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Erschienen in:
10.08.2017 | Cardiac
Myocardial iodine concentration measurement using dual-energy computed tomography for the diagnosis of cardiac amyloidosis: a pilot study
Erschienen in: European Radiology | Ausgabe 2/2018
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Objective
To measure myocardium iodine concentration (MIC) in patients with cardiac amyloidosis (CA) using dual-energy computed tomography (DECT).
Methods
Twenty-two patients with CA, 13 with non-amyloid hypertrophic cardiomyopathies (CH) and 10 control patients were explored with pre-contrast, arterial and 5-minute DECT acquisition (Iomeprol; 1.5 mL/kg). Inter-ventricular septum (IVS) thickness, blood pool iodine concentration (BPIC), MIC (mg/mL), iodine ratio and extra-cellular volume (ECV) were calculated.
Results
IVS thickness was significantly (p < 0.001) higher in CA (17 ± 4 mm) and CH (15 ± 3 mm) patients than in control patients (10 ± 1 mm). CA patients exhibited significantly (p < 0.001) higher 5-minute MIC [2.6 (2.3–3.1) mg/mL], 5-minute iodine ratio (0.88 ± 0.12) and ECV (0.56 ± 0.07) than CH [1.7 (1.4–2.2) mg/mL, 0.57 ± 0.07 and 0.36 ± 0.05, respectively] and control patients [1.9 (1.7–2.4) mg/mL, 0.58 ± 0.07 and 0.35 ± 0.04, respectively). CH and control patients exhibited similar values (p = 0.9). The area under the curve of 5-minute iodine ratio for the differential diagnosis of CA from CH patients was 0.99 (0.73–1.0; p = 0.001). With a threshold of 0.65, the sensitivity and specificity of 5-minute iodine ratio were 100% and 92%, respectively.
Conclusion
Five-minute MIC and iodine ratio were increased in CA patients and exhibited best diagnosis performance to diagnose CA in comparison to other parameters.
Key point
• Dual-energy computed tomography can be used to detect cardiac amyloidosis
• Five-minute myocardial iodine concentration and iodine ratio increase in cardiac amyloidosis
• Among iodine parameters, 5-minute iodine ratio has the best diagnosis performance