title: Dual-energy CT and its potential use for quantitative myocardial CT perfusion.
abstract: Application of quantitative myocardial CT perfusion (CTP) for the assessment of coronary artery disease may have a significant effect on patient care as the functional significance of a coronary stenosis can be evaluated through absolute measurement of the downstream myocardial perfusion (MP) both at rest and under exercise or pharmacologic stress. A main challenge of myocardial CTP is beam hardening (BH), arising from the polychromatic nature of x-rays used in CT scanning and the presence of highly attenuating contrast agent in the heart chambers during the CT acquisition. The BH effect induces significant nonuniform shifts in CT numbers which, if uncorrected, can lead to inaccurate assessment of MP. With the recent developments of dual-energy CT (DECT) scanning on clinical scanners, the BH effect on MP measurement could be reduced with the generation of monochromatic images relatively free of BH artifacts from the acquired dual-energy data. Here, we review the different techniques of acquiring dual-energy scans and generating monochromatic images, followed by discussion on the progress of developing a DECT technique with reduced radiation dose for quantitative myocardial CTP.
authors.affiliation: Imaging Research Laboratories, Robarts Research Institute, 100 Perth Drive London, ON, Canada N6A 5K8. aso@robarts.ca
authors.forename: Aaron
authors.initials: A
authors.lastname: So
authors.forename: Jiang
authors.initials: J
authors.lastname: Hsieh
authors.forename: Suresh
authors.initials: S
authors.lastname: Narayanan
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Thibault
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Imai
authors.forename: Sandeep
authors.initials: S
authors.lastname: Dutta
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.forename: James
authors.initials: J
authors.lastname: Min
authors.forename: Troy
authors.initials: T
authors.lastname: LaBounty
authors.forename: Ting-Yim
authors.initials: TY
authors.lastname: Lee
mesh_terms: D000818:Animals; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005260:Female; D006801:Humans; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D059629:Signal-To-Noise Ratio; D013552:Swine; D014057:Tomography, X-Ray Computed / Q000379:methods*