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Prospective Imaging Shows Benefits in Infarct Assessment

Porcine study compared prospective and retrospective ECG-gated multidetector computed tomography

WEDNESDAY, April 15 (HealthDay News) -- In a pig model, prospective electrocardiogram-gated delayed contrast-enhanced multidetector computed tomography (ECG-gated DCE-MDCT) myocardial imaging can accurately assess the myocardium after myocardial infarction with a lower radiation dose than retrospective ECG-gated DCE-MDCT, according to research published in the April issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

Hyuk-Jae Chang, M.D., Ph.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues analyzed data from 10 pigs that underwent an instigated myocardial infarction, then were imaged 10 days later with 64-slice prospective and retrospective ECG-gated DCE-MDCT after a contrast bolus.

Both methods generated infarct volume measurements that were strongly correlated and in good agreement, the researchers report. Estimated radiation doses were notably reduced with prospective ECG gating (42.4 mGy x cm) versus retrospective ECG-gating (930.1 mGy x cm). The signal-to-noise and contrast-to-noise ratios of infarcted myocardium were lower for prospective gated images, but all examinations with the prospective gating protocol produced images of sufficient quality, the authors write.

"For now, DHE-CMR [delayed hyperenhancement cardiac magnetic resonance] remains the clear frontrunner, although DCE-MDCT may soon become a reasonable alternative in patients not amenable to cardiac magnetic resonance. Further developments in DCE-MDCT portend budding challenges to DHE-CMR, and healthy, expanded debate," write Milind Y. Desai, M.D., and Scott D. Flamm, M.D., of the Cleveland Clinic, Ohio, in an accompanying editorial.

The study was partially supported by research grants from Toshiba Medical Systems.

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