Journal of Nuclear Cardiology

, Volume 22, Issue 3, pp 419–428 | Cite as

Single low-dose CT scan optimized for rest-stress PET attenuation correction and quantification of coronary artery calcium

  • Tyler S. Kaster
  • Girish Dwivedi
  • Leah Susser
  • Jennifer M. Renaud
  • Rob S. B. Beanlands
  • Benjamin J. W. Chow
  • Robert A. deKemp
Original Article

Abstract

Background

Coronary artery calcium is an important marker of coronary artery disease. Myocardial perfusion imaging (MPI) using PET-CT technology requires a CT scan for attenuation correction (CTAC) but is not used routinely to measure coronary calcium burden. This study aimed to determine if a low-dose CTAC scan can also accurately quantify coronary artery calcium.

Methods

Twenty-three patients underwent both a traditional coronary artery calcium scan on a dedicated cardiac CT scanner (CAC-CT) and a myocardial perfusion scan on a hybrid PET-CT scanner. The standard MPI protocol includes rest and stress-matched PET and CTAC scans. The post-stress CTAC scan was modified to approximate the CAC-CT scan protocol while maintaining ~0.5 mSv dose. Coronary artery calcium scores were compared between the Ca-CTAC and CAC-CT scans.

Results

The modified Ca-CTAC scan showed a trend toward slight decreases in segmental stress perfusion of 2-3.5% in the anterior wall segments (P < 0.05). Correlation and agreement between the proposed Ca-CTAC and standard CAC-CT calcium scores at the optimal threshold of 110 HU were also excellent (r2 = 0.99, κ = 1.0). There was a small difference in the regression slope vs unity: Ca-CTAC = 0.96 × CAC (P < 0.05), but the categorical classification of calcium was accurate in all twenty-three patients (κ = 1.0).

Conclusion

A single low-dose rest CTAC scan can be used for accurate attenuation correction of rest and stress PET perfusion images, thus allowing a post-stress CTAC scan to be optimized for improved quantification of coronary artery calcium without increasing radiation dose vs standard protocols.

Keywords

PET/CT imaging coronary artery calcium rubidium 

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Copyright information

© American Society of Nuclear Cardiology 2014

Authors and Affiliations

  • Tyler S. Kaster
    • 1
  • Girish Dwivedi
    • 1
  • Leah Susser
    • 1
  • Jennifer M. Renaud
    • 1
  • Rob S. B. Beanlands
    • 1
  • Benjamin J. W. Chow
    • 1
  • Robert A. deKemp
    • 1
  1. 1.The National Cardiac PET Centre, Division of CardiologyUniversity of Ottawa Heart InstituteOttawaCanada

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