Correlation between pericoronary adipose tissue and coronary artery disease assessed by 512- slice ct spectral at E Hospital

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Coronary artery disease (n=117). Intervention: Pericoronary adipose tissue (PCAT) fat attenuation index at 40 keV (FAI40keV) measured by 512-slice Spectral CT vs. Non-stenotic coronary arteries (and digital subtraction angiography reference). Primary outcome: Significant right coronary artery (RCA) stenosis (>=50%) confirmed by digital subtraction angiography (DSA) (OR 2.29, 95% CI 1.011-5.201, p=0.04).

Q: What does this research mean for the field?

Pericoronary fat attenuation index at 40 keV on spectral CT independently predicts significant coronary artery stenosis with high sensitivity. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Thao Nguyen Phan; Văn Sơn Nguyễn; Thi Thanh Huong Nguyen; Nguyễn Minh Châu

doi:10.47972/vjcts.v57i.1923

October 28, 2026Tạp chí Phẫu thuật và Tim mạch và Lồng ngực Việt NamOpen Access

Correlation between pericoronary adipose tissue and coronary artery disease assessed by 512- slice ct spectral at E Hospital

View Full Paper

Ask AI

Bookmark

Share

Key result

Pericoronary fat attenuation at 40 keV is linked to ~2.3-fold higher odds of significant RCA stenosis.

OR 2.29
95% CI 1.011-5.201
P=0.04
n=117

Why the study?

The study investigated the association between pericoronary adipose tissue attenuation and coronary artery disease using a 512-slice Spectral CT scanner at E Hospital.

Does pericoronary adipose tissue (PCAT) attenuation measured by 512-slice Spectral CT (specifically FAI at 40 keV and 70 keV, λHU, and Eff-Z) correlate with and predict significant coronary artery stenosis in patients undergoing coronary CT angiography?

Key Points

To investigate the association between pericoronary adipose tissue attenuation parameters and the severity of coronary artery disease using a 512-slice spectral CT scanner.
Conducted a cross-sectional descriptive study of 117 patients categorized into non-stenotic (n=39), non-significant stenosis (n=39), and severe stenosis (n=39) groups.
Measured fat attenuation index at 40 keV and 70 keV, slope of the spectral attenuation curve (λHU), and effective atomic number (Eff-Z) using dedicated workstation software, setting the adipose threshold at −190 to −30 HU.
Identified significant stenosis on coronary CT angiography and compared findings against digital subtraction angiography.
PCAT attenuation parameters measured with 512-slice CT differed significantly across the three study groups across individual coronary artery branches (p < 0.05).
In the right coronary artery, fat attenuation index at 40 keV was an independent predictor of significant stenosis, with a cutoff value of −163.25 HU and 94.4% sensitivity.
In the left anterior descending and left circumflex arteries, fat attenuation index at 70 keV and λHU were significant parameters for assessing coronary artery stenosis risk.

Study Design

Type

Cross-Sectional (n=117)

Multicenter

No

Structured PICO

Does pericoronary adipose tissue (PCAT) attenuation measured by 512-slice Spectral CT (specifically FAI at 40 keV and 70 keV, λHU, and Eff-Z) correlate with and predict significant coronary artery stenosis in patients undergoing coronary CT angiography?

P

Population

117 patients undergoing 512-slice spectral coronary CT angiography at E Hospital in Vietnam, stratified equally into non-stenotic, non-significant stenosis (<50%), and severe stenosis (>=50%) groups.

E

Exposure

512-slice Spectral CT (Philips Healthcare) coronary CT angiography with manual workstation measurement of pericoronary adipose tissue (PCAT) attenuation parameters (Fat Attenuation Index [FAI] at 40 keV and 70 keV, spectral curve slope [λHU], and effective atomic number [Eff-Z]) using an adipose tissue attenuation threshold of -190 to -30 HU.

C

Comparator

Comparison across three coronary stenosis severity groups (non-stenotic, non-significant stenosis <50%, and significant stenosis ≥50%), with digital subtraction angiography (DSA) performed as the reference standard in patients with significant stenosis on CCTA.

O

Outcome

Association and diagnostic/predictive value of PCAT attenuation parameters (specifically FAI40keV, FAI70keV, λHU, and Eff-Z) in the three major coronary arteries (RCA, LAD, LCx) for significant coronary artery stenosis (DS ≥50%) on CCTA and DSA.surrogate

Main Result

Odds Ratio: 2.29 (95% CI 1.011–5.201)

Absolute Event Rate: -144.29% vs -170.86%

p-value: p=0.04

Quantification of pericoronary adipose tissue fat attenuation index at low energy (FAI40keV) using 512-slice Spectral CT independently predicts significant right coronary artery stenosis with 94.4% sensitivity at a −163.25 HU cutoff, offering a sensitive non-invasive imaging biomarker of coronary inflammation.

Limitations

Manual measurement of FAI without dedicated AI software to quantify total epicardial fat volume
Measuring ROI around the most severe stenosis in stenotic patients rather than a fixed proximal 40-mm segment may introduce blooming artifacts from calcification at 40 keV
Single-center study with a relatively small sample size
FAI measurements were performed manually without dedicated AI software to measure total epicardial fat volume (EFV).
Measuring the region of interest (ROI) around the most severe stenosis site in stenotic patients (rather than a fixed 40-mm proximal segment) may be subject to calcium blooming artifacts at 40 keV.

Implication

May support FAI at 40 keV for RCA assessment on spectral CT; leaves open prospective validation before clinical use.

Abstract

Objective: To investigate the association between pericoronary adipose tissue (PCAT) attenuation and coronary artery disease (CAD) using a 512-slice Spectral CT scanner at E Hospital. Methods: This cross-sectional descriptive study included 117 patients divided into three groups: the non-stenotic group, the non-significant stenosis group, and the severe stenosis group, with 39 patients in each group. Fat attenuation index (FAI) measurements at 40 keV and 70 keV, λHU, and effective atomic number (Eff-Z) were obtained using dedicated workstation software. In the non-stenotic group, the volume of interest (ROI) was measured 10–50 mm from the origin of the right coronary artery (RCA) and within a 40-mm segment of the left anterior descending artery (LAD) and left circumflex artery (LCx). In patients with stenosis, measurements were performed around the site of the most severe stenosis. The attenuation threshold for adipose tissue was set at −190 to −30 HU. Patients with significant stenosis detected on coronary CT angiography underwent digital subtraction angiography (DSA) for comparison. Results: Significant differences in PCAT attenuation parameters measured using 512-slice CT were observed across the three study groups in the individual coronary artery branches (p < 0.05). In the RCA, FAI at 40 keV (FAI40keV) was an independent predictor of significant stenosis, with a cutoff value of −163.25 HU and a sensitivity of 94.4%. In the LAD and LCx, FAI at 70 keV (FAI70keV) and [λHU value to be specified] were significant parameters for assessing the risk of coronary artery stenosis. Conclusion: PCAT attenuation parameters in the three major coronary arteries vary according to the severity of stenosis. FAI40keV is an independent predictor of significant coronary artery stenosis. The 512-slice Spectral CT technology enables sensitive FAI quantification at low energy levels, providing an important imaging biomarker of underlying vascular inflammation and offering particular value for early cardiovascular risk stratification.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Phan et al. (2026) conducted a cross-sectional in Coronary artery disease (n=117). Pericoronary adipose tissue (PCAT) fat attenuation index at 40 keV (FAI40keV) measured by 512-slice Spectral CT vs. Non-stenotic coronary arteries (and digital subtraction angiography reference) was evaluated on Significant right coronary artery (RCA) stenosis (>=50%) confirmed by digital subtraction angiography (DSA) (OR 2.29, 95% CI 1.011-5.201, p=0.04). Pericoronary fat attenuation index at 40 keV independently predicted significant RCA stenosis on angiography (OR 2.29, 95% CI 1.011-5.201, p=0.04) with 94.4% sensitivity at a -163.25 HU cutoff.

synapsesocial.com/papers/6ae433abd9418cd7c8f469c6 https://doi.org/10.47972/vjcts.v57i.1923

View Full Paper

Ask AI

Bookmark

Share

Correlation between pericoronary adipose tissue and coronary artery disease assessed by 512- slice ct spectral at E Hospital

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Correlation between pericoronary adipose tissue and coronary artery disease assessed by 512- slice ct spectral at E Hospital

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading