Intra-individual comparison of epicardial adipose tissue characteristics on coronary CT angiography between photon-counting detector and energy-integrating detector CT systems

Dmitrij Kravchenko; Milan Vecsey-Nagy; Giuseppe Tremamunno; U Joseph Schoepf; Jim O'Doherty; Julian A Luetkens; Daniel Kuetting; Alexander Isaak; Muhammad Taha Hagar; Tilman Emrich; Akos Varga-Szemes

doi:10.1016/j.ejrad.2024.111728

Intra-individual comparison of epicardial adipose tissue characteristics on coronary CT angiography between photon-counting detector and energy-integrating detector CT systems

Eur J Radiol. 2024 Dec:181:111728. doi: 10.1016/j.ejrad.2024.111728. Epub 2024 Sep 7.

Authors

Affiliations

¹ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, USA; Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany; Quantitative Imaging Laboratory Bonn (QILaB), Bonn, Germany.
² Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, USA; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
³ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, USA; Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy.
⁴ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, USA.
⁵ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, USA; Siemens Medical Solutions USA Inc, Malvern, USA.
⁶ Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany; Quantitative Imaging Laboratory Bonn (QILaB), Bonn, Germany.
⁷ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, USA; Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau 79106, Germany.
⁸ Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, USA; Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany; German Centre for Cardiovascular Research, Partner site Rhine-Main, Mainz, Germany. Electronic address: [email protected].

PMID: 39276400
DOI: 10.1016/j.ejrad.2024.111728

Abstract

Purpose: To explore the potential differences in epicardial adipose tissue (EAT) volume and attenuation measurements between photon-counting detector (PCD) and energy-integrating detector (EID)-CT systems.

Methods: Fifty patients (mean age 69 ± 8 years, 41 male [82 %]) were prospectively enrolled for a research coronary CT angiography (CCTA) on a PCD-CT within 30 days after clinical EID-based CCTA. EID-CT acquisitions were reconstructed using a Bv40 kernel at 0.6 mm slice thickness. The PCD-CT acquisition was reconstructed at a down-sampled resolution (0.6 mm, Bv40; [PCD-DS]) and at ultra-high resolutions (PCD-UHR) with a 0.2 mm slice thickness and Bv40, Bv48, and Bv64 kernels. EAT segmentation was performed semi-automatically at about 1 cm intervals and interpolated to cover the whole epicardium within a threshold of -190 to -30 HU. A subgroup analysis was performed based on quartile groups created from EID-CT data and PCD-UHR_Bv48 data. Differences were measured using repeated-measures ANOVA and the Friedman test. Correlations were tested using Pearson's and Spearman's rho, and agreement using Bland-Altman plots.

Results: EAT volumes significantly differed between some reconstructions (e.g.

Eid-ct: 138 ml [IQR 100, 188]; PCD-DS: 147 ml [110, 206]; P<0.001). Overall, correlations between PCD-UHR and EID-CT EAT volumes were excellent, e.g. PCD-UHR_Bv48: r: 0.976 (95 % CI: 0.958, 0.987); P<0.001; with good agreement (mean bias: -9.5 ml; limits of agreement [LoA]: -40.6, 21.6). On the other hand, correlations regarding EAT attenuation was moderate, e.g. PCD-UHR_BV48: r: 0.655 (95 % CI: 0.461, 0.790); P<0.001; mean bias: 6.5 HU; LoA: -2.0, 15.0.

Conclusion: EAT attenuation and volume measurements demonstrated different absolute values between PCD-UHR, PCD-DS as well as EID-CT reconstructions, but showed similar tendencies on an intra-individual level. New protocols and threshold ranges need to be developed to allow comparison between PCD-CT and EID-CT data.

Keywords: Energy-integrating detector CT; Epicardial adipose tissue; Photon-counting detector CT.

Publication types

Comparative Study

MeSH terms

Adipose Tissue* / diagnostic imaging
Aged
Computed Tomography Angiography* / methods
Coronary Angiography* / methods
Coronary Artery Disease / diagnostic imaging
Epicardial Adipose Tissue
Female
Humans
Male
Pericardium* / diagnostic imaging
Photons
Prospective Studies
Reproducibility of Results