Details

Autor(en) / Beteiligte

• Lorenzatti, Daniel
• Piña, Pamela
• Daich, Jonathan
• Scotti, Andrea
• Perez-Cervera, Javier
• Miranda, Rita
• Feinberg, Ari J.
• Halliburton, Sandra S.
• Ivanc, Thomas B.
• Schenone, Aldo L.
• Kuno, Toshiki
• Latib, Azeem
• Dey, Damini
• Pibarot, Philippe
• Dweck, Marc R.
• Garcia, Mario J.
• Slipczuk, Leandro

Titel

Diagnostic accuracy of virtual non-contrast CT for aortic valve stenosis severity evaluation

Ist Teil von

• Journal of cardiovascular computed tomography, 2024-01, Vol.18 (1), p.50-55

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Computed tomography aortic valve calcium (AVC) score has accepted value for diagnosing and predicting outcomes in aortic stenosis (AS). Multi-energy CT (MECT) allows virtual non-contrast (VNC) reconstructions from contrast scans. We aim to compare the VNC-AVC score to the true non-contrast (TNC)-AVC score for assessing AS severity. We prospectively included patients undergoing a MECT for transcatheter aortic valve replacement (TAVR) planning. TNC-AVC was acquired before contrast, and VNC-AVC was derived from a retrospectively gated contrast-enhanced scan. The Agatston scoring method was used for quantification, and linear regression analysis to derive adjusted-VNC values. Among 109 patients (55% female) included, 43% had concordant severe and 14% concordant moderate AS. TNC scan median dose-length product was 116 ​mGy∗cm. The median TNC-AVC was 2,107 AU (1,093–3,372), while VNC-AVC was 1,835 AU (1293-2,972) after applying the coefficient (1.46) and constant (743) terms. A strong correlation was demonstrated between methods (r ​= ​0.93; p ​< ​0.001). Using accepted thresholds (>1,300 AU for women and >2,000 AU for men), 65% (n ​= ​71) of patients had severe AS by TNC-AVC and 67% (n ​= ​73) by adjusted-VNC-AVC. After estimating thresholds for adjusted-VNC (>1,564 AU for women and >2,375 AU for men), 56% (n ​= ​61) had severe AS, demonstrating substantial agreement with TNC-AVC (κ ​= ​0.77). MECT-derived VNC-AVC showed a strong correlation with TNC-AVC. After adjustment, VNC-AVC demonstrated substantial agreement with TNC-AVC, potentially eliminating the requirement for an additional scan and enabling reductions in both radiation exposure and acquisition time. We studied 109 prospectively included patients undergoing multi-energy CT (MECT) for transcatheter aortic valve replacement (TAVR). True non-contrast (TNC)- aortic valve calcium (AVC) score was prospectively acquired and virtual non-contrast (VNC)-AVC score derived from a contrast-enhanced scan. Agatston method was used and a correction proportionality constant was applied to VNC values. A total of 43% had concordant severe and 14% concordant moderate aortic stenosis (AS). MECT-derived VNC-AVC showed a strong correlation with TNC-AVC. After adjustment, VNC-AVC demonstrated substantial agreement with TNC-AVC, potentially eliminating the requirement for an additional scan and enabling reductions in both radiation exposure and acquisition time.