Patrick Ghibes , Florian Hagen , Matthias Weissinger , Robin Wrazidlo , Konstantin Nikolaou , Abraham Levitin , Levester Kirksey , Christoph Artzner , Gerd Grözinger , Sasan Partovi
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The arterial vasculature of the lower extremity was divided into 10 segments from the iliac vasculature to the calf arterial vasculature. The images were evaluated independently by two experienced readers. Inter-reader agreement was determined using Cohen’s kappa coefficient (κ). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) as well as accuracy were calculated for PC CTA and PC pure lumen reconstruction compared to DSA as gold standard.</div></div><div><h3>Results</h3><div>109 patients (mean age 74.68 ± 11.10 years; 77 males, 32 females) were included in the retrospective analysis. PC pure lumen reconstructions was available for 91 patients (83 %). A total of 933 vascular segments for PC CTA and 780 vascular segments for PC pure lumen reconstruction were evaluated. Good to perfect inter-reader agreement was found for PC CTA (κ = 0.791) and for PC pure lumen reconstruction (κ = 0.829). Sensitivity, Specificity and accuracy for PC CTA were 91 %; 95 % and 93 %, respectively. Sensitivity, Specificity and accuracy for PC pure lumen reconstruction were 85 %, 89 % and 88 %, respectively.</div></div><div><h3>Conclusion</h3><div>Photon-counting CTA demonstrates high sensitivity and specificity for the detection and diagnosis of stenotic lesions in PAD. 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The arterial vasculature of the lower extremity was divided into 10 segments from the iliac vasculature to the calf arterial vasculature. The images were evaluated independently by two experienced readers. Inter-reader agreement was determined using Cohen’s kappa coefficient (κ). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) as well as accuracy were calculated for PC CTA and PC pure lumen reconstruction compared to DSA as gold standard.</div></div><div><h3>Results</h3><div>109 patients (mean age 74.68 ± 11.10 years; 77 males, 32 females) were included in the retrospective analysis. PC pure lumen reconstructions was available for 91 patients (83 %). A total of 933 vascular segments for PC CTA and 780 vascular segments for PC pure lumen reconstruction were evaluated. Good to perfect inter-reader agreement was found for PC CTA (κ = 0.791) and for PC pure lumen reconstruction (κ = 0.829). 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引用次数: 0
摘要
背景光子计数（PC）CT 有可能提高外周动脉疾病（PAD）患者 CT 血管造影（CTA）的诊断信心和图像质量。目的回顾性评估光子计数 CT 血管造影与作为金标准的数字减影血管造影（DSA）相比，在评估 PAD 患者狭窄性疾病方面的诊断性能。材料和方法在2021年11月至2023年11月期间接受PC CTA和DSA检查的所有患者都纳入了这项经机构审查委员会批准、符合HIPAA标准的回顾性分析。下肢动脉血管被分为从髂动脉血管到小腿动脉血管的 10 个区段。图像由两名经验丰富的读者独立评估。使用科恩卡帕系数 (κ)确定阅读者之间的一致性。与作为金标准的 DSA 相比，计算了 PC CTA 和 PC 纯腔重建的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）以及准确性。91名患者（83%）获得了PC纯腔重建。PC CTA 共评估了 933 个血管节段，PC 纯腔重建共评估了 780 个血管节段。PC CTA（κ = 0.791）和 PC 纯管腔重建（κ = 0.829）的阅片师间一致性良好至完美。PC CTA 的敏感性、特异性和准确性分别为 91%、95% 和 93%。结论光子计数 CTA 对 PAD 狭窄病变的检测和诊断具有很高的灵敏度和特异性。与 PC CTA 相比，PC 非钙重建并不能进一步提高准确性。
Diagnostic performance of Photon-counting CT angiography in peripheral artery disease compared to DSA as gold standard
Background
Photon-counting (PC) CT has the potential to improve diagnostic confidence and image quality of CT angiography (CTA) in patients with peripheral artery disease (PAD).
Purpose
To retrospectively evaluate the diagnostic performance of Photon-counting CT angiography for the assessment of stenotic disease in patients with PAD compared to digital subtraction angiography (DSA) as gold standard.
Materials and Methods
All patients undergoing PC CTA followed by DSA between November 2021 and November 2023 were included in this institutional review board approved HIPAA compliant retrospective analysis. The arterial vasculature of the lower extremity was divided into 10 segments from the iliac vasculature to the calf arterial vasculature. The images were evaluated independently by two experienced readers. Inter-reader agreement was determined using Cohen’s kappa coefficient (κ). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) as well as accuracy were calculated for PC CTA and PC pure lumen reconstruction compared to DSA as gold standard.
Results
109 patients (mean age 74.68 ± 11.10 years; 77 males, 32 females) were included in the retrospective analysis. PC pure lumen reconstructions was available for 91 patients (83 %). A total of 933 vascular segments for PC CTA and 780 vascular segments for PC pure lumen reconstruction were evaluated. Good to perfect inter-reader agreement was found for PC CTA (κ = 0.791) and for PC pure lumen reconstruction (κ = 0.829). Sensitivity, Specificity and accuracy for PC CTA were 91 %; 95 % and 93 %, respectively. Sensitivity, Specificity and accuracy for PC pure lumen reconstruction were 85 %, 89 % and 88 %, respectively.
Conclusion
Photon-counting CTA demonstrates high sensitivity and specificity for the detection and diagnosis of stenotic lesions in PAD. PC non-calcium reconstruction does not further increase the accuracy compared to PC CTA.
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.
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