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Variation in aorta attenuation in contrast-enhanced CT and its implications for calcification thresholds

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  • Sven A Holcombe
  • Steven R Horbal
  • Brian E Ross
  • Edward Brown
  • Brian A Derstine
  • Stewart C Wang

Abstract

Background: CT contrast media improves vessel visualization but can also confound calcification measurements. We evaluated variance in aorta attenuation from varied contrast-enhancement scans, and quantified expected plaque detection errors when thresholding for calcification. Methods: We measured aorta attenuation (AoHU) in central vessel regions from 10K abdominal CT scans and report AoHU relationships to contrast phase (non-contrast, arterial, venous, delayed), demographic variables (age, sex, weight), body location, and scan slice thickness. We also report expected plaque segmentation false-negative errors (plaque pixels misidentified as non-plaque pixels) and false-positive errors (vessel pixels falsely identified as plaque), comparing a uniform thresholding approach and a dynamic approach based on local mean/SD aorta attenuation. Results: Females had higher AoHU than males in contrast-enhanced scans by 65/22/20 HU for arterial/venous/delayed phases (p 0.05). Weight was negatively correlated with AoHU by 2.3HU/10kg but other predictors explained only small portions of intra-cohort variance (R2

Suggested Citation

  • Sven A Holcombe & Steven R Horbal & Brian E Ross & Edward Brown & Brian A Derstine & Stewart C Wang, 2022. "Variation in aorta attenuation in contrast-enhanced CT and its implications for calcification thresholds," PLOS ONE, Public Library of Science, vol. 17(11), pages 1-15, November.
    • Handle: RePEc:plo:pone00:0277111
    DOI: 10.1371/journal.pone.0277111
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