title: Delayed contrast-enhanced computed tomography in patients with known or suspected cardiac sarcoidosis: A feasibility study.
abstract: OBJECTIVE
  To evaluate the diagnostic value of delayed contrast-enhanced computed tomography (DE-CT) for cardiac sarcoidosis (CS) in patients with or without implantable devices, including a quantitative comparison with late gadolinium enhancement cardiac magnetic resonance (LGE-CMR).
  
  
  METHODS
  Twenty-four patients (mean age, 64 ± 9 years; 17 women) with known or suspected CS underwent retrospective electrocardiogram-gated DE-CT at 80 kV with knowledge-based iterative model reconstruction. Fourteen patients without implantable devices also underwent LGE-CMR, while ten with pacemakers or implantable cardioverter-defibrillators did not. The presence of hyperenhanced myocardium was assessed visually and quantitatively using a 5-standard deviation threshold above the mean of remote myocardium.
  
  
  RESULTS
  Inter-observer agreement for visual detection of hyperenhanced segments on DE-CT was excellent in patients with implantable devices and in those without (κ = 0.91 and κ = 0.94, respectively). Comparisons of the percent area of hyperenhanced myocardium between DE-CT and LGE-CMR on both per-patient and per-segment analyses showed good correlations (r = 0.96 and r = 0.83, respectively; p < 0.001). The sensitivity and specificity of DE-CT for the diagnosis of CS were 94% and 33%.
  
  
  CONCLUSIONS
  The extent of hyperenhanced lesion with DE-CT showed good agreement with LGE-CMR results. DE-CT showed high sensitivity for detecting CS and may be useful particularly in patients with contraindications to CMR.
  
  
  CONCLUSIONS
  • Delayed contrast-enhanced CT (DE-CT) can be applied to patients with implantable devices. • DE-CT can detect cardiac sarcoidosis (CS) lesions similarly to cardiac MRI. • DE-CT shows high sensitivity for detecting CS. • DE-CT may be useful particularly in patients with contraindications to cardiac MRI.
authors.affiliation: Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Tadao
authors.initials: T
authors.lastname: Aikawa
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan. norikooyama@med.hokudai.ac.jp.
authors.forename: Noriko
authors.initials: N
authors.lastname: Oyama-Manabe
authors.affiliation: Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Masanao
authors.initials: M
authors.lastname: Naya
authors.affiliation: First Department of Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohira
authors.affiliation: First Department of Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Sugimoto
authors.affiliation: First Department of Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Ichizo
authors.initials: I
authors.lastname: Tsujino
authors.affiliation: Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Obara
authors.affiliation: Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Manabe
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan.
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Kudo
authors.affiliation: Department of Cardiovascular Medicine, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsutsui
authors.affiliation: Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Nagara
authors.initials: N
authors.lastname: Tamaki
mesh_terms: D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: Cardiac CT; Cardiac sarcoidosis; Delayed enhancement; Iterative reconstruction; Myocardium