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Risch, Franka; Schwarz, Florian; Braun, Franziska; Bette, Stefanie; Becker, Judith; Scheurig-Muenkler, Christian; Kroencke, Thomas J.; Decker, Josua A.

Assessment of epicardial adipose tissue on virtual non-contrast images derived from photon-counting detector coronary CTA datasets

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  • Medientyp: E-Artikel
  • Titel: Assessment of epicardial adipose tissue on virtual non-contrast images derived from photon-counting detector coronary CTA datasets
  • Beteiligte: Risch, Franka; Schwarz, Florian; Braun, Franziska; Bette, Stefanie; Becker, Judith; Scheurig-Muenkler, Christian; Kroencke, Thomas J.; Decker, Josua A.
  • Erschienen: Springer Science and Business Media LLC, 2022
  • Erschienen in: European Radiology
  • Sprache: Englisch
  • DOI: 10.1007/s00330-022-09257-6
  • ISSN: 1432-1084
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Objectives</jats:title> <jats:p>To assess epicardial adipose tissue (EAT) volume and attenuation of different virtual non-contrast (VNC) reconstructions derived from coronary CTA (CCTA) datasets of a photon-counting detector (PCD) CT-system to replace true non-contrast (TNC) series.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Consecutive patients (<jats:italic>n</jats:italic> = 42) with clinically indicated CCTA and coronary TNC were included. Two VNC series were reconstructed, using a conventional (VNC<jats:sub>Conv</jats:sub>) and a novel calcium-preserving (VNC<jats:sub>PC</jats:sub>) algorithm. EAT was segmented on TNC, VNC<jats:sub>Conv</jats:sub>, VNC<jats:sub>PC</jats:sub>, and CCTA (CTA<jats:sub>-30</jats:sub>) series using thresholds of −190 to −30 HU and an additional segmentation on the CCTA series with an upper threshold of 0 HU (CTA<jats:sub>0</jats:sub>). EAT volumes and their histograms were assessed for each series. Linear regression was used to correlate EAT volumes and the Euclidian distance for histograms. The paired <jats:italic>t</jats:italic>-test and the Wilcoxon signed-rank test were used to assess differences for parametric and non-parametric data.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>EAT volumes from VNC and CCTA series showed significant differences compared to TNC (all <jats:italic>p</jats:italic> &lt; .05), but excellent correlation (all <jats:italic>R</jats:italic><jats:sup>2</jats:sup> &gt; 0.9). Measurements on the novel VNC<jats:sub>PC</jats:sub> series showed the best correlation (<jats:italic>R</jats:italic><jats:sup>2</jats:sup> = 0.99) and only minor absolute differences compared to TNC values. Mean volume differences were −12%, −3%, −13%, and +10% for VNC<jats:sub>Conv</jats:sub>, VNC<jats:sub>PC</jats:sub>, CTA<jats:sub>-30</jats:sub>, and CTA<jats:sub>0</jats:sub> compared to TNC. Distribution of CT values on VNC<jats:sub>PC</jats:sub> showed less difference to TNC than on VNC<jats:sub>Conv</jats:sub> (mean attenuation difference +7% vs. +2%; Euclidean distance of histograms 0.029 vs. 0.016).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>VNC<jats:sub>PC</jats:sub>-reconstructions of PCD-CCTA datasets can be used to reliably assess EAT volume with a high accuracy and only minor differences in CT values compared to TNC. Substitution of TNC would significantly decrease patient’s radiation dose.</jats:p> </jats:sec><jats:sec> <jats:title>Key points</jats:title> <jats:p><jats:italic>• Measurement of epicardial adipose tissue (EAT) volume and attenuation are feasible on virtual non-contrast (VNC) series with excellent correlation to true non-contrast series (all R</jats:italic><jats:sup><jats:italic>2</jats:italic></jats:sup><jats:italic>&gt;0.9).</jats:italic></jats:p> <jats:p><jats:italic>• Differences in VNC algorithms have a significant impact on EAT volume and CT attenuation values.</jats:italic></jats:p> <jats:p><jats:italic>• A novel VNC algorithm (VNC</jats:italic><jats:sub><jats:italic>PC</jats:italic></jats:sub><jats:italic>) enables reliable assessment of EAT volume and attenuation with superior accuracy compared to measurements on conventional VNC- and CCTA-series.</jats:italic></jats:p> </jats:sec>