Diagnostic improvements of calcium-removal image reconstruction algorithm using photon-counting detector CT for calcified coronary lesions

Takahiro Nishihara, Toru Miyoshi, Mitsutaka Nakashima, Noriaki Akagi, Yusuke Morimitsu, Tomohiro Inoue, Takashi Miki, Masatoki Yoshida, Hironobu Toda, Kazufumi Nakamura, Shinsuke Yuasa

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Objective: To investigate the diagnostic performance of a calcium-removal image reconstruction algorithm with photon-counting detector-computed tomography (PCD-CT), a technology that hides only the calcified plaque from the spectral data in coronary calcified lesions. Methods: This retrospective study included 17 patients who underwent PCD-coronary CT angiography (CCTA) with at least one significant coronary stenosis (≥50 %) with calcified plaque by CCTA and invasive coronary angiography (ICA) performed within 60 days of CCTA. A total of 162 segments with calcified plaque were evaluated for subjective image quality using a 4-point scale. Their calcium-removal images were reconstructed from conventional images, and both images were compared with ICA images as the reference standard. The contrast-to noise ratios for both images were calculated. Results: Conventional and calcium-removal images had a subjective image quality of 2.7 ± 0.5 and 3.2 ± 0.9, respectively (p < 0.001). The percentage of segments with a non-diagnostic image quality was 32.7 % for conventional images and 28.3 % for calcium-removal images (p < 0.001). The segment-based diagnostic accuracy revealed an area under the receiver operating characteristic curve of 0.87 for calcium-removal images and 0.79 for conventional images (p = 0.006). Regarding accuracy, the specificity and positive predictive value of calcium-removal images were significantly improved compared with those of conventional images (80.5 % vs. 69.5 %, p = 0.002 and 64.1 % vs. 52.0 %, p < 0.001, respectively). The objective image quality of the mean contrast-to-noise ratio did not differ between the images (13.9 ± 3.6 vs 13.3 ± 3.4, p = 0.356) Conclusions: Calcium-removal images with PCD-CT can potentially be used to evaluate diagnostic performance for calcified coronary artery lesions.

Original languageEnglish
Article number111354
JournalEuropean Journal of Radiology
Volume172
DOIs
Publication statusPublished - Mar 2024

Keywords

  • Computed tomography angiography
  • Coronary artery disease
  • Coronary stenosis、image reconstruction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint

Dive into the research topics of 'Diagnostic improvements of calcium-removal image reconstruction algorithm using photon-counting detector CT for calcified coronary lesions'. Together they form a unique fingerprint.

Cite this