The effect of iterative model reconstruction on coronary artery calcium quantification
- 454 Downloads
Coronary artery calcium (CAC) scoring with computed tomography (CT) is an established tool for quantifying calcified atherosclerotic plaque burden. Despite the widespread use of novel image reconstruction techniques in CT, the effect of iterative model reconstruction on CAC score remains unclear. We sought to assess the impact of iterative model based reconstruction (IMR) on coronary artery calcium quantification as compared to the standard filtered back projection (FBP) algorithm and hybrid iterative reconstruction (HIR). In addition, we aimed to simulate the impact of iterative reconstruction techniques on calcium scoring based risk stratification of a larger asymptomatic population. We studied 63 individuals who underwent CAC scoring. Images were reconstructed with FBP, HIR and IMR and CAC scores were measured. We estimated the cardiovascular risk reclassification rate of IMR versus HIR and FBP in a larger asymptomatic population (n = 504). The median CAC scores were 147.7 (IQR 9.6–582.9), 107.0 (IQR 5.9–526.6) and 115.1 (IQR 9.3–508.3) for FBP, HIR and IMR, respectively. The HIR and IMR resulted in lower CAC scores as compared to FBP (both p < 0.001), however there was no difference between HIR and IMR (p = 0.855). The CAC score decreased by 7.2 % in HIR and 7.3 % in IMR as compared to FBP, resulting in a risk reclassification rate of 2.4 % for both HIR and IMR. The utilization of IMR for CAC scoring reduces the measured calcium quantity. However, the CAC score based risk stratification demonstrated modest reclassification in IMR and HIR versus FBP.
KeywordsCoronary artery disease Computed tomography Iterative model reconstruction Coronary artery calcium scoring Risk stratification
Compliance with ethical standards
The institutional ethics review board has approved our study. Participants provided written informed consent.
Conflict of interest
Rolf Raaijmakers is an employee of Philips HealthTech.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 3.Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Despres JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER III, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB, American Heart Association Statistics C, Stroke Statistics S (2015) Heart disease and stroke statistics–2015 update: a report from the American Heart Association. Circulation 131(4):e29–e322. doi: 10.1161/CIR.0000000000000152 PubMedCrossRefGoogle Scholar
- 5.Petretta M, Daniele S, Acampa W, Imbriaco M, Pellegrino T, Messalli G, Xhoxhi E, Del Prete G, Nappi C, Accardo D, Angeloni F, Bonaduce D, Cuocolo A (2012) Prognostic value of coronary artery calcium score and coronary CT angiography in patients with intermediate risk of coronary artery disease. Int J Cardiovasc Imaging 28(6):1547–1556. doi: 10.1007/s10554-011-9948-5 PubMedCrossRefGoogle Scholar
- 7.Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Mosler TP, Tseng PH, Flores FR, Callister TQ, Raggi P, Berman DS (2007) Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 49(18):1860–1870. doi: 10.1016/j.jacc.2006.10.079 PubMedCrossRefGoogle Scholar
- 8.Puchner SB, Ferencik M, Karolyi M, Do S, Maurovich-Horvat P, Kauczor HU, Hoffmann U, Schlett CL (2013) The effect of iterative image reconstruction algorithms on the feasibility of automated plaque assessment in coronary CT angiography. Int J Cardiovasc Imaging 29(8):1879–1888. doi: 10.1007/s10554-013-0281-z PubMedCrossRefGoogle Scholar
- 10.Yuki H, Utsunomiya D, Funama Y, Tokuyasu S, Namimoto T, Hirai T, Itatani R, Katahira K, Oshima S, Yamashita Y (2014) Value of knowledge-based iterative model reconstruction in low-kV 256-slice coronary CT angiography. J Cardiovasc Comput Tomogr 8(2):115–123. doi: 10.1016/j.jcct.2013.12.010 PubMedCrossRefGoogle Scholar
- 11.Oda S, Utsunomiya D, Funama Y, Katahira K, Honda K, Tokuyasu S, Vembar M, Yuki H, Noda K, Oshima S, Yamashita Y (2014) A knowledge-based iterative model reconstruction algorithm: can super-low-dose cardiac CT be applicable in clinical settings? Acad Radiol 21(1):104–110. doi: 10.1016/j.acra.2013.10.002 PubMedCrossRefGoogle Scholar
- 12.Willemink MJ, Takx RA, de Jong PA, Budde RP, Bleys RL, Das M, Wildberger JE, Prokop M, Buls N, de Mey J, Schilham AM, Leiner T (2014) The impact of CT radiation dose reduction and iterative reconstruction algorithms from four different vendors on coronary calcium scoring. Eur Radiol 24(9):2201–2212. doi: 10.1007/s00330-014-3217-7 PubMedCrossRefGoogle Scholar
- 13.Funabashi N, Irie R, Aiba M, Morimoto R, Kabashima T, Fujii S, Uehara M, Ozawa K, Takaoka H, Kobayashi Y (2013) Adaptive-Iterative-Dose-Reduction 3D with multisector-reconstruction method in 320-slice CT may maintain accurate-measurement of the Agatston-calcium-score of severe-calcification even at higher pulsating-beats and low tube-current in vitro. Int J Cardiol 168(1):601–603. doi: 10.1016/j.ijcard.2013.01.230 PubMedCrossRefGoogle Scholar
- 14.Willemink MJ, Takx RA, de Jong PA, Budde RP, Bleys RL, Das M, Wildberger JE, Prokop M, Buls N, de Mey J, Leiner T, Schilham AM (2014) Computed tomography radiation dose reduction: effect of different iterative reconstruction algorithms on image quality. J Comput Assist Tomogr 38(6):815–823. doi: 10.1097/RCT.0000000000000128 PubMedCrossRefGoogle Scholar
- 16.Christner JA, Kofler JM, McCollough CH (2010) Estimating effective dose for CT using dose-length product compared with using organ doses: consequences of adopting International Commission on Radiological Protection publication 103 or dual-energy scanning. AJR Am J Roentgenol 194(4):881–889. doi: 10.2214/AJR.09.3462 PubMedCrossRefGoogle Scholar
- 20.Folsom AR, Kronmal RA, Detrano RC, O’Leary DH, Bild DE, Bluemke DA, Budoff MJ, Liu K, Shea S, Szklo M, Tracy RP, Watson KE, Burke GL (2008) Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: the Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med 168(12):1333–1339. doi: 10.1001/archinte.168.12.1333 PubMedPubMedCentralCrossRefGoogle Scholar
- 23.Kondos GT, Hoff JA, Sevrukov A, Daviglus ML, Garside DB, Devries SS, Chomka EV, Liu K (2003) Electron-beam tomography coronary artery calcium and cardiac events: a 37-month follow-up of 5635 initially asymptomatic low- to intermediate-risk adults. Circulation 107(20):2571–2576. doi: 10.1161/01.CIR.0000068341.61180.55 PubMedCrossRefGoogle Scholar
- 28.Gebhard C, Fiechter M, Fuchs TA, Ghadri JR, Herzog BA, Kuhn F, Stehli J, Muller E, Kazakauskaite E, Gaemperli O, Kaufmann PA (2013) Coronary artery calcium scoring: influence of adaptive statistical iterative reconstruction using 64-MDCT. Int J Cardiol 167(6):2932–2937. doi: 10.1016/j.ijcard.2012.08.003 PubMedCrossRefGoogle Scholar
- 29.Takx RA, Willemink MJ, Nathoe HM, Schilham AM, Budde RP, de Jong PA, Leiner T (2014) The effect of iterative reconstruction on quantitative computed tomography assessment of coronary plaque composition. Int J Cardiovasc Imaging 30(1):155–163. doi: 10.1007/s10554-013-0293-8 PubMedCrossRefGoogle Scholar
- 30.Willemink MJ, Vliegenthart R, Takx RA, Leiner T, Budde RP, Bleys RL, Das M, Wildberger JE, Prokop M, Buls N, de Mey J, Schilham AM, de Jong PA (2014) Coronary artery calcification scoring with state-of-the-art CT scanners from different vendors has substantial effect on risk classification. Radiology 273(3):695–702. doi: 10.1148/radiol.14140066 PubMedCrossRefGoogle Scholar
- 31.Tatsugami F, Higaki T, Fukumoto W, Kaichi Y, Fujioka C, Kiguchi M, Yamamoto H, Kihara Y, Awai K (2015) Radiation dose reduction for coronary artery calcium scoring at 320-detector CT with adaptive iterative dose reduction 3D. Int J Cardiovasc Imaging 31(5):1045–1052. doi: 10.1007/s10554-015-0637-7 PubMedCrossRefGoogle Scholar
- 34.Tullos BW, Sung JH, Lee JE, Criqui MH, Mitchell ME, Taylor HA (2013) Ankle-brachial index (ABI), abdominal aortic calcification (AAC), and coronary artery calcification (CAC): the Jackson heart study. Int J Cardiovasc Imaging 29(4):891–897. doi: 10.1007/s10554-012-0145-y PubMedPubMedCentralCrossRefGoogle Scholar