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KMID : 1149020180200020037
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Journal of Korean Society of Computed Tomographic Technology
2018 Volume.20 No. 2 p.37 ~ p.42
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The Effects of Iterative Reconstruction on the Measurement of Coronary Artery Calcium Score
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Kim Eui-Tae
Shim Kyu-Seop
Lee Myung-Uk
Son Ji-Hoon
Kim Dong-Yung
Lee Heon-Joon
Han You-Ri
Kang Eun-Sung
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Abstract
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Purpose: The purpose of this study was to apply and assess the effects of the Iterative Reconstruction, which is a method used for the reduction of patients' radiation dose and improvement of image quality, on the Measurement of Coronary artery calcium score.
Material and method: The Aquilion One Vision Edition 320 MDCT (Canon Medical System corporation, Otawa, Japan) of the Institution has been utilized and the subjects were the twenty-one (21) patients who received CT Scanning among the patients who visited the institution from November, 2017 to January, 2018. The collected raw data was reconstructed as FBP and HIR, then utilized the calcium score measurement program of Aquarius iNtuition Edition (TeraRecon, Inc, California, USA) to measure the calcium score, volume score and the noise index. The calcium score measured by three (3) radiologic technologists were compared to observe the reproducibility among the observers of FBP and HIR. On the coronary artery disease grade, which classified the calcium score in 5 levels, the calcium score of the patients was applied to each reconstruction method, and thus the change of grade according to each method was analyzed.
Result: The median value of calcium score for both the FBP and HIR were measured as 179 and 171 respectively (p<0.001), and the median value of the volume scores were 139 and 120 each (p<0.001). The calcium score of HIR when compared to that of FBP showed a significant difference (p<0.001), which was 13.2% lower in the measurement. The Noise Index in FBP was SD 18.7 ±3, and in HIR it was SD 13.3±1.5 ; it had been reduced 29% in HIR(P<0.001). The concordant correlation coefficient in the reproducibility test measured and analyzed by 3 radiologic technologists was 0.995 in FBP, and 0.996 in HIR. In the results of the classification of the calcium score of FBP and HIR images according to the coronary artery disease grade, it has been verified that among twenty-one (21) patients, one (1) patient was classified as different grade(p=0.157).
Conclusion: As the calcium score and volume score of HIR were measured as lower than those of FBP, the actual clinical application of HIR requires attention in contrast to the Agatston method which is the standardized method for diagnosis of cardiovascular diseases. However, in only one (1) patient among twenty-one (21) occurred a difference of coronary artery disease grade due to the application of a different method and the existence of calcium in FBP was equally measured in the HIR. Also, as the reproducibility of the calcium score measurement of HIR was better when compared to FBP, one should consider that the application of HIR might certify significant clinical value.
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KEYWORD
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Calcium score, Coronary artery, FBP, HIR
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