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Accuracy of dual-source computed tomography in quantitative assessment of low density coronary stenosis—a motion phantom study

  • Cardiac
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Abstract

Purpose

We assessed the accuracy and reproducibility of non-calcified plaque quantification as simulated by a low-density stenosis in vessel phantoms using diameter and area measures, as well as the influence of vessel size and motion on quantification accuracy in dual-source computed tomography (DSCT).

Methods

Four phantoms (2, 2.5, 3, and 4 mm in luminal diameter) made from a radiopaque Lucite (126 ± 23 Hounsfield units, HU) simulating a fixed radiolucent concentric coronary stenosis (7 ± 2 HU, 50% luminal narrowing) were connected to a cardiac motion simulator. Stenosis quantification was based on area and diameter measurements. All measurements were highly reproducible (all ICC ≥0.95, p < 0.001).

Results

The mean measured degree of stenosis was 38.0 ± 11.7% for a single diameter measurement, resulting in a mean relative error of 22.0 ± 18.7%, decreasing with increasing phantom size (31.9 ± 22.1%; 25.2 ± 20.9%; 16.3 ± 12.8%; 14.5 ± 11.4%; for 2-, 2.5-, 3-, and 4-mm phantoms, respectively; p < 0.0001). Measurement accuracy significantly increased to 13.3 ± 13.9% by using area measurement (p < 0.0001). The degree of stenosis was not significantly different when comparing a motioned image with an image at rest.

Conclusion

DSCT enables highly reproducible quantification of low density stenosis, but underestimates the degree of stenosis, especially in small vessels. Area-based measurements reflect the true degree of stenosis with higher accuracy than diameter.

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Abbreviations

MDCT:

multi-detector computed tomography

DSCT:

dual-source computed tomography

FOV:

field of view

WW/WL:

window with/window level

HU:

Hounsfield units

ICC:

intra-class correlation

CI:

confidence interval

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Funding sources

This work was supported in parts by Siemens Medical Solutions. Dr. Toepker received support from the Erwin Schroedinger Fellowship Abroad, Austria. Mr. Schlett and Mr. Irlbeck were supported by a grant from the Foundation of German Business.

Conflict of Interest disclosure

CL is an employee of Siemens Medical Solutions.

Author information

Authors and Affiliations

  1. Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, 165 Charles River Plaza Suite 400, Boston, MA, 02114, USA

    Michael Toepker, Christopher L. Schlett, Thomas Irlbeck, Fabian Bamberg, Patrick Donnelly & Udo Hoffmann

  2. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Fabian Bamberg & Udo Hoffmann

  3. Siemens AG, Siemens Medical Solutions, Malvern, PA, USA

    Amir A. Mahabadi & Christiane Leidecker

  4. Department of Radiology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria

    Michael Toepker

  5. Department of Clinical Radiology, University Hospitals Munich, Ludwig-Maximilians-University, Marchioninistr. 15, 81377, Munich, Germany

    Fabian Bamberg

Authors
  1. Michael Toepker
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  2. Christopher L. Schlett
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  3. Thomas Irlbeck
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  4. Amir A. Mahabadi
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  8. Udo Hoffmann
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Corresponding author

Correspondence to Udo Hoffmann.

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Toepker, M., Schlett, C.L., Irlbeck, T. et al. Accuracy of dual-source computed tomography in quantitative assessment of low density coronary stenosis—a motion phantom study. Eur Radiol 20, 542–548 (2010). https://doi.org/10.1007/s00330-009-1587-z

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  • DOI: https://doi.org/10.1007/s00330-009-1587-z

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