Abstract
ObjectiveTo improve image and diagnostic quality in dynamic CT myocardial perfusion imaging (MPI) by using motion compensation and a spatio-temporal filter.MethodsDynamic CT MPI was performed using a 256-slice multidetector computed tomography scanner (MDCT). Data from two different patients–with and without myocardial perfusion defects–were evaluated to illustrate potential improvements for MPI (institutional review board approved). Three datasets for each patient were generated: (i) original data (ii) motion compensated data and (iii) motion compensated data with spatio-temporal filtering performed. In addition to the visual assessment of the tomographic slices, noise and contrast-to-noise-ratio (CNR) were measured for all data. Perfusion analysis was performed using time-density curves with regions-of-interest (ROI) placed in normal and hypoperfused myocardium. Precision in definition of normal and hypoperfused areas was determined in corresponding coloured perfusion maps.ResultsThe use of motion compensation followed by spatio-temporal filtering resulted in better alignment of the cardiac volumes over time leading to a more consistent perfusion quantification and improved detection of the extend of perfusion defects. Additionally image noise was reduced by 78.5%, with CNR improvements by a factor of 4.7. The average effective radiation dose estimate was 7.1±1.1 mSv.ConclusionThe use of motion compensation and spatio-temporal smoothing will result in improved quantification of dynamic CT MPI using a latest generation CT scanner.
Highlights
Dynamic contrast enhanced CT scans enable collection of kinetic parameters
CT Myocardial Perfusion Image Analysis Figure 1 illustrates a representative example of Patient 1 with a large hypodense region in the inferior and inferolateral left ventricular (LV) wall
Similar curves are shown for Patient 2 (Figure 2), who had no significant perfusion deficits detected in CT or magnetic resonance imaging (MRI) perfusion analysis, and no hemodynamically significant coronary stenosis found in interventional angiography performed in the catheter laboratory
Summary
Dynamic contrast enhanced CT scans enable collection of kinetic parameters (time-to-peak, mean-transit-time etc.). Dynamic CT myocardial perfusion imaging (MPI) could help assess the hemodynamic significance of coronary artery stenosis on the associated myocardial tissue. For clinical practice the quantification of myocardial perfusion is of high relevance for diagnosis, prognosis and therapy of CAD. Initial studies illustrated MPI as a feasible and promising method for the assessment of myocardial perfusion deficits [8,9,10,11]. Low tube output typically used in MPI to address the issue of radiation dose could result in relatively high image noise. Movement of the heart during the scanning procedure could result in spatial mis-alignment of the targeted regions and reduce the accuracy of time- and spacedependent evaluation of myocardial perfusion in specific regions of interest (ROI), creating a need for motion correction methods
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