies showing good results. Recently, two multicenter trials have confirmed earlier findings in a larger scale. However challenges of myocardial CT Perfusion is beam hardening artifacts that produce non-uniform changes in CT densitometry generating inadequate assessment of myocardial perfusion. With the recent developments of dual-energy CT (DECT), the beam hardening effect on myocardial perfusion measurement could be reduced by the generation of monochromatic images and material decomposition ones.

The chapter will focus on the utility of DECT in myocardial perfusion and will explain:

  • Platforms for Dual-energy CTP, Scanning techniques, Types of analysis and postprocessing

  • Scientific Evidence, Cases and Radiation dose

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Authors and Affiliations

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

    Patricia M. Carrascosa MD, PhD, FSCCT

  2. Department of Radiology, Miami Cardiac and Vascular Institute and Baptist Health of South Florida, Miami, FL, USA

    Ricardo C. Cury MD, FAHA, FSCCT

Authors
  1. Patricia M. Carrascosa MD, PhD, FSCCT
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  2. Ricardo C. Cury MD, FAHA, FSCCT
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Correspondence to Patricia M. Carrascosa MD, PhD, FSCCT .

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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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Carrascosa, P.M., Cury, R.C. (2015). Myocardial Perfusion by Dual Energy CT. 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_12

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