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European Radiology
Published in: European Radiology 12/2020

Open Access 01-12-2020 | CT Angiography | Cardiac

Towards reference values of pericoronary adipose tissue attenuation: impact of coronary artery and tube voltage in coronary computed tomography angiography

Authors: Runlei Ma, Daan Ties, Marly van Assen, Gert Jan Pelgrim, Grigory Sidorenkov, Peter M. A. van Ooijen, Pim van der Harst, Randy van Dijk, Rozemarijn Vliegenthart

Published in: European Radiology | Issue 12/2020

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Abstract

Objectives

To determine normal pericoronary adipose tissue mean attenuation (PCATMA) values for left the anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) in patients without plaques on coronary CT angiography (cCTA), taking into account tube voltage influence.

Methods

This retrospective study included 192 patients (76 (39.6%) men; median age 49 years (range, 19–79)) who underwent cCTA with third-generation dual-source CT for the suspicion of CAD between 2015 and 2017. We selected patients without plaque on cCTA. PCATMA was measured semi-automatically on cCTA images in the proximal segment of the three main coronary arteries with 10 mm length. Paired t-testing was used to compare PCATMA between combinations of two coronary arteries within each patient, and one-way ANOVA testing was used to compare PCATMA in different kV groups.

Results

The overall mean ± standard deviation (SD) PCATMA was − 90.3 ± 11.1 HU. PCATMA in men was higher than that in women: − 88.5 ± 10.5 HU versus − 91.5 ± 11.3 HU (p = 0.001). PCATMA of LAD, LCX, and RCA was − 92.4 ± 11.6 HU, − 88.4 ± 9.9 HU, and − 90.2 ± 11.4 HU, respectively. Pairwise comparison of the arteries showed significant difference in PCATMA: LAD and LCX (p < 0.001), LAD and RCA (p = 0.009), LCX and RCA (p = 0.033). PCATMA of the 70 kV, 80 kV, 90 kV, 100 kV, and 120 kV groups was − 95.6 ± 9.6 HU, − 90.2 ± 11.5 HU, − 87.3 ± 9.9 HU, − 82.7 ± 6.2 HU, and − 79.3 ± 6.8 HU, respectively (p < 0.001).

Conclusions

In patients without plaque on cCTA, PCATMA varied by tube voltage, with minor differences in PCATMA between coronary arteries (LAD, LCX, RCA). PCATMA values need to be interpreted taking into account tube voltage setting.

Key Points

• In patients without plaque on cCTA, PCAT MA differs slightly by coronary artery (LAD, LCX, RCA).
• Tube voltage of cCTA affects PCAT MA measurement, with mean PCAT MA increasing linearly with increasing kV.
• For longitudinal cCTA analysis of PCAT MA , the use of equal kV setting is strongly recommended.
Appendix
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Metadata
Title
Towards reference values of pericoronary adipose tissue attenuation: impact of coronary artery and tube voltage in coronary computed tomography angiography
Authors
Runlei Ma
Daan Ties
Marly van Assen
Gert Jan Pelgrim
Grigory Sidorenkov
Peter M. A. van Ooijen
Pim van der Harst
Randy van Dijk
Rozemarijn Vliegenthart
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07069-0

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