Coronary Computed Tomography Angiography-Based Calcium Scoring

作者：Tilman Emrich, Gilberto J. Aquino, U. Joseph Schoepf, Franziska Braun, Franka Risch, Stefanie Bette, Piotr Woźnicki, Josua A. Decker, Jim O’Doherty, Verena Brandt, Thomas Allmendinger, Tristan Nowak, Bernhard Schmidt, Thomas Flohr, Thomas Kroencke, Christian Scheurig‐Muenkler, Ákos Varga‐Szemes, Florian Schwarz · 发表于：Investigative Radiology · 年份：2022 · DOI：10.1097/rli.0000000000000868 · 被引用次数：92 · 研究领域：Advanced X-ray and CT Imaging、Cardiac Imaging and Diagnostics、Radiation Dose and Imaging

Purpose 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. Materials and Methods 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 . Results 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]...