Dual energy for material differentiation in coronary arteries using electron-beam CT

The purpose of this paper is to investigate the use of electron-beam Computed Tomography (EBCT) dual energy scanning for improved differentiation of calcified coronary arteries from iodinated-contrasted blood, in fast moving cardiac vessels. The dual energy scanning technique can lead to an improved cardiac examination in a single breath hold with more robust calcium scoring and better vessel characterization. Dual energy can be used for material discrimination in CT imaging to differentiate materials with similar CT number, but different material attenuation properties. Mis-registration is the primary source of error in a dual energy application, since acquisitions have to be made at each energy, and motion between the acquisitions causes inconsistencies in the decomposition algorithm, which may lead to artifacts in the resultant images. Using EBCT to quickly switch x-ray source peak voltage potential (kVp), the mis-registration of patient anatomy is minimized since acquisitions at both energy spectra are completed in one study at the same cardiac phase. Two protocols for scanning the moving heart using EBCT were designed to minimize registration issues. Material basis function decomposition was used to differentiate regions containing calcium and iodine in the image. We find that this protocol is superior to CT imaging at one energy spectrum in discriminating calcium from contrast-enhanced lumen. Using dual energy EBCT scanning can enable accurate calcium scoring, and angiography applications to be performed in one exam.