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Analysis of coronary arterial calcification components with coronary CT angiography using single-source dual-energy CT with fast tube voltage switching

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Abstract

Clinical cardiac applications of single-source dual-energy computed tomography (DECT) have recently been introduced. This study aimed to analyze the components of coronary arterial calcification (CAC) in vivo by material decomposition achieved with DECT. We reconstructed computed tomography (CT) angiography images for 51 consecutive patients with CACs who had undergone electrocardiography-gated coronary CT angiography by single-source DECT with fast tube voltage switching. We placed regions of interest (ROIs) within the CAC with margins of at least 0.5 mm to minimize partial volume averaging. We compared histograms for the effective atomic number (EAN) and the median, mean, and maximum EANs for each CAC with the theoretical EANs for possible CAC components, including hydroxyapatite (HA), calcium oxalate monohydrate (COM), and dicalcium phosphate dehydrate. We also investigated the in vivo EAN for COM and in vitro EAN for HA by our phantom experiment. Analysis of the CAC components was feasible in 177 ROIs from 28 patients. The median EAN was 13.8 ± 0.8 (95 % confidence interval 13.7–13.9), which is similar to the theoretical EAN for COM (13.8). The EAN for HA in vitro was 16.5 ± 0.1, which was slightly higher than the theoretical EAN value for HA (16.1). Notably, the median EAN in 144 ROIs (81.4 %) was between 11.2 and 14.4, which is the reported range of the in vivo EAN for COM. Our results suggest that COM might be a more frequent CAC component than previously reported.

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Abbreviations

ASiR:

Adaptive statistical iterative reconstruction

CABG:

Coronary artery bypass graft

CAC:

Coronary arterial calcification

CAD:

Coronary artery disease

CC:

Calcium carbonate

CI:

Confidence interval

CO:

Calcium oxalate

COM:

Calcium oxalate monohydrate

CT:

Computed tomography

CTA:

Computed tomography angiography

CTDIvol:

Volume CT dose index

DCPD:

Dicalcium phosphate dehydrate

DECT:

Dual-energy computed tomography

DLP:

Dose-length product

EAN:

Effective atomic number

ECG:

Electrocardiogram

HA:

Hydroxyapatite

OCP:

Octacalcium phosphate

ROI:

Region of interest

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Acknowledgments

We thank Isao Tanaka and Rika Fukui (Department of Radiology, Tokyo Women’s Medical University Medical Center East) for their expert technical assistance. We also thank Takuya Hiramoto (GE Healthcare) for his helpful discussion and technical information on single-source DECT.

Conflict of interest

None of the authors has any potential conflict of interests.

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Authors and Affiliations

  1. Departments of Medicine, Tokyo Women’s Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan

    Kazuhiro Matsui, Tetsuya Mitsuhashi, Hisako Omori, Takashi Nakaoka & Hiroshi Sakura

  2. Departments of Radiology, Tokyo Women’s Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan

    Haruhiko Machida & Eiko Ueno

Authors
  1. Kazuhiro Matsui
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  2. Haruhiko Machida
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  3. Tetsuya Mitsuhashi
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  4. Hisako Omori
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  5. Takashi Nakaoka
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  6. Hiroshi Sakura
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  7. Eiko Ueno
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Correspondence to Haruhiko Machida or Takashi Nakaoka.

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Matsui, K., Machida, H., Mitsuhashi, T. et al. Analysis of coronary arterial calcification components with coronary CT angiography using single-source dual-energy CT with fast tube voltage switching. Int J Cardiovasc Imaging 31, 639–647 (2015). https://doi.org/10.1007/s10554-014-0574-x

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  • DOI: https://doi.org/10.1007/s10554-014-0574-x

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