新型冠脉斑块定量软件在光子计数与能量积分CT中的可重复性与流程效率
回顾性纳入170例患者（86例EID-CT，84例PCD-CT），用两种软件定量分析550个斑块的总体积。新型软件测量时间更短（3.9 vs 22.9分钟），观察者内和观察者间可重复性极佳（ICC 0.995-0.998），PCD-CT较EID-CT进一步降低软件间偏倚和自动与手动测量差异。
要点
- 新型斑块定量软件测量速度快、可重复性高，适合临床流程。
- PCD-CT较EID-CT减少手动修正和软件间变异。
- 不同软件平台斑块体积测量值存在显著差异，报告需注明软件。
局限性
- 回顾性研究设计。
- 原型软件目前未商业化，结果外推需谨慎。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
INTRODUCTION: The clinical adoption of quantitative coronary plaque characterization with coronary CT angiography (CCTA) is currently limited by time demands and lack of standardization across software platforms. This study aimed to evaluate the reproducibility and efficiency of a novel plaque quantification tool and to compare results between energy-integrating detector (EID-CT) and photon-counting detector (PCD)-CT.
METHODS: In total, 170 patients were retrospectively enrolled in the current study: 86 patients were scanned using conventional EID-CT, while 84 using a dual-source PCD-CT. Quantitative plaque analysis was carried out using dedicated plaque analysis tools: syngo.CT Coronary Cockpit (Software 1, currently not commercially available) and MEDIS QAngioCT (Software 2) by three experienced readers. Total plaque volume (TPV) was quantified both automatically and manually.
RESULTS: Among the 550 lesions analyzed, median TPV 67.0 mm3 [IQR: 31.4 to 148.7] using Software 1 and 50.8 mm3 [IQR: 23.7 to 110.0] using Software 2 (p < 0.001). Software1 demonstrated shorter measurement times than Software 2 (3.9 ± 2.5 vs. 22.9 ± 8.8 min; p < 0.001) and showed excellent intra- and inter-observer reproducibility for EID-CT and PCD-CT (ICC:0.995-0.998), whereas reproducibility using Software 2 was lower (ICC:0.845-0.880). PCD-CT showed improved agreement in TPV assessment, with a lower mean bias between software tools (PCD-CT:15.0 mm3 vs. EID-CT:45.3 mm3), and a smaller absolute difference between automated and manual measurements using Software 1, compared to EID-CT (PCD-CT:2.5 ± 23.4 mm3 vs. EID-CT:6.6 ± 28 mm3).
CONCLUSION: The prototype software offers a promising approach for rapid, reproducible quantification of coronary atherosclerosis, with PCD-CT technology further reducing manual corrections and inter-platform variability.
引用
- Sipos B, Vattay B, Boussoussou M, et al. Reproducibility and workflow efficiency of a novel software for quantitative coronary plaque characterization using photon-counting and energy-integrating detector computed tomography. Eur J Radiol. 2026. PMID: 42155322. doi:10.1016/j.ejrad.2026.112928
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。