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Emrich, Tilman; Aquino, Gilberto; Schoepf, U. Joseph; Braun, Franziska M.; Risch, Franka; Bette, Stefanie J.; Woznicki, Piotr; Decker, Josua A.; O’Doherty, Jim; Brandt, Verena; Allmendinger, Thomas; Nowak, Tristan; Schmidt, Bernhard; Flohr, Thomas; Kroencke, Thomas J.; Scheurig-Muenkler, Christian; Varga-Szemes, Akos; Schwarz, Florian

Coronary Computed Tomography Angiography-Based Calcium Scoring : In Vitro and In Vivo Validation of a Novel Virtual Noniodine Reconstruction Algorithm on a Clinical, First-Generation Dual-Source Photon Counting-Detector System : In Vitro and In Vivo Validation of a Novel Virtual Noniodine Reconstruction Algorithm on a Clinical, First-Generation Dual-Source Photon Counting-Detector System

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  • Medientyp: E-Artikel
  • Titel: Coronary Computed Tomography Angiography-Based Calcium Scoring : In Vitro and In Vivo Validation of a Novel Virtual Noniodine Reconstruction Algorithm on a Clinical, First-Generation Dual-Source Photon Counting-Detector System : In Vitro and In Vivo Validation of a Novel Virtual Noniodine Reconstruction Algorithm on a Clinical, First-Generation Dual-Source Photon Counting-Detector System
  • Beteiligte: Emrich, Tilman; Aquino, Gilberto; Schoepf, U. Joseph; Braun, Franziska M.; Risch, Franka; Bette, Stefanie J.; Woznicki, Piotr; Decker, Josua A.; O’Doherty, Jim; Brandt, Verena; Allmendinger, Thomas; Nowak, Tristan; Schmidt, Bernhard; Flohr, Thomas; Kroencke, Thomas J.; Scheurig-Muenkler, Christian; Varga-Szemes, Akos; Schwarz, Florian
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2022
  • Erschienen in: Investigative Radiology
  • Sprache: Englisch
  • DOI: 10.1097/rli.0000000000000868
  • ISSN: 1536-0210; 0020-9996
  • Schlagwörter: Radiology, Nuclear Medicine and imaging ; General Medicine
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  • Beschreibung: <jats:sec> <jats:title>Purpose</jats:title> <jats:p>The aim of this study was to evaluate coronary computed tomography angiography (CCTA)-based in vitro and in vivo coronary artery calcium scoring (CACS) using a novel virtual noniodine reconstruction (PureCalcium) on a clinical first-generation photon-counting detector–computed tomography system compared with virtual noncontrast (VNC) reconstructions and true noncontrast (TNC) acquisitions.</jats:p> </jats:sec> <jats:sec> <jats:title>Materials and Methods</jats:title> <jats:p>Although CACS and CCTA are well-established techniques for the assessment of coronary artery disease, they are complementary acquisitions, translating into increased scan time and patient radiation dose. Hence, accurate CACS derived from a single CCTA acquisition would be highly desirable. In this study, CACS based on PureCalcium, VNC, and TNC, reconstructions was evaluated in a CACS phantom and in 67 patients (70 [59/80] years, 58.2% male) undergoing CCTA on a first-generation photon counting detector–computed tomography system. Coronary artery calcium scores were quantified for the 3 reconstructions and compared using Wilcoxon test. Agreement was evaluated by Pearson and Spearman correlation and Bland-Altman analysis. Classification of coronary artery calcium score categories (0, 1–10, 11–100, 101–400, and &gt;400) was compared using Cohen <jats:italic toggle="yes">κ</jats:italic>.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Phantom studies demonstrated strong agreement between CACS<jats:sub>PureCalcium</jats:sub> and CACS<jats:sub>TNC</jats:sub> (60.7 ± 90.6 vs 67.3 ± 88.3, <jats:italic toggle="yes">P</jats:italic> = 0.01, <jats:italic toggle="yes">r</jats:italic> = 0.98, intraclass correlation [ICC] = 0.98; mean bias, 6.6; limits of agreement [LoA], −39.8/26.6), whereas CACS<jats:sub>VNC</jats:sub> showed a significant underestimation (42.4 ± 75.3 vs 67.3 ± 88.3, <jats:italic toggle="yes">P</jats:italic> &lt; 0.001, <jats:italic toggle="yes">r</jats:italic> = 0.94, ICC = 0.89; mean bias, 24.9; LoA, −87.1/37.2). In vivo comparison confirmed a high correlation but revealed an underestimation of CACS<jats:sub>PureCalcium</jats:sub> (169.3 [0.7/969.4] vs 232.2 [26.5/1112.2], <jats:italic toggle="yes">P</jats:italic> &lt; 0.001, <jats:italic toggle="yes">r</jats:italic> = 0.97, ICC = 0.98; mean bias, −113.5; LoA, −470.2/243.2). In comparison, CACS<jats:sub>VNC</jats:sub> showed a similarly high correlation, but a substantially larger underestimation (24.3 [0/272.3] vs 232.2 [26.5/1112.2], <jats:italic toggle="yes">P</jats:italic> &lt; 0.001, <jats:italic toggle="yes">r</jats:italic> = 0.97, ICC = 0.54; mean bias, −551.6; LoA, −2037.5/934.4). CACS<jats:sub>PureCalcium</jats:sub> showed superior agreement of CACS classification (<jats:italic toggle="yes">κ</jats:italic> = 0.88) than CACS<jats:sub>VNC</jats:sub> (<jats:italic toggle="yes">κ</jats:italic> = 0.60).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The accuracy of CACS quantification and classification based on PureCalcium reconstructions of CCTA outperforms CACS derived from VNC reconstructions.</jats:p> </jats:sec>