1
|
Cho HH, Lee SM, You SK. Assessment of deep learning image reconstruction (DLIR) on image quality in pediatric cardiac CT datasets type of manuscript: Original research. PLoS One 2024; 19:e0300090. [PMID: 39186484 PMCID: PMC11346658 DOI: 10.1371/journal.pone.0300090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/28/2024] [Indexed: 08/28/2024] Open
Abstract
BAKGROUND To evaluate the quantitative and qualitative image quality using deep learning image reconstruction (DLIR) of pediatric cardiac computed tomography (CT) compared with conventional image reconstruction methods. METHODS Between January 2020 and December 2022, 109 pediatric cardiac CT scans were included in this study. The CT scans were reconstructed using an adaptive statistical iterative reconstruction-V (ASiR-V) with a blending factor of 80% and three levels of DLIR with TrueFidelity (low-, medium-, and high-strength settings). Quantitative image quality was measured using signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). The edge rise distance (ERD) and angle between 25% and 75% of the line density profile were drawn to evaluate sharpness. Qualitative image quality was assessed using visual grading analysis scores. RESULTS A gradual improvement in the SNR and CNR was noted among the strength levels of the DLIR in sequence from low to high. Compared to ASiR-V, high-level DLIR showed significantly improved SNR and CNR (P<0.05). ERD decreased with increasing angle as the level of DLIR increased. CONCLUSION High-level DLIR showed improved SNR and CNR compared to ASiR-V, with better sharpness on pediatric cardiac CT scans.
Collapse
Affiliation(s)
- Hyun-Hae Cho
- Department of Radiology and Medical Research Institute, College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - So Mi Lee
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Sun Kyoung You
- Department of Radiology, Chungnam National University Hospital, Daejeon, Republic of Korea
| |
Collapse
|
2
|
Nguyen ET, Green CR, Adams SJ, Bishop H, Gleeton G, Hague CJ, Hanneman K, Harris S, Strzelczyk J, Dennie C. CAR and CSTR Cardiac Computed Tomography (CT) Practice Guidelines: Part 1 Coronary CT Angiography (CCTA). Can Assoc Radiol J 2024; 75:488-501. [PMID: 38486401 DOI: 10.1177/08465371241233240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024] Open
Abstract
Imaging the heart is one of the most technically challenging applications of Computed Tomography (CT) due to the presence of cardiac motion limiting optimal visualization of small structures such as the coronary arteries. Electrocardiographic gating during CT data acquisition facilitates motion free imaging of the coronary arteries. Since publishing the first version of the Canadian Association of Radiologists (CAR) cardiac CT guidelines, many technological advances in CT hardware and software have emerged necessitating an update. The goal of these cardiac CT practice guidelines is to present an overview of the current evidence supporting the use of cardiac CT in various clinical scenarios and to outline standards of practice for patient safety and quality of care when establishing a cardiac CT program in Canada.
Collapse
Affiliation(s)
- Elsie T Nguyen
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | | | - Scott J Adams
- Department of Medical Imaging, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Helen Bishop
- Division of Cardiology, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Guylaine Gleeton
- Department of Radiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, QC, Canada
| | - Cameron J Hague
- Department of Diagnostic Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Kate Hanneman
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Scott Harris
- Department of Radiology, Memorial University, St. John's, NL, Canada
| | - Jacek Strzelczyk
- Department of Radiology, University of Manitoba, Winnipeg, MB, Canada
| | - Carole Dennie
- Department of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
3
|
Zhong J, Hu Y, Xing Y, Wang L, Li J, Lu W, Shi X, Ding D, Ge X, Zhang H, Yao W. Deep learning image reconstruction for low-kiloelectron volt virtual monoenergetic images in abdominal dual-energy CT: medium strength provides higher lesion conspicuity. Acta Radiol 2024:2841851241262765. [PMID: 39033390 DOI: 10.1177/02841851241262765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
BACKGROUND The best settings of deep learning image reconstruction (DLIR) algorithm for abdominal low-kiloelectron volt (keV) virtual monoenergetic imaging (VMI) have not been determined. PURPOSE To determine the optimal settings of the DLIR algorithm for abdominal low-keV VMI. MATERIAL AND METHODS The portal-venous phase computed tomography (CT) scans of 109 participants with 152 lesions were reconstructed into four image series: VMI at 50 keV using adaptive statistical iterative reconstruction (Asir-V) at 50% blending (AV-50); and VMI at 40 keV using AV-50 and DLIR at medium (DLIR-M) and high strength (DLIR-H). The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of nine anatomical sites were calculated. Noise power spectrum (NPS) using homogenous region of liver, and edge rise slope (ERS) at five edges were measured. Five radiologists rated image quality and diagnostic acceptability, and evaluated the lesion conspicuity. RESULTS The SNR and CNR values, and noise and noise peak in NPS measurements, were significantly lower in DLIR images than AV-50 images in all anatomical sites (all P < 0.001). The ERS values were significantly higher in 40-keV images than 50-keV images at all edges (all P < 0.001). The differences of the peak and average spatial frequency among the four reconstruction algorithms were significant but relatively small. The 40-keV images were rated higher with DLIR-M than DLIR-H for diagnostic acceptance (P < 0.001) and lesion conspicuity (P = 0.010). CONCLUSION DLIR provides lower noise, higher sharpness, and more natural texture to allow 40 keV to be a new standard for routine VMI reconstruction for the abdomen and DLIR-M gains higher diagnostic acceptance and lesion conspicuity rating than DLIR-H.
Collapse
Affiliation(s)
- Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yangfan Hu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yue Xing
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lingyun Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jianying Li
- Computed Tomography Research Center, GE Healthcare, Beijing, PR China
| | - Wei Lu
- Computed Tomography Research Center, GE Healthcare, Shanghai, PR China
| | - Xiaomeng Shi
- Department of Materials, Imperial College London, London, UK
| | - Defang Ding
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xiang Ge
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| |
Collapse
|
4
|
England A, Rawashdeh M, Moore N, Young R, Curran G, McEntee MF. More sustainable use of iodinated contrast media - Why? Radiography (Lond) 2024; 30 Suppl 1:74-80. [PMID: 38991461 DOI: 10.1016/j.radi.2024.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES Based on a narrative review of the literature to 1) assess the need for and 2) report methods to help deliver a sustainable approach to iodinated contrast media (ICM) administration. KEY FINDINGS Acute ICM shortages have been noted in the literature. As demand for contrast-enhanced imaging continues to increase and access to raw materials becomes more limited, such events may increase. Evidence from the literature has documented a range of iodinated contrast reduction strategies. These include individualised contrast-media dosing, multi-dose bulk ICM vials, switching to alternative modalities or the increased use of non-contrast examinations. The optimisation of imaging parameters, the use of saline chasers, and alternative contrast agents should be further considered. Given the rising concerns regarding the presence and effects of ICMs in waste and drinking water, further consideration of strategies for managing waste and excreted ICMs are starting to emerge. CONCLUSIONS Sustainable ICM practices are needed to help avoid supply shortages and to help protect our environment. Such practices must be led and supported locally, nationally, and internationally. Sustainable ICM practices must be reflected within professional Standards of Proficiencies and be adopted by all members of the multidisciplinary team. IMPLICATIONS FOR PRACTICE Changes to working practices surrounding the sustainable use of ICMs will likely become commonplace. New methods to ensure optimised ICM dosage with minimal wastage will be more heavily featured in departmental practices. Correct disposal of waste and excreted ICMs will also form part of future changes to practice.
Collapse
Affiliation(s)
- A England
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland.
| | - M Rawashdeh
- Department of Medical Imaging Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - N Moore
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - R Young
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - G Curran
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - M F McEntee
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland; Faculty of Health Sciences, University of Southern Denmark, Denmark; Faculty of Medicine, University of Sydney, Australia
| |
Collapse
|
5
|
Liang S, Bai Y, Zhang J, Wang A, Li J, Diao K, He Y. The added value of coronary CTA in chronic total occlusion percutaneous coronary intervention: a systematic review and meta-analysis. Eur Radiol 2024; 34:4041-4052. [PMID: 37951854 DOI: 10.1007/s00330-023-10341-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/24/2023] [Accepted: 08/31/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES To systematically investigate and summarize the utility of coronary computed tomographic angiography (CCTA) in the management of chronic total occlusion (CTO)-percutaneous coronary intervention (PCI). METHODS The authors searched the four databases between 2005 and 2023 for studies investigating the role of CCTA and invasive coronary angiograms (ICA) images when used as the pre-procedural tool for CTO-PCI. Efficacy and safety of CCTA in CTO-PCI treatment as a pre-procedural assessment tool was evaluated. RESULTS Forty-seven studies were finally chosen for this systematic review. CCTA had a high degree of agreement with ICA when applied for J-CTO scoring system. A J-CTO (Multicenter CTO Registry in Japan) score > 3, together with calcification, occlusion length ≥ 20 mm, blunt stump, and bending > 45° were shared imaging risk factors on both ICA and CCTA for technique failure and guidewire crossing over 30 min. Additionally, negative remodeling and multiple diseased vessel were significant indicators on CCTA. Although patients with pre-procedural CCTA showed a trend of higher success rate and easier guidewire crossing, and CCTA showed a slightly higher predictive accuracy for process success, no significant improvement in post-PCI major adverse cardiac events of using CCTA for assessment has been achieved. CONCLUSIONS CCTA is a safe and effective pre-operative tool of CTO-PCI. Except for the shared imaging risk factors with ICA for a hard CTO-PCI including calcification, occlusion length ≥ 20 mm, blunt stump, bending > 45°, and J-CTO score > 3, factors like negative remodeling and multiple diseased vessel were also recognized as significant pre-operative assessment indicators on CCTA. CLINICAL RELEVANCE STATEMENT A pre-procedural assessment based on coronary computed tomographic angiography has the potential to aid in the management of chronic total occlusion percutaneous coronary intervention. KEY POINTS • A coronary computed tomographic angiography-based pre-procedural assessment can help chronic total occlusion-percutaneous coronary intervention management. • The recognized high-risk features detected via coronary computed tomographic angiography and invasive coronary angiograms are comparable in detecting difficult lesions and chronic total occlusion-percutaneous coronary intervention failure. • Coronary computed tomographic angiography has an additional value to be a safe and effective pre-procedural assessment tool for chronic total occlusion-percutaneous coronary intervention.
Collapse
Affiliation(s)
- Shichu Liang
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, Sichuan, China
| | - Yanlin Bai
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Zhang
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, Sichuan, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Aijie Wang
- Department of Radiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, Sichuan, China
| | - Jing Li
- Research Center of Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kaiyue Diao
- Department of Radiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, Sichuan, China.
| | - Yong He
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
6
|
Kawai N, Noda Y, Nakamura F, Kaga T, Suzuki R, Miyoshi T, Mori F, Hyodo F, Kato H, Matsuo M. Low-tube-voltage whole-body CT angiography with extremely low iodine dose: a comparison between hybrid-iterative reconstruction and deep-learning image-reconstruction algorithms. Clin Radiol 2024; 79:e791-e798. [PMID: 38403540 DOI: 10.1016/j.crad.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 02/27/2024]
Abstract
AIM To evaluate arterial enhancement, its depiction, and image quality in low-tube potential whole-body computed tomography (CT) angiography (CTA) with extremely low iodine dose and compare the results with those obtained by hybrid-iterative reconstruction (IR) and deep-learning image-reconstruction (DLIR) methods. MATERIALS AND METHODS This prospective study included 34 consecutive participants (27 men; mean age, 74.2 years) who underwent whole-body CTA at 80 kVp for evaluating aortic diseases between January and July 2020. Contrast material (240 mg iodine/ml) with simultaneous administration of its quarter volume of saline, which corresponded to 192 mg iodine/ml, was administered. CT raw data were reconstructed using adaptive statistical IR-Veo of 40% (hybrid-IR), DLIR with medium- (DLIR-M), and high-strength level (DLIR-H). A radiologist measured CT attenuation of the arteries and background noise, and the signal-to-noise ratio (SNR) was then calculated. Two reviewers qualitatively evaluated the arterial depictions and diagnostic acceptability on axial, multiplanar-reformatted (MPR), and volume-rendered (VR) images. RESULTS Mean contrast material volume and iodine weight administered were 64.1 ml and 15.4 g, respectively. The SNRs of the arteries were significantly higher in the following order of the DLIR-H, DLIR-M, and hybrid-IR (p<0.001). Depictions of six arteries on axial, three arteries on MPR, and four arteries on VR images were significantly superior in the DLIR-M or hybrid-IR than in the DLIR-H (p≤0.009 for each). Diagnostic acceptability was significantly better in the DLIR-M and DLIR-H than in the hybrid-IR (p<0.001-0.005). CONCLUSION DLIR-M showed well-balanced arterial depictions and image quality compared with the hybrid-IR and DLIR-H.
Collapse
Affiliation(s)
- N Kawai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Y Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - F Nakamura
- Department of Radiology, Gifu Municipal Hospital, 7-1 Kashima, Gifu 500-8513, Japan
| | - T Kaga
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - R Suzuki
- Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan
| | - T Miyoshi
- Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan
| | - F Mori
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - F Hyodo
- Department of Pharmacology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Center for One Medicine Innovative Translational Research (COMIT), Institute for Advanced Study, Gifu University, Japan
| | - H Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - M Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| |
Collapse
|
7
|
Yuan D, Wang L, Lyu P, Zhang Y, Gao J, Liu J. Evaluation of image quality on low contrast media with deep learning image reconstruction algorithm in prospective ECG-triggering coronary CT angiography. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024; 40:1377-1388. [PMID: 38722507 DOI: 10.1007/s10554-024-03113-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/08/2024] [Indexed: 06/29/2024]
Abstract
To assess the impact of low-dose contrast media (CM) injection protocol with deep learning image reconstruction (DLIR) algorithm on image quality in coronary CT angiography (CCTA). In this prospective study, patients underwent CCTA were prospectively and randomly assigned to three groups with different contrast volume protocols (at 320mgI/mL concentration and constant flow rate of 5ml/s). After pairing basic information, 210 patients were enrolled in this study: Group A, 0.7mL/kg (n = 70); Group B, 0.6mL/kg (n = 70); Group C, 0.5mL/kg (n = 70). All patients were examined via a prospective ECG-triggered scan protocol within one heartbeat. A high level DLIR (DLIR-H) algorithm was used for image reconstruction with a thickness and interval of 0.625mm. The CT values of ascending aorta (AA), descending aorta (DA), three main coronary arteries, pulmonary artery (PA), and superior vena cava (SVC) were measured and analyzed for objective assessment. Two radiologists assessed the image quality and diagnostic confidence using a 5-point Likert scale. The CM doses were 46.81 ± 6.41mL, 41.96 ± 7.51mL and 34.65 ± 5.38mL for Group A, B and C, respectively. The objective assessments on AA, DA and the three main coronary arteries and the overall subjective scoring showed no significant difference among the three groups (all p > 0.05). The subjective assessment proved that excellent CCTA images can be obtained from the three different contrast media protocols. There were no significant differences in intracoronary attenuation values between the higher HR subgroup and the lower HR subgroup among three groups. CCTA reconstructed with DLIR could be realized with adequate enhancement in coronary arteries, excellent image quality and diagnostic confidence at low contrast dose of a 0.5mL/kg. The use of lower tube voltages may further reduce the contrast dose requirement.
Collapse
Affiliation(s)
- Dian Yuan
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou, Henan Province, 450052, China
| | - Luotong Wang
- CT Imaging Research Center, GE Healthcare China, Beijing, 100176, China
| | - Peijie Lyu
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou, Henan Province, 450052, China
| | - Yonggao Zhang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou, Henan Province, 450052, China
| | - Jianbo Gao
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou, Henan Province, 450052, China
| | - Jie Liu
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| |
Collapse
|
8
|
Meng Z, Guo Y, Deng S, Xiang Q, Cao J, Zhang Y, Zhang K, Ma K, Xie S, Kang Z. Improving image quality of triple-low-protocol renal artery CT angiography with deep-learning image reconstruction: a comparative study with standard-dose single-energy and dual-energy CT with adaptive statistical iterative reconstruction. Clin Radiol 2024; 79:e651-e658. [PMID: 38433041 DOI: 10.1016/j.crad.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 03/05/2024]
Abstract
AIM To investigate the improvement in image quality of triple-low-protocol (low radiation, low contrast medium dose, low injection speed) renal artery computed tomography (CT) angiography (RACTA) using deep-learning image reconstruction (DLIR), in comparison with standard-dose single- and dual-energy CT (DECT) using adaptive statistical iterative reconstruction-Veo (ASIR-V) algorithm. MATERIALS AND METHODS Ninety patients for RACTA were divided into different groups: standard-dose single-energy CT (S group) using ASIR-V at 60% strength (60%ASIR-V), DECT (DE group) with 60%ASIR-V including virtual monochromatic images at 40 keV (DE40 group) and 70 keV (DE70 group), and the triple-low protocol single-energy CT (L group) with DLIR at high level (DLIR-H). The effective dose (ED), contrast medium dose, injection speed, standard deviation (SD), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of abdominal aorta (AA), and left/right renal artery (LRA, RRA), and subjective scores were compared among the different groups. RESULTS The L group significantly reduced ED by 37.6% and 31.2%, contrast medium dose by 33.9% and 30.5%, and injection speed by 30% and 30%, respectively, compared to the S and DE groups. The L group had the lowest SD values for all arteries compared to the other groups (p<0.001). The SNR of RRA and LRA in the L group, and the CNR of all arteries in the DE40 group had highest value compared to others (p<0.05). The L group had the best comprehensive score with good consistency (p<0.05). CONCLUSIONS The triple-low protocol RACTA with DLIR-H significantly reduces the ED, contrast medium doses, and injection speed, while providing good comprehensive image quality.
Collapse
Affiliation(s)
- Z Meng
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, Tianhe Road, 600, Guangzhou, 510620, China
| | - Y Guo
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, Tianhe Road, 600, Guangzhou, 510620, China
| | - S Deng
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, Tianhe Road, 600, Guangzhou, 510620, China
| | - Q Xiang
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, Tianhe Road, 600, Guangzhou, 510620, China
| | - J Cao
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, Tianhe Road, 600, Guangzhou, 510620, China
| | - Y Zhang
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, Tianhe Road, 600, Guangzhou, 510620, China
| | - K Zhang
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, Tianhe Road, 600, Guangzhou, 510620, China
| | - K Ma
- CT Imaging Research Center, GE HealthCare China, Tianhe District, Huacheng Road 87, Guangzhou, 510623, China
| | - S Xie
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, Tianhe Road, 600, Guangzhou, 510620, China.
| | - Z Kang
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, Tianhe Road, 600, Guangzhou, 510620, China.
| |
Collapse
|
9
|
Kawashima H. [[CT] 6. The Current Situation of AI Image Reconstruction in CT]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2024; 80:252-259. [PMID: 38382985 DOI: 10.6009/jjrt.2024-2321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Affiliation(s)
- Hiroki Kawashima
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| |
Collapse
|
10
|
Kusk MW, Hess S, Gerke O, Foley SJ. Potential for Dose Reduction in CT-Derived Left Ventricular Ejection Fraction: A Simulation Study. Tomography 2023; 9:2089-2102. [PMID: 37987350 PMCID: PMC10661257 DOI: 10.3390/tomography9060164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Measuring left ventricular ejection fraction (LVEF) is important for detecting heart failure, e.g., in treatment with potentially cardiotoxic chemotherapy. MRI is considered the reference standard for LVEF, but availability may be limited and claustrophobia or metal implants still present challenges. CT has been shown to be accurate and would be advantageous, as LVEF could be measured in conjunction with routine chest-abdomen-pelvis oncology CT. However, the use of CT is not recommended due to the excessive radiation dose. This study aimed to explore the potential for dose reduction using simulation. Using an anthropomorphic heart phantom scanned at 13 dose levels, a noise simulation algorithm was developed to introduce controlled Poisson noise. Filtered backprojection parameters were iteratively tested to minimise differences in myocardium-to-ventricle contrast/noise ratio, as well as structural similarity index (SSIM) differences between real and simulated images at all dose levels. Fifty-one clinical CT coronary angiographies, scanned with full dose through end-systolic and -diastolic phases, were located retrospectively. Using the developed algorithm, noise was introduced corresponding to 25, 10, 5 and 2% of the original dose level. LVEF was measured using clinical software (Syngo.via VB50) with papillary muscles in and excluded from the LV volume. At each dose level, LVEF was compared to the 100% dose level, using Bland-Altman analysis. The effective dose was calculated from DLP using a conversion factor of 0.026 mSv/mGycm. RESULTS In the clinical images, mean CTDIvol and DLP were 47.1 mGy and 771.9 mGycm, respectively (effective dose 20.0 mSv). Measurements with papillary muscles excluded did not exhibit statistically significant LVEF bias to full-dose images at 25, 10 and 5% simulated dose. At 2% dose, a significant bias of 4.4% was found. With papillary muscles included, small but significant biases were found at all simulated dose levels. CONCLUSION Provided that measurements are performed with papillary muscles excluded from the LV volume, the dose can be reduced by a factor of 20 without significantly affecting LVEF measurements. This corresponds to an effective dose of 1 mSv. CT can potentially be used for LVEF measurement with minimal excessive radiation.
Collapse
Affiliation(s)
- Martin Weber Kusk
- Radiography & Diagnostic Imaging, School of Medicine, University College Dublin, Dublin 4 Belfield, Ireland;
- IRIS—Imaging Research Initiative Southwest, Department of Radiology & Nuclear Medicine, Esbjerg University Hospital, 6700 Esbjerg, Denmark;
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5230 Odense M, Denmark
| | - Søren Hess
- IRIS—Imaging Research Initiative Southwest, Department of Radiology & Nuclear Medicine, Esbjerg University Hospital, 6700 Esbjerg, Denmark;
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5230 Odense M, Denmark
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Shane J. Foley
- Radiography & Diagnostic Imaging, School of Medicine, University College Dublin, Dublin 4 Belfield, Ireland;
| |
Collapse
|
11
|
Wu X, Tang L, Li W, He S, Yue X, Peng P, Wu T, Zhang X, Wu Z, He Y, Chen Y, Huang J, Sun J. Feasibility of accelerated non-contrast-enhanced whole-heart bSSFP coronary MR angiography by deep learning-constrained compressed sensing. Eur Radiol 2023; 33:8180-8190. [PMID: 37209126 DOI: 10.1007/s00330-023-09740-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/14/2023] [Accepted: 03/26/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To examine a compressed sensing artificial intelligence (CSAI) framework to accelerate image acquisition in non-contrast-enhanced whole-heart bSSFP coronary magnetic resonance (MR) angiography. METHODS Thirty healthy volunteers and 20 patients with suspected coronary artery disease (CAD) scheduled for coronary computed tomography angiography (CCTA) were enrolled. Non-contrast-enhanced coronary MR angiography was performed with CSAI, compressed sensing (CS), and sensitivity encoding (SENSE) methods in healthy participants and with CSAI in patients. Acquisition time, subjective image quality score, and objective image quality measurement (blood pool homogeneity, signal-to-noise ratio [SNR], and contrast-to-noise ratio [CNR]) were compared among the three protocols. The diagnostic performance of CASI coronary MR angiography for predicting significant stenosis (≥ 50% diameter stenosis) on CCTA was evaluated. The Friedman test was performed to compare the three protocols. RESULTS Acquisition time was significantly shorter in the CSAI and CS groups than in the SENSE group (10.2 ± 3.2 min vs. 10.9 ± 2.9 min vs. 13.0 ± 4.1 min, p < 0.001). However, the CSAI approach had the highest image quality scores, blood pool homogeneity, mean SNR value, and mean CNR value (all p < 0.001) compared with the CS and SENSE approaches. The sensitivity, specificity, and accuracy of CSAI coronary MR angiography per patient were 87.5% (7/8), 91.7% (11/12), and 90.0% (18/20); those per vessel were 81.8% (9/11), 93.9% (46/49), and 91.7% (55/60); and those per segment were 84.6% (11/13), 98.0% (244/249), and 97.3% (255/262), respectively. CONCLUSIONS CSAI yielded superior image quality within a clinically feasible acquisition time in healthy participants and patients with suspected CAD. CLINICAL RELEVANCE STATEMENT The non-invasive and radiation-free CSAI framework could be a promising tool for rapid screening and comprehensive examination of the coronary vasculature in patients with suspected CAD. KEY POINTS • This prospective study showed that CSAI enables a reduction in acquisition time by 22% with superior diagnostic image quality compared with the SENSE protocol. • CSAI replaces the wavelet transform with a CNN as a sparsifying transform in the CS algorithm, achieving high coronary MR image quality with reduced noise. • CSAI achieved per-patient sensitivity of 87.5% (7/8) and specificity of 91.7% (11/12) respectively for detecting significant coronary stenosis.
Collapse
Affiliation(s)
- Xi Wu
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Lu Tang
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
| | - Wanjiang Li
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
| | - Shuai He
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
| | - Xun Yue
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Pengfei Peng
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
| | - Tao Wu
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China
| | - Xiaoyong Zhang
- Clinical Science, Philips Healthcare, Chengdu, 610041, Sichuan, China
| | - Zhigang Wu
- Clinical Science, Philips Healthcare, Chengdu, 610041, Sichuan, China
| | - Yong He
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Juan Huang
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China.
| | - Jiayu Sun
- Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Lane, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
12
|
Tatsugami F, Nakaura T, Yanagawa M, Fujita S, Kamagata K, Ito R, Kawamura M, Fushimi Y, Ueda D, Matsui Y, Yamada A, Fujima N, Fujioka T, Nozaki T, Tsuboyama T, Hirata K, Naganawa S. Recent advances in artificial intelligence for cardiac CT: Enhancing diagnosis and prognosis prediction. Diagn Interv Imaging 2023; 104:521-528. [PMID: 37407346 DOI: 10.1016/j.diii.2023.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023]
Abstract
Recent advances in artificial intelligence (AI) for cardiac computed tomography (CT) have shown great potential in enhancing diagnosis and prognosis prediction in patients with cardiovascular disease. Deep learning, a type of machine learning, has revolutionized radiology by enabling automatic feature extraction and learning from large datasets, particularly in image-based applications. Thus, AI-driven techniques have enabled a faster analysis of cardiac CT examinations than when they are analyzed by humans, while maintaining reproducibility. However, further research and validation are required to fully assess the diagnostic performance, radiation dose-reduction capabilities, and clinical correctness of these AI-driven techniques in cardiac CT. This review article presents recent advances of AI in the field of cardiac CT, including deep-learning-based image reconstruction, coronary artery motion correction, automatic calcium scoring, automatic epicardial fat measurement, coronary artery stenosis diagnosis, fractional flow reserve prediction, and prognosis prediction, analyzes current limitations of these techniques and discusses future challenges.
Collapse
Affiliation(s)
- Fuminari Tatsugami
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masahiro Yanagawa
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Shohei Fujita
- Departmen of Radiology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Rintaro Ito
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Mariko Kawamura
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawaharacho, Sakyoku, Kyoto, 606-8507, Japan
| | - Daiju Ueda
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Yusuke Matsui
- Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Akira Yamada
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital N15, W5, Kita-Ku, Sapporo 060-8638, Japan
| | - Tomoyuki Fujioka
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Taiki Nozaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-0016, Japan
| | - Takahiro Tsuboyama
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Kenji Hirata
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| |
Collapse
|
13
|
Wu X, Deng L, Li W, Peng P, Yue X, Tang L, Pu Q, Ming Y, Zhang X, Huang X, Chen Y, Huang J, Sun J. Deep Learning-Based Acceleration of Compressed Sensing for Noncontrast-Enhanced Coronary Magnetic Resonance Angiography in Patients With Suspected Coronary Artery Disease. J Magn Reson Imaging 2023; 58:1521-1530. [PMID: 36847756 DOI: 10.1002/jmri.28653] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND The clinical application of coronary MR angiography (MRA) remains limited due to its long acquisition time and often unsatisfactory image quality. A compressed sensing artificial intelligence (CSAI) framework was recently introduced to overcome these limitations, but its feasibility in coronary MRA is unknown. PURPOSE To evaluate the diagnostic performance of noncontrast-enhanced coronary MRA with CSAI in patients with suspected coronary artery disease (CAD). STUDY TYPE Prospective observational study. POPULATION A total of 64 consecutive patients (mean age ± standard deviation [SD]: 59 ± 10 years, 48.4% females) with suspected CAD. FIELD STRENGTH/SEQUENCE A 3.0-T, balanced steady-state free precession sequence. ASSESSMENT Three observers evaluated the image quality for 15 coronary segments of the right and left coronary arteries using a 5-point scoring system (1 = not visible; 5 = excellent). Image scores ≥3 were considered diagnostic. Furthermore, the detection of CAD with ≥50% stenosis was evaluated in comparison to reference standard coronary computed tomography angiography (CTA). Mean acquisition times for CSAI-based coronary MRA were measured. STATISTICAL TESTS For each patient, vessel and segment, sensitivity, specificity, and diagnostic accuracy of CSAI-based coronary MRA for detecting CAD with ≥50% stenosis according to coronary CTA were calculated. Intraclass correlation coefficients (ICCs) were used to assess the interobserver agreement. RESULTS The mean MR acquisition time ± SD was 8.1 ± 2.4 minutes. Twenty-five (39.1%) patients had CAD with ≥50% stenosis on coronary CTA and 29 (45.3%) patients on MRA. A total of 885 segments on the CTA images and 818/885 (92.4%) coronary MRA segments were diagnostic (image score ≥3). The sensitivity, specificity, and diagnostic accuracy were as follows: per patient (92.0%, 84.6%, and 87.5%), per vessel (82.9%, 93.4%, and 91.1%), and per segment (77.6%, 98.2%, and 96.6%), respectively. The ICCs for image quality and stenosis assessment were 0.76-0.99 and 0.66-1.00, respectively. DATA CONCLUSION The image quality and diagnostic performance of coronary MRA with CSAI may show good results in comparison to coronary CTA in patients with suspected CAD. EVIDENCE LEVEL 1. TECHNICAL EFFICACY 2.
Collapse
Affiliation(s)
- Xi Wu
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Liping Deng
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wanjiang Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Pengfei Peng
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xun Yue
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Lu Tang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qian Pu
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yue Ming
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoyong Zhang
- Clinical Science, Philips Healthcare, Chengdu, Sichuan, China
| | - Xiaohua Huang
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Yucheng Chen
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Juan Huang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
14
|
Sato H, Fujimoto S, Tomizawa N, Inage H, Yokota T, Kudo H, Fan R, Kawamoto K, Honda Y, Kobayashi T, Minamino T, Kogure Y. Impact of a Deep Learning-based Super-resolution Image Reconstruction Technique on High-contrast Computed Tomography: A Phantom Study. Acad Radiol 2023; 30:2657-2665. [PMID: 36690564 DOI: 10.1016/j.acra.2022.12.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/17/2022] [Accepted: 12/24/2022] [Indexed: 01/23/2023]
Abstract
RATIONALE AND OBJECTIVES Deep-learning-based super-resolution image reconstruction (DLSRR) is a novel image reconstruction technique that is expected to contribute to improvement in spatial resolution as well as noise reduction through learning from high-resolution computed tomography (CT). This study aims to evaluate image quality obtained with DLSRR and assess its clinical potential. MATERIALS AND METHODS CT images of a Mercury CT 4.0 phantom were obtained using a 320-row multi-detector scanner at tube currents of 100, 200, and 300 mA. Image data were reconstructed by filtered back projection (FBP), hybrid iterative reconstruction (HIR), model-based iterative reconstruction (MBIR), deep-learning-based image reconstruction (DLR), and DLSRR at image reconstruction strength levels of mild, standard, and strong. Noise power spectrum (NPS), task transfer function (TTF), and detectability index were calculated. RESULTS The magnitude of the noise-reducing effect in comparison with FBP was in the order MBIR CONCLUSION The present results suggest that DLSRR can achieve greater noise reduction and improved spatial resolution in the high-contrast region compared with conventional DLR and iterative reconstruction techniques.
Collapse
Affiliation(s)
- Hideyuki Sato
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Shinichiro Fujimoto
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Nobuo Tomizawa
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hidekazu Inage
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Takuya Yokota
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Hikaru Kudo
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Ruiheng Fan
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Keiichi Kawamoto
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Yuri Honda
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Takayuki Kobayashi
- Department of Radiological Technology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yosuke Kogure
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| |
Collapse
|
15
|
Takai Y, Noda Y, Asano M, Kawai N, Kaga T, Tsuchida Y, Miyoshi T, Hyodo F, Kato H, Matsuo M. Deep-learning image reconstruction for 80-kVp pancreatic CT protocol: Comparison of image quality and pancreatic ductal adenocarcinoma visibility with hybrid-iterative reconstruction. Eur J Radiol 2023; 165:110960. [PMID: 37423016 DOI: 10.1016/j.ejrad.2023.110960] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/19/2023] [Accepted: 07/03/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE To evaluate the image quality and visibility of pancreatic ductal adenocarcinoma (PDAC) in 80-kVp pancreatic CT protocol and compare them between hybrid-iterative reconstruction (IR) and deep-learning image reconstruction (DLIR) algorithms. METHOD A total of 56 patients who underwent 80-kVp pancreatic protocol CT for pancreatic disease evaluation from January 2022 to July 2022 were included in this retrospective study. Among them, 20 PDACs were observed. The CT raw data were reconstructed using 40% adaptive statistical IR-Veo (hybrid-IR group) and DLIR at medium- and high-strength levels (DLIR-M and DLIR-H groups, respectively). The CT attenuation of the abdominal aorta, pancreas, and PDAC (if present) at the pancreatic phase and those of the portal vein and liver at the portal venous phase; background noise; signal-to-noise ratio (SNR) of these anatomical structures; and tumor-to-pancreas contrast-to-noise ratio (CNR) were calculated. The confidence scores for the image noise, overall image quality, and visibility of PDAC were qualitatively assigned using a five-point scale. Quantitative and qualitative parameters were compared among the three groups using Friedman test. RESULTS The CT attenuation of all anatomical structures were comparable among the three groups (P = .26-.86), except that of the pancreas (P = .001). Background noise was lower (P <.001) and SNRs (P <.001) and tumor-to-pancreas CNR (P <.001) were higher in the DLIR-H group than those in the other two groups. The image noise, overall image quality, and visibility of PDAC were better in the DLIR-H group than in the other two groups (P <.001-.003). CONCLUSION In 80-kVp pancreatic CT protocol, DLIR at a high-strength level improved image quality and visibility of PDAC.
Collapse
Affiliation(s)
- Yukiko Takai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Masashi Asano
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Nobuyuki Kawai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Tetsuro Kaga
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Yuki Tsuchida
- Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Toshiharu Miyoshi
- Department of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Fuminori Hyodo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan; Institute for Advanced Study, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| |
Collapse
|
16
|
Deng J, Ma T, Yan J, Wu S, Yan G, Li H, Li Y, Zhao L, Fan X, McClure MA, Bhetuwal A. Effect of Low Tube Voltage (100 kV) Combined with ASIR-V on the Visualization and Image Quality of the Adamkiewicz Artery: A Comparison with 120 kV Protocol. Diagnostics (Basel) 2023; 13:2495. [PMID: 37568857 PMCID: PMC10417362 DOI: 10.3390/diagnostics13152495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVE To evaluate the effect of low tube voltage (100 kV) combined with adaptive statistical iterative reconstruction-V (ASIR-V) on the visualization and image quality of the Adamkiewicz artery (AKA). METHODS One hundred patients were prospectively enrolled and randomly assigned into two groups (both n = 50). Group A (100 kV) was reconstructed with filtered back projection (FBP) and ASIR-V from 10% to 100% with 10% intervals. Group B (120 kV) was only reconstructed with FBP. The objective image quality was evaluated by using CT values of the aorta (CTAorta), background noise, signal-to-noise ratio of the descending aorta (SNRAorta), and contrast-to-noise ratio of the spinal cord (CNRSpinal cord). The subjective image quality and visualization scores of the AKA were assessed on a 5-point scale. RESULTS CTAorta was significantly higher in Group A than in Group B (p < 0.001). When ASIR-V weights were ≥60%, significant differences were found in the background noise, SNRAorta, and CNRSpinal cord between the two groups (all p < 0.05). In Group A, compared with FBP, the subjective score gradually increased as ASIR-V increased to 80%, which decreased when ASIR-V exceeded 80%. The visualization scores of the AKA (≥60%) and the ability to detect vessel continuity (≥80%) gradually increased as the ASIR-V weights increased (p < 0.05). The effective radiation dose was reduced by about 40.36% in Group A compared to Group B. CONCLUSIONS compared with conventional scanning protocol, using a combination of low tube voltage (100 kV) and 80% ASIR-V protocol could not only increase the visualization of the AKA, but also improve image quality and reduce the radiation doses.
Collapse
Affiliation(s)
- Jiantao Deng
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Ting Ma
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Jing Yan
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Siyi Wu
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Gaowu Yan
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Hongwei Li
- Department of Radiology, The Third Hospital of Mianyang and Sichuan Mental Health Center, Mianyang 621000, China
| | - Yong Li
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Linwei Zhao
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Xiaoping Fan
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Morgan A. McClure
- Department of Radiology and Imaging, Institute of Rehabilitation and Development of Brain Function, The Second Clinical Medical College of North Sichuan Medical College Nanchong Central Hospital, Nanchong 637000, China
| | - Anup Bhetuwal
- Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| |
Collapse
|
17
|
Zhou XZ, Liu LH, He S, Yao HF, Chen LP, Deng C, Li SL, Zhang XY, Lai H. Diagnostic value of Kaiser score combined with breast vascular assessment from breast MRI for the characterization of breast lesions. Front Oncol 2023; 13:1165405. [PMID: 37483510 PMCID: PMC10359820 DOI: 10.3389/fonc.2023.1165405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives The Kaiser scoring system for breast magnetic resonance imaging is a clinical decision-making tool for diagnosing breast lesions. However, the Kaiser score (KS) did not include the evaluation of breast vascularity. Therefore, this study aimed to use KS combined with breast vascular assessment, defined as KS*, and investigate the effectiveness of KS* in differentiating benign from malignant breast lesions. Methods This retrospective study included 223 patients with suspicious breast lesions and pathologically verified results. The histopathological diagnostic criteria were according to the fifth edition of the WHO classification of breast tumors. The KS* was obtained after a joint evaluation combining the original KS and breast vasculature assessment. The receiver operating characteristic (ROC) curve was used for comparing differences in the diagnostic performance between KS* and KS, and the area under the receiver operating characteristic (AUC) was compared. Results There were 119 (53.4%) benign and 104 (46.6%) malignant lesions in total. The overall sensitivity, specificity, and accuracy of increased ipsilateral breast vascularity were 69.2%, 76.5%, and 73.1%, respectively. The overall sensitivity, specificity, and accuracy of AVS were 82.7%, 76.5%, and 79.4%, respectively. For all lesions included the AUC of KS* was greater than that of KS (0.877 vs. 0.858, P = 0.016). The largest difference in AUC was observed in the non-mass subgroup (0.793 vs. 0.725, P = 0.029). Conclusion Ipsilaterally increased breast vascularity and a positive AVS sign were significantly associated with malignancy. KS combined with breast vascular assessment can effectively improve the diagnostic ability of KS for breast lesions, especially for non-mass lesions.
Collapse
Affiliation(s)
- Xin-zhu Zhou
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lian-hua Liu
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuang He
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hui-fang Yao
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Li-ping Chen
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Chen Deng
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuang-Ling Li
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | | | - Hua Lai
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
18
|
Zhang Y, Wang Y, Li J, Zhang G, Di A, Yuan H. Refining the radiation and contrast medium dose in weight-grouped scanning protocols for coronary CT angiography. J Appl Clin Med Phys 2023:e14041. [PMID: 37211752 DOI: 10.1002/acm2.14041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/13/2023] [Accepted: 05/03/2023] [Indexed: 05/23/2023] Open
Abstract
PURPOSE To refine the currently used, weight-grouped protocol for coronary computed tomography angiography (CCTA), in terms of the radiation and contrast medium dose, through clinical evaluation. METHODS Following the current routine setting that varies between three weight groups (group A: 55-65 kg, group B: 66-75 kg, group C: 76-85 kg), three additional reduction protocols were proposed to each group, with different combinations of lowered tube voltage (70-100 kVp), tube current (100-220 mAs), and iodine delivery rate (0.8-1.5 gI/s). A total of 321 patients scheduled for CCTA due to suspected coronary artery disease were enrolled, who were randomly assigned to one of the four subgroups of settings under the corresponding weight group. The resulting objective image quality was compared by measuring the contrast-to-noise ratio and signal-to-noise ratio. Subjective image quality was graded by two radiologists using a 4-point Likert scale, on a total of 3848 segments. The optimal protocol for each weight group was determined with respect to the image quality and the applied radiation dose. RESULTS For all three groups, no significant difference was noticed in objective images quality between subgroups of dose settings (all p > 0.05). The average score on subjective image quality was ≥3 for every subgroup, while the percentage of score 4 showed greater dependence on the setting, ranging from 83.2% to 91.5%, and was chosen to be the determining factor. The optimal dose settings were found to be 80 kVp, 150 mAs, and 1.0 gI/s for patients of 55-75 kg in weight, and 100 kVp, 170 mAs, and 1.5 gI/s for those of 76-85 kg. CONCLUSION It is feasible to refine the currently used, weight-grouped protocol for CCTA in terms of radiation and contrast medium dose, by use of an optimization strategy where the balance between dose and image quality can be improved in a routine clinical setting.
Collapse
Affiliation(s)
- Yan Zhang
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Ying Wang
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Jing Li
- United Imaging Healthcare, Shanghai, China
| | | | - Aihui Di
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, Beijing, China
| |
Collapse
|
19
|
Bona R, Marini P, Turilli D, Masala S, Scaglione M. Coronary Computed Tomography Angiography with Deep Learning Image Reconstruction: A Preliminary Study to Evaluate Radiation Exposure Reduction. Tomography 2023; 9:1019-1028. [PMID: 37218943 DOI: 10.3390/tomography9030083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/24/2023] Open
Abstract
Coronary computed tomography angiography (CCTA) is a medical imaging technique that produces detailed images of the coronary arteries. Our work focuses on the optimization of the prospectively ECG-triggered scan technique, which delivers the radiation efficiently only during a fraction of the R-R interval, matching the aim of reducing radiation dose in this increasingly used radiological examination. In this work, we analyzed how the median DLP (Dose-Length Product) values for CCTA of our Center decreased significantly in recent times mainly due to a notable change in the technology used. We passed from a median DLP value of 1158 mGy·cm to 221 mGy·cm for the whole exam and from a value of 1140 mGy·cm to 204 mGy·cm if considering CCTA scanning only. The result was obtained through the association of important factors during the dose imaging optimization: technological improvement, acquisition technique, and image reconstruction algorithm intervention. The combination of these three factors allows us to perform a faster and more accurate prospective CCTA with a lower radiation dose. Our future aim is to tune the image quality through a detectability-based study, combining algorithm strength with automatic dose settings.
Collapse
Affiliation(s)
- Rossana Bona
- Medical Physics Unit, Azienda Ospedaliero-Universitaria (AOU), 07100 Sassari, Italy
| | - Piergiorgio Marini
- Medical Physics Unit, Azienda Ospedaliero-Universitaria (AOU), 07100 Sassari, Italy
| | - Davide Turilli
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Salvatore Masala
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Mariano Scaglione
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| |
Collapse
|
20
|
Koetzier LR, Mastrodicasa D, Szczykutowicz TP, van der Werf NR, Wang AS, Sandfort V, van der Molen AJ, Fleischmann D, Willemink MJ. Deep Learning Image Reconstruction for CT: Technical Principles and Clinical Prospects. Radiology 2023; 306:e221257. [PMID: 36719287 PMCID: PMC9968777 DOI: 10.1148/radiol.221257] [Citation(s) in RCA: 51] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/26/2022] [Accepted: 10/13/2022] [Indexed: 02/01/2023]
Abstract
Filtered back projection (FBP) has been the standard CT image reconstruction method for 4 decades. A simple, fast, and reliable technique, FBP has delivered high-quality images in several clinical applications. However, with faster and more advanced CT scanners, FBP has become increasingly obsolete. Higher image noise and more artifacts are especially noticeable in lower-dose CT imaging using FBP. This performance gap was partly addressed by model-based iterative reconstruction (MBIR). Yet, its "plastic" image appearance and long reconstruction times have limited widespread application. Hybrid iterative reconstruction partially addressed these limitations by blending FBP with MBIR and is currently the state-of-the-art reconstruction technique. In the past 5 years, deep learning reconstruction (DLR) techniques have become increasingly popular. DLR uses artificial intelligence to reconstruct high-quality images from lower-dose CT faster than MBIR. However, the performance of DLR algorithms relies on the quality of data used for model training. Higher-quality training data will become available with photon-counting CT scanners. At the same time, spectral data would greatly benefit from the computational abilities of DLR. This review presents an overview of the principles, technical approaches, and clinical applications of DLR, including metal artifact reduction algorithms. In addition, emerging applications and prospects are discussed.
Collapse
Affiliation(s)
| | | | - Timothy P. Szczykutowicz
- From the Department of Radiology (L.R.K., D.M., A.S.W., V.S., D.F.,
M.J.W.) and Stanford Cardiovascular Institute (D.M., D.F., M.J.W.), Stanford
University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105;
Department of Radiology, University of Wisconsin–Madison, School of
Medicine and Public Health, Madison, Wis (T.P.S.); Department of Radiology,
Erasmus Medical Center, Rotterdam, the Netherlands (N.R.v.d.W.); Clinical
Science Western Europe, Philips Healthcare, Best, the Netherlands (N.R.v.d.W.);
and Department of Radiology, Leiden University Medical Center, Leiden, the
Netherlands (A.J.v.d.M.)
| | - Niels R. van der Werf
- From the Department of Radiology (L.R.K., D.M., A.S.W., V.S., D.F.,
M.J.W.) and Stanford Cardiovascular Institute (D.M., D.F., M.J.W.), Stanford
University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105;
Department of Radiology, University of Wisconsin–Madison, School of
Medicine and Public Health, Madison, Wis (T.P.S.); Department of Radiology,
Erasmus Medical Center, Rotterdam, the Netherlands (N.R.v.d.W.); Clinical
Science Western Europe, Philips Healthcare, Best, the Netherlands (N.R.v.d.W.);
and Department of Radiology, Leiden University Medical Center, Leiden, the
Netherlands (A.J.v.d.M.)
| | - Adam S. Wang
- From the Department of Radiology (L.R.K., D.M., A.S.W., V.S., D.F.,
M.J.W.) and Stanford Cardiovascular Institute (D.M., D.F., M.J.W.), Stanford
University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105;
Department of Radiology, University of Wisconsin–Madison, School of
Medicine and Public Health, Madison, Wis (T.P.S.); Department of Radiology,
Erasmus Medical Center, Rotterdam, the Netherlands (N.R.v.d.W.); Clinical
Science Western Europe, Philips Healthcare, Best, the Netherlands (N.R.v.d.W.);
and Department of Radiology, Leiden University Medical Center, Leiden, the
Netherlands (A.J.v.d.M.)
| | - Veit Sandfort
- From the Department of Radiology (L.R.K., D.M., A.S.W., V.S., D.F.,
M.J.W.) and Stanford Cardiovascular Institute (D.M., D.F., M.J.W.), Stanford
University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105;
Department of Radiology, University of Wisconsin–Madison, School of
Medicine and Public Health, Madison, Wis (T.P.S.); Department of Radiology,
Erasmus Medical Center, Rotterdam, the Netherlands (N.R.v.d.W.); Clinical
Science Western Europe, Philips Healthcare, Best, the Netherlands (N.R.v.d.W.);
and Department of Radiology, Leiden University Medical Center, Leiden, the
Netherlands (A.J.v.d.M.)
| | - Aart J. van der Molen
- From the Department of Radiology (L.R.K., D.M., A.S.W., V.S., D.F.,
M.J.W.) and Stanford Cardiovascular Institute (D.M., D.F., M.J.W.), Stanford
University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105;
Department of Radiology, University of Wisconsin–Madison, School of
Medicine and Public Health, Madison, Wis (T.P.S.); Department of Radiology,
Erasmus Medical Center, Rotterdam, the Netherlands (N.R.v.d.W.); Clinical
Science Western Europe, Philips Healthcare, Best, the Netherlands (N.R.v.d.W.);
and Department of Radiology, Leiden University Medical Center, Leiden, the
Netherlands (A.J.v.d.M.)
| | - Dominik Fleischmann
- From the Department of Radiology (L.R.K., D.M., A.S.W., V.S., D.F.,
M.J.W.) and Stanford Cardiovascular Institute (D.M., D.F., M.J.W.), Stanford
University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105;
Department of Radiology, University of Wisconsin–Madison, School of
Medicine and Public Health, Madison, Wis (T.P.S.); Department of Radiology,
Erasmus Medical Center, Rotterdam, the Netherlands (N.R.v.d.W.); Clinical
Science Western Europe, Philips Healthcare, Best, the Netherlands (N.R.v.d.W.);
and Department of Radiology, Leiden University Medical Center, Leiden, the
Netherlands (A.J.v.d.M.)
| | - Martin J. Willemink
- From the Department of Radiology (L.R.K., D.M., A.S.W., V.S., D.F.,
M.J.W.) and Stanford Cardiovascular Institute (D.M., D.F., M.J.W.), Stanford
University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105;
Department of Radiology, University of Wisconsin–Madison, School of
Medicine and Public Health, Madison, Wis (T.P.S.); Department of Radiology,
Erasmus Medical Center, Rotterdam, the Netherlands (N.R.v.d.W.); Clinical
Science Western Europe, Philips Healthcare, Best, the Netherlands (N.R.v.d.W.);
and Department of Radiology, Leiden University Medical Center, Leiden, the
Netherlands (A.J.v.d.M.)
| |
Collapse
|
21
|
De Santis D, Polidori T, Tremamunno G, Rucci C, Piccinni G, Zerunian M, Pugliese L, Del Gaudio A, Guido G, Barbato L, Laghi A, Caruso D. Deep learning image reconstruction algorithm: impact on image quality in coronary computed tomography angiography. LA RADIOLOGIA MEDICA 2023; 128:434-444. [PMID: 36847992 PMCID: PMC10119038 DOI: 10.1007/s11547-023-01607-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 02/03/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE To perform a comprehensive intraindividual objective and subjective image quality evaluation of coronary CT angiography (CCTA) reconstructed with deep learning image reconstruction (DLIR) and to assess correlation with routinely applied hybrid iterative reconstruction algorithm (ASiR-V). MATERIAL AND METHODS Fifty-one patients (29 males) undergoing clinically indicated CCTA from April to December 2021 were prospectively enrolled. Fourteen datasets were reconstructed for each patient: three DLIR strength levels (DLIR_L, DLIR_M, and DLIR_H), ASiR-V from 10% to 100% in 10%-increment, and filtered back-projection (FBP). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) determined objective image quality. Subjective image quality was assessed with a 4-point Likert scale. Concordance between reconstruction algorithms was assessed by Pearson correlation coefficient. RESULTS DLIR algorithm did not impact vascular attenuation (P ≥ 0.374). DLIR_H showed the lowest noise, comparable with ASiR-V 100% (P = 1) and significantly lower than other reconstructions (P ≤ 0.021). DLIR_H achieved the highest objective quality, with SNR and CNR comparable to ASiR-V 100% (P = 0.139 and 0.075, respectively). DLIR_M obtained comparable objective image quality with ASiR-V 80% and 90% (P ≥ 0.281), while achieved the highest subjective image quality (4, IQR: 4-4; P ≤ 0.001). DLIR and ASiR-V datasets returned a very strong correlation in the assessment of CAD (r = 0.874, P = 0.001). CONCLUSION DLIR_M significantly improves CCTA image quality and has very strong correlation with routinely applied ASiR-V 50% dataset in the diagnosis of CAD.
Collapse
Affiliation(s)
- Domenico De Santis
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Tiziano Polidori
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Giuseppe Tremamunno
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Carlotta Rucci
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Giulia Piccinni
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Marta Zerunian
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Luca Pugliese
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Antonella Del Gaudio
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Gisella Guido
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Luca Barbato
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Andrea Laghi
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy.
| | - Damiano Caruso
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| |
Collapse
|
22
|
Takahashi M, Takaoka H, Ota J, Yashima S, Kinoshita M, Suzuki-Eguchi N, Sasaki H, Goto H, Aoki S, Kitahara H, Sano K, Kobayashi Y. An Increased Diagnostic Accuracy of Significant Coronary Artery Stenosis Using 320-slice Computed Tomography with Model-based Iterative Reconstruction in Cases with Severely Calcified Coronary Arteries. Intern Med 2023; 62:169-176. [PMID: 35676040 PMCID: PMC9908388 DOI: 10.2169/internalmedicine.9509-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Objective High-quality images can be obtained with 320-slice computed tomography (CT) with model-based iterative reconstruction (MBIR). We therefore investigated the diagnostic accuracy of 320-slice CT with MBIR for detecting significant coronary artery stenosis. Methods This was a retrospective study of 160 patients who underwent coronary CT and invasive coronary angiography (ICA). The first 100 consecutive patients (Group 1) underwent 320-slice CT without MBIR or small-focus scanning. The next 60 consecutive patients (Group 2) underwent 320-slice CT with both MBIR and small-focus scanning. Patients who underwent coronary artery bypass surgery were excluded. The diagnostic performance of 320-slice CT without MBIR or small-focus scanning and 320-slice CT with both of them, with ICA regarded as a reference standard, was compared to detect significant coronary artery stenosis (≥70% on CT, ≥75% on ICA). Results In a patient-based analysis, the sensitivity, specificity, and overall accuracy of detection of significant stenosis on CT against ICA were 95%, 85%, and 91% in Group 1, and 93%, 83%, and 90% in Group 2, respectively. No significant differences were observed between the two groups in the patient- and segment-based analyses. However, among cases with a severe coronary artery calcium score >400 (31 cases in Group 1 and 28 in Group 2), the specificity and overall accuracy were significantly higher (all p<0.01) in Group 2 than in Group 1 according to the segment-based analysis. Conclusion The diagnostic accuracy of the detection of coronary artery stenosis on CT was improved using 320-slice CT with MBIR.
Collapse
Affiliation(s)
- Manami Takahashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Joji Ota
- Department of Radiology, Chiba University Hospital, Japan
| | - Satomi Yashima
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Makiko Kinoshita
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Noriko Suzuki-Eguchi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Haruka Sasaki
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hiroki Goto
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Shuhei Aoki
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hideki Kitahara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Koichi Sano
- Department of Cardiovascular Medicine, Eastern Chiba Medical Center, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| |
Collapse
|
23
|
Liao J, Huang L, Qu M, Chen B, Wang G. Artificial Intelligence in Coronary CT Angiography: Current Status and Future Prospects. Front Cardiovasc Med 2022; 9:896366. [PMID: 35783834 PMCID: PMC9247240 DOI: 10.3389/fcvm.2022.896366] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/18/2022] [Indexed: 12/28/2022] Open
Abstract
Coronary heart disease (CHD) is the leading cause of mortality in the world. Early detection and treatment of CHD are crucial. Currently, coronary CT angiography (CCTA) has been the prior choice for CHD screening and diagnosis, but it cannot meet the clinical needs in terms of examination quality, the accuracy of reporting, and the accuracy of prognosis analysis. In recent years, artificial intelligence (AI) has developed rapidly in the field of medicine; it played a key role in auxiliary diagnosis, disease mechanism analysis, and prognosis assessment, including a series of studies related to CHD. In this article, the application and research status of AI in CCTA were summarized and the prospects of this field were also described.
Collapse
Affiliation(s)
- Jiahui Liao
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- School of Biomedical Engineering, Guangzhou Xinhua University, Guangzhou, China
| | - Lanfang Huang
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Meizi Qu
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Binghui Chen
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- *Correspondence: Binghui Chen
| | - Guojie Wang
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- Guojie Wang
| |
Collapse
|