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Accuracy of dual-energy computed tomography for the measurement of iodine concentration using cardiac CT protocols: validation in a phantom model

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Abstract

Purpose

To assess the accuracy of dual-energy CT (DECT) for the quantification of iodine concentrations in a thoracic phantom across various cardiac DECT protocols and simulated patient sizes.

Materials and methods

Experiments were performed on first- and second-generation dual-source CT (DSCT) systems in DECT mode using various cardiac DECT protocols. An anthropomorphic thoracic phantom was equipped with tubular inserts containing known iodine concentrations (0–20 mg/mL) in the cardiac chamber and up to two fat-equivalent rings to simulate different patient sizes. DECT-derived iodine concentrations were measured using dedicated software and compared to true concentrations. General linear regression models were used to identify predictors of measurement accuracy

Results

Correlation between measured and true iodine concentrations (n = 72) across CT systems and protocols was excellent (R = 0.994–0.997, P < 0.0001). Mean measurement errors were 3.0 ± 7.0 % and −2.9 ± 3.8 % for first- and second-generation DSCT, respectively. This error increased with simulated patient size. The second-generation DSCT showed the most stable measurements across a wide range of iodine concentrations and simulated patient sizes.

Conclusion

Overall, DECT provides accurate measurements of iodine concentrations across cardiac CT protocols, strengthening the case for DECT-derived blood volume estimates as a surrogate of myocardial blood supply.

Key Points

• Dual-energy CT provides new opportunities for quantitative assessment in cardiac imaging.

• DECT can quantify myocardial iodine as a surrogate for myocardial perfusion.

• DECT measurements of iodine concentrations are overall very accurate.

• The accuracy of such measurements decreases as patient size increases.

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Abbreviations

DECT:

Dual-energy computed tomography

DSCT:

Dual-source computed tomography

ROI:

Region of interest

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Acknowledgements

Dr. Schoepf is a consultant for and receives research support from Bayer, Bracco, GE, Medrad, and Siemens. Dr. Schmidt and Dr. Flohr are Siemens employees. The other authors have no potential conflicts of interest to disclose.

The project described was supported by award number UL1TR000062 from the National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.

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Authors and Affiliations

  1. Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA

    James D. Koonce, Rozemarijn Vliegenthart, U. Joseph Schoepf & Felix G. Meinel

  2. Center for Medical Imaging - North East Netherlands, Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Rozemarijn Vliegenthart

  3. Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC, USA

    U. Joseph Schoepf

  4. Imaging & Therapy Division, Siemens Healthcare, Forchheim, Germany

    Bernhard Schmidt & Thomas G. Flohr

  5. Department of Public Health Services, Medical University of South Carolina, Charleston, SC, USA

    Amy E. Wahlquist & Paul J. Nietert

  6. Department of Radiology, University of Navarra, Pamplona, Spain

    Gorka Bastarrika

  7. Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany

    Felix G. Meinel

Authors
  1. James D. Koonce
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  2. Rozemarijn Vliegenthart
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  3. U. Joseph Schoepf
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  4. Bernhard Schmidt
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  5. Amy E. Wahlquist
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  6. Paul J. Nietert
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  7. Gorka Bastarrika
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  8. Thomas G. Flohr
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  9. Felix G. Meinel
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Corresponding author

Correspondence to U. Joseph Schoepf.

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Koonce, J.D., Vliegenthart, R., Schoepf, U.J. et al. Accuracy of dual-energy computed tomography for the measurement of iodine concentration using cardiac CT protocols: validation in a phantom model. Eur Radiol 24, 512–518 (2014). https://doi.org/10.1007/s00330-013-3040-6

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  • DOI: https://doi.org/10.1007/s00330-013-3040-6

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