Accurate and Robust Quantification of Calcium Mass in Coronary Artery Calcium Using the Integrated Hounsfield Technique
D Black1*, S Molloi2, X Xiao3, Y Shen4, S Nie5, (1) University of California - Irvine, Irvine, CA, (2) University of California, Irvine, CA, (3) ,Irvine, CA, (4) University of California, Irvine, Irvine, CA, (5) University of California, Irvine, CA
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PO-GePV-M-286 (Sunday, 7/10/2022) [Eastern Time (GMT-4)]
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Purpose: Agatston scoring is limited and does not include all the calcium information in computed tomography (CT) scans. Since Agatston scoring is not derived from physical constraints, it may not correlate as well with calcium mass, and a scoring technique that more accurately quantifies calcium mass is needed.
Methods: To overcome the deficits of Agatston CAC scoring, the integrated Hounsfield (HU) technique was adapted for CAC scoring. Although the partial volume effect influences the HU of a particular voxel, the total integrated HU within an ROI is conserved. The simulation study was designed to match the physical parameters of a specific CT scanner. One CT scan was simulated at an energy of 120 keV, and both Agatston CAC (ACAC) scoring and integrated HU CAC (ICAC) scoring were performed. The anatomy for the simulation was designed to match a standard, commercially available anthropomorphic thorax (QRM) phantom with a Cardiac Calcification Insert (CCI) insert containing nine calcifications of different sizes and densities. One scan was acquired from the previously mentioned scanner using the physical QRM phantom and CCI insert along with the simulated image. ACAC scoring and ICAC scoring were performed on this physical phantom.
Results: Linear regression on the simulated phantom was correlated with MCalculated=1.00477MKnown-0.18534(r2=0.99978) and MAgatston=2.447MKnown+24.92(r2=0.8536). The average RMSD for ICAC scoring was 0.441 and the average RMSD for ACAC scoring was 25.79. The physical phantom was correlated with MCalculated=1.01941MKnown-0.13935(r2=0.99954) and MAgatston=3.7371MKnown+9.56552(r2=0.95226). The average RMSD for ICAC scoring on the physical phantom was 0.399 and the average RMSD for ACAC scoring was 16.265.
Conclusion: The results show an excellent correlation between ICAC scoring and known mass for a wide range of coronary artery calcium. ICAC scoring enables a more meaningful and accurate measurement for CAC scoring when compared to ACAC scoring.
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