ArticleThe British journal of radiology2026
Quantification of myocardial iron and fat-an experimental study with photon-counting detector CT.
Article in The British journal of radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo determine the feasibility and accuracy of photon-counting detector (PCD)-CT for iron and fat quantification in the myocardium.
methodsCylindrical tubes were filled with porcine myocardium and iron citrate with iron concentrations of 0-20 mg Fe g-1. Dilution series were prepared with myocardium and iron (no-fat probes) and with 5% fat (fat probes). The tubes were positioned in a chest phantom and were scanned with a calcium-scoring protocol on a PCD-CT. A re-parameterized 3-material decomposition was used to separate iron and fat from myocardium.
resultsOn virtual monoenergetic images, attenuation increased linearly with iron concentrations in both fat and no-fat probes. In no-fat probes, linear regression yielded a slope of 1.2 HU (mg Fe g-1)-1 with an intercept of 35.8 HU (R2 = 0.964). In the fat probes, the slope was similar at 1.1 HU (mg Fe g-1)-1, while the regression line shifted downwards by 6.1 HU with an intercept of 29.6 HU (R2 = 0.985). Iron maps separated fat from iron with calculated median fat fractions of 4.85 in the fat and 0.90 in the no-fat probes. In iron images, attenuation increased linearly with increasing iron concentrations, with similar slopes between fat and no-fat probes and negligible differences in the intercept.
conclusionsExperimental evidence indicates the feasibility and accuracy of PCD-CT for iron and fat quantification in the myocardium. Iron-specific 3-material decomposition eliminates the confounding effect of fat on myocardial iron quantification. ADVANCES IN KNOWLEDGE: This study highlights the value of dual-energy CT with 3-material decomposition for quantifying iron and fat in the myocardium. Thus, CT could serve as alternative for the current reference standard MRI.
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