scholarly journals Diagnostic Performance of Unenhanced Electrocardiogram-gated Cardiac CT for Myocardial Edema Using Cardiac T2 Mapping as a Reference Standard

2021 ◽  
Author(s):  
Takafumi Emoto ◽  
Masafumi Kidoh ◽  
Seitaro Oda ◽  
Daisuke Sakabe ◽  
Kosuke Morita ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Large Scale ◽  
Tissue Characterization ◽  
Cardiac Ct ◽  
Volume Fraction ◽  
T2 Mapping ◽  
Characteristic Curve ◽  
Extracellular Volume ◽  
Myocardial Edema ◽  
Reference Standard

Abstract Purpose To assess the diagnostic performance of unenhanced electrocardiogram (ECG)-gated cardiac CT for myocardial edema, using T2 mapping as the reference standard. Methods This study included 34 patients (23 men; age 64.7 ± 14.6 years) who underwent cardiac CT and MRI. On the unenhanced ECG-gated cardiac CT images, regions of interest (ROIs) were drawn on the septal myocardium. Using T2 mapping as the reference standard, the diagnostic performance of unenhanced cardiac CT for myocardial edema was evaluated by using the area under the receiver operating characteristic curve (AUC) with sensitivity and specificity. Results Mean CT values moderately correlated with mean T2 values (Rho = -0.41; P < 0.05). Mean CT values provided a sensitivity of 63.2% and a specificity of 93.3% for detecting myocardial edema, with a cut-off value of ≤ 45.0 HU (AUC = 0.77; P < 0.01). Inter-observer reproducibility in measuring mean CT values was excellent (ICC = 0.93; [95% CI: 0.86, 0.96]). Conclusion This is the first clinical study to assess the diagnostic performance of unenhanced ECG-gated cardiac CT for myocardial edema, using T2 mapping as the reference standard. Our study suggested that the CT value of myocardium in unenhanced ECG-gated cardiac CT may be an optional parameter in addition to late iodine enhancement and extracellular volume fraction for myocardial tissue characterization, but further prospective, large-scale clinical studies are needed.

scholarly journals T1 and T2 Mapping in Cardiology: “Mapping the Obscure Object of Desire”

Cardiology ◽  
2017 ◽  
Vol 138 (4) ◽  
pp. 207-217 ◽  
Author(s):  
Sophie Mavrogeni ◽  
Dimitris Apostolou ◽  
Panayiotis Argyriou ◽  
Stella Velitsista ◽  
Lilika Papa ◽  
...  
Keyword(s):  
Heart Failure ◽  
T1 Mapping ◽  
Clinical Decision Making ◽  
Volume Fraction ◽  
T2 Mapping ◽  
Extracellular Volume ◽  
Diffuse Fibrosis ◽  
Post Contrast ◽  
Cardiac Amyloid ◽  
Native T1

The increasing use of cardiovascular magnetic resonance (CMR) is based on its capability to perform biventricular function assessment and tissue characterization without radiation and with high reproducibility. The use of late gadolinium enhancement (LGE) gave the potential of non-invasive biopsy for fibrosis quantification. However, LGE is unable to detect diffuse myocardial disease. Native T1 mapping and extracellular volume fraction (ECV) provide knowledge about pathologies affecting both the myocardium and interstitium that is otherwise difficult to identify. Changes of myocardial native T1 reflect cardiac diseases (acute coronary syndromes, infarction, myocarditis, and diffuse fibrosis, all with high T1) and systemic diseases such as cardiac amyloid (high T1), Anderson-Fabry disease (low T1), and siderosis (low T1). The ECV, an index generated by native and post-contrast T1 mapping, measures the cellular and extracellular interstitial matrix (ECM) compartments. This myocyte-ECM dichotomy has important implications for identifying specific therapeutic targets of great value for heart failure treatment. On the other hand, T2 mapping is superior compared with myocardial T1 and ECM for assessing the activity of myocarditis in recent-onset heart failure. Although these indices can significantly affect the clinical decision making, multicentre studies and a community-wide approach (including MRI vendors, funding, software, contrast agent manufacturers, and clinicians) are still missing.

scholarly journals Non-invasive assessment of liver fibrosis in autoimmune hepatitis: Diagnostic value of liver magnetic resonance parametric mapping including extracellular volume fraction

2020 ◽  
Author(s):  
Narine Mesropyan ◽  
Patrick Kupczyk ◽  
Leona Dold ◽  
Tobias J. Weismüller ◽  
Alois M. Sprinkart ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Liver Stiffness ◽  
Extracellular Volume Fraction ◽  
Diagnostic Value ◽  
Parametric Mapping ◽  
Significant Fibrosis ◽  
Non Invasive ◽  
Mapping Parameters

Abstract Purpose Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease that leads to severe fibrosis and cirrhosis. The aim of this study was to determine the diagnostic value of T1 and T2 mapping as well as extracellular volume fraction (ECV) for non-invasive assessment of liver fibrosis in AIH patients. Methods In this prospective study, 27 patients (age range: 19–77 years) with AIH underwent liver MRI. T1 and T2 relaxation times as well as ECV were quantified by mapping techniques. The presence of significant fibrosis (≥ F2) was defined as magnetic resonance elastography (MRE)-based liver stiffness ≥ 3.66 kPa. MRE was used as reference standard, against which the diagnostic performance of MRI-derived mapping parameters was tested. Diagnostic performance was compared by utilizing receiver-operating characteristic (ROC) analysis. Results MRE-based liver stiffness correlated with both, hepatic native T1 (r = 0.69; P < 0.001) as well as ECV (r = 0.80; P < 0.001). For the assessment of significant fibrosis, ECV yielded a sensitivity of 85.7% (95% confidence interval (CI): 60.1–96.0%) and a specificity of 84.6% (CI 60.1–96.0%); hepatic native T1 yielded a sensitivity of 85.7% (CI 60.1–96.0%); and a specificity of 76.9% (CI 49.7–91.8%). Diagnostic performance of hepatic ECV (area under the curve (AUC): 0.885), native hepatic T1 (AUC: 0.846) for assessment of significant fibrosis was similar compared to clinical fibrosis scores (APRI (AUC: 0.852), FIB-4 (AUC: 0.758), and AAR (0.654) (P > 0.05 for each comparison)). Conclusion Quantitative mapping parameters such as T1 and ECV can identify significant fibrosis in AIH patients. Future studies are needed to explore the value of parametric mapping for the evaluation of different disease stages.

scholarly journals Diagnostic performance of lung ultrasound for transient tachypnea of the newborn: A meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248827
Author(s):  
Lili He ◽  
Yinghua Sun ◽  
Wei Sheng ◽  
Qiong Yao
Keyword(s):  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Large Scale ◽  
Lung Ultrasound ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Relevant Literature ◽  
Cochrane Library ◽  
Lower Sensitivity ◽  
Summary Receiver Operating Characteristic

Several recent studies demonstrated that lung ultrasound could achieve desired diagnostic accuracy for transient tachypnea of the neonate (TTN). However, the diagnostic performance of lung ultrasound for TTN has not been systematically studied to date. This meta-analysis aimed to investigate the performance of lung ultrasound in diagnosing TTN. The relevant literature was searched in PubMed, Medline, the Cochrane Library, and Embase databases without any restriction in terms of language and time until January 31, 2021. Studies that assessed the diagnostic performance of lung ultrasound for TTN were included. Seven studies with 1514 participants were summarized. The lung ultrasound provided more accurate performance for diagnosing TTN with pooled sensitivity and specificity of 0.67 [95% confidence interval (CI) = 0.63–0.71] and 0.97 (95% CI = 0.95–0.98), respectively. A higher summarized area under the summary receiver operating characteristic curve was observed as 0.9906. Lower sensitivity and area under the curve (AUC) of B-lines for TTN were observed as 0.330 (95% CI = 0.27–0.38) and 0.5000, respectively. Lung ultrasound provided highly accurate AUC, sensitivity, and specificity in detecting TTN. Large-scale studies are warranted in the future to confirm these results.

scholarly journals Diagnostic performance and clinical implications of rapid SARS-CoV-2 antigen testing in Mexico using real-world nationwide COVID-19 registry data

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256447
Author(s):  
Omar Yaxmehen Bello-Chavolla ◽  
Neftali Eduardo Antonio-Villa ◽  
Luisa Fernández-Chirino ◽  
Enrique C. Guerra ◽  
Carlos A. Fermín-Martínez ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Diagnostic Performance ◽  
Large Scale ◽  
Characteristic Curve ◽  
False Negative ◽  
High Specificity ◽  
Adverse Outcomes ◽  
Clinical Implications ◽  
Predictive Values ◽  
Qrt Pcr

Background SARS-CoV-2 testing capacity is important to monitor epidemic dynamics and as a mitigation strategy. Given difficulties of large-scale quantitative reverse transcription polymerase chain reaction (qRT-PCR) implementation, rapid antigen tests (Rapid Ag-T) have been proposed as alternatives in settings like Mexico. Here, we evaluated diagnostic performance of Rapid Ag-T for SARS-CoV-2 infection and its associated clinical implications compared to qRT-PCR testing in Mexico. Methods We analyzed data from the COVID-19 registry of the Mexican General Directorate of Epidemiology up to April 30th, 2021 (n = 6,632,938) and cases with both qRT-PCR and Rapid Ag-T (n = 216,388). We evaluated diagnostic performance using accuracy measures and assessed time-dependent changes in the Area Under the Receiver Operating Characteristic curve (AUROC). We also explored test discordances as predictors of hospitalization, intubation, severe COVID-19 and mortality. Results Rapid Ag-T is primarily used in Mexico City. Rapid Ag-T have low sensitivity 37.6% (95%CI 36.6–38.7), high specificity 95.5% (95%CI 95.1–95.8) and acceptable positive 86.1% (95%CI 85.0–86.6) and negative predictive values 67.2% (95%CI 66.2–69.2). Rapid Ag-T has optimal diagnostic performance up to days 3 after symptom onset, and its performance is modified by testing location, comorbidity, and age. qRT-PCR (-) / Rapid Ag-T (+) cases had higher risk of adverse COVID-19 outcomes (HR 1.54 95% CI 1.41–1.68) and were older, qRT-PCR (+)/ Rapid Ag-T(-) cases had slightly higher risk or adverse outcomes and ≥7 days from symptom onset (HR 1.53 95% CI 1.48–1.59). Cases detected with rapid Ag-T were younger, without comorbidities, and milder COVID-19 course. Conclusions Rapid Ag-T could be used as an alternative to qRT-PCR for large scale SARS-CoV-2 testing in Mexico. Interpretation of Rapid Ag-T results should be done with caution to minimize the risk associated with false negative results.

scholarly journals A Framework of Whole Heart Extracellular Volume Fraction Estimation for Low-Dose Cardiac CT Images

2012 ◽  
Vol 16 (5) ◽  
pp. 842-851 ◽  
Author(s):  
Xinjian Chen ◽  
Marcelo S. Nacif ◽  
Songtao Liu ◽  
Christopher Sibley ◽  
Ronald M. Summers ◽  
...  
Keyword(s):  
Low Dose ◽  
Cardiac Ct ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Extracellular Volume Fraction ◽  
Ct Images ◽  
Whole Heart

scholarly journals Evaluation of Extracellular Volume by Computed Tomography is Useful for Prediction of Prognosis in Dilated Cardiomyopathy

2021 ◽  
Author(s):  
Satomi Yashima ◽  
Hiroyuki Takaoka ◽  
Manami Takahashi ◽  
Makiko Kinoshita ◽  
Haruka Sasaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Dilated Cardiomyopathy ◽  
Cardiac Ct ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Left Ventricular ◽  
Cox Proportional Hazards Model ◽  
Left Ventricular Myocardium ◽  
Operating Characteristics

Abstract Purpose: Dilated cardiomyopathy (DCM) is commonly encountered in daily clinical practice, and screening for coronary artery disease and other cardiomyopathies is necessary for its diagnosis. Cardiac CT is useful for the screening of coronary artery stenosis, and extracellular volume fraction (ECV) analysis by CT has become available using new specific software. Here, we evaluated the utility of ECV analysis using cardiac CT to predict patient prognosis in cases with DCM. Methods: We analyzed 70 cases with DCM and coronary computed tomography (CT) with available late-phase images. We evaluated the ECV of the left ventricular myocardium (LVM) using commercially available software (Ziostation 2, Ziosoft Inc, Japan). Results: ECV on LVM was 34.5±4.9%. Major adverse cardiac events (MACE) occurred in 20 cases (29%). ECV of the LVM on CT and the presence of significant valvular disease were significantly higher in cases with MACE than in those without (37.6±5.9 vs 33.2±3.9% and 55% vs 24%, P=0.0057 and P=0.013). LVEF was significantly lower in cases with MACE than in those without (22.3±7.6 vs 30.8±11.8%, P=0.0008). The best cut-off value of ECV on LVM for prediction of MACE was 32.7% based on receiver operating characteristics analysis. Cases with ECV ≥32.7% had significantly higher MACE based on Kaplan-Meier analysis (P=0.012). Only ECV on LVM was an independent predictor of MACE based on a Cox proportional hazards model (P=0.028). Conclusion: Evaluation of ECV on LVM by CT is useful for predicting MACE in patients with DCM.

scholarly journals Quantification of Liver Fibrosis at T1 and T2 Mapping with Extracellular Volume Fraction MRI: Preclinical Results

Radiology ◽  
2018 ◽  
Vol 288 (3) ◽  
pp. 748-754 ◽  
Author(s):  
Julian A. Luetkens ◽  
Sabine Klein ◽  
Frank Träber ◽  
Frederic C. Schmeel ◽  
Alois M. Sprinkart ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Volume Fraction ◽  
T2 Mapping ◽  
Extracellular Volume ◽  
Extracellular Volume Fraction ◽  
T1 And T2

Abstract 16663: Importance of Assessment for Diffuse Ventricular Fibrosis in Atrial Fibrillation Using Cardiac Ct-Derived Myocardial Extracellular Volume Fraction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hisanori Kanazawa ◽  
Miwa Ito ◽  
Yusei Kawahara ◽  
Tadashi Hoshiyama ◽  
Kenichi Tsujita
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Ct ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Extracellular Volume Fraction ◽  
Left Ventricular ◽  
Volume Index ◽  
Characteristic Analysis ◽  
Recurrence Group ◽  
Af Recurrence

Introduction: Previous cardiac MRI studies reported that the baseline diffuse LV fibrosis status should be evaluated before performing catheter ablation (CA) to identify the responders early and triage them with appropriate treatment. However, no study has been conducted to evaluate diffuse LV fibrosis in conjunction with pre-ablation planning cardiac CT. Objectives: The purpose of this study was to quantify diffuse left ventricular (LV) fibrosis by the CT-derived extracellular volume fraction (CT-ECV%) in conjunction with cardiac CT performed for CA planning and evaluate its determinants in patients with atrial fibrillation (AF). Methods: Prior to AF ablation, 98 patients (50 patients with paroxysmal AF and 48 patients with persistent AF) underwent pre-ablation planning cardiac CT. Additionally, delayed cardiac CT was performed to measure CT-ECV% as an index of diffuse myocardial fibrosis. Results: Persistent AF patients more frequently had a history of heart failure. Left atrial (LA) volume index was greater in persistent AF patients compared with paroxysmal AF patients. CT-ECV% of persistent AF patients was significantly higher than that of paroxysmal AF patients (30 ± 5 % vs. 26 ± 5 %, p < 0.001). Univariate and multivariate analysis revealed that only persistent AF was independent associated with CT-ECV%. Furthermore, CT-ECV% in recurrence group after CA for AF was higher than that in non-recurrence group (29 ± 4 % vs. 26 ± 5 %, p = 0.013). Multivariate logistic regression analysis revealed that CT-ECV% was significantly correlated with AF recurrence after CA for AF. Receiver operating characteristic analysis showed that more than 28 % in the CT-ECV% was a significant predictor of AF recurrence (area under the curve 0.692, log-rank test: p < 0.001). Conclusions: The quantification of diffuse LV fibrosis by CT-ECV% in conjunction with pre-ablation planning cardiac CT is feasible in AF patients, and persistent AF is independently associated with increasing diffuse LV fibrosis. Furthermore, CT-ECV% was significantly associated with AF recurrence after CA for AF. These findings suggested that it was more important to evaluate cardiac remodeling using CT and intervene early in AF.

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