title: Analysis of coronary arterial calcification components with coronary CT angiography using single-source dual-energy CT with fast tube voltage switching.
abstract: Clinical cardiac applications of single-source dual-energy computed tomography (DECT) have recently been introduced. This study aimed to analyze the components of coronary arterial calcification (CAC) in vivo by material decomposition achieved with DECT. We reconstructed computed tomography (CT) angiography images for 51 consecutive patients with CACs who had undergone electrocardiography-gated coronary CT angiography by single-source DECT with fast tube voltage switching. We placed regions of interest (ROIs) within the CAC with margins of at least 0.5 mm to minimize partial volume averaging. We compared histograms for the effective atomic number (EAN) and the median, mean, and maximum EANs for each CAC with the theoretical EANs for possible CAC components, including hydroxyapatite (HA), calcium oxalate monohydrate (COM), and dicalcium phosphate dehydrate. We also investigated the in vivo EAN for COM and in vitro EAN for HA by our phantom experiment. Analysis of the CAC components was feasible in 177 ROIs from 28 patients. The median EAN was 13.8 ± 0.8 (95% confidence interval 13.7-13.9), which is similar to the theoretical EAN for COM (13.8). The EAN for HA in vitro was 16.5 ± 0.1, which was slightly higher than the theoretical EAN value for HA (16.1). Notably, the median EAN in 144 ROIs (81.4%) was between 11.2 and 14.4, which is the reported range of the in vivo EAN for COM. Our results suggest that COM might be a more frequent CAC component than previously reported.
authors.affiliation: Departments of Medicine, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Matsui
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Machida
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mitsuhashi
authors.forename: Hisako
authors.initials: H
authors.lastname: Omori
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakaoka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakura
authors.forename: Eiko
authors.initials: E
authors.lastname: Ueno
mesh_terms: D000368:Aged; D055424:Cardiac-Gated Imaging Techniques; D017023:Coronary Angiography / Q000295:instrumentation / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D016208:Databases, Factual; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000295:instrumentation; D061205:Vascular Calcification / Q000000981:diagnostic imaging*