Abstract
BackgroundMyocardial perfusion measurement with a low-dose first-pass analysis (FPA) dynamic computed tomography (CT) perfusion technique depends upon acquisition of two whole-heart volume scans at the base and peak of the aortic enhancement. Hence, the objective of this study was to validate an optimal timing protocol for volume scan acquisition at the base and peak of the aortic enhancement.MethodsContrast-enhanced CT of 28 Yorkshire swine (weight, 55 ± 24 kg, mean ± standard deviation) was performed under rest and stress conditions over 20–30 s to capture the aortic enhancement curves. From these curves, an optimal timing protocol was simulated, where one volume scan was acquired at the base of the aortic enhancement while a second volume scan was acquired at the peak of the aortic enhancement. Low-dose FPA perfusion measurements (PFPA) were then derived and quantitatively compared to the previously validated retrospective FPA perfusion measurements as a reference standard (PREF). The 32-cm diameter volume CT dose index, {mathrm{CTDI}}_{mathrm{vol}}^{32} and size-specific dose estimate (SSDE) of the low-dose FPA perfusion protocol were also determined.ResultsPFPA were related to the reference standard by PFPA = 0.95 · PREF + 0.07 (r = 0.94, root-mean-square error = 0.27 mL/min/g, root-mean-square deviation = 0.04 mL/min/g). The {mathrm{CTDI}}_{mathrm{vol}}^{32} and SSDE of the low-dose FPA perfusion protocol were 9.2 mGy and 14.6 mGy, respectively.ConclusionsAn optimal timing protocol for volume scan acquisition at the base and peak of the aortic enhancement was retrospectively validated and has the potential to be used to implement an accurate, low-dose, FPA perfusion technique.
Highlights
Myocardial perfusion measurement with a low-dose first-pass analysis (FPA) dynamic computed tomography (CT) perfusion technique depends upon acquisition of two whole-heart volume scans at the base and peak of the aortic enhancement
A new first-pass analysis (FPA) dynamic CT perfusion technique has been shown to improve the accuracy of perfusion measurement through whole-heart craniocaudal coverage, with additional potential to reduce the effective radiation dose through maximal acquisition number reduction
First-pass analysis perfusion measurement theory The FPA perfusion technique is enabled by 320-slice CT scanner technology and models the entire myocardium as a single lumped compartment
Summary
Myocardial perfusion measurement with a low-dose first-pass analysis (FPA) dynamic computed tomography (CT) perfusion technique depends upon acquisition of two whole-heart volume scans at the base and peak of the aortic enhancement. Current dynamic CT perfusion techniques are known to be inaccurate [9,10,11] and Hubbard et al European Radiology Experimental (2019) 3:16 have limited craniocaudal coverage Such techniques deliver high effective radiation doses from 5.3 to 10 mSv per stress or rest perfusion measurement, despite attempts to reduce tube voltage, modulate tube current, and reduce the number of acquisitions [12,13,14,15]. The technique only requires two optimally timed first-pass volume scans acquired at the base and the peak of the aortic enhancement for accurate perfusion measurement [16,17,18]. Dynamic bolus tracking-based prospective timing and acquisition of the two first-pass volume scans may provide a better solution but remains to be developed and optimized
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