Universität zu Köln

Laukamp, Kai Roman, Dastmalchian, Sara, Tandon, Yasmeen K., Ciancibello, Leslie, Pennig, Lenhard, Lennartz, Simon, Al-Kindi, Sadeer, Rajagopalan, Sanjay, Bera, Kaustav, Hokamp, Nils Grosse, Gilkeson, Robert and Gupta, Amit (2022). Imaging of the Left Atrial Appendage Before Occluder Device Placement: Evaluation of Virtual Monoenergetic Images in a Single-Bolus Dual-Phase Protocol. J. Comput. Assist. Tomogr., 46 (5). S. 735 - 742. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1532-3145

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Abstract

Purpose Preimplantation cardiac computed tomography (CT) for assessment of the left atrial appendage (LAA) enables correct sizing of the device and the detection of contraindications, such as thrombi. In the arterial phase, distinction between false filling defects and true thrombi can be hampered by insufficient contrast medium distribution. A delayed scan can be used to further differentiate both conditions, but contrast in these acquisitions is relatively lower. In this study, we investigated whether virtual monoenergetic images (VMI) from dual-energy spectral detector CT (SDCT) can be used to enhance contrast and visualization in the delayed phase. Materials and Methods Forty-nine patients receiving SDCT imaging of the LAA were retrospectively enrolled. The imaging protocol comprised dual-phase acquisitions with single-bolus contrast injection. Conventional images (CI) from both phases and 40-keV VMI from the delayed phase were reconstructed. Attenuation, signal-, and contrast-to-noise ratios (SNR/CNR) were calculated by placing regions-of-interest in the LAA, left atrium, and muscular portion of interventricular septum. Two radiologists subjectively evaluated conspicuity and homogeneity of contrast distribution within the LAA. Results Contrast of the LAA decreased significantly in the delayed phase but was significantly improved by VMI, showing comparable attenuation, SNR, and CNR to CI from the arterial phase (attenuation/SNR/CNR, CI arterial phase: 266.0 +/- 117.0 HU/14.2 +/- 7.2/6.6 +/- 3.9; CI-delayed phase: 107.6 +/- 35.0 HU/5.9 +/- 3.0/1.0 +/- 1.0; VMI delayed phase: 260.3 +/- 108.6 HU/18.2 +/- 10.6/4.8 +/- 3.4). The subjective reading confirmed the objective findings showing improved conspicuity and homogeneity in the delayed phase. Conclusions The investigated single-bolus dual-phase acquisition protocol provided improved visualization of the LAA. Homogeneity of contrast media was higher in the delayed phase, while VMI maintained high contrast.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Laukamp, Kai Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Dastmalchian, Sara UNSPECIFIED UNSPECIFIED UNSPECIFIED Tandon, Yasmeen K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ciancibello, Leslie UNSPECIFIED UNSPECIFIED UNSPECIFIED Pennig, Lenhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Lennartz, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Al-Kindi, Sadeer UNSPECIFIED UNSPECIFIED UNSPECIFIED Rajagopalan, Sanjay UNSPECIFIED UNSPECIFIED UNSPECIFIED Bera, Kaustav UNSPECIFIED UNSPECIFIED UNSPECIFIED Hokamp, Nils Grosse UNSPECIFIED UNSPECIFIED UNSPECIFIED Gilkeson, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Gupta, Amit UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-679886
DOI:	10.1097/RCT.0000000000001330
Journal or Publication Title:	J. Comput. Assist. Tomogr.
Volume:	46
Number:	5
Page Range:	S. 735 - 742
Date:	2022
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1532-3145
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MULTIDETECTOR COMPUTED-TOMOGRAPHY; LAYER DETECTOR CT; CARDIAC CT; CONTRAST-MEDIA; THROMBUS; STROKE; FIBRILLATION; ENHANCEMENT; ANGIOGRAPHY; ACCURACY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67988