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Late iodine enhancement computed tomography with image subtraction for assessment of myocardial infarction

  • Cardiac
  • Published:
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Abstract

Objective

To evaluate the feasibility of image subtraction in late iodine enhancement CT (LIE-CT) for assessment of myocardial infarction (MI).

Methods

A comprehensive cardiac CT protocol and late gadolinium enhancement MRI (LGE-MRI) was used to assess coronary artery disease in 27 patients. LIE-CT was performed after stress CT perfusion (CTP) and CT angiography. Subtraction LIE-CT was created by subtracting the mask volume of the left ventricle (LV) cavity from the original LIE-CT using CTP dataset. The %MI volume was quantified as the ratio of LIE to entire LV volume, and transmural extent (TME) of LIE was classified as 0%, 1–24%, 25–49%, 50–74% or 75–100%. These results were compared with LGE-MRI using the Spearman rank test, Bland-Altman method and chi-square test.

Results

One hundred twenty-five (29%) of 432 segments were positive on LGE-MRI. Correlation coefficients for original and subtraction LIE-CT to LGE-MRI were 0.79 and 0.85 for %MI volume. Concordances of the 5-point grading scale between original and subtraction LIE-CT with LGE-MRI were 75% and 84% for TME; concordance was significantly improved using the subtraction technique (p <0.05).

Conclusion

Subtraction LIE-CT allowed more accurate assessment of MI extent than the original LIE-CT.

Key Points

• Subtraction LIE-CT allows for accurate assessment of the extent of myocardial infarction.

• Subtraction LIE-CT shows a close correlation with LGE-MRI in %MI volume.

• Subtraction LIE-CT has significantly higher concordance with TME assessment than original LIE-CT.

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Abbreviations

CAD:

Coronary artery disease

CM:

Contrast medium

CT:

Computed tomography

CTA:

Computed tomography angiography

CTP:

Computed tomography perfusion

HU :

Hounsfield units

LGE:

Late gadolinium enhancement

LIE:

Late iodine enhancement

LV:

Left ventricle

MI:

Myocardial infarction

MRI:

Magnetic resonance imaging

SD :

Standard deviations

TME:

Transmural extent

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon City, Ehime, 791-0295, Japan

    Yuki Tanabe, Teruhito Kido, Akira Kurata, Takanori Kouchi, Naoki Fukuyama, Takahiro Yokoi, Masao Miyagawa & Teruhito Mochizuki

  2. Department of Cardiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon City, Ehime, 791-0295, Japan

    Teruyoshi Uetani

  3. Department of Clinical Biostatistics, Section of Cancer Prevention and Epidemiology, Clinical Research Center, National Hospital Organization Shikoku Cancer Center, Minami-umemoto, Matsuyama City, Ehime, 791-0280, Japan

    Natsumi Yamashita

Authors
  1. Yuki Tanabe
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  2. Teruhito Kido
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Corresponding author

Correspondence to Yuki Tanabe.

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Guarantor

The scientific guarantor of this publication is Teruhito Mochizuki.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors, Dr. Natsumi Yamashita, Department of Clinical Biostatistics, Section of Cancer Prevention and Epidemiology, Clinical Research Center, National Hospital Organization Shikoku Cancer Center, is an expert in statistics.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Methodology

• retrospective

• observational

• performed at one institution

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Tanabe, Y., Kido, T., Kurata, A. et al. Late iodine enhancement computed tomography with image subtraction for assessment of myocardial infarction. Eur Radiol 28, 1285–1292 (2018). https://doi.org/10.1007/s00330-017-5048-9

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  • DOI: https://doi.org/10.1007/s00330-017-5048-9

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