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<p>Reduced contrast media (CM) dose at elevated heart rates (HRs) poses a challenge for coronary artery disease (CAD) assessment. Using a dynamic phantom, we evaluated the performance of a vendor-specific coronary motion-compensated reconstruction (MCR) at various simulated HRs and reduced CM dose in low virtual monoenergetic images (VMIs) from coronary computed tomography angiography (CCTA). A clinical CCTA protocol was used to image a 5-mm artificial coronary artery, filled with 100% (400 Hounsfield units (HU)) and 50% CM dose, using a robotic arm for translation at six velocities (0–50&#xa0;mm/s, 10&#xa0;mm/s steps). Conventional images and VMIs (40–70&#xa0;keV, 10&#xa0;keV steps) were reconstructed without and with MCR. The study evaluated the MCR influence on motion area and contrast-to-noise ratio (CNR) of the resulting segmented arteries (motion area), with the static conventional reconstructed artery at 100% CM dose as the reference, and non-overlapping 95% confidence intervals with the reference indicating significant differences. At 50% CM dose, motion area increased significantly (up to 50%) at elevated velocities (≥ 30&#xa0;mm/s) without MCR, while no significant variations were observed with MCR. Additionally, without MCR, VMIs exhibited significant CNR decreases (up to 65%) at velocities ≥ 30&#xa0;mm/s. Only the combination of MCR and 40&#xa0;keV VMI achieved CNR comparable to the reference, regardless of HR. The combination of MCR with low VMIs enables 50% CM dose reduction, with similar motion area and CNR when compared to conventional CCTA with 100% CM dose. These parameter settings can potentially be used to optimize low CM dose CCTA at higher HRs.</p> Graphical abstract <p></p>

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Optimizing coronary CT angiography with spectral dual-layer CT: motion-compensated virtual monoenergetic imaging achieves 50% contrast dose reduction in a phantom study

  • 期刊论文

  • 发表日期：

    2025年11月7日

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  • E. Encinas Vargas,
  • P. M. Tetteroo,
  • C. H. Kristiansen,
  • M. M. Dobrolinska,
  • M. J. W. Greuter,
  • M. Vembar,
  • M. Grass,
  • T. Leiner,
  • B. K. Velthuis,
  • N. R. van der Werf,
  • D. Suchá

摘要

Reduced contrast media (CM) dose at elevated heart rates (HRs) poses a challenge for coronary artery disease (CAD) assessment. Using a dynamic phantom, we evaluated the performance of a vendor-specific coronary motion-compensated reconstruction (MCR) at various simulated HRs and reduced CM dose in low virtual monoenergetic images (VMIs) from coronary computed tomography angiography (CCTA). A clinical CCTA protocol was used to image a 5-mm artificial coronary artery, filled with 100% (400 Hounsfield units (HU)) and 50% CM dose, using a robotic arm for translation at six velocities (0–50 mm/s, 10 mm/s steps). Conventional images and VMIs (40–70 keV, 10 keV steps) were reconstructed without and with MCR. The study evaluated the MCR influence on motion area and contrast-to-noise ratio (CNR) of the resulting segmented arteries (motion area), with the static conventional reconstructed artery at 100% CM dose as the reference, and non-overlapping 95% confidence intervals with the reference indicating significant differences. At 50% CM dose, motion area increased significantly (up to 50%) at elevated velocities (≥ 30 mm/s) without MCR, while no significant variations were observed with MCR. Additionally, without MCR, VMIs exhibited significant CNR decreases (up to 65%) at velocities ≥ 30 mm/s. Only the combination of MCR and 40 keV VMI achieved CNR comparable to the reference, regardless of HR. The combination of MCR with low VMIs enables 50% CM dose reduction, with similar motion area and CNR when compared to conventional CCTA with 100% CM dose. These parameter settings can potentially be used to optimize low CM dose CCTA at higher HRs.

Graphical abstract