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Open Access 01-03-2022 | Computed Tomography | Cardiac

Coronary calcium scores on dual-source photon-counting computed tomography: an adapted Agatston methodology aimed at radiation dose reduction

Authors: Niels R. van der Werf, Marcel J. W. Greuter, Ronald Booij, Aad van der Lugt, Ricardo P. J. Budde, Marcel van Straten

Published in: European Radiology | Issue 8/2022

Abstract

Objectives

The aim of this study was to determine mono-energetic (monoE) level–specific photon-counting CT (PCCT) Agatston thresholds, to yield monoE level independent Agatston scores validated with a dynamic cardiac phantom. Also, we examined the potential of dose reduction for PCCT coronary artery calcium (CAC) studies, when reconstructed at low monoE levels.

Methods

Theoretical CAC monoE thresholds were calculated with data from the National Institute of Standards and Technology (NIST) database. Artificial CAC with three densities were moved in an anthropomorphic thorax phantom at 0 and 60–75 bpm, and scanned at full and 50% dose on a first-generation dual-source PCCT. For all densities, Agatston scores and maximum CT numbers were determined. Agatston scores were compared with the reference at full dose and 70 keV monoE level; deviations (95% confidence interval) < 10% were deemed to be clinically not-relevant.

Results

Averaged over all monoE levels, measured CT numbers deviated from theoretical CT numbers by 6%, 13%, and − 4% for low-, medium-, and high-density CAC, respectively. At 50% reduced dose and 60–75 bpm, Agatston score deviations were non-relevant for 60 to 100 keV and 60 to 120 keV for medium- and high-density CAC, respectively.

Conclusion

MonoE level–specific Agatston score thresholds resulted in similar scores as in standard reconstructions at 70 keV. PCCT allows for a potential dose reduction of 50% for CAC scoring using low monoE reconstructions for medium- and high-density CAC.

Key Points

• Mono-energy level–specific Agatston thresholds allow for reproducible coronary artery calcium quantification on mono-energetic images.

• Increased calcium contrast-to-noise ratio at reduced mono-energy levels allows for coronary artery calcium quantification at 50% reduced radiation dose for medium- and high-density calcifications.

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Title: Coronary calcium scores on dual-source photon-counting computed tomography: an adapted Agatston methodology aimed at radiation dose reduction
Authors: Niels R. van der Werf
Marcel J. W. Greuter
Ronald Booij
Aad van der Lugt
Ricardo P. J. Budde
Marcel van Straten
Publication date: 01-03-2022
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Published in: European Radiology / Issue 8/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-022-08642-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Coronary calcium scores on dual-source photon-counting computed tomography: an adapted Agatston methodology aimed at radiation dose reduction

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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