2510. Intra-Individual Comparison of Coronary Artery Stenosis Measurements between Photon Counting Detector-CT and Energy Integrating Detector-CT
Authors* Denotes Presenting Author
Emese Zsarnoczay *;
Medical Imaging Centre, Semmelweis University; Medical University of South Carolina
Elias Wolf;
Medical University of South Carolina; University Medical Center of the Johannes Gutenberg University Mainz
U. Joseph Schoepf;
Medical University of South Carolina
Nicola Fink;
Medical University of South Carolina; University Hospital, LMU Munich
Jim O'Doherty;
Siemens Healthcare USA
Akos Varga-Szemes;
Medical University of South Carolina
Tilman Emrich;
Medical University of South Carolina; University Medical Center of the Johannes Gutenberg University Mainz
Objective:
To evaluate the intra-individual difference in percentage diameter stenosis (PDS) measurements for coronary artery stenosis grading based on a photon-counting detector computed tomography (PCD-CT) compared with a conventional energy integrating detector (EID-CT).
Materials and Methods:
In this single-center, prospective study, a cohort of 23 patients (16 men, 65 ± 12.1 years) with 42 coronary artery stenoses underwent standard of care CCTA on a conventional EID-CT and a second research CCTA on a clinical PCD-CT system within a median of 5.5 (3.0 - 12.5) days between August 2021 and March 2022. Radiation dose, contrast volume and injection, as well as reconstruction parameters were matched to the greatest extent possible between the CT systems. PDS measurements and Coronary Artery Disease Reporting and Data System (CAD-RADS) classification were performed by two trained observers using a commercially available software solution.
Results:
PDS measurements between PCD-CT and EID-CT showed a good correlation (r = 0.97, p < 0.0001), however, PCD-CT measured significantly lower PDS values (PDSPCD-CT 44.9% [32.4% - 60.7%] versus PDSEID-CT: 46.4% [34.3% - 62.6%], p < 0.0001, mean bias 1.8, LoA -5.3/8.9). Out of 23 patients, this led to a new per-patient CAD-RADS classification in 3 cases (13.04%, new-lower) for the first reader and in 4 cases (13.04%, new-lower and 4.36%, new-higher) for the second reader. Interreader agreement between the two readers for each stenosis was very strong (ICC = 0.98).
Conclusion:
Coronary artery stenosis measurements between PCD-CT and EID-CT are comparable with a slight mean difference of 1.5% between the two systems. This difference led to a change in the per-patient CAD-RADS classification for 13 to 17% of the patients.
