Intra-individual radiomic analysis of pericoronary adipose tissue: Photon-counting detector vs energy-integrating detector CT angiography

Abstract

Background

The impact of novel photon-counting detector (PCD)-CT technology on in-vivo radiomics is not fully understood. This study aimed to compare the intra-individual stability and reproducibility of pericoronary adipose tissue (PCAT) radiomic features between PCD-CT and energy-integrating detector (EID)-CT in patients undergoing coronary CT angiography (CCTA) on both systems.

Methods

Patients undergoing clinically indicated CCTA on an EID-CT were prospectively enrolled for research PCD-CCTA within 30 days. Image acquisition parameters were standardized; PCD-CT datasets were reconstructed both down-sampled to 0.6 mm to match the clinical scan (PCD-CT_DS) and at 0.2 mm ultrahigh-resolution mode (PCD-CT_UHR). Automatic PCAT segmentation was performed; a total of 110 radiomic feature classes were extracted and compared across the three datasets (EID-CT, PCD-CT_DS, and PCD-CD_UHR). Feature stability was assessed using paired t-test filtered for false discoveries using Benjamini–Hochberg method, and reproducibility using intraclass correlation coefficient (ICC).

Results

A total of 42 patients (34 male [81.0 %]; 67.9 ± 7.6 years) were included. Feature stability was 91 % for EID-CT vs. PCD-CT_DS, but decreased for UHR datasets (EID-CT vs. PCD-CT_UHR: 55 %; PCD-CT_DS vs. PCD-CT_UHR: 51 %). However, inter-scanner reproducibility was poor in both comparisons (EID-CT vs. PCD-CT_DS median ICC: 0.43 [0.03–0.69]; EID-CT vs. PCD-CT_UHR: 0.29 [0.01–0.51]). Nevertheless, reproducibility improved within PCD-CT datasets (PCD-CT_DS vs. PCD-CT_UHR: 0.72 [0.48–0.83]), regardless of the difference in slice thickness.

Conclusions

Most PCAT radiomic features remained stable between EID-CT and PCD-CT_DS, although inter-scanner reproducibility was poor, emphasizing the significant impact of detector technology. Conversely, reproducibility of features within PCD-CT datasets showed more consistent results, even when comparing standard to UHR.