Table 4.
Comparison of Imaging Modalities for the evaluation of NICM
| Echo | CMR | CT | SPECT | PET | |
|---|---|---|---|---|---|
|
Scan time |
15-25 min |
30-45 min |
10 min |
2 hours |
1 h1/ 2-2 hours |
|
Radiation |
None |
None |
1.5-2 mSv (64-slice Coronary CT) |
41 mSv (Thallium stress/rest) 9 mSv (Sestamibi) |
14 mSv (F-18 FDG) |
| |
|
|
6–10 mSv (multi-detector row CT) |
|
|
| |
|
|
1–1.3 mSv |
|
|
| |
|
|
1.5-6 mSv (multi-detector coronary calcium scoring) [124] |
|
|
|
Risks |
None |
NSF (related to some types of gadolinium-based contrast if severe renal failure) |
Radiation Renal failure Allergy |
Radiation Allergy (rare) |
Radiation Allergy (rare) |
|
Contra-indications |
None |
MRI-incompatible implants and devices Pregnancy during first trimester (precautionary) |
Renal failure Pregnancy |
Pregnancy |
Pregnancy |
|
Limitations |
Operator dependent Acoustic window (obese, COPD) Imaging of apical segments and RV (spatial resolution) |
Availability Lower temporal resolution |
Not ideal for serial follow-up owing to radiation Currently not suited for detection of fibrosis, perfusion and wall motion Blood flow cannot be assessed |
Availability Low spatial resolution |
Availability Low spatial resolution |
|
Accuracy of LV /RV function and volumes |
++ 3D echo |
+++ |
- |
++ |
- |
|
Wall thickness /Mass quantification |
+ (localised hypertrophy can be missed) |
+++ |
+ |
- |
- |
|
Detection of oedema |
- (non-specific findings such as wall thickening) |
+++ (STIR sequences) |
- |
+ (non-specific; areas of reduced perfusion) |
+++ FDG (uptake) |
|
Imaging of fibrosis |
- (suspected with 2D strain) |
+++ |
+ |
- |
+ |
|
Detection of microvascular disease/ Stress Perfusion |
+ Contrast echo Stress echo |
+++ |
+ Perfusion |
++ [125] |
+++ (considered gold standard) |
| Assessment of Myocyte Metabolism | - | + (Field of research, CMR spectroscopy) | - | + (technical limitations, quantitative methods unavailable) | +++ |