Delayed contrast-enhanced computed tomography in patients with known or suspected cardiac sarcoidosis: A feasibility study

Tadao Aikawa, Noriko Oyama-Manabe, Masanao Naya, Hiroshi Ohira, Ayako Sugimoto, Ichizo Tsujino, Masahiko Obara, Osamu Manabe, Kohsuke Kudo, Hiroyuki Tsutsui, Nagara Tamaki

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Abstract

Objectives: To evaluate the diagnostic value of delayed contrast-enhanced computed tomography (DE-CT) for cardiac sarcoidosis (CS) in patients with or without implantable devices, including a quantitative comparison with late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Methods: Twenty-four patients (mean age, 64 ± 9 years; 17 women) with known or suspected CS underwent retrospective electrocardiogram-gated DE-CT at 80 kV with knowledge-based iterative model reconstruction. Fourteen patients without implantable devices also underwent LGE-CMR, while ten with pacemakers or implantable cardioverter-defibrillators did not. The presence of hyperenhanced myocardium was assessed visually and quantitatively using a 5-standard deviation threshold above the mean of remote myocardium. Results: Inter-observer agreement for visual detection of hyperenhanced segments on DE-CT was excellent in patients with implantable devices and in those without (κ = 0.91 and κ = 0.94, respectively). Comparisons of the percent area of hyperenhanced myocardium between DE-CT and LGE-CMR on both per-patient and per-segment analyses showed good correlations (r = 0.96 and r = 0.83, respectively; p < 0.001). The sensitivity and specificity of DE-CT for the diagnosis of CS were 94% and 33%. Conclusions: The extent of hyperenhanced lesion with DE-CT showed good agreement with LGE-CMR results. DE-CT showed high sensitivity for detecting CS and may be useful particularly in patients with contraindications to CMR. Key Points: • Delayed contrast-enhanced CT (DE-CT) can be applied to patients with implantable devices. • DE-CT can detect cardiac sarcoidosis (CS) lesions similarly to cardiac MRI. • DE-CT shows high sensitivity for detecting CS. • DE-CT may be useful particularly in patients with contraindications to cardiac MRI.

Original languageEnglish
Pages (from-to)4054-4063
Number of pages10
JournalEuropean Radiology
Volume27
Issue number10
DOIs
Publication statusPublished - Oct 1 2017

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Feasibility Studies
Sarcoidosis
Tomography
Gadolinium
Magnetic Resonance Spectroscopy
Equipment and Supplies
Myocardium
Implantable Defibrillators
Electrocardiography
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Aikawa, T., Oyama-Manabe, N., Naya, M., Ohira, H., Sugimoto, A., Tsujino, I., ... Tamaki, N. (2017). Delayed contrast-enhanced computed tomography in patients with known or suspected cardiac sarcoidosis: A feasibility study. European Radiology, 27(10), 4054-4063. https://doi.org/10.1007/s00330-017-4824-x

Delayed contrast-enhanced computed tomography in patients with known or suspected cardiac sarcoidosis : A feasibility study. / Aikawa, Tadao; Oyama-Manabe, Noriko; Naya, Masanao; Ohira, Hiroshi; Sugimoto, Ayako; Tsujino, Ichizo; Obara, Masahiko; Manabe, Osamu; Kudo, Kohsuke; Tsutsui, Hiroyuki; Tamaki, Nagara.

In: European Radiology, Vol. 27, No. 10, 01.10.2017, p. 4054-4063.

Research output: Contribution to journalArticle

Aikawa, T, Oyama-Manabe, N, Naya, M, Ohira, H, Sugimoto, A, Tsujino, I, Obara, M, Manabe, O, Kudo, K, Tsutsui, H & Tamaki, N 2017, 'Delayed contrast-enhanced computed tomography in patients with known or suspected cardiac sarcoidosis: A feasibility study', European Radiology, vol. 27, no. 10, pp. 4054-4063. https://doi.org/10.1007/s00330-017-4824-x
Aikawa, Tadao ; Oyama-Manabe, Noriko ; Naya, Masanao ; Ohira, Hiroshi ; Sugimoto, Ayako ; Tsujino, Ichizo ; Obara, Masahiko ; Manabe, Osamu ; Kudo, Kohsuke ; Tsutsui, Hiroyuki ; Tamaki, Nagara. / Delayed contrast-enhanced computed tomography in patients with known or suspected cardiac sarcoidosis : A feasibility study. In: European Radiology. 2017 ; Vol. 27, No. 10. pp. 4054-4063.
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AU - Aikawa, Tadao

AU - Oyama-Manabe, Noriko

AU - Naya, Masanao

AU - Ohira, Hiroshi

AU - Sugimoto, Ayako

AU - Tsujino, Ichizo

AU - Obara, Masahiko

AU - Manabe, Osamu

AU - Kudo, Kohsuke

AU - Tsutsui, Hiroyuki

AU - Tamaki, Nagara

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N2 - Objectives: To evaluate the diagnostic value of delayed contrast-enhanced computed tomography (DE-CT) for cardiac sarcoidosis (CS) in patients with or without implantable devices, including a quantitative comparison with late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Methods: Twenty-four patients (mean age, 64 ± 9 years; 17 women) with known or suspected CS underwent retrospective electrocardiogram-gated DE-CT at 80 kV with knowledge-based iterative model reconstruction. Fourteen patients without implantable devices also underwent LGE-CMR, while ten with pacemakers or implantable cardioverter-defibrillators did not. The presence of hyperenhanced myocardium was assessed visually and quantitatively using a 5-standard deviation threshold above the mean of remote myocardium. Results: Inter-observer agreement for visual detection of hyperenhanced segments on DE-CT was excellent in patients with implantable devices and in those without (κ = 0.91 and κ = 0.94, respectively). Comparisons of the percent area of hyperenhanced myocardium between DE-CT and LGE-CMR on both per-patient and per-segment analyses showed good correlations (r = 0.96 and r = 0.83, respectively; p < 0.001). The sensitivity and specificity of DE-CT for the diagnosis of CS were 94% and 33%. Conclusions: The extent of hyperenhanced lesion with DE-CT showed good agreement with LGE-CMR results. DE-CT showed high sensitivity for detecting CS and may be useful particularly in patients with contraindications to CMR. Key Points: • Delayed contrast-enhanced CT (DE-CT) can be applied to patients with implantable devices. • DE-CT can detect cardiac sarcoidosis (CS) lesions similarly to cardiac MRI. • DE-CT shows high sensitivity for detecting CS. • DE-CT may be useful particularly in patients with contraindications to cardiac MRI.

AB - Objectives: To evaluate the diagnostic value of delayed contrast-enhanced computed tomography (DE-CT) for cardiac sarcoidosis (CS) in patients with or without implantable devices, including a quantitative comparison with late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Methods: Twenty-four patients (mean age, 64 ± 9 years; 17 women) with known or suspected CS underwent retrospective electrocardiogram-gated DE-CT at 80 kV with knowledge-based iterative model reconstruction. Fourteen patients without implantable devices also underwent LGE-CMR, while ten with pacemakers or implantable cardioverter-defibrillators did not. The presence of hyperenhanced myocardium was assessed visually and quantitatively using a 5-standard deviation threshold above the mean of remote myocardium. Results: Inter-observer agreement for visual detection of hyperenhanced segments on DE-CT was excellent in patients with implantable devices and in those without (κ = 0.91 and κ = 0.94, respectively). Comparisons of the percent area of hyperenhanced myocardium between DE-CT and LGE-CMR on both per-patient and per-segment analyses showed good correlations (r = 0.96 and r = 0.83, respectively; p < 0.001). The sensitivity and specificity of DE-CT for the diagnosis of CS were 94% and 33%. Conclusions: The extent of hyperenhanced lesion with DE-CT showed good agreement with LGE-CMR results. DE-CT showed high sensitivity for detecting CS and may be useful particularly in patients with contraindications to CMR. Key Points: • Delayed contrast-enhanced CT (DE-CT) can be applied to patients with implantable devices. • DE-CT can detect cardiac sarcoidosis (CS) lesions similarly to cardiac MRI. • DE-CT shows high sensitivity for detecting CS. • DE-CT may be useful particularly in patients with contraindications to cardiac MRI.

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