Changes in measured size of atherosclerotic plaque calcifications in dual-energy CT of ex vivo carotid endarterectomy specimens: effect of monochromatic keV image reconstructions

Objective The aim of this study was to compare the size of the calcifications measured on the different keV images to a histological standard. Methods Five ex vivo carotid endarterectomy (CEA) specimens were imaged with a dual-energy CT. CT images were reconstructed at different monochromatic spectr...

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Bibliographic Details
Published in:European radiology 2013-02, Vol.23 (2), p.367-374
Main Authors: Mannelli, Lorenzo, Mitsumori, Lee M., Ferguson, Marina, Xu, Dongxiang, Chu, Baocheng, Branch, Kelley R., Shuman, William P., Yuan, Chun
Format: Article
Language:English
Subjects:
Atherosclerosis
Biopsy, Needle
Calcification
Calcinosis - diagnostic imaging
Calcinosis - surgery
Carotid Stenosis - diagnostic imaging
Carotid Stenosis - pathology
Carotid Stenosis - surgery
Computed Tomography
Confidence Intervals
Diagnostic Radiology
Endarterectomy, Carotid - methods
Energy
Female
Histology
Humans
Image Processing, Computer-Assisted - methods
Imaging
Immunohistochemistry
Internal Medicine
Interventional Radiology
Male
Medicine
Medicine & Public Health
Neuroradiology
Plaque, Atherosclerotic - diagnostic imaging
Plaque, Atherosclerotic - pathology
Radiographic Image Interpretation, Computer-Assisted - methods
Radiology
Sampling Studies
Sensitivity and Specificity
Specimen Handling
Tomography
Tomography, X-Ray Computed - methods
Ultrasound
X-rays
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Summary:Objective The aim of this study was to compare the size of the calcifications measured on the different keV images to a histological standard. Methods Five ex vivo carotid endarterectomy (CEA) specimens were imaged with a dual-energy CT. CT images were reconstructed at different monochromatic spectral energies (40, 60, 77, 80, 100, 120, 140 keV). Cross-sectional area of the plaque calcifications present on each CT image was measured. The histological calcium areas on each corresponding CEA specimen were traced manually on digitised images of Toluidine Blue/Basic Fuchsin stained plastic sections. The CT images and corresponding histology sections were matched. The CT-derived calcium areas on each keV image were compared to the calcified area measurements by histology. Results A total of 107 histology sections were matched to corresponding CT images. The average calcified area per section by histology was 7.6 ± 7 mm 2 (range 0–26.4 mm 2 ). There was no significant difference between the calcified areas measured by histology and those measured on CT–virtual monochromatic spectral (VMS) reconstructed images at 77 keV ( P  = 0.08), 80 keV ( P  = 0.20) and 100 keV ( P  = 0.14). Conclusions Calcium area measured on the 80 keV image set was most comparable to the amount of calcium measured by histology. Key Points • Dual-energy computed tomography allows reconstruction of virtual monochromatic images. • Virtual monochromatic images reconstructed at different keVs reveal different atherosclerotic calcification quantification. • Virtual monochromatic images allows better evaluation of calcified atherosclerotic plaques.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-012-2623-y