PMID- 29989514 OWN - NLM STAT- MEDLINE DCOM- 20180910 LR - 20180910 IS - 1527-1315 (Electronic) IS - 0033-8419 (Linking) VI - 288 IP - 3 DP - 2018 Sep TI - Myocardial Delayed Enhancement CT for the Evaluation of Heart Failure: Comparison to MRI. PG - 682-691 LID - 10.1148/radiol.2018172523 [doi] AB - Purpose To assess the diagnostic performance of dual-energy CT with myocardial delayed enhancement (MDE) in the detection and classification of myocardial scar in patients with heart failure, with late gadolinium enhancement (LGE) MRI as the standard of reference. Materials and Methods MDE CT and LGE MRI were performed in 44 patients with heart failure (30 men; mean patient age, 66 years +/- 14) between 2013 and 2016, and images were retrospectively analyzed. The presence and patterns of MDE on iodine-density and virtual monochromatic (VM) images were assessed by two independent readers. Contrast-to-noise ratio (CNR) and percentage signal intensity increase relative to normal myocardium were measured. Diagnostic performance and area under the receiver operating characteristic curve for MDE CT and kappa values for reader agreement were determined. Results Thirty-five of the 44 patients (80%) demonstrated a focal area of LGE, with a nonischemic pattern in 22 of the 44 patients (50%) and an ischemic pattern in 13 (30%). Iodine-density images demonstrated the highest CNR and percentage signal intensity increase on CT images (P < .05), resulting in the highest diagnostic performance in the detection of any MDE CT abnormality (92% sensitivity [195 of 213 segments] and 98% specificity [481 of 491 segments]). The areas under the receiver operating characteristic curve for iodine-density images and 40-keV VM images in the detection of MDE were 0.97 and 0.95, respectively (P < .001). Kappa values for reader agreement were 0.82 for iodine-density images and 0.72 for 40-keV VM images. Conclusion Myocardial delayed enhancement CT enables accurate detection and localization of scar in patients with heart failure when compared with late gadolinium enhancement MRI, the reference standard. CI - (c) RSNA, 2018 Online supplemental material is available for this article. FAU - Ohta, Yasutoshi AU - Ohta Y AUID- ORCID: 0000-0001-8286-0271 AD - From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan. FAU - Kitao, Shinichiro AU - Kitao S AD - From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan. FAU - Yunaga, Hiroto AU - Yunaga H AD - From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan. FAU - Fujii, Shinya AU - Fujii S AD - From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan. FAU - Mukai, Natsuko AU - Mukai N AD - From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan. FAU - Yamamoto, Kazuhiro AU - Yamamoto K AD - From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan. FAU - Ogawa, Toshihide AU - Ogawa T AD - From the Division of Radiology, Department of Pathophysiological and Therapeutic Science (Y.O., S.K., H.Y., S.F., T.O.), and Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine (N.M., K.Y.), Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan. LA - eng PT - Comparative Study PT - Journal Article DEP - 20180710 PL - United States TA - Radiology JT - Radiology JID - 0401260 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM CIN - Radiology. 2018 Sep;288(3):692-693. PMID: 29989518 MH - Aged MH - *Contrast Media MH - Female MH - *Gadolinium MH - Heart/diagnostic imaging MH - Heart Failure/*diagnostic imaging MH - Humans MH - Magnetic Resonance Imaging/*methods MH - Male MH - Radiographic Image Enhancement/*methods MH - Radiographic Image Interpretation, Computer-Assisted/methods MH - Reproducibility of Results MH - Retrospective Studies MH - Sensitivity and Specificity MH - Time MH - Tomography, X-Ray Computed/*methods EDAT- 2018/07/11 06:00 MHDA- 2018/09/11 06:00 CRDT- 2018/07/11 06:00 PHST- 2018/07/11 06:00 [pubmed] PHST- 2018/09/11 06:00 [medline] PHST- 2018/07/11 06:00 [entrez] AID - 10.1148/radiol.2018172523 [doi] PST - ppublish SO - Radiology. 2018 Sep;288(3):682-691. doi: 10.1148/radiol.2018172523. Epub 2018 Jul 10.