Details of a Researcher - Jinzaki, Masahiro

Papers - Jinzaki, Masahiro

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Quantitative assessment of fatty infiltration and muscle volume of the rotator cuff muscles using 3-dimensional 2-point Dixon magnetic resonance imaging.

Matsumura N, Oguro S, Okuda S, Jinzaki M, Matsumoto M, Nakamura M, Nagura T.

Journal of Shoulder and Elbow Surgery (Elsevier) 26 ( 10 ) e309 - e318 2017.10

Research paper (scientific journal), Joint Work, ISSN 10582746

BACKGROUND:

In patients with rotator cuff tears, muscle degeneration is known to be a predictor of irreparable tears and poor outcomes after surgical repair. Fatty infiltration and volume of the whole muscles constituting the rotator cuff were quantitatively assessed using 3-dimensional 2-point Dixon magnetic resonance imaging.

METHODS:

Ten shoulders with a partial-thickness tear, 10 shoulders with an isolated supraspinatus tear, and 10 shoulders with a massive tear involving supraspinatus and infraspinatus were compared with 10 control shoulders after matching age and sex. With segmentation of muscle boundaries, the fat fraction value and the volume of the whole rotator cuff muscles were computed. After reliabilities were determined, differences in fat fraction, muscle volume, and fat-free muscle volume were evaluated.

RESULTS:

Intra-rater and inter-rater reliabilities were regarded as excellent for fat fraction and muscle volume. Tendon rupture adversely increased the fat fraction value of the respective rotator cuff muscle (P < .002). In the massive tear group, muscle volume was significantly decreased in the infraspinatus (P = .035) and increased in the teres minor (P = .039). With subtraction of fat volume, a significant decrease of fat-free volume of the supraspinatus muscle became apparent with a massive tear (P = .003).

CONCLUSION:

Three-dimensional measurement could evaluate fatty infiltration and muscular volume with excellent reliabilities. The present study showed that chronic rupture of the tendon adversely increases the fat fraction of the respective muscle and indicates that the residual capacity of the rotator cuff muscles might be overestimated in patients with severe fatty infiltration.

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Preliminary Experience of Endovascular Embolization Using N-Butyl Cyanoacrylate for Hemoptysis due to Infectious Pulmonary Artery Pseudoaneurysms via Systemic Arterial Approach.

Torikai H, Hasegawa I, Jinzaki M, Narimatsu Y.

Journal of Vascular and Interventional Radiology (Elsevier) 28 ( 10 ) 1438 - 1442.e1 2017.10

Research paper (scientific journal), Joint Work, ISSN 10510443

We report 5 patients with hemoptysis due to infectious pulmonary artery pseudoaneurysm (PAP) treated with endovascular embolization using N-butyl cyanoacrylate (NBCA) injected via bronchial and nonbronchial systemic arterial approaches. Infectious diseases included inactive tuberculosis (n = 3), nontuberculous mycobacteriosis (n = 1), and chronic infection of unknown origin (n = 1). Seven PAPs were detected on selective systemic angiography, and injection of NBCA was performed. Disappearance of all PAPs was confirmed on systemic arteriography after the intervention. In all patients, hemoptysis was stopped without major complications, and it did not recur during the follow-up period (mean, 351 d; range, 285-427 d).

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Bone SPECT/CT Localizes Increased Bone Metabolism and Subsequent Bone Resorption in Reflex Sympathetic Dystrophy.

Narimatsu H, Nakahara T, Kodama S, Hisazumi H, Tominaga S, Ohkuma K, Jinzaki M.

Clinical Nuclear Medicine (Wolters Kluwer Health) 42 ( 10 ) 784 - 786 2017.10

Research paper (scientific journal), Joint Work, ISSN 03639762

A 64-year-old man with lung cancer with a history of revascularization of the occluded right femoral artery underwent bone scintigraphy, which showed intense uptake in the distal side of the right leg. The additional SPECT/CT clarified that the uptake was predominantly increased in the epiphyses of the right ankle and foot with possible osteopenia. One month later, follow-up SPECT/CT showed the manifestation of periosteal resorption in the hypermetabolic sites with slight decrease in bone metabolism. Radiological correlation between bone metabolism and subsequent bone resorption in addition to clinical symptoms in this patient suggested the diagnosis of reflex sympathetic dystrophy.

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Image quality of virtual monochromatic images obtained using 320-detector row CT: A phantom study evaluating the effects of iterative reconstruction and body size

Okamura T., Yamada Y., Yamada M., Yamazaki A., Shiraga N., Jinzaki M.

European Journal of Radiology (European Journal of Radiology) 95 212 - 221 2017.10

ISSN 0720048X

Objectives To compare the image quality between virtual monochromatic spectral (VMS) images obtained using 320-row detector CT and polychromatic 120-kVp images reconstructed with or without iterative reconstruction using various phantom sizes. Materials and methods Torso phantoms simulating three patient sizes and containing four syringes filled with water or different contrast media (5, 10, 15 mgI/mL15 mgI/ml) were used. The phantoms were scanned using dual-energy (80/135-kVp) and single-energy (120-kVp) protocols at different settings (20 mGy, 12 mGy, and 6 mGy). VMS images were generated at 1-keV intervals (range, 35–135 keV). Both the VMS images and the single-energy 120-kVp images were reconstructed using filtered back projection (FBP) and adaptive iterative dose reduction 3D (AIDR-3D). The signal-to-noise ratio (SNR), and the contrast-to-noise ratio (CNR) were assessed. Results Using FBP reconstruction, the SNR and CNR of the VMS images were lower than or similar to those of the 120-kVp images for most dose settings. Using AIDR-3D reconstruction, however, the 70-keV VMS images had higher SNRs and CNRs than the 120-kVp images at most settings. Conclusions The image quality of VMS images with FBP reconstruction tended to be lower than that of the 120-kVp images. With the use of AIDR-3D, however, approximately 70-keV VMS images had a higher image quality than the 120-kVp images.

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【血管性病変の塞栓術　コンプレックスケースレビュー】コイル塞栓後に、瘤のネック近傍の再増大を認めた腎動脈瘤の1例

井上政則, 中塚誠之, 陣崎雅弘

IVR: Interventional Radiology ((一社)日本インターベンショナルラジオロジー学会) 32 ( 3 ) 192 - 196 2017.10

ISSN 1340-4520

症例は70歳代男性で、内腸骨動脈瘤の精査中に左腎動脈瘤を指摘された。ダイナミックCTでは、動脈相にて左腎門部近傍の腹側枝の分枝に洋なし状の26×24×23mm大の嚢状動脈瘤を認めた。壁在血栓を伴い、瘤壁の石灰化を部分的に認めた。末梢分枝の支配領域は狭いことを考慮して、末梢分枝を塞栓した上で瘤内塞栓を行う方針となった。瘤の流入血管の塞栓は行わず、末梢分枝の近位の枝は1本開存している。30ヵ月後のダイナミックCTにて瘤のネック部の急速な増大とコイルの変位を認めたため、再塞栓を施行した。CTでネック部は急速に増大しているため、真性瘤ではあると思われたが、瘤壁が脆弱である可能性が高いと判断した。このため瘤壁に圧をかけないように慎重にpackingを行い、そのコイルを土台に流入血管を密に塞栓する方針とした。DSAで瘤は完全に塞栓され、流入血管内のコイルも腎動脈に突出することなく密に塞栓されたことを確認して手技を終了した。

Diagnostic accuracy of lung subtraction iodine mapping CT for the evaluation of pulmonary perfusion in patients with chronic thromboembolic pulmonary hypertension: Correlation with perfusion SPECT/CT.

Tamura M, Yamada Y, Kawakami T, Kataoka M, Iwabuchi Y, Sugiura H, Hashimoto M, Nakahara T, Okuda S, Nakatsuka S, Sano F, Abe T, Maekawa Y, Fukuda K, Jinzaki M.

International Journal of Cardiology (Elsevier) 243 538 - 543 2017.09

Research paper (scientific journal), Joint Work, ISSN 01675273

BACKGROUND:

For treatment of chronic thromboembolic pulmonary hypertension (CTEPH), the evaluation of segmental pulmonary perfusion is important. There are no previous reports about lung subtraction iodine mapping (LSIM) computed tomography (CT) for evaluation of segmental pulmonary perfusion in patients with CTEPH, using lung perfusion SPECT/CT (LPS) as the reference.

METHODS:

50 patients (age, 60.7±16.7years) with known or suspected CTEPH were enrolled in this study. Non-contrast chest CT and CT pulmonary angiography (CTPA) were performed on a 320-detector row CT system. Then, based on a non-rigid registration followed by subtraction of non-contrast images from contrast-enhanced images, color-coded LSIM images were generated. LPS was performed using a SPECT/CT system within a period of 2months, and served as the reference standard. LSIM and CTPA images were evaluated in a blinded manner for the detection of pulmonary perfusion defects on a segment-by-segment basis.

RESULTS:

The sensitivity, specificity, accuracy, and positive and negative predictive values of LSIM for the detection of segmental perfusion defects were 95% (734/773), 84% (107/127), 93% (841/900), 97% (734/754) and 73% (107/146), respectively, while the corresponding values for CTPA were 65% (505/773), 61% (78/127), 65% (583/900), 91% (505/554) and 23% (78/346). Generalized estimating equations analyses revealed a significantly better performance of LSIM than that of CTPA regarding the sensitivity, accuracy, and positive and negative predictive values (all P<0.0001).

CONCLUSIONS:

LSIM is a feasible technique for segment-based evaluation of pulmonary perfusion in patients with CTEPH, and it provides a significantly higher diagnostic accuracy compared with CTPA.

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Preoperatively determining the margins of subcutaneous malignant soft tissue tumours using contrast-enhanced ultrasonography.

Oguro S, Kikuta K, Sasaki A, Okuma K, Matsumoto S, Sugiura H, Morioka H, Nakamura M, Matsumoto M, Jinzaki M.

Journal of Medical Ultrasonics(2001) (Springer) Epub ahead of print ( 2 ) 385 - 388 2017.09

Research paper (scientific journal), Joint Work, ISSN 13464523

The purpose of this technical report is to demonstrate the feasibility of contrast-enhanced ultrasonography for preoperative evaluation of the lateral extent of subcutaneous malignant soft tissue tumours. Patients with subcutaneous malignant soft tissue tumours who underwent surgery between March 2016 and May 2016 were selected for inclusion. Contrast-enhanced ultrasonography using Sonazoid® was performed 1 day before the operation. The tumour margin was determined based on contrast-enhanced ultrasonography and marked on the skin using a permanent marker. After surgery, the extent of the tumour area was determined based on microscopic findings. The distance between the edge of the tumour and the skin markings was histologically measured. The mean distance between the extent of infiltrative tumour growth based on the microscopic findings and the skin marking was 1.3 ± 1.6 mm. The greatest distance between microscopically determined tumour invasion and the skin marking was 4 mm. Contrast-enhanced ultrasonography of subcutaneous malignant soft tissue tumours was not only feasible, but also highly accurate in estimating tumour margins as well as infiltrative tumour growth compared with macroscopic and microscopic analysis, respectively.

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婦人科疾患の鑑別診断のポイント第2章子宮頸部　1. 子宮頸部の充実性腫瘤の鑑別

秋田あやの, 秋田大宇, 奥田茂男, 陣崎雅弘

画像診断 (学研メディカル秀潤社) 37 ( 11 ) s50 - s55 2017.09

ISSN 0285-0524

婦人科疾患の鑑別診断のポイント第2章子宮頸部　2. 子宮頸管内腫瘤の鑑別

秋田あやの, 秋田大宇, 奥田茂男, 陣崎雅弘

画像診断 (学研メディカル秀潤社) 37 ( 11 ) s56 - s61 2017.09

ISSN 0285-0524

Imaging Findings of Atypical Type II Endoleak Through Vasa Vasorum After Abdominal Endovascular Aneurysm Repair.

Torikai H, Inoue M, Nakatsuka S, Tamura M, Yashiro H, Yoshitake A, Shimizu H, Jinzaki M

CardioVascular and Interventional Radiology (Springer) Epub ahead of print ( 1 ) 186 - 190 2017.08

Research paper (scientific journal), Joint Work, ISSN 01741551

A type II endoleak (T2EL) is the most common endoleak after endovascular aneurysm repair (EVAR), and a persistent T2EL has been occasionally associated with aneurysmal enlargement. Typical findings of a T2EL consist of an endoleak cavity with inflow and outflow arteries of aortic branch vessels. However, an atypical T2EL, in which hypertrophied vasa vasorum and enlargement of a thrombosed aneurysm are observed, has no endoleak cavity. We have seen three cases of continuous aortic aneurysmal growth after EVAR caused by atypical T2ELs without endoleak cavities through developed vasa vasorum. In this report, the imaging findings of selective angiography and dynamic computed tomography of these cases are reviewed.

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腎嚢胞のCT画像に生じるpseudoenhancement effectの抑制に関わる撮影条件の検討　連続X線と仮想単色X線、画像再構成法、およびビーム幅の違いにおけるファントム検証

杉澤浩一, 市川勝弘, 南島一也, 長谷川雅一, 山田祥岳, 陣崎雅弘

日本放射線技術学会雑誌 ((公社)日本放射線技術学会) 73 ( 8 ) 636 - 645 2017.08

ISSN 0369-4305

Relationship between diminution of small pulmonary vessels and emphysema in chronic obstructive pulmonary disease.

Mashimo S, Chubachi S, Tsutsumi A, Kameyama N, Sasaki M, Jinzaki M, Nakamura H, Asano K, Reilly JJ Jr, Betsuyaku T.

Clinical Imaging (Elsevier) 46 85 - 90 2017.07

Research paper (scientific journal), Joint Work, ISSN 08997071

OBJECTIVES:

To investigate the relationship between small pulmonary vessels and extent of emphysema on CT in individual lungs with chronic obstructive pulmonary disease (COPD).

METHODS:

Forty-nine patients were included. The percentage of cross-sectional area of vessels <5mm2 (%CSA <5) and extent of emphysema were assessed.

RESULTS:

Less than half of the COPD patients demonstrated an inverse correlation between %CSA <5 and percentage of low attenuation area (LAA%). In the remaining patients, %CSA <5 was homogeneously distributed.

CONCLUSION:

Not all patients with COPD demonstrated an inverse correlation of the distributions between %CSA <5 and LAA% in individual lungs.

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Pre-treatment interleukin-6 levels strongly affect bone erosion progression and repair detected by magnetic resonance imaging in rheumatoid arthritis patients.

Kondo Y, Kaneko Y, Sugiura H, Matsumoto S, Nishina N, Kuwana M, Jinzaki M, Takeuchi T

Rheumatology (Oxford Academic) 56 ( 7 ) 1089 - 1094 2017.07

Research paper (scientific journal), Joint Work, ISSN 14620324

Objective.:

To examine the relationship between MRI structural damage and repair and plasma inflammatory cytokines in patients with RA.

Methods.:

A total of 88 newly diagnosed, untreated RA patients were enrolled. Contrast MRI of the dominant hand and X-rays of the hands and feet were performed at baseline and 1 year later. MR images were evaluated using RA MRI scoring, and X-ray.

were assessed by the modified total Sharp score. Erosion progression was defined as changes in RA MRI scoring erosion or modified total Sharp score erosion of >0.5. Erosion repair was defined as erosion score changes of less than -0.5. Plasma levels of 10 cytokines were measured by electrochemiluminescence assay.

Results.:

Progression of bone erosion and repair were observed more frequently in MRI than in X-rays (erosion, 52% vs 26%, P < 0.001; repair, 26% vs 15%, P = 0.003, respectively). Baseline IL-6 levels and seropositivity were independent relevant factors for MRI erosion progression, with IL-6 having stronger effect than seropositivity. A receiver operating characteristic curve identified the baseline IL-6 level of 7.6 pg/ml for predicting erosion progression during 1 year, with an area under the curve of 0.82; higher IL-6 levels resulted in more erosion progression. Baseline low IL-6 was also an independent predictor for MRI erosion repair.

Conclusion.:

In newly diagnosed, untreated RA patients, baseline plasma IL-6 levels are responsible for 1-year MRI bone erosion progression and repair.

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Prognostic Value of Combined CT Angiography and Myocardial Perfusion Imaging versus Invasive Coronary Angiography and Nuclear Stress Perfusion Imaging in the Prediction of Major Adverse Cardiovascular Events: The CORE320 Multicenter Study.

Chen MY, Rochitte CE, Arbab-Zadeh A, Dewey M, George RT, Miller JM, Niinuma H, Yoshioka K, Kitagawa K, Sakuma H, Laham R, Vavere AL, Cerci RJ, Mehra VC, Nomura C, Kofoed KF, Jinzaki M, Kuribayashi S, Scholte AJ, Laule M, Tan SY, Hoe J, Paul N, Rybicki FJ, Brinker JA, Arai AE, Matheson MB, Cox C, Clouse ME, Di Carli MF, Lima JA.

Radiology (RSNA) 284 ( 1 ) 55 - 65 2017.07

Research paper (scientific journal), Joint Work, ISSN 00338419

Purpose To compare the prognostic importance (time to major adverse cardiovascular event [MACE]) of combined computed tomography (CT) angiography and CT myocardial stress perfusion imaging with that of combined invasive coronary angiography (ICA) and stress single photon emission CT myocardial perfusion imaging. Materials and Methods This study was approved by all institutional review boards, and written informed consent was obtained. Between November 2009 and July 2011, 381 participants clinically referred for ICA and aged 45-85 years were enrolled in the Combined Noninvasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-Detector Row Computed Tomography (CORE320) prospective multicenter diagnostic study. All images were analyzed in blinded independent core laboratories, and a panel of physicians adjudicated all adverse events. MACE was defined as revascularization (>30 days after index ICA), myocardial infarction, or cardiac death; hospitalization for chest pain or congestive heart failure; or arrhythmia. Late MACE was defined similarly, except for patients who underwent revascularization within the first 182 days after ICA, who were excluded. Comparisons of 2-year survival (time to MACE) used standard Kaplan-Meier curves and restricted mean survival times bootstrapped with 2000 replicates. Results An MACE (49 revascularizations, five myocardial infarctions, one cardiac death, nine hospitalizations for chest pain or congestive heart failure, and one arrhythmia) occurred in 51 of 379 patients (13.5%). The 2-year MACE-free rates for combined CT angiography and CT perfusion findings were 94% negative for coronary artery disease (CAD) versus 82% positive for CAD and were similar to combined ICA and single photon emission CT findings (93% negative for CAD vs 77% positive for CAD, P < .001 for both). Event-free rates for CT angiography and CT perfusion versus ICA and single photon emission CT for either positive or negative results were not significantly different for MACE or late MACE (P > .05 for all). The area under the receiver operating characteristic curve (AUC) for combined CT angiography and CT perfusion (AUC = 68; 95% confidence interval [CI]: 62, 75) was similar (P = .36) to that for combined ICA and single photon emission CT (AUC = 71; 95% CI: 65, 79) in the identification of MACE at 2-year follow-up. Conclusion Combined CT angiography and CT perfusion enables similar prediction of 2-year MACE, late MACE, and event-free survival similar to that enabled by ICA and single photon emission CT. © RSNA, 2017 Online supplemental material is available for this article.

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Difference in the craniocaudal gradient of the maximum pixel value change rate between chronic obstructive pulmonary disease patients and normal subjects using sub-mGy dynamic chest radiography with a flat panel detector system.

Yamada Y, Ueyama M, Abe T, Araki T, Abe T, Nishino M, Jinzaki M, Hatabu H, Kudoh S.

European Journal of Radiology (Elsevier) 92 37 - 44 2017.07

Research paper (scientific journal), Joint Work, ISSN 0720048X

OBJECTIVES:

To compare the craniocaudal gradients of the maximum pixel value change rate (MPCR) during tidal breathing between chronic obstructive pulmonary disease (COPD) patients and normal subjects using dynamic chest radiography.

MATERIALS AND METHODS:

This prospective study was approved by the institutional review board and all participants provided written informed consent. Forty-three COPD patients (mean age, 71.6±8.7 years) and 47 normal subjects (non-smoker healthy volunteers) (mean age, 54.8±9.8 years) underwent sequential chest radiographs during tidal breathing in a standing position using dynamic chest radiography with a flat panel detector system. We evaluated the craniocaudal gradient of MPCR. The results were analyzed using an unpaired t-test and the Tukey-Kramer method.

RESULTS:

The craniocaudal gradients of MPCR in COPD patients were significantly lower than those in normal subjects (right inspiratory phase, 75.5±48.1 vs. 108.9±42.0s-1cm-1, P<0.001; right expiratory phase, 66.4±40.6 vs. 89.8±31.6s-1cm-1, P=0.003; left inspiratory phase, 75.5±48.2 vs. 108.2±47.2s-1cm-1, P=0.002; left expiratory phase, 60.9±38.2 vs. 84.3±29.5s-1cm-1, P=0.002). No significant differences in height, weight, or BMI were observed between COPD and normal groups. In the sub-analysis, the gradients in severe COPD patients (global initiative for chronic obstructive lung disease [GOLD] 3 or 4, n=26) were significantly lower than those in mild COPD patients (GOLD 1 or 2, n=17) for both right and left inspiratory/expiratory phases (all P≤0.005).

CONCLUSIONS:

A decrease of the craniocaudal gradient of MPCR was observed in COPD patients. The craniocaudal gradient was lower in severe COPD patients than in mild COPD patients.

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FDG-PET/CTにて原発巣の指摘が困難であった転移性卵巣癌の一例

岩渕雄, 中原理紀, 片桐真理, 伊藤一成, 松坂陽至, 緒方雄史, 陣崎雅弘

臨床核医学 (放射線診療研究会) 50 ( 4 ) 50 - 52 2017.07

ISSN 0912-5817

症例は40歳代女性で、10年前、左卵巣癌ステージIa(粘液性腺癌G1)に対し左付属器切除術が行われた。下腹部痛で受診し、卵巣腫大を指摘され、産婦人科へ紹介受診となった。経腟超音波で内部に嚢胞成分を伴う卵巣充実性腫瘍を認め、術前に精査のため造影FDG-PET/CTを施行した。右卵巣に16cm大の嚢胞成分を伴う腫瘤を認め、SUVmax:3.15とFDG軽度集積亢進を認めた。卵巣原発もしくは転移性卵巣癌のも考えられたが、PETのMIP像で積極的に原発巣を疑うような明瞭なFDG異常蓄積は指摘できなかった。しかし、造影CTでは胃のび漫性壁肥厚を認め、腹腔動脈近傍から左胃動脈周囲に不整な軟部影形成を認めた。転移性卵巣癌の可能性が考えられ、MRIを施行したところ、骨盤内に嚢胞成分を有し、T2強調像で全体に高信号を呈する腫瘍性病変を認めた。脂肪抑制造影T1強調像では腫瘍内部に緩徐な造影効果を認めた。症状、画像から卵巣茎捻転とそれに伴う卵巣広範性浮腫が疑われ、緊急で腹式単純子宮全摘+右付属器切除術を施行した。部分的な腺管形成傾向も認め、多臓器からの腺癌の転移と診断した。上部消化管内視鏡検査で胃に潰瘍性病変や粘膜上皮の肥厚が確認され、生検で粘液を含む印環細胞癌およびそれに伴う転移性卵巣癌(Krukenberg腫瘍)と診断し、化学療法のため消化器内科に転科となった。

Three-dimensional measurement of the human cadaver foot bone kinematics under axial loading condition using biplane X-ray fluoroscopy

Ito K., Hosoda K., Shimizu M., Ikemoto S., Nagura T., Seki H., Kitashiro M., Jinzaki M., Imanishi N., Aiso S., Ogihara N.

Footwear Science (Footwear Science) 9 S148 - S150 2017.06

ISSN 19424280

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Low-signal Intensity Rims along the Cerebral Cortex and U-fibers on Susceptibility-weighted Imaging in Progressive Multifocal Leukoencephalopathy.

Arita Y, Fujiwara H, Kurasawa J, Momoshima S, Takizawa T, Jinzaki M.

Magnetic Resonance in Medicine (Wiley) Epub ahead of print 2017.06

Research paper (scientific journal), Joint Work

産婦人科におけるリスクマネジメント妊娠中のX線照射

鈴木達也, 奥田茂男, 杉澤浩一, 陣崎雅弘

産婦人科の実際 (金原出版) 66 ( 6 ) 753 - 757 2017.06

ISSN 0558-4728

Quantitative Analysis of Iodine Image of Dual-energy Computed Tomography at Rest: Comparison With 99mTc-Tetrofosmin Stress-rest Single-photon Emission Computed Tomography Myocardial Perfusion Imaging as the Reference Standard.

Nakahara T, Toyama T, Jinzaki M, Seki R, Saito Y, Higuchi T, Yamada M, Arai M, Tsushima Y, Kuribayashi S, Kurabayashi M.

Journal of Thoracic Imaging (LWW Journals) Epub ahead of print ( 2 ) 97 - 104 2017.06

Research paper (scientific journal), ISSN 08835993

PURPOSE:

Dual-energy computed tomography (DECT) can be used for visual determination of iodine distribution in the myocardium (iodine image); however, the accuracy and reproducibility of the process remains debatable. Because of the low contrast-to-noise ratio of CT, we hypothesized that quantitative measurement may be more accurate for detecting myocardial ischemia. In this study, we evaluated our quantitative method by comparing it with visual analysis using Tc-tetrofosmin (TF) stress-rest single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) as the reference standard.

MATERIALS AND METHODS:

Forty-three patients who had a significant stenosis on cardiac rest DECT and had received Tc-TF stress-rest SPECT MPI within 1 month were retrospectively analyzed. The regions of interest were set on iodine images in accordance with the American Heart Association (AHA) 17-segment model (a total of 731 segments). The regions of interest values were divided by the amount of iodine (mg) per unit weight (kg) and defined as perfusion value (perfusion value analysis). All segments were also visually analyzed and receiver operating characteristic curve analysis performed to identify the superior analysis.

RESULTS:

The receiver operating characteristic curve analysis showed that perfusion value analysis is significantly superior to visual analysis [the area under the curve: 0.921 (95% confidence interval, 0.860-0.981) versus 0.685 (95% confidence interval, 0.580-0.791), respectively, P<0.05], with 93.8% sensitivity, 99.1% specificity, 98.9% accuracy, 83.3% positive predictive value, and 99.7% negative predictive value (P<0.01).

CONCLUSIONS:

Quantitative analysis of the iodine image of rest DECT, called perfusion value analysis, is more accurate than visual analysis when compared with Tc-TF SPECT MPI as the reference standard.

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