{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["36(1)"],"submitter":["van der Bie J"],"pubmed_abstract":["<h4>Objectives</h4>This study investigated differences between aortic valve calcium (AVC) scores derived from true non-contrast (TNC) and virtual-non-contrast reconstructions acquired with photon-counting detector CT (PCD-CT) and the impact of ECG-phase variability on AVC scores.<h4>Materials and methods</h4>A hundred patients undergoing PCD-CT for transcatheter aortic valve implantation (TAVI) planning were retrospectively analyzed. Scores were computed using the Agatston methodology for TNC and virtual-non-iodine (VNI) reconstruction at scanner-selected optimal phase (best) and a fixed ECG-phase (300 ms). For VNI reconstructions, additional phases from 150 ms to 450 ms with 50 ms increments were reconstructed. AVC scores of TNC<sub>best</sub> vs TNC<sub>300</sub>, VNI<sub>best</sub> vs TNC<sub>best,</sub> VNI<sub>300</sub> vs TNC<sub>300</sub>, and all VNI phases vs VNI<sub>best</sub> were compared using Wilcoxon signed-rank tests. The agreement was assessed using scatter plots, Bland-Altman plots, and intra-class coefficients. AVC scores were also categorized based on the likelihood of severe aortic stenosis. Differences between reconstructions were evaluated as percentages (reclassification) and analyzed using Cohen's kappa coefficients.<h4>Results</h4>TNC<sub>best</sub> and TNC<sub>300</sub> differed significantly (mean bias: 226; LoA: [-820, 1300]; p < 0.001, reclassification 17%). VNI<sub>best</sub> vs TNC<sub>best</sub> resulted in a mean bias of -512 (LoA: [-1900, 860]; p < 0.001) and reclassification of 17%. TNC<sub>300</sub> vs VNI<sub>300</sub> demonstrated a bias of -200 and reclassification of 14% (κ = 0.72). VNI reconstructions showed less variability across phases than the difference between TNC<sub>best</sub> and TNC<sub>300</sub> (range, mean bias: 22-146).<h4>Conclusion</h4>VNI is a feasible alternative for AVC scoring but tends to overestimate compared to TNC. While phase-dependent variability in TNC underscores the need for standardization, further optimization of VNI is necessary for routine clinical use.<h4>Key points</h4>Question What is the performance of AVC score calculation from virtual non-contrast images with PCD-CT and the impact of the reconstructed ECG-phase? Findings VNI reconstructions tend to overestimate the scores compared to non-enhanced acquisitions. ECG phase significantly impacts AVC scores for non-enhanced acquisitions and VNI reconstructions. Clinical relevance Utilizing VNI reconstructions to calculate AVC scores might reduce radiation dose, and understanding the influence of ECG-phase on these scores might improve reliability."],"journal":["European radiology"],"pagination":["194-202"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC12711920"],"repository":["biostudies-literature"],"pubmed_title":["Multiphase aortic valve calcium scoring on true-non-contrast and calcium-preserving spectral reconstructions using dual-source photon-counting detector CT."],"pmcid":["PMC12711920"],"pubmed_authors":["van der Bie J","van Straten M","Hirsch A","Bos D","van Mieghem NM","van den Dorpel MMP","Budde RPJ"],"additional_accession":[]},"is_claimable":false,"name":"Multiphase aortic valve calcium scoring on true-non-contrast and calcium-preserving spectral reconstructions using dual-source photon-counting detector CT.","description":"<h4>Objectives</h4>This study investigated differences between aortic valve calcium (AVC) scores derived from true non-contrast (TNC) and virtual-non-contrast reconstructions acquired with photon-counting detector CT (PCD-CT) and the impact of ECG-phase variability on AVC scores.<h4>Materials and methods</h4>A hundred patients undergoing PCD-CT for transcatheter aortic valve implantation (TAVI) planning were retrospectively analyzed. Scores were computed using the Agatston methodology for TNC and virtual-non-iodine (VNI) reconstruction at scanner-selected optimal phase (best) and a fixed ECG-phase (300 ms). For VNI reconstructions, additional phases from 150 ms to 450 ms with 50 ms increments were reconstructed. AVC scores of TNC<sub>best</sub> vs TNC<sub>300</sub>, VNI<sub>best</sub> vs TNC<sub>best,</sub> VNI<sub>300</sub> vs TNC<sub>300</sub>, and all VNI phases vs VNI<sub>best</sub> were compared using Wilcoxon signed-rank tests. The agreement was assessed using scatter plots, Bland-Altman plots, and intra-class coefficients. AVC scores were also categorized based on the likelihood of severe aortic stenosis. Differences between reconstructions were evaluated as percentages (reclassification) and analyzed using Cohen's kappa coefficients.<h4>Results</h4>TNC<sub>best</sub> and TNC<sub>300</sub> differed significantly (mean bias: 226; LoA: [-820, 1300]; p < 0.001, reclassification 17%). VNI<sub>best</sub> vs TNC<sub>best</sub> resulted in a mean bias of -512 (LoA: [-1900, 860]; p < 0.001) and reclassification of 17%. TNC<sub>300</sub> vs VNI<sub>300</sub> demonstrated a bias of -200 and reclassification of 14% (κ = 0.72). VNI reconstructions showed less variability across phases than the difference between TNC<sub>best</sub> and TNC<sub>300</sub> (range, mean bias: 22-146).<h4>Conclusion</h4>VNI is a feasible alternative for AVC scoring but tends to overestimate compared to TNC. While phase-dependent variability in TNC underscores the need for standardization, further optimization of VNI is necessary for routine clinical use.<h4>Key points</h4>Question What is the performance of AVC score calculation from virtual non-contrast images with PCD-CT and the impact of the reconstructed ECG-phase? Findings VNI reconstructions tend to overestimate the scores compared to non-enhanced acquisitions. ECG phase significantly impacts AVC scores for non-enhanced acquisitions and VNI reconstructions. Clinical relevance Utilizing VNI reconstructions to calculate AVC scores might reduce radiation dose, and understanding the influence of ECG-phase on these scores might improve reliability.","dates":{"release":"2026-01-01T00:00:00Z","publication":"2026 Jan","modification":"2026-06-06T04:37:27.05Z","creation":"2026-05-25T03:12:07.752Z"},"accession":"S-EPMC12711920","cross_references":{"pubmed":["40696218"],"doi":["10.1007/s00330-025-11814-8"]}}