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.


Journal

Investigative radiology
ISSN: 1536-0210
Titre abrégé: Invest Radiol
Pays: United States
ID NLM: 0045377

Informations de publication

Date de publication:
01 08 2022
Historique:
pubmed: 24 3 2022
medline: 12 7 2022
entrez: 23 3 2022
Statut: ppublish

Résumé

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. 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 >400) was compared using Cohen κ . Phantom studies demonstrated strong agreement between CACS PureCalcium and CACS TNC (60.7 ± 90.6 vs 67.3 ± 88.3, P = 0.01, r = 0.98, intraclass correlation [ICC] = 0.98; mean bias, 6.6; limits of agreement [LoA], -39.8/26.6), whereas CACS VNC showed a significant underestimation (42.4 ± 75.3 vs 67.3 ± 88.3, P < 0.001, r = 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 PureCalcium (169.3 [0.7/969.4] vs 232.2 [26.5/1112.2], P < 0.001, r = 0.97, ICC = 0.98; mean bias, -113.5; LoA, -470.2/243.2). In comparison, CACS VNC showed a similarly high correlation, but a substantially larger underestimation (24.3 [0/272.3] vs 232.2 [26.5/1112.2], P < 0.001, r = 0.97, ICC = 0.54; mean bias, -551.6; LoA, -2037.5/934.4). CACS PureCalcium showed superior agreement of CACS classification ( κ = 0.88) than CACS VNC ( κ = 0.60). The accuracy of CACS quantification and classification based on PureCalcium reconstructions of CCTA outperforms CACS derived from VNC reconstructions.

Identifiants

pubmed: 35318969
doi: 10.1097/RLI.0000000000000868
pii: 00004424-202208000-00006
doi:

Substances chimiques

Calcium SY7Q814VUP

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

536-543

Informations de copyright

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of interest and sources of funding: U. Joseph Schoepf receives institutional research support and / or personal fees from Bayer, Bracco, Elucid Bioimaging, Guerbet, HeartFlow, and Siemens. Akos Varga-Szemes receives institutional research support and / or personal fees from Elucid Bioimaging and Siemens. Tilman Emrich received a speaker fee and travel support from Siemens Medical Solutions USA Inc. Jim O’Doherty is a employee of Siemens Medical Solutions USA Inc. Thomas Allmendinger, Tristan Nowak, Bernhard Schmidt and Thomas Flohr are employees of Siemens Healthineers

Références

Divakaran S, Cheezum MK, Hulten EA, et al. Use of cardiac CT and calcium scoring for detecting coronary plaque: implications on prognosis and patient management. Br J Radiol . 2015;88:20140594.
Knuuti J, Wijns W, Saraste A, et al. 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes: the Task Force for the Diagnosis and Management of Chronic Coronary Syndromes of the European Society of Cardiology (ESC). Eur Heart J . 2020;41:407–477. Available at: https://doi.org/10.1093/eurheartj/ehz425 .
doi: 10.1093/eurheartj/ehz425
Moss AJ, Williams MC, Newby DE, et al. The updated NICE guidelines: cardiac CT as the first-line test for coronary artery disease. Curr Cardiovasc Imaging Rep . 2017;10:15. Available at: https://pubmed.ncbi.nlm.nih.gov/28446943 .
Schwarz F, Nance JWJ, Ruzsics B, et al. Quantification of coronary artery calcium on the basis of dual-energy coronary CT angiography. Radiology . 2012;264:700–707.
Gassert FG, Schacky CE, Müller-Leisse C, et al. Calcium scoring using virtual non-contrast images from a dual-layer spectral detector CT: comparison to true non-contrast data and evaluation of proportionality factor in a large patient collective. Eur Radiol . 2021;31:6193–6199.
Song I, Yi JG, Park JH, et al. Virtual non-contrast CT using dual-energy spectral CT: feasibility of coronary artery calcium scoring. Korean J Radiol . 2016;17:321–329.
Rajendran K, Petersilka M, Henning A, et al. First clinical photon-counting detector CT system: technical evaluation. Radiology . 2021;212579.
Willemink MJ, Persson M, Pourmorteza A, et al. Photon-counting CT: technical principles and clinical prospects. Radiology . 2018;289:293–312. Available at: http://pubs.rsna.org/doi/10.1148/radiol.2018172656 . Accessed February 18, 2021.
doi: 10.1148/radiol.2018172656
Sandfort V, Persson M, Pourmorteza A, et al. Spectral photon-counting CT in cardiovascular imaging. J Cardiovasc Comput Tomogr . 2021;15:218–225. Available at: https://linkinghub.elsevier.com/retrieve/pii/S1934592520305037 . Accessed February 18, 2021.
Farhadi F, Rajagopal JR, Nikpanah M, et al. Review of technical advancements and clinical applications of photon-counting computed tomography in imaging of the thorax. J Thorac Imaging . 2021;36:84–94. Available at: https://journals.lww.com/10.1097/RTI.0000000000000569 . Accessed February 18, 2021.
doi: 10.1097/RTI.0000000000000569
Euler A, Higashigaito K, Mergen V, et al. High-pitch photon-counting detector computed tomography angiography of the aorta: intraindividual comparison to energy-integrating detector computed tomography at equal radiation dose. Invest Radiol . 2022;57:115–121.
Groen JM, Greuter MJW, Vliegenthart R, et al. Calcium scoring using 64-slice MDCT, dual source CT and EBT: a comparative phantom study. Int J Cardiovasc Imaging . 2008;24:547–556.
Allmendinger T, Nowak T, Flohr T, et al. Photon-counting detector CT-based vascular calcium removal algorithm [published ahead of print January 11, 2022]. Invest Radiol .
Agatston AS, Janowitz WR, Hildner FJ, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol . 1990;15:827–832. Available at: https://www.sciencedirect.com/science/article/pii/073510979090282T .
Rumberger JA, Brundage BH, Rader DJ, et al. Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc . 1999;74:243–252.
Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med . 2016;15:155–163. Available at: https://pubmed.ncbi.nlm.nih.gov/27330520 .
Osborne-grinter M, Kwiecinski J, Doris M, et al. Association of coronary artery calcium score with qualitatively and quantitatively assessed adverse plaque on coronary CT angiography in the SCOT-HEART trial [published online ahead of print September 16, 2021]. Eur Heart J Cardiovasc Imaging .
Patel J, Pallazola VA, Dudum R, et al. Assessment of coronary artery calcium scoring to guide statin therapy allocation according to risk-enhancing factors: the Multi-Ethnic Study of Atherosclerosis. JAMA Cardiol . 2021;23298:1–10.
Maron DJ, Hochman JS, Reynolds HR, et al. Initial invasive or conservative strategy for stable coronary disease. N Engl J Med . 2020;382:1395–1407.
Xia C, Vonder M, Sidorenkov G, et al. Cardiovascular risk factors and coronary calcification in a middle-aged Dutch population: the ImaLife Study. J Thorac Imaging . 2021;36:174–180.
Han D, Lee JH, Hartaigh BÓ, et al. Role of computed tomography screening for detection of coronary artery disease. Clin Imaging . 2016;40:307–310.
Moselewski F, Ferencik M, Achenbach S, et al. Threshold-dependent variability of coronary artery calcification measurements—implications for contrast-enhanced multi-detector row–computed tomography. Eur J Radiol . 2006;57:390–395.
Mühlenbruch G, Wildberger JE, Koos R, et al. Coronary calcium scoring using 16-row multislice computed tomography: nonenhanced versus contrast-enhanced studies in vitro and in vivo. Invest Radiol . 2005;40:148–154.
van der Werf NR, Rodesch PA, Si-Mohamed S, et al. Improved coronary calcium detection and quantification with low-dose full field-of-view photon-counting CT: a phantom study [published online ahead of print January 8, 2022]. Eur Radiol .
van der Werf NR, Si-Mohamed S, Rodesch PA, et al. Coronary calcium scoring potential of large field-of-view spectral photon-counting CT: a phantom study. Eur Radiol . 2022;32:152–162.
van der Werf NR, van Gent M, Booij R, et al. Dose reduction in coronary artery calcium scoring using mono-energetic images from reduced tube voltage dual-source photon-counting CT data: a dynamic phantom study. Diagnostics (Basel, Switzerland) . 2021;11:2192.
Mergen V, Higashigaito K, Allmendinger T, et al. Tube voltage-independent coronary calcium scoring on a first-generation dual-source photon-counting CT—a proof-of-principle phantom study [published online ahead of print November 15, 2021]. Int J Cardiovasc Imaging .
Sandstedt M, Marsh JJ, Rajendran K, et al. Improved coronary calcification quantification using photon-counting-detector CT: an ex vivo study in cadaveric specimens. Eur Radiol . 2021;31:6621–6630.
Symons R, Sandfort V, Mallek M, et al. Coronary artery calcium scoring with photon-counting CT: first in vivo human experience. Int J Cardiovasc Imaging . 2019;35:733–739.
van Praagh GD, Wang J, van der Werf NR, et al. Coronary artery calcium scoring: toward a new standard. Invest Radiol . 2022;57:13–22.
Rutten A, Isgum I, Prokop M. Coronary calcification: effect of small variation of scan starting position on Agatston, volume, and mass scores. Radiology . 2008;246:90–98.
Willemink MJ, van der Werf NR, Nieman K, et al. Coronary artery calcium: a technical argument for a new scoring method. J Cardiovasc Comput Tomogr . 2019;13:347–352.
Willemink MJ, Vliegenthart R, Takx RAP, et al. Coronary artery calcification scoring with state-of-the-art CT scanners from different vendors has substantial effect on risk classification. Radiology . 2014;273:695–702.
Greuter MJW, Groen JM, Nicolai LJ, et al. A model for quantitative correction of coronary calcium scores on multidetector, dual source, and electron beam computed tomography for influences of linear motion, calcification density, and temporal resolution: a cardiac phantom study. Med Phys . 2009;36:5079–5088.
Ulzheimer S, Kalender WA. Assessment of calcium scoring performance in cardiac computed tomography. Eur Radiol . 2003;13:484–497.
Eberhard M, Mergen V, Higashigaito K, et al. Coronary calcium scoring with first generation dual-source photon-counting CT—first evidence from phantom and in-vivo scans. Diagnostics (Basel) . 2021;11:1708.
Skoog S, Henriksson L, Gustafsson H, et al. Comparison of the Agatston score acquired with photon-counting detector CT and energy-integrating detector CT: ex vivo study of cadaveric hearts [published online ahead of print January 5, 2022]. Int J Cardiovasc Imaging .

Auteurs

Gilberto Aquino (G)

From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston.

U Joseph Schoepf (UJ)

From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston.

Franziska M Braun (FM)

Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.

Franka Risch (F)

Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.

Stefanie J Bette (SJ)

Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.

Piotr Woznicki (P)

Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.

Josua A Decker (JA)

Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.

Jim O'Doherty (J)

Siemens Medical Solutions USA Inc, Malvern, PA.

Verena Brandt (V)

From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston.

Thomas Allmendinger (T)

Siemens Healthineers, Forchheim, Germany.

Tristan Nowak (T)

Siemens Healthineers, Forchheim, Germany.

Bernhard Schmidt (B)

Siemens Healthineers, Forchheim, Germany.

Thomas Flohr (T)

Siemens Healthineers, Forchheim, Germany.

Thomas J Kroencke (TJ)

Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.

Christian Scheurig-Muenkler (C)

Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.

Akos Varga-Szemes (A)

From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston.

Florian Schwarz (F)

Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.

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