Key result
Iodine contrast enhancement during cardiac CT significantly alters pericoronary adipose tissue attenuation, reducing apparent volume by approximately 15% and changing 78% of radiomic features.
Why the study?
The presence of iodine as a potential confounding factor on PCAT HU and textures has not been adequately investigated, despite PCAT being vascularly connected with coronary vasculature.
How do acquisition timing and obstructive stenosis affect pericoronary adipose tissue (PCAT) assessments on cardiac CT?
Observational (n=9)
Blinded readers
No
How do acquisition timing and obstructive stenosis affect pericoronary adipose tissue (PCAT) assessments on cardiac CT?
p-value: p=<0.05
PCAT assessments derived from CCTA are highly sensitive to contrast acquisition timing and the presence of obstructive stenosis, highlighting a potential confounding factor that may require data normalization.
May bias pericoronary adipose tissue metrics on contrast CT; leaves open standardization of imaging protocols for radiomic studies.
Features of pericoronary adipose tissue (PCAT) assessed from coronary computed tomography angiography (CCTA) are associated with inflammation and cardiovascular risk. As PCAT is vascularly connected with coronary vasculature, the presence of iodine is a potential confounding factor on PCAT HU and textures that has not been adequately investigated. Use dynamic cardiac CT perfusion (CCTP) to inform contrast determinants of PCAT assessment. From CCTP, we analyzed HU dynamics of territory-specific PCAT, myocardium, and other adipose depots in patients with coronary artery disease. HU, blood flow, and radiomics were assessed over time. Changes from peak aorta time, Pa, chosen to model the time of CCTA, were obtained. HU in PCAT increased more than in other adipose depots. The estimated blood flow in PCAT was ~23% of that in the contiguous myocardium. Comparing PCAT distal and proximal to a significant stenosis, we found less enhancement and longer time-to-peak distally. Two-second offsets [before, after] Pa resulted in [ 4-HU, 3-HU] differences in PCAT. Due to changes in HU, the apparent PCAT volume reduced ~15% from the first scan (P1) to Pa using a conventional fat window. Comparing radiomic features over time, 78% of features changed >10% relative to P1. CCTP elucidates blood flow in PCAT and enables analysis of PCAT features over time. PCAT assessments (HU, apparent volume, and radiomics) are sensitive to acquisition timing and the presence of obstructive stenosis, which may confound the interpretation of PCAT in CCTA images. Data normalization may be in order.
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Wu et al. (2023) conducted an observational in Suspected coronary artery disease (n=9). Iodine contrast enhancement vs. Pre-contrast baseline was evaluated on Change in pericoronary adipose tissue (PCAT) attenuation (HU) from pre-contrast to peak enhancement (p=<0.05). Iodine contrast enhancement during cardiac CT significantly alters pericoronary adipose tissue attenuation, reducing apparent volume by approximately 15% and changing 78% of radiomic features.
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