Gadolinium-based coronary CT angiography on a clinical photon-counting-detector system: a dynamic circulating phantom study.

Phantoms, Imaging Computed Tomography Angiography / methods Contrast Media / administration & dosage Coronary Angiography / methods Humans Photons Gadolinium DTPA / administration & dosage
Aorta (thoracic) Computed tomography angiography Contrast media Coronary vessels Gadolinium-DTPA

Journal

European radiology experimental
ISSN: 2509-9280
Titre abrégé: Eur Radiol Exp
Pays: England
ID NLM: 101721752

Informations de publication

Date de publication:
18 Oct 2024
Historique:
received: 24 05 2024
accepted: 02 08 2024
medline: 18 10 2024
pubmed: 18 10 2024
entrez: 18 10 2024
Statut: epublish

Résumé

Coronary computed tomography angiography (CCTA) offers non-invasive diagnostics of the coronary arteries. Vessel evaluation requires the administration of intravenous contrast. The purpose of this study was to evaluate the utility of gadolinium-based contrast agent (GBCA) as an alternative to iodinated contrast for CCTA on a first-generation clinical dual-source photon-counting-detector (PCD)-CT system. A dynamic circulating phantom containing a three-dimensional-printed model of the thoracic aorta and the coronary arteries were used to evaluate injection protocols using gadopentetate dimeglumine at 50%, 100%, 150%, and 200% of the maximum approved clinical dose (0.3 mmol/kg). Virtual monoenergetic image (VMI) reconstructions ranging from 40 keV to 100 keV with 5 keV increments were generated on a PCD-CT. Contrast-to-noise ratio (CNR) was calculated from attenuations measured in the aorta and coronary arteries and noise measured in the background tissue. Attenuation of at least 350 HU was deemed as diagnostic. The highest coronary attenuation (441 ± 23 HU, mean ± standard deviation) and CNR (29.5 ± 1.5) was achieved at 40 keV and at the highest GBCA dose (200%). There was a systematic decline of attenuation and CNR with higher keV reconstructions and lower GBCA doses. Only reconstructions at 40 and 45 keV at 200% and 40 keV at 150% GBCA dose demonstrated sufficient attenuation above 350 HU. Current PCD-CT protocols and settings are unsuitable for the use of GBCA for CCTA at clinically approved doses. Future advances to the PCD-CT system including a 4-threshold mode, as well as multi-material decomposition may add new opportunities for k-edge imaging of GBCA. Patients allergic to iodine-based contrast media and the future of multicontrast CT examinations would benefit greatly from alternative contrast media, but the utility of GBCA for coronary photon-counting-dector-CT angiography remains limited without further optimization of protocols and scanner settings. GBCA-enhanced coronary PCD-CT angiography is not feasible at clinically approved doses. GBCAs have potential applications for the visualization of larger vessels, such as the aorta, on PCD-CT angiography. Higher GBCA doses and lower keV reconstructions achieved higher attenuation values and CNR.

Sections du résumé

BACKGROUND BACKGROUND
Coronary computed tomography angiography (CCTA) offers non-invasive diagnostics of the coronary arteries. Vessel evaluation requires the administration of intravenous contrast. The purpose of this study was to evaluate the utility of gadolinium-based contrast agent (GBCA) as an alternative to iodinated contrast for CCTA on a first-generation clinical dual-source photon-counting-detector (PCD)-CT system.
METHODS METHODS
A dynamic circulating phantom containing a three-dimensional-printed model of the thoracic aorta and the coronary arteries were used to evaluate injection protocols using gadopentetate dimeglumine at 50%, 100%, 150%, and 200% of the maximum approved clinical dose (0.3 mmol/kg). Virtual monoenergetic image (VMI) reconstructions ranging from 40 keV to 100 keV with 5 keV increments were generated on a PCD-CT. Contrast-to-noise ratio (CNR) was calculated from attenuations measured in the aorta and coronary arteries and noise measured in the background tissue. Attenuation of at least 350 HU was deemed as diagnostic.
RESULTS RESULTS
The highest coronary attenuation (441 ± 23 HU, mean ± standard deviation) and CNR (29.5 ± 1.5) was achieved at 40 keV and at the highest GBCA dose (200%). There was a systematic decline of attenuation and CNR with higher keV reconstructions and lower GBCA doses. Only reconstructions at 40 and 45 keV at 200% and 40 keV at 150% GBCA dose demonstrated sufficient attenuation above 350 HU.
CONCLUSION CONCLUSIONS
Current PCD-CT protocols and settings are unsuitable for the use of GBCA for CCTA at clinically approved doses. Future advances to the PCD-CT system including a 4-threshold mode, as well as multi-material decomposition may add new opportunities for k-edge imaging of GBCA.
RELEVANCE STATEMENT CONCLUSIONS
Patients allergic to iodine-based contrast media and the future of multicontrast CT examinations would benefit greatly from alternative contrast media, but the utility of GBCA for coronary photon-counting-dector-CT angiography remains limited without further optimization of protocols and scanner settings.
KEY POINTS CONCLUSIONS
GBCA-enhanced coronary PCD-CT angiography is not feasible at clinically approved doses. GBCAs have potential applications for the visualization of larger vessels, such as the aorta, on PCD-CT angiography. Higher GBCA doses and lower keV reconstructions achieved higher attenuation values and CNR.

Identifiants

DOI: 10.1186/s41747-024-00501-w PMID: 39422839
pubmed: 39422839
doi: 10.1186/s41747-024-00501-w
pii: 10.1186/s41747-024-00501-w
doi:

Substances chimiques

Contrast Media 0
Gadolinium DTPA K2I13DR72L

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

118

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Dmitrij Kravchenko (D)

Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.
Quantitative Imaging Laboratory Bonn (QILaB), Bonn, Germany.

Chiara Gnasso (C)

Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.

U Joseph Schoepf (UJ)

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

Milan Vecsey-Nagy (M)

Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.

Giuseppe Tremamunno (G)

Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome-Radiology Unit-Sant'Andrea University Hospital, Rome, Italy.

Jim O'Doherty (J)

Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
Siemens Medical Solutions USA Inc, Malvern, PA, USA.

Andrew Zhang (A)

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

Julian A Luetkens (JA)

Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.
Quantitative Imaging Laboratory Bonn (QILaB), Bonn, Germany.

Daniel Kuetting (D)

Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.
Quantitative Imaging Laboratory Bonn (QILaB), Bonn, Germany.

Ulrike Attenberger (U)

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

Bernhard Schmidt (B)

Siemens Medical Solutions, Forchheim, Germany.

Akos Varga-Szemes (A)

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

Tilman Emrich (T)

Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA. tilman.emrich@unimedizin-mainz.de.
Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany. tilman.emrich@unimedizin-mainz.de.
German Centre for Cardiovascular Research, Partner Site Rhine-Main, Mainz, Germany. tilman.emrich@unimedizin-mainz.de.
ORCID: 0000-0003-4156-7727

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questionsmedicales.fr › Équipement et fournitures › Fantômes en imagerie › Gadolinium-based coronary CT angiography on a...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Tomographie à rayons X › Tomodensitométrie › Angiographie par tomodensitométrie › Gadolinium-based coronary CT angiography on a...
questionsmedicales.fr › Actions chimiques et utilisations › Utilisations spécialisées de produits chimiques › Produits de contraste › Gadolinium-based coronary CT angiography on a...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic cardiovasculaire › Tests de la fonction cardiaque › Coronarographie › Gadolinium-based coronary CT angiography on a...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Gadolinium-based coronary CT angiography on a...
questionsmedicales.fr › Phénomènes physiques › Rayonnement › Rayonnement non ionisant › Lumière › Photons › Gadolinium-based coronary CT angiography on a...
questionsmedicales.fr › Composés chimiques organiques › Complexes de coordination › Acide gadopentétique › Gadolinium-based coronary CT angiography on a...