TY - JOUR
T1 - Diagnostic accuracy of virtual non-contrast CT for aortic valve stenosis severity evaluation
AU - Lorenzatti, Daniel
AU - Piña, Pamela
AU - Daich, Jonathan
AU - Scotti, Andrea
AU - Perez-Cervera, Javier
AU - Miranda, Rita
AU - Feinberg, Ari J.
AU - Halliburton, Sandra S.
AU - Ivanc, Thomas B.
AU - Schenone, Aldo L.
AU - Kuno, Toshiki
AU - Latib, Azeem
AU - Dey, Damini
AU - Pibarot, Philippe
AU - Dweck, Marc R.
AU - Garcia, Mario J.
AU - Slipczuk, Leandro
N1 - Publisher Copyright:
© 2023 Society of Cardiovascular Computed Tomography
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Background: 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. Methods: 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. Results: 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). Conclusions: 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.
AB - Background: 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. Methods: 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. Results: 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). Conclusions: 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.
KW - Aortic stenosis
KW - Calcium score
KW - Dual-energy CT
KW - Multi-energy CT
KW - Spectral CT
KW - Transcatheter aortic valve replacement
KW - Virtual non-contrast
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U2 - 10.1016/j.jcct.2023.10.007
DO - 10.1016/j.jcct.2023.10.007
M3 - Article
AN - SCOPUS:85175309308
SN - 1934-5925
VL - 18
SP - 50
EP - 55
JO - Journal of Cardiovascular Computed Tomography
JF - Journal of Cardiovascular Computed Tomography
IS - 1
ER -