ARRS 2022 Abstracts

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E1330. CT Coronary Angiography on a Detector-Based Spectral CT Platform: Evaluation of Patients with CAD-RADS Score of 3 and Above
Authors
  1. Mae Igi; LSU Health New Orleans
  2. Jenna Miller; University of Pennsylvania
  3. Kia Sayers; Yale University
  4. David Smith; LSU Health New Orleans
  5. Aran Toshav; LSU Health New Orleans
  6. Bradley Spieler; LSU Health New Orleans
  7. Raman Danrad; LSU Health New Orleans
Objective:
Coronary CTA (CTCA) performed on a detector-based spectral scanner helps to accurately determine severity of stenosis compared with single energy CT (SECT) in patients with an original CAD-RADS score greater or equal to 3.

Materials and Methods:
This retrospective trial was conducted between January 2017 and December 2019 and included 52 patients with a CAD-RADS score greater or equal to 3. Two reading sessions were performed 6 weeks apart. The first reading session was performed using only conventional images, and the second reading session was performed using spectral results. Detector-based spectral CT CAD-RADS scores were compared with cardiac stress test and/or cardiac catheterization results for final characterization of stenosis. The mean CAD-RADS score was calculated for both the conventional images and spectral images.

Results:
The CAD-RADS scores for SECT and spectral CT for 41 segments from 32 patients were compared. Available associated stress test and/or cardiac catheterization results were also compared with CAD-RADS scores. In 51% (21/41) of segments, the correct diagnosis was achieved with the help of spectral CT results. A mean CAD-RADS score of 3.56 was obtained using spectral results, compared to 3.93 using conventional images. A two-tailed paired t-test determined the difference to be significant with a p-value of 0.007.

Conclusion:
Detector-based spectral CT is uniquely suited for non-invasive coronary artery imaging due to the perfect temporal and spatial co-registration of low energy and high energy data. CTCA performed on a detector-based spectral scanner, with its ability to generate both monoenergetic reconstruction and material decomposition, can help to resolve diagnostic issues that arise from artifacts encountered on SECT. Detector-based spectral CT could play an important role in diagnosis of CAD, as it may lead to corrected recategorization of lesions.