Dual-Energy Computed Tomography in Cardiac Imaging

Benjamin Böttcher; Emese Zsarnoczay; Akos Varga-Szemes; Uwe Joseph Schoepf; Felix G Meinel; Marly van Assen; Carlo N De Cecco

doi:10.1016/j.rcl.2023.05.004

Dual-Energy Computed Tomography in Cardiac Imaging

Radiol Clin North Am. 2023 Nov;61(6):995-1009. doi: 10.1016/j.rcl.2023.05.004. Epub 2023 Jun 18.

Authors

Benjamin Böttcher¹, Emese Zsarnoczay², Akos Varga-Szemes³, Uwe Joseph Schoepf³, Felix G Meinel⁴, Marly van Assen⁵, Carlo N De Cecco⁶

Affiliations

¹ Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Road NE, Suite D112, Atlanta, GA 30322, USA; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Strasse 6, 18057 Rostock, Germany.
² Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Center, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary.
³ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA.
⁴ Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Strasse 6, 18057 Rostock, Germany.
⁵ Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Road NE, Suite D112, Atlanta, GA 30322, USA.
⁶ Division of Cardiothoracic Imaging and Imaging Informatics, Department of Radiology and Imaging Sciences, Emory University Hospital, Emory Healthcare, Inc. 1365 Clifton Road NE, Suite - AT503, Atlanta, GA 30322, USA. Electronic address: carlo.dececco@emory.edu.

PMID: 37758366
DOI: 10.1016/j.rcl.2023.05.004

Abstract

Dual-energy computed tomography (DECT) acquires images using two energy spectra and offers a variation of reconstruction techniques for improved cardiac imaging. Virtual monoenergetic images decrease artifacts improving coronary plaque and stent visualization. Further, contrast attenuation is increased allowing significant reduction of contrast dose. Virtual non-contrast reconstructions enable coronary artery calcium scoring from contrast-enhanced scans. DECT provides advanced plaque imaging with detailed analysis of plaque components, indicating plaque stability. Extracellular volume assessment using DECT offers noninvasive detection of myocardial fibrosis. This review aims to outline the current cardiac applications of DECT, summarize recent literature, and discuss their findings.

Keywords: Cardiovascular imaging; Coronary plaque imaging; Dual-energy computed tomography; Myocardial perfusion imaging; Myocardial tissue characterization; Photon counting.

Publication types

Review

MeSH terms

Heart* / diagnostic imaging
Humans
Radiography, Dual-Energy Scanned Projection* / methods
Tomography, X-Ray Computed / methods