Quantitation of in vitro coronary artery calcium using ultrafast computed tomography

Ultrafast computed tomography (UFCT) has the potential to quantify coronary hydroxyapatite (HAP). However, no definitive studies validating this technique are available. We constructed a human chest phantom model with coronary arteries represented by cylindrical holes containing: (1) calcium chloride solutions, (2) a block of HAP immersed in paraffin (without partial volume effect), and (3) HAP granules embedded in a gelatin matrix (with partial volume effect). We scanned this model to determine the relationship between measured CT number per voxel and density of the calcium per voxel. The relationships between CT number and concentration of calcium chloride was linear (r = 0.992 to 0.999). Using a commercially available standard bone mineral phantom, we were able to estimate the concentration of HAP to an accuracy from 94 to 97% when partial volume effects were absent. However, when partial volume effects were present, two methods of estimating HAP produced significant errors (1 to 384%, and 17 to 52%). We conclude that significant partial voluming errors degrade the accuracy of HAP quantitation and that further evaluation and corrections are needed before such quantitation is clinically applied.