CT investigation of patient-specific phantoms with coronary artery disease

Purpose: To develop coronary phantoms that mimic patient geometry and coronary blood flow conditions for CT imaging optimization and software validation. Materials and Methods: Five patients with varying degrees of coronary artery disease underwent 320-detector row coronary CT angiography (Aquilion ONE, Canon Medical Systems). The aorta and coronary arteries were segmented using a Vitrea Workstation (Vital Images). Patient anatomy was manipulated in Autodesk Meshmixer and 3D printed in Tango+, a flexible polymer, using an Eden260V printer (Stratasys). Phantoms were connected to a pump that simulates physiologic pulsatile flow waveforms, correlated with a simulated ECG signal. Distal resistance was optimized for all three coronary vessels until physiologically accurate flow rates and pressure were observed. Phantoms underwent coronary CT Angiography (CTA) using a standard acquisition protocol and contrast mixed in the flow loop. Image data from the phantoms were input to a CT-FFR research software and compared to those derived from the clinical data. Results: All five patient-specific phantoms were successfully imaged with CTA and the images were analyzed by the CTFFR software. The phantom CT-FFR results had a mean difference of -5.4% compared to the patient CT-FFR results. Patient and phantom CT-FFR agreed for all three coronary vessels, with Pearson correlations r = 0.83, 0.68, 0.62 (LAD, LCX, RCA). Conclusions: 3D printed patient-specific phantoms can be manipulated through material properties, flow regulations, and a pulsatile waveform to create accurate flow conditions for CT based experimentation.