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Tube voltage-independent coronary calcium scoring on a first-generation dual-source photon-counting CT—a proof-of-principle phantom study

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Abstract

To evaluate the accuracy of coronary artery calcium (CAC) scoring at various tube voltages and different monoenergetic image reconstructions on a first-generation dual-source photon-counting detector CT (PCD-CT). A commercially available anthropomorphic chest phantom with calcium inserts was scanned at different tube voltages (90 kV, Sn100kV, 120 kV, and Sn140kV) on a first-generation dual-source PCD-CT system with quantum technology using automatic exposure control with an image quality (IQ) level of 20. The same phantom was also scanned on a conventional energy-integrating detector CT (120 kV; weighted filtered back projection) for reference. Extension rings were used to emulate different patient sizes. Virtual monoenergetic images at 65 keV and 70 keV applying different levels of quantum iterative reconstruction (QIR) were reconstructed from the PCD-CT data sets. CAC scores were determined and compared to the reference. Radiation doses were noted. At an IQ level of 20, radiation doses ranged between 1.18 mGy and 4.64 mGy, depending on the tube voltage and phantom size. Imaging at 90 kV or Sn100kV was associated with a size-dependent radiation dose reduction between 23% and 48% compared to 120 kV. Tube voltage adapted image reconstructions with 65 keV and QIR 3 at 90 kV and with 70 keV and QIR 1 at Sn100kV allowed to calculate CAC scores comparable to conventional EID-CT scans with a percentage deviation of ≤ 5% for all phantom sizes. Our phantom study indicates that CAC scoring with dual-source PCD-CT is accurate at various tube voltages, offering the possibility of substantial radiation dose reduction.

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The data underlying this article will be shared on reasonable request to the corresponding author.

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Abbreviations

CAC:

Coronary artery calcium

EID-CT:

Energy-integrating detector computed tomography

QIR:

Quantum iterative reconstruction

PCD-CT:

Photon-counting detector computed tomography

VMI:

Virtual monoenergetic image

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Funding

V.M. is funded by the research grant “Young Talents in Clinical Research” of the Swiss Academy of Medical Sciences (SAMS) and the G. & J. Bangerter-Rhyner Foundation.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland

    V. Mergen, K. Higashigaito, R. Manka, A. Euler, H. Alkadhi & M. Eberhard

  2. Siemens Healthineers, Forchheim, Germany

    T. Allmendinger

  3. Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    R. Manka

Authors
  1. V. Mergen
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  2. K. Higashigaito
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  3. T. Allmendinger
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  4. R. Manka
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  5. A. Euler
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  6. H. Alkadhi
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  7. M. Eberhard
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Correspondence to M. Eberhard.

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T.A. is employee of Siemens Healthineers. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Mergen, V., Higashigaito, K., Allmendinger, T. et al. Tube voltage-independent coronary calcium scoring on a first-generation dual-source photon-counting CT—a proof-of-principle phantom study. Int J Cardiovasc Imaging 38, 905–912 (2022). https://doi.org/10.1007/s10554-021-02466-y

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