Qualitative and Quantitative Evaluation of Structural Myocardial Alterations by Grating-Based Phase-Contrast Computed Tomography. Issue 1 (January 2018)

• Record Type: Journal Article
• Authors: Notohamiprodjo, Susan; Webber, Nicole; Birnbacher, Lorenz; Willner, Marian; Viermetz, Manuel; Herzen, Julia; Marschner, Mathias; Mayr, Doris; Bartsch, Harald; Saam, Tobias; Auweter, Sigrid; Pfeiffer, Franz; Reiser, Maximilian F.; Hetterich, Holger
• Is Part Of: Investigative radiology. Volume 53:Issue 1(2018:Jan.)
• Publication Date: 2018-01
• Subjects: phase-contrast computed tomography -- grating-interferometry -- x-ray -- cardiomyopathy -- heart disease; Diagnosis, Radioscopic -- Periodicals; Radiology, Medical -- Periodicals; 616.0757
• DOI: 10.1097/RLI.0000000000000408
• Languages: English
• ISSNs: 0020-9996

Abstract

Abstract : Objectives: Grating-based phase-contrast computed tomography (gb-PCCT) relies on x-ray refraction instead of absorption to generate high-contrast images in biological soft tissue. The aim of this study was to evaluate the potential of gb-PCCT for the depiction of structural changes in heart disease. Materials and Methods: Four human heart specimens from patients with hypertensive disease, ischemic disease, dilated heart disease, and cardiac lipomatosis were examined. The gb-PCCT setup consisted of an x-ray tube (40 kV, 70 mA), grating-interferometer, and detector, and allowed simultaneous acquisition of phase- and absorption-contrast data. With histopathology as the standard of reference, myocardium (MC), fibrotic scar (FS), interstitial fibrosis (IF), and fatty tissue (FT) were visually and quantitatively evaluated. Systematic differences in absorption- and phase-contrast Hounsfield units ( HU abs and HU p ) were assessed. Results: Thirteen corresponding cross-sections were included, and MC, FS, IF, and FT were found in 13 (100%), 4 (30.8%), 7 (53.8%), and 13 (100%) cross-sections, respectively. Mean HU p / HU abs were 52.5/54.1, 86.6/69.7, 62.4/62.3, and −38.6/−258.9 for MC, FS, IF, and FT, respectively. An overlap in HU abs was observed for MC and IF ( P = 0.84) but not for HU p ( P < 0.01). Contrast-to-noise ratios were significantly higher in phase- than in absorption-contrast for MC/FT (35.4 vs 7.8; P < 0.01) and for MC/FS (12.3 vs 0.2; P < 0.01). Conclusions: Given its superior soft tissue contrast, gb-PCCT is able to depict structural changes in different cardiomyopathies, which can currently not be obtained by x-ray absorption-based imaging methods. If current technical limitations can be overcome, gb-PCCT may evolve as a powerful tool for the anatomical assessment of cardiomyopathy.