Rolf Symons1, Younhee Choi2, Tyler E Cork3, Mark A Ahlman2, Marissa Mallek2, David A Bluemke4, Veit Sandfort2. 1. Radiology and Imaging Sciences - National Institutes of Health Clinical Center, Bethesda, MD, USA; Department of Imaging and Pathology, Medical Imaging Research Centre, University Hospitals Leuven, Leuven, Belgium. 2. Radiology and Imaging Sciences - National Institutes of Health Clinical Center, Bethesda, MD, USA. 3. Radiology and Imaging Sciences - National Institutes of Health Clinical Center, Bethesda, MD, USA; Department of Radiological Sciences, University of California, Los Angeles, CA, USA; Department of Bioengineering, University of California, Los Angeles, CA, USA. 4. Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA. Electronic address: dbluemke@wisc.edu.
Abstract
BACKGROUND: To optimize spectral coronary computed tomography angiography (CTA) for quantification of coronary artery plaque components. MATERIALS AND METHODS: Fifty-one subjects were prospectively enrolled (88.2% male) (NCT02740699). Dual energy coronary CTA was performed at 90/Sn150 kVp using a 3rd generation dual-source CT scanner (SOMATOM Force, Siemens Healthcare). Dual energy images were reconstructed with a) linear mixed blending of 90 and Sn150 kVp data, b) virtual monoenergetic algorithm from 40 to 150 keV (at 10- keV intervals), and c) noise-optimized virtual monoenergetic algorithm from 40 to 150 keV. Image noise, iodine signal-to-noise-ratio (SNR), and contrast-to-noise ratio (CNR) for calcified and non-calcified plaque were measured. Qualitative readings of image quality were performed. Semi-automated software (QAngioCT, Medis) was used to quantify coronary plaque. Linear mixed-models that account for within-subject correlation of plaques were used to compare the results. RESULTS: 100-150 keV noise-optimized virtual monoenergetic images had lower image noise than linear mixed images (all P < 0.05). The highest iodine SNR was achieved in 40 keV noise-optimized virtual monoenergetic images (33.3 ± 0.6 vs 23.3 ± 0.7 for linear mixed images, P < 0.001). 40-70 keV noise-optimized virtual monoenergetic images and 70 keV virtual monoenergetic images had superior coronary plaque CNR versus linear mixed images (all P < 0.01) with a maximum improvement of 20.1% and 22.7% for calcified plaque and non-calcified plaque (38.8 ± 2.2 vs 32.3 ± 2.3 and 17.3 ± 1.3 vs 14.1 ± 1.4, respectively). Using 90/Sn150 kVp linear mixed images as a reference, the plaque quantity was similar for 70 keV noise-optimized virtual monoenergetic images whereas low keV images (e.g. 40 keV) yielded significantly higher coronary plaque volumes (all P < 0.001). CONCLUSION: Spectral coronary CTA with low energy (40-70 keV) post-processing can improve the CNR of coronary plaque components. However, low energies (such as 40 keV) resulted in different absolute volumes of coronary plaque compared to "conventional" mixed 90/Sn150 kVp images. Published by Elsevier Inc.
BACKGROUND: To optimize spectral coronary computed tomography angiography (CTA) for quantification of coronary artery plaque components. MATERIALS AND METHODS: Fifty-one subjects were prospectively enrolled (88.2% male) (NCT02740699). Dual energy coronary CTA was performed at 90/Sn150 kVp using a 3rd generation dual-source CT scanner (SOMATOM Force, Siemens Healthcare). Dual energy images were reconstructed with a) linear mixed blending of 90 and Sn150 kVp data, b) virtual monoenergetic algorithm from 40 to 150 keV (at 10- keV intervals), and c) noise-optimized virtual monoenergetic algorithm from 40 to 150 keV. Image noise, iodine signal-to-noise-ratio (SNR), and contrast-to-noise ratio (CNR) for calcified and non-calcified plaque were measured. Qualitative readings of image quality were performed. Semi-automated software (QAngioCT, Medis) was used to quantify coronary plaque. Linear mixed-models that account for within-subject correlation of plaques were used to compare the results. RESULTS: 100-150 keV noise-optimized virtual monoenergetic images had lower image noise than linear mixed images (all P < 0.05). The highest iodine SNR was achieved in 40 keV noise-optimized virtual monoenergetic images (33.3 ± 0.6 vs 23.3 ± 0.7 for linear mixed images, P < 0.001). 40-70 keV noise-optimized virtual monoenergetic images and 70 keV virtual monoenergetic images had superior coronary plaque CNR versus linear mixed images (all P < 0.01) with a maximum improvement of 20.1% and 22.7% for calcified plaque and non-calcified plaque (38.8 ± 2.2 vs 32.3 ± 2.3 and 17.3 ± 1.3 vs 14.1 ± 1.4, respectively). Using 90/Sn150 kVp linear mixed images as a reference, the plaque quantity was similar for 70 keV noise-optimized virtual monoenergetic images whereas low keV images (e.g. 40 keV) yielded significantly higher coronary plaque volumes (all P < 0.001). CONCLUSION: Spectral coronary CTA with low energy (40-70 keV) post-processing can improve the CNR of coronary plaque components. However, low energies (such as 40 keV) resulted in different absolute volumes of coronary plaque compared to "conventional" mixed 90/Sn150 kVp images. Published by Elsevier Inc.
Authors: Robbert Willem van Hamersvelt; Ivana Išgum; Pim A de Jong; Maarten Jan Maria Cramer; Geert E H Leenders; Martin J Willemink; Michiel Voskuil; Tim Leiner Journal: BMJ Open Date: 2019-03-01 Impact factor: 2.692
Authors: David C Rotzinger; Salim A Si-Mohamed; Jérôme Yerly; Sara Boccalini; Fabio Becce; Loïc Boussel; Reto A Meuli; Salah D Qanadli; Philippe C Douek Journal: Eur Radiol Date: 2021-03-19 Impact factor: 5.315