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- Title
CT for the evaluation of myocardial extracellular volume with MRI as reference: a systematic review and meta-analysis.
- Authors
Zhang, Hui; Guo, Huimin; Liu, Guangyao; Wu, Chuang; Ma, Yurong; Li, Shilan; Zheng, Yurong; Zhang, Jing
- Abstract
Objective: Myocardial extracellular volume (ECV) fraction is an important imaging biomarker in clinical decision-making. CT-ECV is a potential alternative to MRI for ECV quantification. We conducted a meta-analysis to comprehensively assess the reliability of CT for ECV quantification with MRI as a reference. Methods: We systematically searched PubMed, EMBASE, and the Cochrane Library for relevant articles published since the establishment of the database in July 2022. The articles comparing CT-ECV with MRI as a reference were included. Meta-analytic methods were applied to determine the pooled weighted bias, limits of agreement (LOA), and correlation coefficient (r) between CT-ECV and MRI-ECV. Results: Seventeen studies with a total of 459 patients and 2231 myocardial segments were included. The pooled mean difference (MD), LOA, and r for ECV quantification at the per-patient level was (0.07%; 95% LOA: − 0.42 to 0.55%) and 0.89 (95% CI: 0.86–0.91), respectively, while on the per-segment level was (0.44%; 95% LOA: 0.16–0.72%) and 0.84 (95% CI: 0.82–0.85), respectively. The pooled r from studies with the ECViodine method for ECV quantification was significantly higher compared to those with the ECVsub method (0.94 (95% CI: 0.91–0.96) vs. 0.84 (95% CI: 0.80–0.88), respectively, p = 0.03). The pooled r from septal segments was significantly higher than those from non-septal segments (0.88 (95% CI: 0.86–0.90) vs. 0.76 (95% CI: 0.71–0.90), respectively, p = 0.009). Conclusion: CT showed a good agreement and excellent correlation with MRI for ECV quantification and is a potentially attractive alternative to MRI. Clinical relevance statement: The myocardial extracellular volume fraction can be acquired using a CT scan, which is not only a viable alternative to myocardial extracellular volume fraction derived from MRI but is also less time-consuming and costly for patients. Key Points: • Noninvasive CT-ECV is a viable alternative to MRI-ECV for ECV quantification. • CT-ECV using the ECViodine method showed more accurate myocardial ECV quantification than ECVsub. • Septal myocardial segments showed lower measurement variability than non-septal segments for the ECV quantification.
- Subjects
MAGNETIC resonance imaging; COMPUTED tomography
- Publication
European Radiology, 2023, Vol 33, Issue 12, p8464
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-023-09872-x