Virgile Chevance1, Thibaud Damy2,3,4, Vania Tacher5,3, François Legou5, Fourat Ridouani5, Alain Luciani5,6, Hicham Kobeiter5,3, Alain Rahmouni5,6, Jean-François Deux5,3,4. 1. Service d'Imagerie Médicale, AP-HP (Assistance Publique-Hôpitaux de Paris, Créteil), Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil, F-94000, France. virgile.chevance@gmail.com. 2. Service de Cardiologie, AP-HP (Assistance Publique-Hôpitaux de Paris, Créteil), Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil, F-94000, France. 3. DHU (Département Hospitalo-Universitaire) ATVB (Ageing-Thorax-Vessels-Blood), IMRB (Institut Mondor de Recherche Biomédicale), Université Paris-Est-Créteil, (UPEC), Créteil, F-94000, France. 4. GRC Amyloid Research Institute and Reseau Amylose Mondor, Groupe Hospitalier Henri Mondor-Albert Chenevier, Université Paris-Est-Créteil (UPEC), Créteil, F-94000, France. 5. Service d'Imagerie Médicale, AP-HP (Assistance Publique-Hôpitaux de Paris, Créteil), Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil, F-94000, France. 6. DHU (Département Hospitalo-Universitaire) VIC (Virus-Immunity-Cancer), IMRB (Institut Mondor de Recherche Biomédicale), Université Paris-Est-Créteil, (UPEC), Créteil, F-94000, France.
Abstract
OBJECTIVE: To measure myocardium iodine concentration (MIC) in patients with cardiac amyloidosis (CA) using dual-energy computed tomography (DECT). METHODS: Twenty-two patients with CA, 13 with non-amyloid hypertrophic cardiomyopathies (CH) and 10 control patients were explored with pre-contrast, arterial and 5-minute DECT acquisition (Iomeprol; 1.5 mL/kg). Inter-ventricular septum (IVS) thickness, blood pool iodine concentration (BPIC), MIC (mg/mL), iodine ratio and extra-cellular volume (ECV) were calculated. RESULTS: IVS thickness was significantly (p < 0.001) higher in CA (17 ± 4 mm) and CH (15 ± 3 mm) patients than in control patients (10 ± 1 mm). CA patients exhibited significantly (p < 0.001) higher 5-minute MIC [2.6 (2.3-3.1) mg/mL], 5-minute iodine ratio (0.88 ± 0.12) and ECV (0.56 ± 0.07) than CH [1.7 (1.4-2.2) mg/mL, 0.57 ± 0.07 and 0.36 ± 0.05, respectively] and control patients [1.9 (1.7-2.4) mg/mL, 0.58 ± 0.07 and 0.35 ± 0.04, respectively). CH and control patients exhibited similar values (p = 0.9). The area under the curve of 5-minute iodine ratio for the differential diagnosis of CA from CH patients was 0.99 (0.73-1.0; p = 0.001). With a threshold of 0.65, the sensitivity and specificity of 5-minute iodine ratio were 100% and 92%, respectively. CONCLUSION: Five-minute MIC and iodine ratio were increased in CA patients and exhibited best diagnosis performance to diagnose CA in comparison to other parameters. KEY POINT: • Dual-energy computed tomography can be used to detect cardiac amyloidosis • Five-minute myocardial iodine concentration and iodine ratio increase in cardiac amyloidosis • Among iodine parameters, 5-minute iodine ratio has the best diagnosis performance.
OBJECTIVE: To measure myocardium iodine concentration (MIC) in patients with cardiac amyloidosis (CA) using dual-energy computed tomography (DECT). METHODS: Twenty-two patients with CA, 13 with non-amyloid hypertrophic cardiomyopathies (CH) and 10 control patients were explored with pre-contrast, arterial and 5-minute DECT acquisition (Iomeprol; 1.5 mL/kg). Inter-ventricular septum (IVS) thickness, blood pool iodine concentration (BPIC), MIC (mg/mL), iodine ratio and extra-cellular volume (ECV) were calculated. RESULTS: IVS thickness was significantly (p < 0.001) higher in CA (17 ± 4 mm) and CH (15 ± 3 mm) patients than in control patients (10 ± 1 mm). CA patients exhibited significantly (p < 0.001) higher 5-minute MIC [2.6 (2.3-3.1) mg/mL], 5-minute iodine ratio (0.88 ± 0.12) and ECV (0.56 ± 0.07) than CH [1.7 (1.4-2.2) mg/mL, 0.57 ± 0.07 and 0.36 ± 0.05, respectively] and control patients [1.9 (1.7-2.4) mg/mL, 0.58 ± 0.07 and 0.35 ± 0.04, respectively). CH and control patients exhibited similar values (p = 0.9). The area under the curve of 5-minute iodine ratio for the differential diagnosis of CA from CH patients was 0.99 (0.73-1.0; p = 0.001). With a threshold of 0.65, the sensitivity and specificity of 5-minute iodine ratio were 100% and 92%, respectively. CONCLUSION: Five-minute MIC and iodine ratio were increased in CA patients and exhibited best diagnosis performance to diagnose CA in comparison to other parameters. KEY POINT: • Dual-energy computed tomography can be used to detect cardiac amyloidosis • Five-minute myocardial iodine concentration and iodine ratio increase in cardiac amyloidosis • Among iodine parameters, 5-minute iodine ratio has the best diagnosis performance.
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