光子计数探测器与能量积分探测器计算机断层扫描测量冠状动脉周围脂肪衰减指数的个体内差异
Intra-individual Differences in Pericoronary Fat Attenuation Index Measurements Between Photon-counting and Energy-integrating Detector Computed Tomography.
作者信息
Tremamunno Giuseppe, Vecsey-Nagy Milan, Hagar Muhammad Taha, Schoepf U Joseph, O'Doherty Jim, Luetkens Julian A, Kuetting Daniel, Isaak Alexander, Varga-Szemes Akos, Emrich Tilman, Kravchenko Dmitrij
机构信息
Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (G.T., M.V-N., M.T.H., J.O., A.V-S., T.E., D.K.); Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy (G.T.).
Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (G.T., M.V-N., M.T.H., J.O., A.V-S., T.E., D.K.); Heart and Vascular Centre, Semmelweis University, Budapest, Hungary (M.V-N.).
出版信息
Acad Radiol. 2025 Mar;32(3):1333-1343. doi: 10.1016/j.acra.2024.11.055. Epub 2024 Dec 10.
RATIONALE AND OBJECTIVES
The purpose of this study was to explore intra-individual differences in pericoronary adipose tissue (PCAT) fat attenuation index (FAI) between photon-counting detector (PCD)- and energy-integrating detector (EID)-CT.
MATERIAL AND METHODS
Patients were prospectively enrolled for a PCD-CT research scan within 30 days of EID-CT. Both acquisitions were reconstructed using a Qr36 kernel at 0.6 mm slice thickness (EID and PCD-down-sampled [DS]) and at 0.2 mm ultra-high resolution (UHR) for the PCD-CT. Iterative reconstruction was turned "off" (filter back projection used as alternative reconstruction method) or set to a recommended level in current literature. Coronary PCAT FAI was measured automatically using established thresholds of -190 to -30 HU at a set distance and radius. Statistical testing was performed using repeated-measures ANOVA and Bonferroni's multiple comparison tests (p significance was determined to be <0.003).
RESULTS
In total, 40 patients (mean age 68±8 years, 32 males [80%]) were included for analysis. Absolute FAI measurements differed significantly for all vessels between all reconstructions in the ANOVA comparison (all p<.001). The FAI decreased going from EID-CT to PCD-DS, to PCD-UHR with iterative reconstruction turned off (e.g. right coronary artery: EID-CT: -76.5±8.9 vs -80.9±7.0 vs -88.3±6.7 HU, respectively; p < 0.001). The mean FAI of datasets using iterative reconstruction did not demonstrate significant differences on multiple comparisons (e.g. left circumflex artery: EID: -65.7±8.5; PCD-DS: -66.0±7.4; PCD-UHR: -67.8±7.0 HU, respectively; p>0.06).
CONCLUSION
Intra-individual absolute PCAT FAI measurements differ significantly between EID- and PCD-CT when controlling for reconstruction kernel and slice thickness. However, the use of iterative reconstruction minimizes most differences in FAI, enabling inter-scanner comparability.
原理与目的
本研究旨在探讨在光子计数探测器（PCD）CT和能量积分探测器（EID）CT之间，冠状动脉周围脂肪组织（PCAT）的脂肪衰减指数（FAI）的个体内差异。
材料与方法
患者在接受EID-CT扫描后30天内前瞻性地纳入PCD-CT研究扫描。两种扫描采集均使用Qr36内核以0.6毫米层厚（EID和PCD下采样[DS]）以及PCD-CT的0.2毫米超高分辨率（UHR）进行重建。迭代重建关闭（使用滤波反投影作为替代重建方法）或设置为当前文献中的推荐水平。使用设定的距离和半径下-190至-30 HU的既定阈值自动测量冠状动脉PCAT FAI。使用重复测量方差分析和Bonferroni多重比较检验进行统计检验（p值显著性确定为<0.003）。
结果
总共纳入40例患者（平均年龄68±8岁，32例男性[80%]）进行分析。在方差分析比较中，所有重建之间所有血管的绝对FAI测量值均存在显著差异（所有p<0.001）。在关闭迭代重建的情况下，FAI从EID-CT到PCD-DS再到PCD-UHR逐渐降低（例如右冠状动脉：EID-CT：-76.5±8.9 vs -80.9±7.0 vs -88.3±6.7 HU，分别为；p<0.001）。使用迭代重建的数据集的平均FAI在多重比较中未显示出显著差异（例如左旋支动脉：EID：-65.7±8.5；PCD-DS：-66.0±7.4；PCD-UHR：-67.8±7.0 HU，分别为；p>0.06）。
结论
在控制重建内核和层厚时，EID-CT和PCD-CT之间个体内绝对PCAT FAI测量值存在显著差异。然而，使用迭代重建可最大程度减少FAI的差异，实现不同扫描仪之间的可比性。
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