title: Myocardial Characterization Using Dual-Energy CT in Doxorubicin-Induced DCM: Comparison With CMR T1-Mapping and Histology in a Rabbit Model.
abstract: This study sought to evaluate whether patterns of myocardial change in doxorubicin-induced dilated cardiomyopathy determined using dual-energy computed tomography (CT) were similar to characterization by extracellular volume fraction (ECV) using cardiac magnetic resonance (CMR) T1-mapping and collagen volume fraction (CVF) measured using histology.
  
  
  
  Anthracycline chemoagents are effective against a wide range of malignant conditions. However, cardiotoxicity is a well-known adverse effect of these drugs. Dual-energy CT could be as useful as magnetic resonance (MR) to evaluate myocardial change in anthracycline-induced cardiotoxicity.
  
  
  
  A dilated cardiomyopathy rabbit model was generated by injecting 11 adult New Zealand rabbits with 1.0 mg/kg of doxorubicin twice weekly for 16 weeks. Contrast-enhanced dual-energy CT and pre-contrast and post-contrast T1-mapping CMR using a prototype modified Look-Locker inversion recovery on a clinical 3-T scanner were performed on 15 rabbits, including 4 control animals, to calculate ECV at baseline, and at 6, 12, and 16 weeks after doxorubicin administration.
  
  
  
  The mean ECV values (%) on CT and CMR at 6, 12, and 16 weeks after modeling were significantly higher than those measured at baseline (CT ECV: 35.3%, 41.9%, 42.1% vs. 28.5%; MR ECV: 32.6%, 35.8%, 41.3% vs. 28.8%, respectively; all p < 0.001). CT ECV and MR ECV values were well correlated (r = 0.888; p < 0.001). Both were well correlated with CVF on histology (CT ECV vs. CVF, r = 0.925, p < 0.001 and MR ECV vs. CVF, r = 0.961, p < 0.001, respectively).
  
  
  
  Dual-energy CT ECV correlated well with CMR and histology. Dual-energy CT is useful for characterizing doxorubicin-induced cardiomyopathy by measuring ECV fraction; however, further technical improvements are desirable to lower motion artifact and improve image quality of the iodine map.
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Yoo Jin
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University, Seoul, Korea.
authors.forename: Tai Kyung
authors.initials: TK
authors.lastname: Kim
authors.affiliation: Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany.
authors.forename: Donghyun
authors.initials: D
authors.lastname: Hong
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Chul Hwan
authors.initials: CH
authors.lastname: Park
authors.affiliation: Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University, Seoul, Korea.
authors.forename: Sae Jong
authors.initials: SJ
authors.lastname: Yoo
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Wickum
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Hur
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Hye-Jeong
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Suh
authors.affiliation: Siemens AG Healthcare, Erlangen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Greiser
authors.affiliation: Siemens Ltd., Seoul, Korea.
authors.forename: Mun Young
authors.initials: MY
authors.lastname: Paek
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: bchoi@yuhs.ac.
authors.forename: Byoung Wook
authors.initials: BW
authors.lastname: Choi
mesh_terms: D000818:Animals; D000903:Antibiotics, Antineoplastic; D016477:Artifacts; D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D066126:Cardiotoxicity; D003094:Collagen / Q000378:metabolism; D004195:Disease Models, Animal; D004317:Doxorubicin; D005240:Feasibility Studies; D005355:Fibrosis; D008279:Magnetic Resonance Imaging; D008297:Male; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D011237:Predictive Value of Tests; D011817:Rabbits; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin; D003094:Collagen
keywords: cardiac imaging techniques; cardiomyopathy; dual-energy scanned projection; magnetic resonance imaging; mapping; radiography