Spectral coronary multidetector computed tomography angiography: Dual benefit by facilitating plaque characterization and enhancing lumen depiction

Objective: To assess ex vivo specimens of atherosclerotic coronary arteries by dual energy (DE) multidetector computed tomography (MDCT) imaging, and to correlate depicted vessel lumen morphology and detected tissue characteristics with histopathologic analysis. Methods: Coronary arteries were imaged on a 16-slice MDCT using a DE protocol consisting of a 90- and 140-kV scan. Coronary arteries were perfused with iodine- and gadolinium-based contrast agents. The DE K-edge subtractions were performed. Regions-of-interest were placed on histopathologically/radiographically-matched vascular lumen and wall, fibromuscular and calcified plaque, and fat tissues. Vascular/tissue contrast-to-noise ratios (CNR) were calculated, and their dependence on tissue type and contrast agent type was statistically evaluated. Results: Tissue CNR analysis confirmed that all tissue types were successfully distinguished. Vascular wall and fibromuscular plaque achieved a significant increase in CNR ratios when DE techniques were used compared with 140 kV protocols. Conclusions: Spectral DE MDCT imaging of ex vivo atherosclerotic coronary arteries allows successful tissue characterization and enhances depiction of coronary lumen.