Evaluation of the influence of acquisition and reconstruction parameters for 16-row multidetector CT on coronary calcium scoring using a stationary and dynamic cardiac phantom

A calcium-scoring phantom with hydroxyapatite-filled cylindrical holes (0.5 to 4 mm) was used. High-resolution scans were performed for an accuracy baseline. The phantom was mounted to a moving heart phantom. Non-moving data with the implementation of an ECG-signal were acquired for different pitches (0.2/0.3), heart rates (60/80/95 bpm) and collimations (16 × 0.75/16 × 1.5 mm). Images were reconstructed with a cone-beam multi-cycle algorithm at a standard thickness/increment of 3 mm/1.5 mm and the thinnest possible thickness (0.8/0.4 and 2/1). Subsequently, ECG-gated moving calcium-scoring phantom data were acquired. The calcium volume and Agatston score were measured. The temporal resolution and reconstruction cycles were calculated. High-resolution scans determine the calcium volume with a high accuracy (mean overestimation, 0.8%). In the non-moving measurements, the volume underestimation ranged from about 6% (16 × 0.75 mm; 0.8/0.4 mm) to nearly 25% (16 × 1.5 mm; 3/1.5 mm). Moving scans showed increased measurement errors depending on the reconstructed RR interval, collimation, pitch, heart rate and gantry rotation time. Also, a correlation with the temporal resolution could be found. The reliability of calcium-scoring results can be improved with the use of a narrower collimation, a lower pitch and the reconstruction of thinner images, resulting in higher patient doses. The choice of the correct cardiac phase within the RR interval is essential to minimize measurement errors.