Study of technical factors affecting pericoronary adipose tissue attenuation measured in coronary computed tomography angiography
Main Article Content
Abstract
Purpose:
To determine the impact of reconstruction-related technical factors on pericoronary adipose tissue (PCAT) density measurement on coronary CT angiography (CCTA), addressing a key source of variability that currently limits the biomarker’s clinical applicability.
Materials and Methods: Fifty consecutive CCTA examinations were analyzed. PCAT density was quantified using multiple reconstruction settings, including filtered back projection (FBP), iterative reconstruction (IR), varying IR iteration strengths, and different reconstruction kernels. Associations between PCAT density, patient characteristics, and reconstruction parameters were assessed.
Results: PCAT density values fell within the expected adipose-tissue range (–190 to –30 HU), with a mean of –72.7 ± 22.2 HU on FBP. No significant correlation was observed between PCAT density and age, BMI, or heart rate (all p>0.05). In contrast, reconstruction-related factors produced substantial variability: both reconstruction algorithm (FBP vs IR; p=0.011) and kernel selection (p<0.001) significantly altered attenuation values, whereas IR iteration strength had no measurable effect (p>0.05).
Conclusion: PCAT density is stable across patient-level characteristics but highly sensitive to reconstruction algorithm and kernel type. As the first Vietnamese study to directly examine these technical sources of bias, our findings underscore the critical need for reconstruction-parameter standardization to enable reliable PCAT quantification and support its future use as an emerging biomarker of coronary inflammation and cardiovascular risk.
Keywords
CCTA, pericoronary adipose tissue attenuation, image reconstruction.
Article Details
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