Improved coronary calcium detection and quantification with low-dose full field-of-view photon-counting CT: a phantom...

Area of Science:

• Medical Imaging
• Radiology
• Cardiovascular Imaging

Background:

• Coronary artery calcium (CAC) scoring is crucial for cardiovascular risk assessment.
• Conventional computed tomography (CT) is the standard for CAC detection and quantification.
• Optimizing detection accuracy and radiation dose remains an ongoing challenge.

Purpose of the Study:

• To systematically compare the detection and quantification capabilities of spectral photon-counting CT (SPCCT) against conventional CT for CAC.
• To evaluate the potential for radiation dose reduction with SPCCT while maintaining diagnostic performance.
• To assess the accuracy of SPCCT in estimating the physical volume and mass of coronary artery calcifications.

Main Methods:

• Utilized routine clinical CAC CT protocols with anthropomorphic thorax phantoms containing calcifications.
• Acquired data at a 50% reduced radiation dose by lowering tube current and decreasing slice thickness.
• Defined calcification detectability by voxel threshold and assessed quantification against known physical volumes and masses.

Main Results:

• SPCCT demonstrated superior CAC detection rates compared to conventional CT across different phantom sizes.
• At reduced radiation doses and slice thickness, SPCCT showed substantial improvements in CAC detection (up to 150%) compared to CT.
• While routine protocols showed significant deviations in volume quantification, SPCCT exhibited improved accuracy, particularly at reduced slice thickness and for high-density calcifications.

Conclusions:

• SPCCT offers superior detection of coronary artery calcium compared to conventional CT.
• CAC detection performance with SPCCT is maintained even with a 50% reduction in radiation dose.
• SPCCT provides more accurate physical volume and mass estimations of coronary artery calcium than conventional CT.