Diagnostic performance of shuttle-mode myocardial CT late enhancement: Comparison with late gadolinium enhancement cardiovascular MR.

Authors

Takanori Kokawa, Satoshi Nakamura, Shiro Nakamori, Tairo Kurita, Naoki Nagasawa, Kaoru Dohi, Hajime Sakuma, Kakuya Kitagawa

Published in

Journal of cardiovascular computed tomography. Oct 07, 2026. Epub Oct 07, 2026.

Abstract

Although myocardial CT late enhancement (CT-LE) has been reported in various studies, its diagnostic performance using shuttle-mode dual-source CT has not been fully validated for detecting myocardial infarction (MI) and assessing its transmural extent against late gadolinium enhancement cardiovascular MR (LGE-CMR). This study aimed to evaluate the diagnostic performance of shuttle-mode myocardial CT-LE in detecting MI with LGE-CMR as a reference standard.
This study included 56 patients with suspected or known coronary artery disease who underwent both comprehensive cardiac CT, including myocardial CT-LE, and LGE-CMR from a prospective, multicenter trial (AMPLIFiED). Sixteen myocardial segments per patient (excluding the apical cap based on AHA classification) were assessed. Segments were classified as having or not having MI; segments with MI were further categorized by transmural extent: <50%, 50-99%, or 100%. Two observers independently assessed myocardial CT-LE images. LGE-CMR findings were determined by consensus between two observers.
In the segment-based analysis (n = 896), myocardial CT-LE showed a sensitivity of 97.6% and a positive predictive value (PPV) of 93.0%-94.1% for MI detection (specificity, 99.3%-99.4%; negative predictive value [NPV], 99.8%). Agreement for transmural extent was high (weighted kappa, 0.82-0.83). Inter-reader reproducibility for binary MI detection was excellent (agreement, 99.4%; kappa, 0.97). In an exploratory patient-level analysis based on 19 LGE-CMR-positive patients, sensitivity was 94.7% (95% confidence interval [CI], 74.0%-99.9%) for Observer A and 100% (95% CI, 82.4%-100%) for Observer B; the corresponding PPVs were 94.7% and 90.5%.
Shuttle-mode myocardial CT-LE demonstrated excellent agreement with LGE-CMR for the detection and transmural assessment of MI. Its high sensitivity for subendocardial MI supports its value as a reliable alternative to LGE-CMR.

PMID:
42838816
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.

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