Intraindividual Comparison of Ultrahigh-Spatial-Resolution Photon-Counting Detector CT and Energy-Integrating Detector CT for Coronary Stenosis Measurement.

Autor:	Vecsey-Nagy M; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.).; Heart and Vascular Center, Semmelweis University, Budapest, Hungary (M.V.-N., B.S.)., Tremamunno G; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.).; Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Italy (G.T.)., Schoepf UJ; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.)., Gnasso C; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.).; Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy (C.G.)., Zsarnóczay E; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.).; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary (E.Z., P.M.-H.)., Fink N; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.).; Department of Radiology, University Hospital, LMU Munich, Germany (N.F.)., Kravchenko D; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.).; Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Germany (D.K.)., Halfmann MC; Department of Diagnostic and Interventional Radiology (M.C.H., T.E.), University Medical Center of the Johannes Gutenberg-University Mainz, Germany., Laux GS; Department of Cardiology (G.S.L.), University Medical Center of the Johannes Gutenberg-University Mainz, Germany., O'Doherty J; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.).; Siemens Medical Solutions, Malvern, PA (J.O.)., Szilveszter B; Heart and Vascular Center, Semmelweis University, Budapest, Hungary (M.V.-N., B.S.)., Maurovich-Horvat P; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary (E.Z., P.M.-H.)., Kabakus IM; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.)., Suranyi PS; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.)., Varga-Szemes A; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.)., Emrich T; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston (M.V.-N., G.T., U.J.S., C.G., E.Z., N.F., D.K., J.O.D., I.M.K., P.S.S., A.V.-S., T.E.).; Department of Diagnostic and Interventional Radiology (M.C.H., T.E.), University Medical Center of the Johannes Gutenberg-University Mainz, Germany.
Jazyk:	angličtina
Zdroj:	Circulation. Cardiovascular imaging [Circ Cardiovasc Imaging] 2024 Oct; Vol. 17 (10), pp. e017112. Date of Electronic Publication: 2024 Sep 27.
DOI:	10.1161/CIRCIMAGING.124.017112
Abstrakt:	Background: A recent simulation study proposed that stenosis measurements on coronary computed tomography (CT) angiography are influenced by the improved spatial resolution of photon-counting detector (PCD)-CT. The aim of the current study was to evaluate the impact of ultrahigh-spatial-resolution (UHR) on coronary stenosis measurements and Coronary Artery Disease Reporting and Data System (CAD-RADS) reclassification rates in patients undergoing coronary CT angiography on both PCD-CT and energy-integrating detector (EID)-CT and to compare measurements against quantitative coronary angiography. Methods: Patients with coronary calcification on EID-CT (collimation, 192×0.6 mm) were prospectively enrolled for a research coronary CT angiography with UHR PCD-CT (collimation, 120×0.2 mm) within 30 days (between April 1, 2023 and January 31, 2024). PCD-CT was acquired with the same or lower CT dose index and equivalent contrast media volume as EID-CT. Percentage diameter stenosis (PDS) for calcified, partially calcified, and noncalcified lesions were compared between scanners. Patient-level reclassification rates for CAD-RADS were evaluated. The accuracy of PDS measurements was validated against quantitative coronary angiography in patients who underwent invasive coronary angiography. Results: In total, PDS of 278 plaques were quantified in 49 patients (calcified, 202; partially calcified, 51; noncalcified, 25). PCD-CT-based PDS values were lower than EID-CT measurements for calcified (45.1±20.7 versus 54.6±19.2%; P <0.001) and partially calcified plaques (44.3±19.6 versus 54.9±20.0%; P <0.001), without significant differences for noncalcified lesions (39.1±15.2 versus 39.0±16.0%; P =0.98). The reduction in stenosis degrees led to a 49.0% (24/49) reclassification rate to a lower CAD-RADS with PCD-CT. In a subset of 12 patients with 56 lesions, UHR-based PDS values showed higher agreement with quantitative coronary angiography (mean difference, 7.3%; limits of agreement, -10.7%/25.2%) than EID-CT measurements (mean difference, 17.4%; limits of agreement, -6.9%/41.7%). Conclusions: Compared with conventional EID-CT, UHR PCD-CT results in lower PDS values and more accurate stenosis measurements in coronary plaques with calcified components and leads to a substantial Coronary Artery Disease Reporting and Data System reclassification rate in 49.0% of patients. Competing Interests: Dr Schoepf receives institutional research support and/or honoraria for speaking and consulting from Bayer, Bracco, Elucid Bioimaging, Guerbet, HeartFlow, Keya Medical, and Siemens Healthineers. Drs Szilveszter and Maurovich-Horvat receive institutional research and travel support from Siemens Healthineers. Dr Varga-Szemes receives institutional research and travel support from Siemens Healthineers and is a consultant and shareholder for Elucid Bioimaging. Dr Emrich is a consultant for Circle Cardiovascular Imaging Inc. and receives travel support, speaker fee, and institutional research support from Siemens Healthineers.
Databáze:	MEDLINE
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