Myocardial Characterization Using Dual-Energy CT in Doxorubicin-Induced DCM: Comparison With CMR T1-Mapping and Histology in a Rabbit Model

Yoo Jin Hong, Tai Kyung Kim, Donghyun Hong, Chul Hwan Park, Sae Jong Yoo, Mary Ellen Wickum, Jin Hur, Hye Jeong Lee, Young Jin Kim, Young Joo Suh, Andreas Greiser, Mun Young Paek, Byoung Wook Choi

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46 Citations (Scopus)


Objectives 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. Background 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. Methods 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. Results 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). Conclusions 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.

Original languageEnglish
Pages (from-to)836-845
Number of pages10
JournalJACC: Cardiovascular Imaging
Issue number7
Publication statusPublished - 2016 Jul 1

Bibliographical note

Publisher Copyright:
© 2016 American College of Cardiology Foundation

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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