Universität zu Köln

Langenbach, I. L., Wienemann, H., Klein, K., Scholtz, J. E., Pennig, L., Langzam, E., Pahn, G., Holz, J. A., Maintz, D., Naehle, C. P. and Langenbach, M. C. (2023). Coronary calcium scoring using virtual non-contrast reconstructions on a dual-layer spectral CT system: Feasibility in the clinical practice. Eur. J. Radiol., 159. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-7727

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Abstract

Purpose: To evaluate the clinical applicability of a prototype virtual non-contrast (VNC) reconstruction algorithm based on coronary CT angiography (cCTA) to assess calcified coronary plaques by calcium scoring (CACS).Methods: Eighty consecutive patients suspected of coronary artery disease were retrospectively included. All patients underwent a cardiac CT using a dual-layer spectral-detector CT system. The standardized acquisition protocol included unenhanced CACS and cCTA. Datasets were acquired using 120 keV. VNC-reconstructions were calculated from the cCTA images at 2.5 mm (VNC group 1), 2.5 of 0.9 mm (group 2), and 0.9 mm (group 3) slice thickness. We compared the Agatston score and Coronary Artery Calcium Data and Reporting System (CAC-DRS) of all VNC reconstructions with the true non-contrast (TNC)-dataset as the gold standard. Results: In total, 73 patients were evaluated. Fifty patients (68.5 %) had a CACS > 0 based on TNC. We found a significant difference in the Agatston score comparing all VNC-reconstructions (1: 1.35, 2: 3.7, 3: 10.4) with the TNC dataset (3.8) (p < 0.001). Correlation analysis of the datasets showed an excellent correlation of the TNC results with the different VNC-reconstructions (r = 0.904-0.974, p < 0.001) with a slope of 1.89-2.53. Mean differences and limits of agreement by Bland-Altman analysis between TNC and group 1 were 83 and -196 to 362, respectively. By using the VNC-reconstructions, in group 1 23 patients (31.5 %), in group 2 10 (13.7 %), and in group 3 23 (31.5 %) were reclassified according to CAC-DRS compared to TNC. Classification according to CAC-DRS revealed a significant difference between TNC and group 1 (p = 0.024) and no significance compared to groups 2 and 3 (p = 0.670 and 0.273).Conclusion: The investigated VNC reconstruction algorithm of routine cCTA allows the detection and evaluation of coronary calcium burden without the requirement for an additional acquisition of an unenhanced CT scan for CACS and, therefore, a reduction of radiation exposure.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Langenbach, I. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wienemann, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klein, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Scholtz, J. E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pennig, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Langzam, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pahn, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Holz, J. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Naehle, C. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Langenbach, M. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-689574
DOI:	10.1016/j.ejrad.2022.110681
Journal or Publication Title:	Eur. J. Radiol.
Volume:	159
Date:	2023
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-7727
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ARTERY CALCIUM; SCCT GUIDELINES; QUANTIFICATION; ANGIOGRAPHY; SOCIETY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68957