Authors:	Wolf, Elias V. Halfmann, Moritz C. Schoepf, U. Joseph Zsarnoczay, Emese Fink, Nicola Griffith, Joseph P. Aquino, Gilberto J. Willemink, Martin J. O'Doherty, Jim Hell, Michaela M. Suranyi, Pal Kabakus, Ismael M. Baruah, Dhiraj Varga-Szemes, Akos Emrich, Tilman
Title:	Intra-individual comparison of coronary calcium scoring between photon counting detector- and energy integrating detector-CT : effects on risk reclassification
Online publication date:	19-Feb-2024
Year of first publication:	2023
Language:	english
Abstract:	Purpose: To compare coronary artery calcium volume and score (CACS) between photon-counting detector (PCD) and conventional energy integrating detector (EID) computed tomography (CT) in a phantom and prospective patient study. Methods: A commercially available CACS phantom was scanned with a standard CACS protocol (120 kVp, slice thickness/increment 3/1.5 mm, and a quantitative Qr36 kernel), with filtered back projection on the EID-CT, and with monoenergetic reconstruction at 70 keV and quantum iterative reconstruction off on the PCD-CT. The same settings were used to prospectively acquire data in patients (n = 23, 65 ± 12.1 years), who underwent PCD- and EID-CT scans with a median of 5.5 (3.0–12.5) days between the two scans in the period from August 2021 to March 2022. CACS was quantified using a commercially available software solution. A regression formula was obtained from the aforementioned comparison and applied to simulate risk reclassification in a pre-existing cohort of 514 patients who underwent a cardiac EID-CT between January and December 2021. Results: Based on the phantom experiment, CACSPCD–CT showed a more accurate measurement of the reference CAC volumes (overestimation of physical volumes: PCD-CT 66.1 ± 1.6% vs. EID-CT: 77.2 ± 0.5%). CACSEID–CT and CACSPCD–CT were strongly correlated, however, the latter measured significantly lower values in the phantom (CACSPCD–CT: 60.5 (30.2–170.3) vs CACSEID–CT 74.7 (34.6–180.8), p = 0.0015, r = 0.99, mean bias –9.7, Limits of Agreement (LoA) –36.6/17.3) and in patients (non-significant) (CACSPCD–CT: 174.3 (11.1–872.7) vs CACSEID–CT 218.2 (18.5–876.4), p = 0.10, r = 0.94, mean bias –41.1, LoA –315.3/232.5). The systematic lower measurements of Agatston score on PCD-CT system led to reclassification of 5.25% of our simulated patient cohort to a lower classification class. Conclusion: CACSPCD–CT is feasible and correlates strongly with CACSEID–CT, however, leads to lower CACS values. PCD-CT may provide results that are more accurate for CACS than EID-CT.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-10050
Version:	Published version
Publication type:	Zeitschriftenaufsatz
Document type specification:	Scientific article
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Frontiers in Cardiovascular Medicine 9
Pages or article number:	1053398
Publisher:	Frontiers Media
Publisher place:	Lausanne
Issue date:	2023
ISSN:	2297-055X
Publisher DOI:	10.3389/fcvm.2022.1053398
Appears in collections:	DFG-491381577-G