Quantitative analysis of coronary vessels with optimized intracoronary CT number

Area of Science:

• Cardiovascular imaging
• Medical physics
• Radiology

Background:

• Intracoronary CT number variability can affect coronary vessel quantification.
• Coronary CT angiography (CCTA) is a key imaging modality for assessing coronary artery disease.
• Optimizing CT numbers is crucial for accurate CCTA-based measurements.

Purpose of the Study:

• To evaluate a novel method for measuring coronary vessel diameter and area using CCTA.
• To validate the feasibility of using an optimized intracoronary CT number (350 HU) for improved vessel quantification.
• To establish a reliable CCTA-based approach for estimating media-to-media diameter and external elastic membrane (EEM) area.

Main Methods:

• Intravascular ultrasound (IVUS) imaging was performed in 52 patients with significant stenosis.
• Coronary CT angiography (CCTA) was optimized to target an intracoronary CT number of 350 HU.
• Measurements of 0-to-0 HU distances and areas in CCTA images were compared to IVUS-derived media-to-media distances and EEM areas.

Main Results:

• A strong correlation was found between 0-to-0 HU distance in CCTA and media-to-media diameter in IVUS (r=0.97, p<0.001).
• The CT-to-IVUS ratio (C:I) was determined to be 1.1.
• A strong correlation was observed between estimated EEM area from CCTA and actual EEM area from IVUS (r=0.95, p<0.001).

Conclusions:

• Coronary artery media-to-media diameter can be accurately estimated using CCTA with an optimized 350 HU intracoronary CT number.
• External elastic membrane (EEM) area can be reliably estimated by CCTA when vessel borders are defined at 0 HU.
• This optimized CCTA method enhances the accuracy of coronary vessel quantification.