INVITED REVIEW
Myocardial Characterization on CT: Late Iodine Enhancement and Extracellular Volume
Axel Bartoli,
Chiara Gnasso,
Anna Palmisano,
Andrea Bettinelli,
Davide Vignale,
Antonio Esposito,
Axel Bartoli
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
Department of Radiology, TIMONE Hospital, AP-HM, Marseille, France
CRMBM – UMR CNRS 7339, Aix-Marseille University, Marseille, France
Search for more papers by this authorChiara Gnasso
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
Search for more papers by this authorCorresponding Author
Anna Palmisano
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
Correspondence: Anna Palmisano ([email protected])
Search for more papers by this authorAndrea Bettinelli
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
Search for more papers by this authorDavide Vignale
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
Search for more papers by this authorAntonio Esposito
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
Search for more papers by this authorAxel Bartoli,
Chiara Gnasso,
Anna Palmisano,
Andrea Bettinelli,
Davide Vignale,
Antonio Esposito,
Axel Bartoli
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
Department of Radiology, TIMONE Hospital, AP-HM, Marseille, France
CRMBM – UMR CNRS 7339, Aix-Marseille University, Marseille, France
Search for more papers by this authorChiara Gnasso
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
Search for more papers by this authorCorresponding Author
Anna Palmisano
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
Correspondence: Anna Palmisano ([email protected])
Search for more papers by this authorAndrea Bettinelli
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
Search for more papers by this authorDavide Vignale
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
Search for more papers by this authorAntonio Esposito
Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
Search for more papers by this authorFirst published: 18 February 2025
Axel Bartoli and Chiara Gnasso equally contributed to this study.
ABSTRACT
Myocardial tissue characterization is fundamental in diagnosing, treating, and managing various cardiac diseases. In recent years, cardiac computed tomography (CCT) emerged as a valuable alternative to cardiac magnetic resonance (CMR) for myocardial tissue characterization, with the possibility to detect myocardial scar and quantify the extracellular volume fraction in a single CT study with the advantage of combined coronary arteries evaluation, shorter scanning time, and less susceptibility to device artifacts compared to CMR. However, CCT is typically affected by a lower contrast-to-noise ratio and potentially increased radiation exposure. Therefore, a deep understanding of the available technology and the strategies for acquisition optimization is of fundamental importance to improve image quality and accuracy, while minimizing radiation exposure. This review summarizes principles of myocardial characterization on CCT, acquisition protocols according to the different technologies available including the dual-energy CT and the innovative photon-counting detector CT, and setting of clinical utility.
Conflicts of Interest
The authors declare no conflicts of interest.
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