Towards universal comparability of pericoronary adipose tissue attenuation: a coronary computed tomography angiography phantom study

Towards universal comparability of pericoronary adipose tissue attenuation: a coronary computed tomography angiography phantom study

Objectives Different computed tomography (CT) scanners, variations in acquisition protocols, and technical parameters employed for image reconstruction may introduce bias in the analysis of pericoronary adipose tissue (PCAT) attenuation derived from coronary computed tomography angiography (CCTA). T...

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Bibliographic Details
Published in:European radiology Vol. 33; no. 4; pp. 2324 - 2330
Main Authors: Etter, Dominik, Warnock, Geoff, Koszarski, Frederic, Niemann, Tilo, Mikail, Nidaa, Bengs, Susan, Buechel, Ronny R., Kaufmann, Philipp, Gebhard, Cathérine, Rossi, Alexia
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-04-2023
Springer Nature B.V
Subjects:
Adipose tissue
Adipose Tissue - diagnostic imaging
Agar
Algorithms
Angiography
Animals
Arteries
Attenuation
Body fat
Cardiac
Computed tomography
Computed Tomography Angiography - methods
Contrast Media - pharmacology
Conversion
Coronary Angiography - methods
Coronary artery
Diagnostic Radiology
Electric potential
Image acquisition
Image processing
Image reconstruction
Imaging
Internal Medicine
Interventional Radiology
Iodine
Iterative methods
Longitudinal studies
Medical imaging
Medicine
Medicine & Public Health
Neuroradiology
Parameters
Radiographic Image Interpretation, Computer-Assisted - methods
Radiology
Scanners
Swine
Tomography
Tomography, X-Ray Computed - methods
Ultrasound
Voltage
Computed tomography angiography
Adipose tissue
Image reconstruction
Coronary arteries
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Summary:Objectives Different computed tomography (CT) scanners, variations in acquisition protocols, and technical parameters employed for image reconstruction may introduce bias in the analysis of pericoronary adipose tissue (PCAT) attenuation derived from coronary computed tomography angiography (CCTA). Therefore, the aim of this study was to establish the effect of tube voltage, measured as kilovoltage peak (kVp), and iterative reconstruction on PCAT mean attenuation (PCAT MA ). Methods Twelve healthy ex vivo porcine hearts were injected with iodine-enriched agar-agar to allow for ex vivo CCTA imaging on a 256-slice CT and a dual-source CT system. Images were acquired at tube voltages of 80, 100, 120, and 140 kVp and reconstructed by using both filtered back projection and iterative reconstruction algorithms. PCAT MA was measured semi-automatically on CCTA images in the proximal segment of coronary arteries. Results The tube voltage showed a significant effect on PCAT MA measurements on both the 256-slice CT scanner ( p < 0.001) and the dual-source CT system ( p = 0.013), resulting in higher attenuation values with increasing tube voltage. Similarly, the use of iterative reconstructions was associated with a significant increase of PCAT MA (256-slice CT: p < 0.001 and dual-source CT: p = 0.014). Averaged conversion factors to correct PCAT MA measurements for tube voltage other than 120 kVp were 1.267, 1.080 and 0.947 for 80, 100, and 140 kVp, respectively. Conclusion PCAT MA values are significantly affected by acquisition and reconstruction parameters. The same tube voltage and reconstruction type are recommended when PCAT attenuation is used in multicenter and longitudinal studies. Key Points • The tube voltage used for CCTA acquisition affects pericoronary adipose tissue attenuation, resulting in higher attenuation values of fat with increasing tube voltage. • Conversion factors for pericoronary adipose tissue attenuation values could be used to adjust for differences in attenuation between scans performed at different tube voltages. • In longitudinal CCTA studies employing pericoronary adipose tissue attenuation as imaging endpoint, it is recommended to maintain tube voltage and image reconstruction type constant across serial scans.
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ISSN:1432-1084
0938-7994
1432-1084
DOI:10.1007/s00330-022-09274-5