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01-05-2015 | Computed Tomography

Dual energy computed tomography quantification of carotid plaques calcification: comparison between monochromatic and polychromatic energies with pathology correlation

Authors: Lorenzo Mannelli, Lawrence MacDonald, Marcello Mancini, Marina Ferguson, William P. Shuman, Monica Ragucci, Serena Monti, Dongxiang Xu, Chun Yuan, Lee M. Mitsumori

Published in: European Radiology | Issue 5/2015

Abstract

Purpose

We compared carotid plaque calcification detection sensitivity and apparent cross-sectional area on CT as a function of CT beam energy using conventional CT techniques and virtual mono-energetic CT images generated from dual-energy acquisitions.

Methods & materials

Five ex-vivo carotid endarterectomy (CEA) specimens were imaged with dual-energy computed tomography. Virtual monochromatic spectrum (VMS) CT images were reconstructed at energies between 40-140 keV. The same specimens were imaged using conventional polyenergetic spectrum (PS) CT with peak beam energies 80, 100, 120, and 140 kVp. The histological calcium areas on each corresponding CEA specimen were traced manually on digitized images of Toluidine-Blue/Basic-Fuchsin stained plastic sections.

Results

40 keV VMS CT images provided high detection sensitivity (97 %) similar to conventional PS CT images (~96 %). The calcification size measured on CT decreased systematically with increasing CT beam energy; the rate of change was larger for the VMS images than for PS images.

Conclusion

From a single dual-energy CT, multiple VMS-CT images can be generated, yielding equivalent detection sensitivity and size correlations as conventional PS-CT in CEA calcification imaging. VMS-CT at 80-100 keV provided the most accurate estimates of calcification size, as compared to histology, but detection sensitivity was reduced for smaller calcifications on these images.

Key Points

• Calcifications depicted at 80-100 keV were most similar to the histology standard.

• Conventional polychromatic images demonstrated excellent correlation with plaque size at pathology.

• Conventional polychromatic images systematically overestimate plaque size.

• Plaque calcifications can be missed on high energy monochromatic images.

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Title: Dual energy computed tomography quantification of carotid plaques calcification: comparison between monochromatic and polychromatic energies with pathology correlation
Authors: Lorenzo Mannelli
Lawrence MacDonald
Marcello Mancini
Marina Ferguson
William P. Shuman
Monica Ragucci
Serena Monti
Dongxiang Xu
Chun Yuan
Lee M. Mitsumori
Publication date: 01-05-2015
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 5/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3523-0

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Springer Medicine

Dual energy computed tomography quantification of carotid plaques calcification: comparison between monochromatic and polychromatic energies with pathology correlation

Abstract

Purpose

Methods & materials

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods & materials

Results

Conclusion

Key Points

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