Feasibility of Coronary Artery Calcium Scoring on Dual-Energy Chest Computed Tomography: A Prospective Comparison with Electrocardiogram-Gated Calcium Score Computed Tomography

• Main Authors: Sun Yong Lee, Tae Hoon Kim, Kyunghwa Han, Jae Min Shin, Ji Young Kim, Daein Kim, Chul Hwan Park
• Format: Article
• Language: English
• Published: MDPI AG 2021-02-01
• Series: Journal of Clinical Medicine
• Subjects: coronary artery calcium score; correlation coefficient; dual-energy computed tomography; ECG-gated cardiac CT; wide-detector CT
• Online Access: https://www.mdpi.com/2077-0383/10/4/653

This study aimed to evaluate the feasibility of assessment using the coronary artery calcium score (CACS) in dual-energy chest computed tomography (CT). <b>Materials and Methods</b>: We prospectively enrolled 30 patients (19 male, 11 female; mean age, 63.73 ± 9.40 years) who clinically required contrast-enhanced chest CT. The patients underwent electrocardiogram-gated cardiac calcium-scoring CT with a slice thickness of 2.5 mm followed by a sequentially non-gated contrast-enhanced dual-energy chest CT using 140/80 fast kVp switching technology with slice thicknesses of 1.25 mm and 2.5 mm. Virtual unenhanced (VUE) images were then reconstructed from the dual-energy CT using the material suppressed iodine (MSI) technique. <b>Results</b>: The mean heart rates were 63.33 ± 12.01 beats per minute. The mean CACS on the coronary calcium-scoring CT was 361.1 ± 435.5, and CACSs of the VUE images were 76.8 ± 128.6 (2.5 mm slice) and 108.7 ± 165.1 (1.25 mm slice). The correlation coefficients of CACS between the coronary calcium-scoring CT with the VUE 2.5 mm and 1.25 mm images were 0.888 and 0.904, respectively. The inter-observer agreements for the calcium score measurement between the calcium-scoring CT, VUE 2.5 mm, and VUE 1.25 mm were 1.000, 0.999, and 1.000, respectively. <b>Conclusions</b>: In conclusion, assessment of CACS using dual-energy chest CT might be feasible when using MSI virtual unenhanced dual-energy chest CT images with a slice thickness of 1.25 mm.