Ultra-high resolution photon-counting detector coronary CT minimizes overestimation bias compared to invasive reference

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-05-06 DOI:10.1016/j.ejrad.2025.112154

Gerald Siegfried Laux , Moritz C. Halfmann , Larissa Kavermann , Stefanie Bockius , Maike Knorr , Tommaso Gori , Pal Maurovich-Horvat , Akos Varga-Szemes , Philipp Lurz , Tobias Bäuerle , Michaela M. Hell , Tilman Emrich

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引用次数: 0

Abstract

Background

Photon-counting detector (PCD) coronary CT angiography (CCTA) at ultra-high-resolution (UHR) is a promising tool for the detailed evaluation of the coronary arteries. However, correlation with invasive quantitative coronary angiography (QCA) has not been thoroughly investigated. We here evaluated the efficacy of UHR-CCTA against invasive QCA in patients suspected of coronary artery disease (CAD).

Methods

Retrospectively, patients suggestive of CAD were included if they had undergone UHR-CCTA on a PCD-CT system showing coronary stenosis which clinically indicated subsequent invasive coronary angiography and no prior coronary interventions. CCTA datasets were reconstructed in 0.6 mm, 0.4 mm, and UHR 0.2 mm slice thicknesses. The extent of stenosis was compared between QCA and CCTA using univariate analysis of variance with post-hoc testing and Bland-Altman plots. Diagnostic performance was assessed based on the detection of relevant coronary stenosis (≥50 %) as confirmed by QCA.

Results

Forty-nine patients (71 ± 9 years; 37 % male) were included. Stenosis evaluation for 103 segments revealed decreasing mean stenosis diameter with improving spatial resolution (61.4 % for 0.6 mm, 55.3 % for 0.4 mm, 50.9 % for UHR 0.2 mm; p ≤ 0.001). Bias between CCTA and QCA decreased with increasing resolution (13.2 %, limits of agreement [LoA] 30 vs. 9.4 %, 28.1 vs. 5.2 %, 23). UHR-CCTA reconstructions showed superior diagnostic accuracy and positive predictive value (PPV) for detecting relevant CAD compared to lower resolutions (61.2 vs. 61.2 % vs. 71.4 and 53.7 % vs. 53.9 vs. 61.8 %, respectively).

Conclusions

UHR-CCTA with photon-counting detector CT demonstrated a decrease in overestimation bias and an increase in PPV.

Abstract Image

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与有创参考相比，超高分辨率光子计数检测器冠状动脉CT最大限度地减少了高估偏差

超高分辨率（UHR）光子计数检测器（PCD）冠状动脉CT血管造影（CCTA）是一种很有前途的冠状动脉详细评估工具。然而，与有创定量冠状动脉造影（QCA）的相关性尚未深入研究。我们在此评估了UHR-CCTA对疑似冠状动脉疾病（CAD）患者侵袭性QCA的疗效。方法回顾性地纳入提示冠心病的患者，如果他们在PCD-CT系统上进行了UHR-CCTA，显示冠状动脉狭窄，临床表明随后进行了侵入性冠状动脉造影，并且之前没有冠状动脉介入治疗。CCTA数据集以0.6 mm、0.4 mm和UHR 0.2 mm的切片厚度重建。采用单变量方差分析、事后检验和Bland-Altman图比较QCA和CCTA之间的狭窄程度。根据QCA确认的相关冠状动脉狭窄（≥50%）的检测来评估诊断效果。结果49例患者(71±9岁；（37%为男性）。103个节段的狭窄评价显示，随着空间分辨率的提高，平均狭窄直径降低(0.6 mm为61.4%，0.4 mm为55.3%，0.2 mm为50.9%；p≤0.001)。CCTA和QCA之间的偏倚随着分辨率的增加而降低（13.2%，一致限度[LoA] 30比9.4%，28.1比5.2%,23）。与低分辨率相比，UHR-CCTA重建在检测相关CAD方面显示出更高的诊断准确性和阳性预测值（PPV）（分别为61.2 vs 61.2% vs 71.4和53.7% vs 53.9% vs 61.8%）。结论suhr - ccta配合光子计数检测器CT可降低高估偏倚，增加PPV。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.