AUTHOR=Dang Yuxue , Chen Xujiao , Ma Shaowei , Ma Yue , Ma Quanmei , Zhou Ke , Liu Ting , Wang Kunhua , Hou Yang 

TITLE=Association of Pericoronary Adipose Tissue Quality Determined by Dual-Layer Spectral Detector CT With Severity of Coronary Artery Disease: A Preliminary Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.720127

DOI=10.3389/fcvm.2021.720127

ISSN=2297-055X

ABSTRACT=<p><bold>Background:</bold> Pericoronary adipose tissue (PCAT) is considered as a source of inflammatory mediators, leading to the development of coronary atherosclerosis. The study aimed to investigate the correlation between PCAT quality derived from dual-layer spectral detector CT (SDCT) and the severity of coronary artery disease (CAD), and whether PCAT parameters were independently associated with the presence of CAD.</p><p><bold>Materials and Methods:</bold> A total of 403 patients with symptoms of chest pain who underwent SDCT were included. PCAT quality including fat attenuation index (FAI) measured from conventional polychromatic CT images (FAI<sub>120kvp</sub>) and spectral virtual mono-energetic images at 40 keV (FAI<sub>40keV</sub>), slope of spectral HU curve (λ<sub>HU</sub>), and effective atomic number (Eff-Z) were measured around the lesions representing the maximal degree of vascular stenosis in each patient. Meanwhile, overall epicardial adipose tissue (EAT) attenuation was acquired in the conventional polychromatic energy imaging.</p><p><bold>Results:</bold> FAI<sub>40keV</sub>, λ<sub>HU</sub>, Eff-Z, and FAI<sub>120kvp</sub> increased along with the degree of CAD in general and were superior to the overall EAT attenuation for detecting the presence of CAD. Multivariate logistic regression analysis indicated that FAI<sub>40keV</sub> was the most powerful independent indicator (odds ratio 1.058, 95% CI 1.044–1.073; <italic>p</italic> &lt; 0.001) of CAD among these parameters. Using an optimal cut-off (−131.8 HU), FAI<sub>40keV</sub> showed higher diagnostic accuracy of 80.6% compared with the other parameters.</p><p><bold>Conclusions:</bold> These preliminary findings suggest that FAI<sub>40keV</sub> on SDCT may be an appealing surrogate maker to allow monitoring of PCAT changes in the development of CAD.</p>