Influence of virtual monoenergetic reconstructions on coronary CT angiography-based fractional flow reserve with photon-counting detector CT: intra-individual comparison with energy-integrating detector CT.

• Tác giả: Tilman Emrich, Nicola Fink, Chiara Gnasso, Joseph Griffith, Muhammad Taha Hagar, Dmitrij Kravchenko, Andrea Laghi, Jim O'Doherty, Daniel Pinos, U Joseph Schoepf, Giuseppe Tremamunno, Akos Varga-Szemes, Milan Vecsey-Nagy, Emese Zsarnoczay
• Ngôn ngữ: eng
• Ký hiệu phân loại: 920.71 Men
• Thông tin xuất bản: Germany : Insights into imaging , 2025
• Bộ sưu tập: NCBI
• ID: 196568

Tóm tắt

 OBJECTIVES: This study aimed to assess the impact of the photon-counting detector (PCD)-CT-based virtual monoenergetic image (VMI) reconstruction keV levels on CT-based fractional flow reserve (CT-FFR), compared to the energy-integrating detector (EID)-CT. METHODS: Patients undergoing clinically indicated coronary CT angiography (CCTA) on an EID-CT were prospectively enrolled for a research CCTA on a PCD-CT within 30 days. PCD-CT datasets were reconstructed at VMI levels of 45, 55, 70, and 90 keV. CT-FFR was obtained semiautomatically using an on-site machine learning algorithm by two readers. CT-FFR ≤ 0.80 was considered hemodynamically significant. RESULTS: A total of 20 patients (63.3 ± 8.8 years
  13 men (65%) were included. Median CT-FFR values in the per-vessel analysis for PCD-CT scans were 0.86 (0.81-0.92) for 45 keV, 0.87 (0.80-0.93) for 55 keV, 0.85 (0.79-0.92) for 70 keV and 0.82 (0.76-0.89) for 90 keV, and 0.86 (0.71-0.93) for EID-CT. Comparison among different VMIs showed significant differences only for 45 vs. 90 keV (p <
  0.001), and 55 vs. 90 keV (p <
  0.001). No significant differences were found in the pairwise comparison between any VMI and EID-CT (all p >
  0.05). PCD-CT at 70 keV showed the highest correlation (r = 0.83, p <
  0.001), agreement (ICC: 0.90 (0.84-0.94)), and the lowest bias (mean bias -0.01
  limits of agreement, 0.84/0.94) when compared to EID-CT. CONCLUSION: VMI reconstructions showed significant influence on CT-FFR values only at the extreme levels of the spectrum, while no significant differences were found in comparison with EID-CT. VMI at 70 keV demonstrates the highest correlation and agreement, with the lowest bias compared to EID-CT. CRITICAL RELEVANCE STATEMENT: Evidence on novel spectral photon-counting detector (PCD)-CT's impact on CT-fractional flow reserve (FFR) is limited
  our results demonstrate the feasibility of CT-FFR using PCD-CT, showing no significant differences between various virtual monoenergetic images and energy-integrating detector (EID)-CT values KEY POINTS: The impact of spectral photon-counting detector (PCD)-CT on CT-derived fractional flow reserve (CT-FFR) is unclear. Spectral PCD-CT-based CT-FFR is feasible, differing only at extreme virtual monoenergetic image levels. CT-FFR from PCD-CT at 70 keV showed the strongest correlation with energy-integrating detector-CT.