Giuseppe Tremamunno, Daniel Pinos, Emese Zsarnoczay, U Joseph Schoepf, Milan Vecsey-Nagy, Chiara Gnasso, Nicola Fink, Dmitrij Kravchenko, Muhammad Taha Hagar, Joseph Griffith, Jim O'Doherty, Andrea Laghi, Tilman Emrich, Akos Varga-Szemes
{"title":"光子计数检测器CT虚拟单能重建对冠状动脉CT血管造影分流血流储备的影响：与能量积分检测器CT的个体内比较。","authors":"Giuseppe Tremamunno, Daniel Pinos, Emese Zsarnoczay, U Joseph Schoepf, Milan Vecsey-Nagy, Chiara Gnasso, Nicola Fink, Dmitrij Kravchenko, Muhammad Taha Hagar, Joseph Griffith, Jim O'Doherty, Andrea Laghi, Tilman Emrich, Akos Varga-Szemes","doi":"10.1186/s13244-025-01927-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the impact of the photon-counting detector (PCD)-CT-based virtual monoenergetic image (VMI) reconstruction keV levels on CT-based fractional flow reserve (CT-FFR), compared to the energy-integrating detector (EID)-CT.</p><p><strong>Methods: </strong>Patients undergoing clinically indicated coronary CT angiography (CCTA) on an EID-CT were prospectively enrolled for a research CCTA on a PCD-CT within 30 days. PCD-CT datasets were reconstructed at VMI levels of 45, 55, 70, and 90 keV. CT-FFR was obtained semiautomatically using an on-site machine learning algorithm by two readers. CT-FFR ≤ 0.80 was considered hemodynamically significant.</p><p><strong>Results: </strong>A total of 20 patients (63.3 ± 8.8 years; 13 men (65%) were included. Median CT-FFR values in the per-vessel analysis for PCD-CT scans were 0.86 (0.81-0.92) for 45 keV, 0.87 (0.80-0.93) for 55 keV, 0.85 (0.79-0.92) for 70 keV and 0.82 (0.76-0.89) for 90 keV, and 0.86 (0.71-0.93) for EID-CT. Comparison among different VMIs showed significant differences only for 45 vs. 90 keV (p < 0.001), and 55 vs. 90 keV (p < 0.001). No significant differences were found in the pairwise comparison between any VMI and EID-CT (all p > 0.05). PCD-CT at 70 keV showed the highest correlation (r = 0.83, p < 0.001), agreement (ICC: 0.90 (0.84-0.94)), and the lowest bias (mean bias -0.01; limits of agreement, 0.84/0.94) when compared to EID-CT.</p><p><strong>Conclusion: </strong>VMI reconstructions showed significant influence on CT-FFR values only at the extreme levels of the spectrum, while no significant differences were found in comparison with EID-CT. VMI at 70 keV demonstrates the highest correlation and agreement, with the lowest bias compared to EID-CT.</p><p><strong>Critical relevance statement: </strong>Evidence on novel spectral photon-counting detector (PCD)-CT's impact on CT-fractional flow reserve (FFR) is limited; our results demonstrate the feasibility of CT-FFR using PCD-CT, showing no significant differences between various virtual monoenergetic images and energy-integrating detector (EID)-CT values KEY POINTS: The impact of spectral photon-counting detector (PCD)-CT on CT-derived fractional flow reserve (CT-FFR) is unclear. Spectral PCD-CT-based CT-FFR is feasible, differing only at extreme virtual monoenergetic image levels. CT-FFR from PCD-CT at 70 keV showed the strongest correlation with energy-integrating detector-CT.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"36"},"PeriodicalIF":4.1000,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832851/pdf/","citationCount":"0","resultStr":"{\"title\":\"Influence of virtual monoenergetic reconstructions on coronary CT angiography-based fractional flow reserve with photon-counting detector CT: intra-individual comparison with energy-integrating detector CT.\",\"authors\":\"Giuseppe Tremamunno, Daniel Pinos, Emese Zsarnoczay, U Joseph Schoepf, Milan Vecsey-Nagy, Chiara Gnasso, Nicola Fink, Dmitrij Kravchenko, Muhammad Taha Hagar, Joseph Griffith, Jim O'Doherty, Andrea Laghi, Tilman Emrich, Akos Varga-Szemes\",\"doi\":\"10.1186/s13244-025-01927-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study aimed to assess the impact of the photon-counting detector (PCD)-CT-based virtual monoenergetic image (VMI) reconstruction keV levels on CT-based fractional flow reserve (CT-FFR), compared to the energy-integrating detector (EID)-CT.</p><p><strong>Methods: </strong>Patients undergoing clinically indicated coronary CT angiography (CCTA) on an EID-CT were prospectively enrolled for a research CCTA on a PCD-CT within 30 days. PCD-CT datasets were reconstructed at VMI levels of 45, 55, 70, and 90 keV. CT-FFR was obtained semiautomatically using an on-site machine learning algorithm by two readers. CT-FFR ≤ 0.80 was considered hemodynamically significant.</p><p><strong>Results: </strong>A total of 20 patients (63.3 ± 8.8 years; 13 men (65%) were included. Median CT-FFR values in the per-vessel analysis for PCD-CT scans were 0.86 (0.81-0.92) for 45 keV, 0.87 (0.80-0.93) for 55 keV, 0.85 (0.79-0.92) for 70 keV and 0.82 (0.76-0.89) for 90 keV, and 0.86 (0.71-0.93) for EID-CT. Comparison among different VMIs showed significant differences only for 45 vs. 90 keV (p < 0.001), and 55 vs. 90 keV (p < 0.001). No significant differences were found in the pairwise comparison between any VMI and EID-CT (all p > 0.05). PCD-CT at 70 keV showed the highest correlation (r = 0.83, p < 0.001), agreement (ICC: 0.90 (0.84-0.94)), and the lowest bias (mean bias -0.01; limits of agreement, 0.84/0.94) when compared to EID-CT.</p><p><strong>Conclusion: </strong>VMI reconstructions showed significant influence on CT-FFR values only at the extreme levels of the spectrum, while no significant differences were found in comparison with EID-CT. VMI at 70 keV demonstrates the highest correlation and agreement, with the lowest bias compared to EID-CT.</p><p><strong>Critical relevance statement: </strong>Evidence on novel spectral photon-counting detector (PCD)-CT's impact on CT-fractional flow reserve (FFR) is limited; our results demonstrate the feasibility of CT-FFR using PCD-CT, showing no significant differences between various virtual monoenergetic images and energy-integrating detector (EID)-CT values KEY POINTS: The impact of spectral photon-counting detector (PCD)-CT on CT-derived fractional flow reserve (CT-FFR) is unclear. Spectral PCD-CT-based CT-FFR is feasible, differing only at extreme virtual monoenergetic image levels. CT-FFR from PCD-CT at 70 keV showed the strongest correlation with energy-integrating detector-CT.</p>\",\"PeriodicalId\":13639,\"journal\":{\"name\":\"Insights into Imaging\",\"volume\":\"16 1\",\"pages\":\"36\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2025-02-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832851/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Insights into Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13244-025-01927-5\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Insights into Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13244-025-01927-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Influence of virtual monoenergetic reconstructions on coronary CT angiography-based fractional flow reserve with photon-counting detector CT: intra-individual comparison with energy-integrating detector CT.
Objectives: This study aimed to assess the impact of the photon-counting detector (PCD)-CT-based virtual monoenergetic image (VMI) reconstruction keV levels on CT-based fractional flow reserve (CT-FFR), compared to the energy-integrating detector (EID)-CT.
Methods: Patients undergoing clinically indicated coronary CT angiography (CCTA) on an EID-CT were prospectively enrolled for a research CCTA on a PCD-CT within 30 days. PCD-CT datasets were reconstructed at VMI levels of 45, 55, 70, and 90 keV. CT-FFR was obtained semiautomatically using an on-site machine learning algorithm by two readers. CT-FFR ≤ 0.80 was considered hemodynamically significant.
Results: A total of 20 patients (63.3 ± 8.8 years; 13 men (65%) were included. Median CT-FFR values in the per-vessel analysis for PCD-CT scans were 0.86 (0.81-0.92) for 45 keV, 0.87 (0.80-0.93) for 55 keV, 0.85 (0.79-0.92) for 70 keV and 0.82 (0.76-0.89) for 90 keV, and 0.86 (0.71-0.93) for EID-CT. Comparison among different VMIs showed significant differences only for 45 vs. 90 keV (p < 0.001), and 55 vs. 90 keV (p < 0.001). No significant differences were found in the pairwise comparison between any VMI and EID-CT (all p > 0.05). PCD-CT at 70 keV showed the highest correlation (r = 0.83, p < 0.001), agreement (ICC: 0.90 (0.84-0.94)), and the lowest bias (mean bias -0.01; limits of agreement, 0.84/0.94) when compared to EID-CT.
Conclusion: VMI reconstructions showed significant influence on CT-FFR values only at the extreme levels of the spectrum, while no significant differences were found in comparison with EID-CT. VMI at 70 keV demonstrates the highest correlation and agreement, with the lowest bias compared to EID-CT.
Critical relevance statement: Evidence on novel spectral photon-counting detector (PCD)-CT's impact on CT-fractional flow reserve (FFR) is limited; our results demonstrate the feasibility of CT-FFR using PCD-CT, showing no significant differences between various virtual monoenergetic images and energy-integrating detector (EID)-CT values KEY POINTS: The impact of spectral photon-counting detector (PCD)-CT on CT-derived fractional flow reserve (CT-FFR) is unclear. Spectral PCD-CT-based CT-FFR is feasible, differing only at extreme virtual monoenergetic image levels. CT-FFR from PCD-CT at 70 keV showed the strongest correlation with energy-integrating detector-CT.
期刊介绍：
Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere!
I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe.
Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy.
A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field.
I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly.
The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members.
The journal went open access in 2012, which means that all articles published since then are freely available online.
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