Enhanced diagnostic value for coronary CT angiography of calcified coronary arteries using dual energy and a novel high-Z contrast material: a phantom study

Jack W. Lambert; Karen G. Ordovas; Yuxin Sun; Benjamin M. Yeh

doi:10.1117/12.2217165

31 March 2016 Enhanced diagnostic value for coronary CT angiography of calcified coronary arteries using dual energy and a novel high-Z contrast material: a phantom study

Jack W. Lambert, Karen G. Ordovas, Yuxin Sun, Benjamin M. Yeh

Author Affiliations +

Proceedings Volume 9783, Medical Imaging 2016: Physics of Medical Imaging; 978343 (2016) https://doi.org/10.1117/12.2217165
Event: SPIE Medical Imaging, 2016, San Diego, California, United States

Abstract

Dual-energy CT is emerging as a dose-saving tool for coronary CT angiography that allows calcium-scoring without the need for a separate unenhanced scan acquisition. Unfortunately the similar attenuation coefficient profiles of iodine and calcium limits the accuracy of their decomposition in the material basis images. We evaluate a tungsten-based contrast material with a more distinct attenuation profile from calcium, and compare its performance to a conventional iodinated agent. We constructed a custom thorax phantom containing simulated sets of vessels 3, 6 and 9 mm in diameter. The vessel sets were walled with concentric and eccentric calcifications (“plaque”) with concentrations of 0, 20, 30 and 40% weight calcium hydroxyapatite (HAP). The phantom was filled sequentially with iodine and tungsten contrast material, and scanned helically using a fast-kV-switching DECT scanner. At material decomposition, both iodine and tungsten vessel lumens were separable from the HAP vessel walls, but separation was superior with tungsten which showed minimal false positive signal in the HAP image. Assessing their relative performance using line profiles, the HAP signal was greater in the tungsten separation in 6/9 of the vessel sets, and within 15% of the iodine separation for the remaining 3/9 sets. The robust phantom design enabled systematic evaluation of dual-energy material separation for calcium and a candidate non-iodinated vascular contrast element. This approach can be used to screen further agents and also refine dual energy CT material decomposition approaches.

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Jack W. Lambert, Karen G. Ordovas, Yuxin Sun, and Benjamin M. Yeh "Enhanced diagnostic value for coronary CT angiography of calcified coronary arteries using dual energy and a novel high-Z contrast material: a phantom study", Proc. SPIE 9783, Medical Imaging 2016: Physics of Medical Imaging, 978343 (31 March 2016); https://doi.org/10.1117/12.2217165

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KEYWORDS

Tungsten

Calcium

Iodine

Arteries

Angiography

Signal attenuation

Computed tomography

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