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Spectral imaging with dual-layer spectral detector computed tomography for the detection of perfusion defects in acute coronary syndrome

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Abstract

To evaluate the feasibility of spectral imaging with dual-layer spectral detector computed tomography (CT) for the diagnosis of acute coronary syndrome. We identified 30 consecutive patients who underwent cardiac CT using dual-layer spectral detector CT and were diagnosed with acute ischemic syndrome by an invasive coronary angiography. We reconstructed 120 kVp images and generated virtual monochromatic images (VMIs; 40–200 keV in 10 keV increments), iodine concentration maps, and effective atomic number (Z) maps. We calculated the contrast and contrast-to-noise ratio (CNR) between myocardial normal and hypo-perfusion and chose the VMIs with the best CNR for quantitative analysis. We compared the image noise, contrast, and CNR of 120 kVp images and the best VMIs, CT value, iodine concentration, and effective Z between myocardial normal and hypo-perfusion with the paired t test. As the X-ray energy decreased, venous attenuation, contrast, and CNR gradually increased. The 40 keV image yielded the best CNR. The contrast and CNR between myocardial normal and hypo-perfusion were significantly higher in 40 keV images than those in 120 kVp images. The iodine concentration and the effective Z were significantly higher in normal myocardium than those in hypo-perfused myocardium. Spectral imaging with dual-layer spectral detector CT is a feasible technique to detect the hypo-perfused area of acute ischemic syndrome.

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Abbreviations

VMI:

Virtual monochromatic image

ACS:

Acute coronary syndromes

CTA:

Coronary computed tomographic angiography

DECT:

Dual-energy CT

DL-DECT:

Dual-layer DECT

SD:

Standard deviation

CNR:

Contrast-to-noise ratio

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Authors and Affiliations

  1. Minamino Cardiovascular Hospital, 1-25-1, Hyoue, Hachioji, Tokyo, 192-0918, Japan

    Junji Mochizuki & Yoshiki Hata

  2. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan

    Takeshi Nakaura, Naofumi Yoshida, Yasunori Nagayama, Masafumi Kidoh, Hiroyuki Uetani & Toshinori Hirai

  3. Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

    Yoshinori Funama & Minako Azuma

Authors
  1. Junji Mochizuki
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  2. Takeshi Nakaura
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  3. Naofumi Yoshida
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  4. Yasunori Nagayama
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  5. Masafumi Kidoh
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  6. Hiroyuki Uetani
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  7. Yoshinori Funama
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  8. Yoshiki Hata
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  9. Minako Azuma
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  10. Toshinori Hirai
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Correspondence to Takeshi Nakaura.

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Mochizuki, J., Nakaura, T., Yoshida, N. et al. Spectral imaging with dual-layer spectral detector computed tomography for the detection of perfusion defects in acute coronary syndrome. Heart Vessels 37, 1115–1124 (2022). https://doi.org/10.1007/s00380-021-02019-2

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  • DOI: https://doi.org/10.1007/s00380-021-02019-2

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