Aortic valve calcification scoring with computed tomography: impact of iterative reconstruction techniques

Hinzpeter, Ricarda; Weber, Lutz W. D.; Euler, André; Kasel, Albert Markus; Tanner, Felix C.; Alkadhi, Hatem; Eberhard, Matthias

doi:10.1007/s10554-020-01862-0

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…Recently, Tao et al proposed a kV-independent protocol for CAC scoring using a dedicated reconstruction kernel [ 18 , 19 ], allowing for consistent attenuation of calcifications at tube potentials other than 120 kV. Several studies evaluated iterative reconstruction algorithms to facilitate radiation dose reduction for calcium scoring scans [ 20 , 21 , 22 , 23 ]. However, these are usually not applied because of a systematic underestimation of calcification scores [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Coronary Calcium Scoring with First Generation Dual-Source Photon-Counting CT—First Evidence from Phantom and In-Vivo Scans

et al. 2021

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We evaluated the accuracy of coronary artery calcium (CAC) scoring on a dual-source photon-counting detector CT (PCD-CT). An anthropomorphic chest phantom underwent ECG-gated sequential scanning on a PCD-CT at 120 kV with four radiation dose levels (CTDIvol, 2.0–8.6 mGy). Polychromatic images at 120 kV (T3D) and virtual monoenergetic images (VMI), from 60 to 75 keV without quantum iterative reconstruction (no QIR) and QIR strength levels 1–4, were reconstructed. For reference, the same phantom was scanned on a conventional energy-integrating detector CT (120 kV; filtered back projection) at identical radiation doses. CAC scoring in 20 patients with PCD-CT (120 kV; no QIR and QIR 1–4) were included. In the phantom, there were no differences between CAC scores of different radiation doses (all, p > 0.05). Images with 70 keV, no QIR (CAC score, 649); 65 keV, QIR 3 (656); 65 keV; QIR4 (648) and T3D, QIR4 (656) showed a <1% deviation to the reference (653). CAC scores significantly decreased at increasing QIR levels (all, p < 0.001) and for each 5 keV-increase (all, p < 0.001). Patient data (median CAC score: 86 [inter-quartile range: 38–978] at 70 keV) confirmed relationships and differences between reconstructions from the phantom. First phantom and in-vivo experience with a clinical dual-source PCD-CT system shows accurate CAC scoring with VMI reconstructions at different radiation dose levels.

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Section: Discussionmentioning

confidence: 99%

“…Several studies evaluated iterative reconstruction algorithms to facilitate radiation dose reduction for calcium scoring scans [ 20 , 21 , 22 , 23 ]. However, these are usually not applied because of a systematic underestimation of calcification scores [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Coronary Calcium Scoring with First Generation Dual-Source Photon-Counting CT—First Evidence from Phantom and In-Vivo Scans

et al. 2021

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Effect of temporal resolution on calcium scoring: insights from photon-counting detector CT

Sartoretti,

Mergen,

Dzaferi

et al. 2024

Int J Cardiovasc Imaging

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To intra-individually investigate the variation of coronary artery calcium (CAC), aortic valve calcium (AVC), and mitral annular calcium (MAC) scores and the presence of blur artifacts as a function of temporal resolution in patients undergoing non-contrast cardiac CT on a dual-source photon counting detector (PCD) CT. This retrospective, IRB-approved study included 70 patients (30 women, 40 men, mean age 78 ± 9 years) who underwent ECG-gated cardiac non-contrast CT with PCD-CT (gantry rotation time 0.25 s) prior to transcatheter aortic valve replacement. Each scan was reconstructed at a temporal resolution of 66 ms using the dual-source information and at 125 ms using the single-source information. Average heart rate and heart rate variability were calculated from the recorded ECG. CAC, AVC, and MAC were quantified according to the Agatston method on images with both temporal resolutions. Two readers assessed blur artifacts using a 4-point visual grading scale. The influence of average heart rate and heart rate variability on calcium quantification and blur artifacts of the respective structures were analyzed by linear regression analysis. Mean heart rate and heart rate variability during data acquisition were 76 ± 17 beats per minute (bpm) and 4 ± 6 bpm, respectively. CAC scores were smaller on 66 ms (median, 511; interquartile range, 220–978) than on 125 ms reconstructions (538; 203–1050, p < 0.001). Median AVC scores [2809 (2009–3952) versus 3177 (2158–4273)] and median MAC scores [226 (0-1284) versus 251 (0-1574)] were also significantly smaller on 66ms than on 125ms reconstructions (p < 0.001). Reclassification of CAC and AVC risk categories occurred in 4% and 11% of cases, respectively, whereby the risk category was always overestimated on 125ms reconstructions. Image blur artifacts were significantly less on 66ms as opposed to 125 ms reconstructions (p < 0.001). Intra-individual analyses indicate that temporal resolution significantly impacts on calcium scoring with cardiac CT, with CAC, MAC, and AVC being overestimated at lower temporal resolution because of increased motion artifacts eventually leading to an overestimation of patient risk.

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Artificial Intelligence and Texture Analysis in Cardiac Imaging

et al. 2020

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Aortic valve calcification scoring with computed tomography: impact of iterative reconstruction techniques

Cited by 5 publications

References 21 publications

Coronary Calcium Scoring with First Generation Dual-Source Photon-Counting CT—First Evidence from Phantom and In-Vivo Scans

Coronary Calcium Scoring with First Generation Dual-Source Photon-Counting CT—First Evidence from Phantom and In-Vivo Scans

Effect of temporal resolution on calcium scoring: insights from photon-counting detector CT

Artificial Intelligence and Texture Analysis in Cardiac Imaging

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