Myocardial Characterization Using Dual-Energy CT in Doxorubicin-Induced DCM: Comparison With CMR T1-Mapping and Histology in a Rabbit Model

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• 作者：Yoo Jin Hong ; MD ; PhD^a ; Tai Kyung Kim ; DVM^b ; Donghyun Hong ; MS^c ; Chul Hwan Park ; MD^d ; Sae Jong Yoo ; DVM^b ; Mary Ellen Wickum ; MS^a ; Jin Hur ; MD ; PhD^a ; Hye-Jeong Lee ; MD ; PhD^a ; Young Jin Kim ; MD ; PhD^a ; Young Joo Suh ; MD^a ; Andreas Greiser ; PhD^e ; Mun Young Paek ; MS^f ; Byoung Wook Choi ; MD ; PhD^a ; ^{bchoi@yuhs.ac" class="auth_mail" title="E-mail the corresponding author}
• 关键词：cardiac imaging techniques ; cardiomyopathy ; dual-energy scanned projection ; magnetic resonance imaging ; mapping ; radiography
• 刊名：JACC: Cardiovascular Imaging
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：9
• 期：7
• 页码：836-845
• 全文大小：1598 K

文摘

This study sought to evaluate whether patterns of myocardial change in doxorubicin-induced dilated cardiomyopathy determined using dual-energy computed tomography (CT) were similar to characterization by extracellular volume fraction (ECV) using cardiac magnetic resonance (CMR) T1-mapping and collagen volume fraction (CVF) measured using histology.

Background

Anthracycline chemoagents are effective against a wide range of malignant conditions. However, cardiotoxicity is a well-known adverse effect of these drugs. Dual-energy CT could be as useful as magnetic resonance (MR) to evaluate myocardial change in anthracycline-induced cardiotoxicity.

Methods

A dilated cardiomyopathy rabbit model was generated by injecting 11 adult New Zealand rabbits with 1.0 mg/kg of doxorubicin twice weekly for 16 weeks. Contrast-enhanced dual-energy CT and pre-contrast and post-contrast T1-mapping CMR using a prototype modified Look-Locker inversion recovery on a clinical 3-T scanner were performed on 15 rabbits, including 4 control animals, to calculate ECV at baseline, and at 6, 12, and 16 weeks after doxorubicin administration.

Results

The mean ECV values (%) on CT and CMR at 6, 12, and 16 weeks after modeling were significantly higher than those measured at baseline (CT ECV: 35.3%, 41.9%, 42.1% vs. 28.5%; MR ECV: 32.6%, 35.8%, 41.3% vs. 28.8%, respectively; all p < 0.001). CT ECV and MR ECV values were well correlated (r = 0.888; p < 0.001). Both were well correlated with CVF on histology (CT ECV vs. CVF, r = 0.925, p < 0.001 and MR ECV vs. CVF, r = 0.961, p < 0.001, respectively).

Conclusions

Dual-energy CT ECV correlated well with CMR and histology. Dual-energy CT is useful for characterizing doxorubicin-induced cardiomyopathy by measuring ECV fraction; however, further technical improvements are desirable to lower motion artifact and improve image quality of the iodine map.