title: Comparison of myocardial perfusion evaluation with single versus dual-energy CT and effect of beam-hardening artifacts.
abstract: OBJECTIVE
  We sought to explore the feasibility and diagnostic performance of dual-energy computed tomography (DECT) versus single-energy computed tomography (SECT) for the evaluation of myocardial perfusion in patients with intermediate to high likelihood of coronary artery disease.
  
  
  METHODS
  The present prospective study involved patients with known or suspected coronary artery disease referred for myocardial perfusion imaging by single-photon emission computed tomography. Forty patients were included in the study protocol and scanned using DECT imaging (n = 20) or SECT imaging (n = 20). The same pharmacologic stress was used for DECT, SECT, and single-photon emission computed tomography scans.
  
  
  RESULTS
  A total of 1360 left ventricular segments were evaluated by DECT and SECT. The contrast-to-noise ratio was similar between groups (DECT 8.8 ± 2.9 vs. SECT 7.7 ± 4.2; P = .22). The diagnostic performance of DECT was greater than that of SECT in identifying perfusion defects (area under the receiver operating characteristic curve of DECT 0.90 [0.86-0.94] vs SECT 0.80 [0.76-0.84]; P = .0004) and remained unaffected when including only segments affected by beam-hardening artifacts (area under the receiver operating characteristic curve = DECT 0.90 [0.84-0.96) vs. SECT 0.77 [0.69-0.84]; P = .007).
  
  
  CONCLUSIONS
  Our results suggest that myocardial perfusion by DECT imaging is feasible and might have improved diagnostic performance compared to SECT imaging for the assessment of myocardial CT perfusion. Furthermore, the diagnostic performance of DECT remained unaffected by the presence of beam-hardening artifacts.
authors: Department of Cardiovascular Imaging, Diagnóstico Maipú, Av Maipú 1668, Vicente López, B1602ABQ, Buenos Aires, Argentina. Electronic address: patriciacarrascosa@diagnosticomaipu.com.ar.
authors: Patricia M
authors: PM
authors: Carrascosa
authors: Baptist Hospital of Miami, Miami, Florida; Baptist Cardiac and Vascular Institute, Miami, Florida.
authors: Ricardo C
authors: RC
authors: Cury
authors: Department of Cardiovascular Imaging, Diagnóstico Maipú, Av Maipú 1668, Vicente López, B1602ABQ, Buenos Aires, Argentina.
authors: Alejandro
authors: A
authors: Deviggiano
authors: Department of Cardiovascular Imaging, Diagnóstico Maipú, Av Maipú 1668, Vicente López, B1602ABQ, Buenos Aires, Argentina.
authors: Carlos
authors: C
authors: Capunay
authors: Department of Cardiovascular Imaging, Diagnóstico Maipú, Av Maipú 1668, Vicente López, B1602ABQ, Buenos Aires, Argentina.
authors: Roxana
authors: R
authors: Campisi
authors: Department of Cardiovascular Imaging, Diagnóstico Maipú, Av Maipú 1668, Vicente López, B1602ABQ, Buenos Aires, Argentina.
authors: Marina
authors: M
authors: López de Munain
authors: Department of Cardiovascular Imaging, Diagnóstico Maipú, Av Maipú 1668, Vicente López, B1602ABQ, Buenos Aires, Argentina.
authors: Javier
authors: J
authors: Vallejos
authors: Department of Cardiovascular Imaging, Diagnóstico Maipú, Av Maipú 1668, Vicente López, B1602ABQ, Buenos Aires, Argentina.
authors: Carlos
authors: C
authors: Tajer
authors: Department of Cardiovascular Imaging, Diagnóstico Maipú, Av Maipú 1668, Vicente López, B1602ABQ, Buenos Aires, Argentina.
authors: Gaston A
authors: GA
authors: Rodriguez-Granillo
mesh_terms: D000628:Aminophylline / Q000008:administration & dosage; D016477:Artifacts; D002316:Cardiotonic Agents / Q000008:administration & dosage; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004176:Dipyridamole / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011446:Prospective Studies; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D002316:Cardiotonic Agents; D003287:Contrast Media; D014665:Vasodilator Agents; C093233:iobitridol; D000628:Aminophylline; D007472:Iohexol; D004176:Dipyridamole
keywords: Computed tomography; dypiridamole; spectral imaging