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The International Journal of Cardiovascular Imaging

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Open Access 04-01-2024 | CT Angiography | Original Paper

Virtual non-contrast series of photon-counting detector computed tomography angiography for aortic valve calcium scoring

Authors: Franka Risch, Eva Harmel, Katharina Rippel, Bastian Wein, Philip Raake, Evaldas Girdauskas, Sébastien Elvinger, Tamer Owais, Christian Scheurig-Muenkler, Thomas Kroencke, Florian Schwarz, Franziska Braun, Josua A. Decker

Published in: The International Journal of Cardiovascular Imaging | Issue 4/2024

Abstract

The aim of our study was to evaluate two different virtual non-contrast (VNC) algorithms applied to photon counting detector (PCD)-CT data in terms of noise, effectiveness of contrast media subtraction and aortic valve calcium (AVC) scoring compared to reference true non-contrast (TNC)-based results. Consecutive patients underwent TAVR planning examination comprising a TNC scan, followed by a CTA of the heart. VNC series were reconstructed using a conventional (VNC_conv) and a calcium-preserving (VNC_pc) algorithm. Noise was analyzed by means of the standard deviation of CT-values within the left ventricle. To assess the effectiveness of contrast media removal, heart volumes were segmented and the proportion of their histograms > 130HU was taken. AVC was measured by Agatston and volume score. 41 patients were included. Comparable noise levels to TNC were achieved with all VNC reconstructions. Contrast media was effectively virtually removed (proportions > 130HU from 81% to < 1%). Median calcium scores derived from VNC_conv underestimated TNC-based scores (up to 74%). Results with smallest absolute difference to TNC were obtained with VNC_pc reconstructions (0.4 mm, Br36, QIR 4), but with persistent significant underestimation (median 29%). Both VNC algorithms showed near-perfect (r²>0.9) correlation with TNC. Thin-slice VNC reconstructions provide equivalent noise levels to standard thick-slice TNC series and effective virtual removal of iodinated contrast. AVC scoring was feasible on both VNC series, showing near-perfect correlation, but with significant underestimation. VNC_pc with 0.4 mm slices and Br36 kernel at QIR 4 gave the most comparable results and, with further advances, could be a promising replacement for additional TNC.

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Title: Virtual non-contrast series of photon-counting detector computed tomography angiography for aortic valve calcium scoring
Authors: Franka Risch
Eva Harmel
Katharina Rippel
Bastian Wein
Philip Raake
Evaldas Girdauskas
Sébastien Elvinger
Tamer Owais
Christian Scheurig-Muenkler
Thomas Kroencke
Florian Schwarz
Franziska Braun
Josua A. Decker
Publication date: 04-01-2024
Publisher: Springer Netherlands
Keywords: CT Angiography
Computed Tomography
Computed Tomography
Published in: The International Journal of Cardiovascular Imaging / Issue 4/2024
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-023-03040-4

2024 ASCO Annual Meeting

Springer Medicine

Virtual non-contrast series of photon-counting detector computed tomography angiography for aortic valve calcium scoring

Abstract

2024 ASCO Annual Meeting

Springer Medicine

Abstract

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