Iodine quantification based on rest / stress perfusion dual energy CT to differentiate ischemic, infarcted and normal myocardium

Background: The aim of this study was to assess the potential of rest-stress DECT iodine quantification to discriminate between normal, ischemic, and infarcted myocardium.Methods: Patients who underwent rest-stress DECT on a 2nd generation dual-source system and cardiac magnetic resonance (CMR) were retrospectively included from a prospective study cohort. CMR was performed to identify ischemic and infarcted myocardium and categorize patients into ischemic, infarcted, and control groups. Controls were analyzed on a per-slice and per-segment basis. Regions of interest (ROIs) were placed in ischemic and infarcted areas based on CMR. Additionally, ROIs were placed in the septal area to assess normal and remote myocardium.Results: We included 42 patients: 10 ischemic, 17 infarcted, and 15 controls. Iodine concentrations showed no significant between segments in controls. Iodine concentrations for normal myocardium increased significantly from rest to stress (median 3.7 mg/mL (interquartile range 3.5-3.9) vs. 4.5 mg/mL (4.3-4.9)) (p Conclusion: DECT iodine concentration from rest-stress imaging can potentially differentiate between normal, ischemic, and infarcted myocardium.