Virtual non-contrast series of photon-counting detector computed tomography angiography for aortic valve calcium scoring

The aim of our study was to evaluate two different virtual non-contrast (VNC) algorithms applied to photon counting detector (PCD)-CT data in terms of noise, effectiveness of contrast media subtraction and aortic valve calcium (AVC) scoring compared to reference true non-contrast (TNC)-based results...

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Bibliographic Details
Published in:The international journal of cardiovascular imaging 2024-04, Vol.40 (4), p.723-732
Main Authors: Risch, Franka, Harmel, Eva, Rippel, Katharina, Wein, Bastian, Raake, Philip, Girdauskas, Evaldas, Elvinger, Sébastien, Owais, Tamer, Scheurig-Muenkler, Christian, Kroencke, Thomas, Schwarz, Florian, Braun, Franziska, Decker, Josua A.
Format: Article
Language:English
Subjects:
Algorithms
Angiography
Aorta
Aortic valve
Calcium
Cardiac Imaging
Cardiology
Computed tomography
Contrast agents
Contrast media
Effectiveness
Heart valves
Imaging
Medicine
Medicine & Public Health
Noise levels
Original Paper
Photons
Radiology
Ventricle
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Summary:The aim of our study was to evaluate two different virtual non-contrast (VNC) algorithms applied to photon counting detector (PCD)-CT data in terms of noise, effectiveness of contrast media subtraction and aortic valve calcium (AVC) scoring compared to reference true non-contrast (TNC)-based results. Consecutive patients underwent TAVR planning examination comprising a TNC scan, followed by a CTA of the heart. VNC series were reconstructed using a conventional (VNC conv ) and a calcium-preserving (VNC pc ) algorithm. Noise was analyzed by means of the standard deviation of CT-values within the left ventricle. To assess the effectiveness of contrast media removal, heart volumes were segmented and the proportion of their histograms > 130HU was taken. AVC was measured by Agatston and volume score. 41 patients were included. Comparable noise levels to TNC were achieved with all VNC reconstructions. Contrast media was effectively virtually removed (proportions > 130HU from 81% to 0.9) correlation with TNC. Thin-slice VNC reconstructions provide equivalent noise levels to standard thick-slice TNC series and effective virtual removal of iodinated contrast. AVC scoring was feasible on both VNC series, showing near-perfect correlation, but with significant underestimation. VNC pc with 0.4 mm slices and Br36 kernel at QIR 4 gave the most comparable results and, with further advances, could be a promising replacement for additional TNC.
ISSN:1875-8312
1569-5794
1875-8312
1573-0743
DOI:10.1007/s10554-023-03040-4