迭代束硬化校正联合先进模型迭代重建技术在锡滤低电压 CT 冠状动脉钙化积分中的应用：对冠状动脉钙化定量和图像质量的影响。
Iterative beam-hardening correction with advanced modeled iterative reconstruction in low voltage CT coronary calcium scoring with tin filtration: Impact on coronary artery calcium quantification and image quality.
机构信息
Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany.
Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
出版信息
J Cardiovasc Comput Tomogr. 2017 Sep-Oct;11(5):354-359. doi: 10.1016/j.jcct.2017.07.003. Epub 2017 Jul 24.
OBJECTIVE
We investigated the impact of iterative beam-hardening correction (IBHC) with advanced modeled iterative reconstruction (ADMIRE) of ultra-low radiation-dose tin filtered (Sn100 kVp) CACS acquisitions on image quality, calcium quantification, and risk classification.
METHODS
CT data of 60 patients (55% male, age 62.3 ± 9.8years) who underwent a 3rd generation dual-source CACS scan using a prospectively ECG-triggered 100 kVp sequential acquisition protocol with tin filtration (Sn100 kVp) were reconstructed using IBHC with filtered back projection (FBP) and ADMIRE with strength levels of three and five. Image noise was calculated and Agatston scores were derived from all reconstructions. Image noise, Agatston score categories, and percentile-based cardiac risk categorization of the respective reconstruction techniques were compared.
RESULTS
The mean estimated radiation dose equivalent of CACS acquisitions in the study population was 0.20 ± 0.07 mSv. Mean image noise significantly decreased with ADMIRE compared to FBP (both p < 0.0001). Agatston scores derived from the respective reconstructions were significantly different in a paired comparison (median [25th and 75th percentile]): FBP 34.7 [1.9, 153.6], ADMIRE 3 28.6 [1.1, 134.5], ADMIRE 5 22.7 [0.3, 116.8]; both p < 0.0001). Agatston score categories and cardiac risk categorization showed excellent agreement of ADMIRE 3 and ADMIRE 5 with FBP (ĸ = 0.92 [0.86-0.98] and ĸ = 0.86 [0.79-0.94]; ĸ = 0.94 [0.87-1.00] and ĸ = 0.91 [0.83-0.99]; however, modest cardiac risk reclassifications of 3% and 7% for ADMIRE 3 and ADMIRE 5, respectively, were observed.
CONCLUSION
Iterative reconstruction using IBHC ADMIRE in low voltage, ultra-low dose CACS with tin filtration significantly decreased image noise. However, it also reduced Agatston scores compared to FBP, which may have an impact on subsequent cardiac risk classification, although risk reclassification occurred only in a modest number of subjects.
目的
本研究旨在探讨迭代束硬化校正（IBHC）联合先进模型迭代重建（ADMIRE）在超低辐射剂量锡滤过（Sn100kVp）冠状动脉钙化评分（CACS）采集的应用，评估其对图像质量、钙定量和风险分类的影响。
方法
选取 60 例患者（55%为男性，年龄 62.3±9.8 岁）的 CT 数据，这些患者采用前瞻性心电图触发 100kVp 连续采集方案进行第三代双源 CACS 扫描，采集时使用锡滤过（Sn100kVp）。使用 IBHC 联合滤波反投影（FBP）以及 ADMIRE 联合 3 级和 5 级强度水平进行重建。计算图像噪声并从所有重建图像中提取出 Agatston 评分。比较不同重建技术的图像噪声、Agatston 评分分类和基于百分位的心脏风险分类。
结果
研究人群中 CACS 采集的平均估算辐射剂量当量为 0.20±0.07mSv。与 FBP 相比，ADMIRE 显著降低了图像噪声（均 p<0.0001）。配对比较显示，不同重建方法得出的 Agatston 评分存在显著差异（中位数[25 百分位和 75 百分位]）：FBP 34.7[1.9, 153.6]，ADMIRE 3 28.6[1.1, 134.5]，ADMIRE 5 22.7[0.3, 116.8]；均 p<0.0001）。ADMIRE 3 和 ADMIRE 5 与 FBP 的 Agatston 评分分类和心脏风险分类具有极好的一致性（κ=0.92[0.86-0.98]和 κ=0.86[0.79-0.94]；κ=0.94[0.87-1.00]和 κ=0.91[0.83-0.99]）；然而，ADMIRE 3 和 ADMIRE 5 分别观察到 3%和 7%的心脏风险适度重新分类。
结论
在低电压、超低剂量锡滤过 CACS 中，使用 IBHC ADMIRE 进行迭代重建可显著降低图像噪声。然而，与 FBP 相比，它还降低了 Agatston 评分，这可能会对后续的心脏风险分类产生影响，尽管仅在少数患者中发生了风险重新分类。
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