Stenosis quantification of coronary arteries in coronary vessel phantoms with second-generation dual-source CT: Influence of measurement parameters and limitations

Michael Toepker, Gordon Euller, Ewald Unger, Michael Weber, Daniela Kienzl, Christian J. Herold, Helmut Ringl

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. The purpose of this study was to use second-generation dual-source CT to assess the influence of size, degree of stenosis, luminal contrast attenuation, and plaque geometry on stenosis quantification in a coronary artery phantom. Materials and Methods. Six vessel phantoms with three outer diameters (2, 3, and 4 mm), each containing three radiolucent plaques (72.2 HU) that simulated eccentric and concentric 43.8%, 75%, and 93.8% stenoses were made with a 3D printer system. These phantoms were filled with an iodine-saline solution mixture at luminal attenuations of 150, 200, 250, 300, and 350 HU and were attached to a cardiac motion simulator. Dual-source CT was performed with a standardized ECG-gated protocol (120 kV, 360 mAs per rotation) at a simulated heart rate of 70 beats/min. Two independent readers quantified the degree of stenosis using area-based measurements. Results. All measurements were highly reproducible (intraclass correlation, = 0.791; p < 0.001). The mean measured degree of stenosis for a phantom with a 3-mm outer diameter at 250-HU luminal attenuation was 49.0% ± 10.0% for 43.8% stenosis, 71.7% ± 9.6% for 75.0% stenosis, and 85.4% ± 5.9% for 93.8% stenosis. With decreasing phantom size, measurement error increased for all degrees of stenosis. The absolute error increased for measurements at a low luminal attenuation of 150 HU (p < 0.001) and for low-grade stenoses compared with medium- and high-grade stenoses (p < 0.001). Conclusion. The results are an overview of factors that influence stenosis quantification in simulated coronary arteries. Dual-source CT is highly reproducible and accurate for quantification of low-density stenosis in vessels with a diameter of 3 mm and attenuation of at least 200 HU for different degrees of stenosis and plaque geometry.

Original languageEnglish (US)
Pages (from-to)W227-W234
JournalAmerican Journal of Roentgenology
Volume201
Issue number2
DOIs
StatePublished - Aug 1 2013

Keywords

  • Cardiac CT
  • Limitations
  • Stenosis quantification
  • Vessel phantom

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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