Comparison of Performance of Micro-Computed Tomography (Micro-CT) and Synchrotron Radiation CT in Assessing Coronary Stenosis Caused by Calcified Plaques in Coronary Artery Phantoms

Abstract

Synchrotron-radiation-computed tomography (SRCT) allows more accurate calcified plaque and coronary stenosis assessment as a result of its superior spatial resolution; however, typical micro-computed tomography (micro-CT) systems have even higher resolution. The purpose of this study was to compare the performance of high-resolution micro-CT with SRCT in the assessment of calcified plaques and a previously published dataset of coronary stenosis assessment. This experimental study involved micro-CT scanning of three-dimensional printed coronary artery models with calcification in situ used in our previously published SRCT study on coronary stenosis assessment. Measurements of coronary stenosis utilizing both modalities were compared using a paired sample t-test. The degrees of stenosis measured on all but one micro-CT dataset were statistically significantly lower than the corresponding SRCT measurements reported in our previous paper (p < 0.0005–0.05). This indicates that the superior spatial resolution of micro-CT was able to further reduce over-estimation of stenosis caused by extensive calcification of coronary arteries and, hence, false positive results. Our results showed that the high-resolution micro-CT used in this study outperformed the Australian Synchrotron SRCT in both calcified plaque and coronary stenosis assessment. These findings will become clinically important for cardiovascular event prediction and enable reclassification of individuals with low and intermediate risk into appropriate risk categories when the technical challenges of micro-CT in clinical practice such as the small field of view and demanding on image processing power are addressed.

Cardiovascular Computed Tomography in the Diagnosis of Cardiovascular Disease: Beyond Lumen Assessment

“…Various approaches have been proposed to address the issues encountered in coronary plaques, such as the use of image post-processing methods, iterative reconstruction, and thin slice thicknesses, as well as the use of AI algorithms [79][80][81][82][83][84][85][86][87][88][89]. This has improved coronary CTA performance to some extent; however, the specificity and PPV are still mod-erate (less than 70%) [88][89][90][91][92][93]. The recent advancements in CT technology and specifically the emergence of photon-counting CT have overcome this limitation to a greater extent, with superior spatial resolution and multi-energy imaging characteristics contributing to improving the diagnostic value [21][22][23][24][25][26][27][28].…”