E2097. Evaluation of Coronary Artery Calcification using Gated Stationary
Chest Tomosynthesis Through 4D Extended Cardiac-Torso (XCAT) Simulation
Authors
Umer Ahmed;
University of North Carolina School of Medicine
Christy Inscoe;
University of North Carolina School of Medicine
Shuang Xu;
University of North Carolina School of Medicine
Yueh Lee;
University of North Carolina School of Medicine
Objective:
A rapidly expanding body of literature has provided evidence that coronary calcium (CAC) scoring has strong positive predictive value (PPV) for future major adverse coronary events (MACEs). CAC scoring relies upon cardiac computed tomography (CT), which is associated with high radiation dose and cost. Thus, routine imaging to monitor changes in CAC scores is impractical with CT. Our carbon nanotube-based (CNT)-gated stationary digital chest tomosynthesis system (SDCT) provides a low radiation, low cost, and potentially portable alternative. In this study, we aimed to evaluate the ability of SDCT to perform CAC scoring using 4D digital phantom software, which allows for generation of lesions of different sizes and densities in different coronary vessels.
Materials and Methods:
We evaluated the ability of this system to perform CAC scoring using a 4D extended cardiac-torso (XCAT) phantom software, which allowed us to generate digital phantoms with varying levels of calcification in different coronary vessels. A total of six phantoms were generated with calcified plaques of either low or high density in segments of the right coronary, left circumflex, or left anterior descending vessels. Each phantom was then scanned through both CT and SDCT projector software, which enabled simulated images to be generated. CAC scoring was performed on both sets of images and then compared.
Results:
CAC scoring of the CT images using the Agatson method demonstrated that five of the phantoms fell within the moderate range of CAC scores (100 - 399) and one phantom was in the severe range (400 - 999). Scoring of the SDCT images was performed by attaining total area of the plaque in all slices. Correlation of the SDCT plaque total area and CT Agatson score resulted in an R2 of 0.607. The average difference between SDCT plaque total area and CT Agatson score was 1361.6, 95% CI -2440.3 - 5163.5.
Conclusion:
Our carbon nanotube-based gated stationary digital chest tomosynthesis system provides a low radiation, low cost, and potentially portable alternative to CT for routine monitoring of coronary calcium scores in patients.
