Small calcified coronary atherosclerotic plaque simulation model: minimal size and attenuation detectable by 64-MDCT and MicroCT | springermedicine.com

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The International Journal of Cardiovascular Imaging

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Open Access 01-04-2012 | Original paper

Small calcified coronary atherosclerotic plaque simulation model: minimal size and attenuation detectable by 64-MDCT and MicroCT

Authors: Wisnumurti Kristanto, Peter M. A. van Ooijen, Jaap M. Groen, Rozemarijn Vliegenthart, Matthijs Oudkerk

Published in: The International Journal of Cardiovascular Imaging | Issue 4/2012

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Abstract

Zero calcium score may not reflect the absence of calcifications as small calcifications could be missed. This study aimed to evaluate minimal size and minimal attenuation of coronary calcifications detectable by computed tomography (CT) and to determine the minimal spatial resolution required for detecting calcification onset. Using open source CT simulation software, CTSim^©, several 50%-stenotic coronary artery phantoms were designed with 5 μm resolution, realistic morphology and tissue-specific Hounsfield Unit (HU) values. The plaque had an attenuation resembling fibrous plaque and contained a single calcification. X-ray projections were simulated with settings resembling non-contrast-enhanced 64 multi detector-row CT (64-MDCT). Scanning and reconstruction were simulated with spatial resolution of a 64-MDCT (0.4mm) and of a MicroCT (48 μm). Starting from a single calcium granule, the calcification was simulated to grow in size and attenuation until it could be detected using clinically accepted calcium determination scheme on MicroCT and 64-MDCT images. The smallest coronary calcifications detectable at MicroCT and 64-MDCT, which had a realistic attenuation (−1,024 to 3,072 HU), were of 25 μm and 215 μm diameter, respectively. The area was overestimated 7.7 and 8.8 times, respectively. Calcifications with smaller size need to have an unrealistically high attenuation to be detectable by 64-MDCT. In conclusion, 64-MDCT is only able to detect coronary calcifications with minimal diameter of 215 μm. Consequently, early onset of calcification in coronary plaque will remain invisible when using CT and a zero calcium score can not exclude the presence of coronary calcification.

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Title: Small calcified coronary atherosclerotic plaque simulation model: minimal size and attenuation detectable by 64-MDCT and MicroCT
Authors: Wisnumurti Kristanto
Peter M. A. van Ooijen
Jaap M. Groen
Rozemarijn Vliegenthart
Matthijs Oudkerk
Publication date: 01-04-2012
Publisher: Springer Netherlands
Published in: The International Journal of Cardiovascular Imaging / Issue 4/2012
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-011-9869-3

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