The Feasibility of a Model-Based Iterative Reconstruction Technique Tuned for the Myocardium on Myocardial Computed Tomography Late Enhancement

Author:

Toritani Hidetaka1,Yoshida Kazuki2ORCID,Hosokawa Takaaki2,Tanabe Yuki2,Yamamoto Yuta3,Nishiyama Hikaru2,Kido Tomoyuki2,Kawaguchi Naoto2,Matsuda Megumi2,Nakano Shota4,Miyazaki Shigehiro5,Uetani Teruyoshi5,Inaba Shinji5,Yamaguchi Osamu5,Kido Teruhito2

Affiliation:

1. Ehime University School of Medicine

2. Department of Radiology, Ehime University Graduate School of Medicine, Toon City

3. Department of Radiology, Saiseikai Matsuyama Hospital, Matsuyama City, Ehime Prefecture

4. Canon Medical Systems Corporation, Otawara City, Tochigi Prefecture

5. Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime Prefecture, Japan.

Abstract

Objectives This study evaluated the feasibility of a model-based iterative reconstruction technique (MBIR) tuned for the myocardium on myocardial computed tomography late enhancement (CT-LE). Methods Twenty-eight patients who underwent myocardial CT-LE and late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) within 1 year were retrospectively enrolled. Myocardial CT-LE was performed using a 320-row CT with low tube voltage (80 kVp). Myocardial CT-LE images were scanned 7 min after CT angiography (CTA) without additional contrast medium. All myocardial CT-LE images were reconstructed with hybrid iterative reconstruction (HIR), conventional MBIR (MBIR_cardiac), and new MBIR tuned for the myocardium (MBIR_myo). Qualitative (5-grade scale) scores and quantitative parameters (signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]) were assessed as image quality. The sensitivity, specificity, and accuracy of myocardial CT-LE were evaluated at the segment level using an American Heart Association (AHA) 16-segment model, with LGE-MRI as a reference standard. These results were compared among the different CT image reconstructions. Results In 28 patients with 448 segments, 160 segments were diagnosed with positive by LGE-MRI. In the qualitative assessment of myocardial CT-LE, the mean image quality scores were 2.9 ± 1.2 for HIR, 3.0 ± 1.1 for MBIR_cardiac, and 4.0 ± 1.0 for MBIR_myo. MBIR_myo showed a significantly higher score than HIR (P < 0.001) and MBIR_cardiac (P = 0.018). In the quantitative image quality assessment of myocardial CT-LE, the median image SNR was 10.3 (9.1–11.1) for HIR, 10.8 (9.8–12.1) for MBIR_cardiac, and 16.8 (15.7–18.4) for MBIR_myo. The median image CNR was 3.7 (3.0–4.6) for HIR, 3.8 (3.2–5.1) for MBIR_cardiac, and 6.4 (5.0–7.7) for MBIR_myo. MBIR_myo significantly improved the SNR and CNR of CT-LE compared to HIR and MBIR_cardiac (P < 0.001). The sensitivity, specificity, and accuracy for the detection of myocardial CT-LE were 70%, 92%, and 84% for HIR; 71%, 92%, and 85% for MBIR_cardiac; and 84%, 92%, and 89% for MBIR_myo, respectively. MBIR_myo showed significantly higher image quality, sensitivity, and accuracy than the others (P < 0.05). Conclusions MBIR tuned for myocardium improved image quality and diagnostic performance for myocardial CT-LE assessment.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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