Calcium scoring on coronary computed angiography with photon-counting technology: predictors of performance

Abstract Funding Acknowledgements Type of funding sources: None. Background Spectral CT imaging and virtual non-contrast (VNC) reconstruction techniques allow coronary artery calcium score (CACS) calculations from angiography (CCTA) datasets. A novel material decomposition algorithm (PureCalcium, PC) developed for photon-counting detector (PCD-CT) yields the potential further increasing accuracy CCTA-based CACS measurements, however, little is known about means optimizing its performance routine Agatston-scoring. Purpose The aim current study was to determine predictors a non-iodine PCD-CT. Materials Methods Calcium scoring on non-enhanced scans predominantly used as complementary examination CCTA both acquisition time radiation dose, thus, acquiring accurate datasets are warranted. In study, CAC volumes were calculated using true (TNC) images PC reconstructions in 139 consecutive patients (61.5 ± 10.9 years, 41.7% female) undergoing clinically indicated CCTA. Relative differences (TNC–PC/TNC) PC-based each patient. Predictors degree discrepancy determined linear regression analysis. Results Overall, BMI heart rate did not affect measurements. However, application higher tube voltage (140 kVp instead 120 kVp) significantly decreased relative difference measurements TNC values (β=-0.33 [95%CI: −0.64 – −0.03]). Furthermore, average volume/lesion ratio also proved be an independent predictor (β=-0.01 −0.02 −0.004]). Conclusions based may substitute conventional selected population patients. It seems plausible that can improved by increased protocols, provided spectral information gathered CTA enhanced 140 kVp. must noted hindered smaller calcified lesions.