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Impact of Cardiac Motion on coronary artery calcium scoring using a virtual non-iodine algorithm on photon-counting detector CT: a dynamic phantom study

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Abstract

This study assessed the impact of cardiac motion and in-vessel attenuation on coronary artery calcium (CAC) scoring using virtual non-iodine (VNI) against virtual non-contrast (VNC) reconstructions on photon-counting detector CT. Two artificial vessels containing calcifications and different in-vessel attenuations (500, 800HU) were scanned without (static) and with cardiac motion (60, 80, 100 beats per minute [bpm]). Images were post-processed using a VNC and VNI algorithm at 70 keV and quantum iterative reconstruction (QIR) strength 2. Calcium mass, Agatston scores, cardiac motion susceptibility (CMS)-indices were compared to physical mass, static scores as well as between reconstructions, heart rates and in-vessel attenuations. VNI scores decreased with rising heart rate (p < 0.01) and showed less underestimation than VNC scores (p < 0.001). Only VNI scores were similar to the physical mass at static measurements, and to static scores at 60 bpm. Agatston scores using VNI were similar to static scores at 60 and 80 bpm. Standard deviation of CMS-indices was lower for VNI-based than for VNC-based CAC scoring. VNI scores were higher at 500 than 800HU (p < 0.001) and higher than VNC scores (p < 0.001) with VNI scores at 500 HU showing the lowest deviation from the physical reference. VNI-based CAC quantification is influenced by cardiac motion and in-vessel attenuation, but least when measuring Agatston scores, where it outperforms VNC-based CAC scoring.

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Data Availability

The datasets of this study are available from the corresponding author on reasonable request.

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Funding

This study was supported by Siemens Healthineers.

Author information

Authors and Affiliations

  1. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC, 29425, USA

    Nicola Fink, Emese Zsarnoczay, U. Joseph Schoepf, Jim O’Doherty, Joseph P. Griffith III, Milán Vecsey-Nagy, Daniel Pinos, Akos Varga-Szemes & Tilman Emrich

  2. Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany

    Nicola Fink & Jens Ricke

  3. Medical Imaging Center, Semmelweis University, Korányi Sándor utca 2, Budapest, 1083, Hungary

    Emese Zsarnoczay

  4. Siemens Medical Solutions, Malvern, PA, 19355, USA

    Jim O’Doherty

  5. Department of Diagnostic and Interventional Radiology, University Medical Center of Johannes Gutenberg- University, Langenbeckstr. 1, Mainz, 55131, Germany

    Moritz C. Halfmann & Tilman Emrich

  6. Siemens Healthcare GmbH, Siemensstr. 1, Forchheim, 91301, Germany

    Thomas Allmendinger & Junia Hagenauer

  7. Faculty of Medicine, Friedrich Alexander University of Erlangen-Nuremberg, Krankenhausstr. 12, Erlangen, 91054, Germany

    Junia Hagenauer

  8. MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Varosmajor utca 68, Budapest, 1122, Hungary

    Milán Vecsey-Nagy

  9. Department of Cardiology, Munich University Clinic, Ludwig-Maximilians-University, Munich, 80636, Germany

    Ullrich Ebersberger

  10. German Centre for Cardiovascular Research, Mainz, 55131, Germany

    Tilman Emrich

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  1. Nicola Fink
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Contributions

NF performed data curation, analysis and interpretation and drafted the manuscript. TE and AVS designed the study, interpreted the data and substantially edited the manuscript. EZ, DP, MVN and JPG advised data reconstruction, supported data analysis and revised the manuscript. JOD, TA and JH advised on the phantom setup, performed phantom data acquisition and revised the manuscript. MCH and JR supported data analysis and interpretation and substantially revised the manuscript. UJS supervised the study conception and data interpretation and substantially edited the manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to U. Joseph Schoepf.

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Competing interests

U. Joseph Schoepf receives institutional research support and / or personal fees from Bayer, Bracco, Elucid Bioimaging, Guerbet, HeartFlow, Inc., Keya Medical, and Siemens. Akos Varga-Szemes receives institutional research support and / or personal fees from Bayer, Elucid Bioimaging and Siemens. Tilman Emrich received a speaker fee and travel support from Siemens Medical Solutions USA Inc, institutional research support by Siemens Healthineers. Jim O’Doherty, Thomas Allmendinger and Junia Hagenauer are employees of Siemens Medical Solutions USA Inc.

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Fink, N., Zsarnoczay, E., Schoepf, U.J. et al. Impact of Cardiac Motion on coronary artery calcium scoring using a virtual non-iodine algorithm on photon-counting detector CT: a dynamic phantom study. Int J Cardiovasc Imaging 39, 2083–2092 (2023). https://doi.org/10.1007/s10554-023-02912-z

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