Impact of reconstruction parameters on the accuracy of myocardial extracellular volume quantification on a first-generation, photon-counting detector CT.

IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Radiology Experimental Pub Date : 2024-06-19 DOI:10.1186/s41747-024-00469-7
Chiara Gnasso, Daniel Pinos, U Joseph Schoepf, Milan Vecsey-Nagy, Gilberto J Aquino, Nicola Fink, Emese Zsarnoczay, Robert J Holtackers, Jonathan Stock, Pal Suranyi, Akos Varga-Szemes, Tilman Emrich
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Abstract

Background: The potential role of cardiac computed tomography (CT) has increasingly been demonstrated for the assessment of diffuse myocardial fibrosis through the quantification of extracellular volume (ECV). Photon-counting detector (PCD)-CT technology may deliver more accurate ECV quantification compared to energy-integrating detector CT. We evaluated the impact of reconstruction settings on the accuracy of ECV quantification using PCD-CT, with magnetic resonance imaging (MRI)-based ECV as reference.

Methods: In this post hoc analysis, 27 patients (aged 53.1 ± 17.2 years (mean ± standard deviation); 14 women) underwent same-day cardiac PCD-CT and MRI. Late iodine CT scans were reconstructed with different quantum iterative reconstruction levels (QIR 1-4), slice thicknesses (0.4-8 mm), and virtual monoenergetic imaging levels (VMI, 40-90 keV); ECV was quantified for each reconstruction setting. Repeated measures ANOVA and t-test for pairwise comparisons, Bland-Altman plots, and Lin's concordance correlation coefficient (CCC) were used.

Results: ECV values did not differ significantly among QIR levels (p = 1.000). A significant difference was observed throughout different slice thicknesses, with 0.4 mm yielding the highest agreement with MRI-based ECV (CCC = 0.944); 45-keV VMI reconstructions showed the lowest mean bias (0.6, 95% confidence interval 0.1-1.4) compared to MRI. Using the most optimal reconstruction settings (QIR4. slice thickness 0.4 mm, VMI 45 keV), a 63% reduction in mean bias and a 6% increase in concordance with MRI-based ECV were achieved compared to standard settings (QIR3, slice thickness 1.5 mm; VMI 65 keV).

Conclusions: The selection of appropriate reconstruction parameters improved the agreement between PCD-CT and MRI-based ECV.

Relevance statement: Tailoring PCD-CT reconstruction parameters optimizes ECV quantification compared to MRI, potentially improving its clinical utility.

Key points: • CT is increasingly promising for myocardial tissue characterization, assessing focal and diffuse fibrosis via late iodine enhancement and ECV quantification, respectively. • PCD-CT offers superior performance over conventional CT, potentially improving ECV quantification and its agreement with MRI-based ECV. • Tailoring PCD-CT reconstruction parameters optimizes ECV quantification compared to MRI, potentially improving its clinical utility.

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重建参数对第一代光子计数探测器 CT 心肌细胞外容积量化准确性的影响。
背景:心脏计算机断层扫描(CT)在通过量化细胞外容积(ECV)评估弥漫性心肌纤维化方面的潜在作用已日益得到证实。与能量积分探测器 CT 相比,光子计数探测器 (PCD) -CT 技术可提供更准确的 ECV 定量。我们以基于磁共振成像(MRI)的 ECV 为参照,评估了重建设置对 PCD-CT ECV 定量准确性的影响:在这项事后分析中,27 名患者(年龄为 53.1 ± 17.2 岁(平均 ± 标准差);14 名女性)在同一天接受了心脏 PCD-CT 和 MRI 检查。晚期碘 CT 扫描采用不同的量子迭代重建级别(QIR 1-4)、切片厚度(0.4-8 毫米)和虚拟单能成像级别(VMI,40-90 千伏)进行重建;对每种重建设置的 ECV 进行量化。采用重复测量方差分析和 t 检验进行配对比较、布兰-阿尔特曼图和林氏一致性相关系数(CCC):不同 QIR 水平的 ECV 值差异不大(p = 1.000)。不同切片厚度的 ECV 值差异明显,其中 0.4 mm 与 MRI ECV 值的一致性最高(CCC = 0.944);与 MRI 相比,45-keV VMI 重建的平均偏差最小(0.6,95% 置信区间 0.1-1.4)。与标准设置(QIR3,切片厚度 1.5 mm;VMI 65 keV)相比,使用最理想的重建设置(QIR4,切片厚度 0.4 mm;VMI 45 keV),平均偏差减少了 63%,与基于 MRI 的 ECV 的一致性提高了 6%:结论:选择适当的重建参数可提高 PCD-CT 和基于 MRI 的心血管动态图像之间的一致性:与磁共振成像相比,定制 PCD-CT 重建参数可优化 ECV 定量,从而提高其临床实用性:- CT在心肌组织特征描述方面的应用前景越来越广,可分别通过晚期碘增强和ECV量化评估局灶性和弥漫性纤维化。- PCD-CT 比传统 CT 性能更优越,有可能改善 ECV 定量及其与基于 MRI 的 ECV 的一致性。- 与磁共振成像相比,定制 PCD-CT 重建参数可优化 ECV 定量,从而提高其临床实用性。
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来源期刊
European Radiology Experimental
European Radiology Experimental Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
6.70
自引率
2.60%
发文量
56
审稿时长
18 weeks
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