Intra-individual Differences in Pericoronary Fat Attenuation Index Measurements Between Photon-counting and Energy-integrating Detector Computed Tomography

Giuseppe Tremamunno,Milan Vecsey-Nagy,Muhammad Taha Hagar,U. Joseph Schoepf,Jim O’Doherty, Julian A. Luetkens,Daniel Kuetting,Alexander Isaak,Akos Varga-Szemes,Tilman Emrich,Dmitrij Kravchenko

Academic Radiology（2024）

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Abstract

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.

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Key words

Pericoronary adipose tissue,Photon-counting detector CT,Energy-integrating detector CT

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【要点】：本研究探讨了个体内使用光子计数探测器（PCD）和能量积分探测器（EID）CT在测量冠周脂肪组织（PCAT）脂肪衰减指数（FAI）的差异，发现迭代重建技术可以减少FAI的差异，提高不同扫描设备间的一致性。

【方法】：通过前瞻性招募患者在30天内完成PCD-CT和EID-CT扫描，并使用Qr36核和0.6 mm切片厚度（EID和PCD降采样[DS]）以及0.2 mm超高分辩率（UHR）对PCD-CT进行重建。采用迭代重建技术或不使用迭代重建技术，使用自动测量方法计算冠状动脉PCAT FAI。

【实验】：共40名患者（平均年龄68±8岁，80%为男性）参与分析。在方差分析中，所有血管的绝对FAI测量值在所有重建方法间存在显著差异（p<0.001）。从EID-CT到PCD-DS，再到PCD-UHR且迭代重建关闭的情况下，FAI值显著降低（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；p < 0.001）。使用迭代重建技术的数据集在多次比较中未显示显著差异（例如，左回旋支动脉：EID：-65.7±8.5；PCD-DS：-66.0±7.4；PCD-UHR：-67.8±7.0 HU，分别；p>0.06）。数据集未明确提及具体名称。