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Automatic quantification of the myocardial extracellular volume by cardiac computed tomography: Synthetic ECV by CCT

Treibel, TA; Fontana, M; Steeden, JA; Nasis, A; Yeung, J; White, SK; Sivarajan, S; ... Bandula, S; + view all (2017) Automatic quantification of the myocardial extracellular volume by cardiac computed tomography: Synthetic ECV by CCT. Journal of Cardiovascular Computed Tomography , 11 (3) pp. 221-226. 10.1016/j.jcct.2017.02.006. Green open access

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Abstract

BACKGROUND: The quantification of extracellular volume fraction (ECV) by Cardiac Computed Tomography (CCT) can identify changes in the myocardial interstitium due to fibrosis or infiltration. Current methodologies require laboratory blood hematocrit (Hct) measurement – which complicates the technique. The attenuation of blood (HUblood) is known to change with anemia. We hypothesized that the relationship between Hct and HUblood could be calibrated to rapidly generate a synthetic ECV without formally measuring Hct. METHODS: The association between Hct and HUblood was derived from forty non-contrast thoracic CT scans using regression analysis. Synthetic Hct was then used to calculate synthetic ECV, and in turn compared with ECV using blood Hct in a validation cohort with mild interstitial expansion due to fibrosis (aortic stenosis, n = 28, ECVCT = 28 ± 4%) and severe interstitial expansion due to amyloidosis (n = 27; ECVCT = 54 ± 11%, p < 0.001). For histological validation, synthetic ECV was correlated with collagen volume fraction (CVF) in a separate cohort with aortic stenosis (n = 18). All CT scans were performed at 120 kV and 160 mAs. RESULTS: HUblood was a good predictor of Hct (R2 = 0.47; p < 0.01), with the regression model (Hct = [0.51 * HUblood] + 17.4) describing the association. Synthetic ECV correlated well with conventional ECV (R2 = 0.96; p < 0.01) with minimal bias and 2SD difference of 5.7%. Synthetic ECV correlated as well as conventional ECV with histological CVF (both R2 = 0.50, p < 0.01). Finally, we implemented an automatic ECV plug-in for offline analysis. CONCLUSION: Synthetic ECV by CCT provides instantaneous quantification of the myocardial extracellular space without the need for blood sampling.

Type: Article
Title: Automatic quantification of the myocardial extracellular volume by cardiac computed tomography: Synthetic ECV by CCT
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jcct.2017.02.006
Publisher version: http://doi.org/10.1016/j.jcct.2017.02.006
Language: English
Additional information: © 2017 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved. This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Radiology, Nuclear Medicine & Medical Imaging, Cardiovascular System & Cardiology, Computed tomography, Myocardial tissue characterization, Extracellular matrix, Myocardial extracellular volume fraction, Myocardial fibrosis, Cardiac amyloidosis, CARDIOVASCULAR MAGNETIC-RESONANCE, ATTENUATION MEASUREMENTS, SEVERE ANEMIA, CT, FIBROSIS, FRACTION, AMYLOIDOSIS, DISEASE, HEMATOCRIT
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Metabolism and Experi Therapeutics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Childrens Cardiovascular Disease
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/1544888
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