Initial use of fast switched dual energy CT for coronary artery disease

William Pavlicek; Prasad Panse; Amy Hara; Thomas Boltz; Robert Paden; Didem Yamak; Paul Licato; Naveen Chandra; Darin Okerlund; Sandeep Dutta; Rahul Bhotika; David Langan

doi:10.1117/12.844859

22 March 2010 Initial use of fast switched dual energy CT for coronary artery disease

William Pavlicek, Prasad Panse, Amy Hara, Thomas Boltz, Robert Paden, Didem Yamak, Paul Licato, Naveen Chandra, Darin Okerlund, Sandeep Dutta, Rahul Bhotika, David Langan

Author Affiliations +

Proceedings Volume 7622, Medical Imaging 2010: Physics of Medical Imaging; 76221V (2010) https://doi.org/10.1117/12.844859
Event: SPIE Medical Imaging, 2010, San Diego, California, United States

Abstract

Coronary CT Angiography (CTA) is limited in patients with calcified plaque and stents. CTA is unable to confidently differentiate fibrous from lipid plaque. Fast switched dual energy CTA offers certain advantages. Dual energy CTA removes calcium thereby improving visualization of the lumen and potentially providing a more accurate measure of stenosis. Dual energy CTA directly measures calcium burden (calcium hydroxyapatite) thereby eliminating a separate non-contrast series for Agatston Scoring. Using material basis pairs, the differentiation of fibrous and lipid plaques is also possible. Patency of a previously stented coronary artery is difficult to visualize with CTA due to resolution constraints and localized beam hardening artifacts. Monochromatic 70 keV or Iodine images coupled with Virtual Non-stent images lessen beam hardening artifact and blooming. Virtual removal of stainless steel stents improves assessment of in-stent re-stenosis. A beating heart phantom with 'cholesterol' and 'fibrous' phantom coronary plaques were imaged with dual energy CTA. Statistical classification methods (SVM, kNN, and LDA) distinguished 'cholesterol' from 'fibrous' phantom plaque tissue. Applying this classification method to 16 human soft plaques, a lipid 'burden' may be useful for characterizing risk of coronary disease. We also found that dual energy CTA is more sensitive to iodine contrast than conventional CTA which could improve the differentiation of myocardial infarct and ischemia on delayed acquisitions. These phantom and patient acquisitions show advantages with using fast switched dual energy CTA for coronary imaging and potentially extends the use of CT for addressing problem areas of non-invasive evaluation of coronary artery disease.

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William Pavlicek, Prasad Panse, Amy Hara, Thomas Boltz, Robert Paden, Didem Yamak, Paul Licato, Naveen Chandra, Darin Okerlund, Sandeep Dutta, Rahul Bhotika, and David Langan "Initial use of fast switched dual energy CT for coronary artery disease", Proc. SPIE 7622, Medical Imaging 2010: Physics of Medical Imaging, 76221V (22 March 2010); https://doi.org/10.1117/12.844859

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