Ex vivo coronary calcium volume quantification using a high-spatial-resolution clinical photon-counting-detector computed tomography

Jeffrey F. Marsh Jr.; Patrick D. VanMeter; Kishore Rajendran; Shuai Leng; Cynthia H. McCollough

doi:10.1117/1.JMI.10.4.043501

4 July 2023 Ex vivo coronary calcium volume quantification using a high-spatial-resolution clinical photon-counting-detector computed tomography

Jeffrey F. Marsh Jr., Patrick D. VanMeter, Kishore Rajendran, Shuai Leng, Cynthia H. McCollough

Author Affiliations +

Journal of Medical Imaging, Vol. 10, Issue 4, 043501 (July 2023). https://doi.org/10.1117/1.JMI.10.4.043501

Abstract

Purpose

Coronary artery calcification (CAC) is an important indicator of coronary disease. Accurate volume quantification of CAC is challenging using computed tomography (CT) due to calcium blooming, which is a consequence of limited spatial resolution. Ex vivo coronary specimens were scanned on an ultra-high-resolution (UHR) clinical photon-counting detector (PCD) CT scanner, and the accuracy of CAC volume estimation was compared with a state-of-the-art conventional energy-integrating detector (EID) CT, a previous-generation investigational PCD-CT, and micro-CT.

Approach

CAC specimens (n = 13) were scanned on EID-CT and PCD-CT using matched parameters (120 kV, 9.3 mGy CTDI_vol). EID-CT images were reconstructed using our institutional routine clinical protocol for CAC quantification. UHR PCD-CT data were reconstructed using a sharper kernel. An image-based denoising algorithm was applied to the PCD-CT images to achieve similar noise levels as EID-CT. Micro-CT images served as the volume reference standard. Calcification images were segmented, and their volume estimates were compared. The CT data were further compared with previous work using an investigational PCD-CT.

Results

Compared with micro-CT, CT volume estimates had a mean absolute percent error of 24.1 % ± 25.6 % for clinical PCD-CT, 60.1 % ± 48.2 % for EID-CT, and 51.1 % ± 41.7 % for previous-generation PCD-CT. Clinical PCD-CT absolute percent error was significantly (p < 0.01) lower than both EID-CT and previous generation PCD-CT. The mean calcification CT number and contrast-to-noise ratio were both significantly (p < 0.01) higher in clinical PCD-CT relative to EID-CT.

Conclusions

UHR clinical PCD-CT showed reduced calcium blooming artifacts and further enabled improved accuracy of CAC quantification beyond that of conventional EID-CT and previous generation PCD-CT systems.

Citation Download Citation

Jeffrey F. Marsh Jr., Patrick D. VanMeter, Kishore Rajendran, Shuai Leng, and Cynthia H. McCollough "Ex vivo coronary calcium volume quantification using a high-spatial-resolution clinical photon-counting-detector computed tomography," Journal of Medical Imaging 10(4), 043501 (4 July 2023). https://doi.org/10.1117/1.JMI.10.4.043501

Received: 21 September 2022; Accepted: 20 June 2023; Published: 4 July 2023

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