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Dreesen HJH, Stroszczynski C, Lell MM. Optimizing Coronary Computed Tomography Angiography Using a Novel Deep Learning-Based Algorithm. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:1548-1556. [PMID: 38438697 PMCID: PMC11300758 DOI: 10.1007/s10278-024-01033-w] [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: 09/25/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 03/06/2024]
Abstract
Coronary computed tomography angiography (CCTA) is an essential part of the diagnosis of chronic coronary syndrome (CCS) in patients with low-to-intermediate pre-test probability. The minimum technical requirement is 64-row multidetector CT (64-MDCT), which is still frequently used, although it is prone to motion artifacts because of its limited temporal resolution and z-coverage. In this study, we evaluate the potential of a deep-learning-based motion correction algorithm (MCA) to eliminate these motion artifacts. 124 64-MDCT-acquired CCTA examinations with at least minor motion artifacts were included. Images were reconstructed using a conventional reconstruction algorithm (CA) and a MCA. Image quality (IQ), according to a 5-point Likert score, was evaluated per-segment, per-artery, and per-patient and was correlated with potentially disturbing factors (heart rate (HR), intra-cycle HR changes, BMI, age, and sex). Comparison was done by Wilcoxon-Signed-Rank test, and correlation by Spearman's Rho. Per-patient, insufficient IQ decreased by 5.26%, and sufficient IQ increased by 9.66% with MCA. Per-artery, insufficient IQ of the right coronary artery (RCA) decreased by 18.18%, and sufficient IQ increased by 27.27%. Per-segment, insufficient IQ in segments 1 and 2 decreased by 11.51% and 24.78%, respectively, and sufficient IQ increased by 10.62% and 18.58%, respectively. Total artifacts per-artery decreased in the RCA from 3.11 ± 1.65 to 2.26 ± 1.52. HR dependence of RCA IQ decreased to intermediate correlation in images with MCA reconstruction. The applied MCA improves the IQ of 64-MDCT-acquired images and reduces the influence of HR on IQ, increasing 64-MDCT validity in the diagnosis of CCS.
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Affiliation(s)
- H J H Dreesen
- Department of Radiology, University Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany.
- Department of Radiology, Neuroradiology and Nuclear Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.
| | - C Stroszczynski
- Department of Radiology, University Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany
| | - M M Lell
- Department of Radiology, Neuroradiology and Nuclear Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
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Zhang Z, Liu Z, Hong N, Chen L. Effect of a second-generation motion correction algorithm on image quality and measurement reproducibility of coronary CT angiography in patients with a myocardial bridge and mural coronary artery. Clin Radiol 2024; 79:e462-e467. [PMID: 38135576 DOI: 10.1016/j.crad.2023.11.025] [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: 06/12/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023]
Abstract
AIM To determine the effect of second-generation motion correction (MC2) on image quality and measurement reproducibility of cardiac CT images in patients with a myocardial bridge and mural coronary artery (MB-MCA) compared to standard (STD) images without motion correction and with first-generation motion correction (MC1). MATERIALS AND METHODS A total of 66 patients with MB-MCA in the left anterior descending branch who underwent 256-detector CT with single-heartbeat acquisition were included. Images were reconstructed at 45% and 75% R-R intervals using STD, MC1, and MC2 algorithms. Image quality for MB-MCA was assessed by two observers on a four-point scale (1 = poor and 4 = excellent) and compared among STD, MC1, and MC2. Depth and length of MB, lumen area, and minimal diameter of MCA were measured and compared. RESULTS At 45% R-R interval, image quality scores were 1.59 ± 0.78, 2.21 ± 0.97, and 3.21 ± 0.62 for MCA, and 2.48 ± 0.79, 2.76 ± 0.75, and 3.58 ± 0.58 for MB with STD, MC1 and MC2, respectively. At 75% R-R interval, these values were 2.26 ± 0.60, 3.03 ± 0.89, and 3.59 ± 0.55 for MCA and 3.00 ± 0.93, 3.17 ± 0.83, and 3.80 ± 0.44 for MB. Although MC1 was superior to STD in displaying MCA, there was no statistical difference between the two algorithms for MB (p>0.05). Compared with STD and MC1, MC2 statistically improved image quality and interpretability for both MCA and MB and had narrower limits in interobserver agreement for measurements at both 45% and 75% R-R intervals. CONCLUSION MC2 improves CT image quality and measurement reproducibility in patients with MB-MCA compared to STD and MC1.
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Affiliation(s)
- Z Zhang
- Department of Radiology, Peking University People's Hospital, Beijing, 100044, China
| | - Z Liu
- Department of Radiology, Peking University People's Hospital, Beijing, 100044, China
| | - N Hong
- Department of Radiology, Peking University People's Hospital, Beijing, 100044, China
| | - L Chen
- Department of Radiology, Peking University People's Hospital, Beijing, 100044, China.
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Gong H, Ahmed Z, Chang S, Koons EK, Thorne JE, Rajiah P, Foley TA, Fletcher JG, McCollough CH, Leng S. Motion artifact correction in cardiac CT using cross-phase temporospatial information and synergistic attention gate and spatial transformer sub-networks. Phys Med Biol 2024; 69:035023. [PMID: 38181426 PMCID: PMC10840999 DOI: 10.1088/1361-6560/ad1b6a] [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: 08/17/2023] [Accepted: 01/05/2024] [Indexed: 01/07/2024]
Abstract
Objectives.To improve quality of coronary CT angiography (CCTA) images using a generalizable motion-correction algorithm.Approach. A neural network with attention gate and spatial transformer (ATOM) was developed to correct coronary motion. Phantom and patient CCTA images (39 males, 32 females, age range 19-92, scan date 02/2020 to 10/2021) retrospectively collected from dual-source CT were used to create training, development, and testing sets corresponding to 140- and 75 ms temporal resolution, with 75 ms images as labels. To test generalizability, ATOM was deployed for locally adaptive motion-correction in both 140- and 75 ms patient images. Objective metrics were used to assess motion-corrupted and corrected phantom and patient images, including structural-similarity-index (SSIM), dice-similarity-coefficient (DSC), peak-signal-noise-ratio (PSNR), and normalized root-mean-square-error (NRMSE). In objective quality assessment, ATOM was compared with several baseline networks, including U-net, U-net plus attention gate, U-net plus spatial transformer, VDSR, and ResNet. Two cardiac radiologists independently interpreted motion-corrupted and -corrected images at 75 and 140 ms in a blinded fashion and ranked diagnostic image quality (worst to best: 1-4, no ties).Main results. ATOM improved quality metrics (p< 0.05) before/after correction: in phantom, SSIM 0.87/0.95, DSC 0.85/0.93, PSNR 19.4/22.5, NRMSE 0.38/0.27; in patient images, SSIM 0.82/0.88, DSC 0.88/0.90, PSNR 30.0/32.0, NRMSE 0.16/0.12. ATOM provided more consistent improvement of objective image quality, compared to the presented baseline networks. The motion-corrected images received better ranks than un-corrected at the same temporal resolution (p< 0.05): 140 ms images 1.65/2.25, and 75 ms images 3.1/3.2. The motion-corrected 75 ms images received the best rank in 65% of testing cases. A fair-to-good inter-reader agreement was observed (Kappa score 0.58).Significance. ATOM reduces motion artifacts, improving visualization of coronary arteries. This algorithm can be used to virtually improve temporal resolution in both single- and dual-source CT.
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Affiliation(s)
- Hao Gong
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, United States of America
| | - Zaki Ahmed
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, United States of America
| | - Shaojie Chang
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, United States of America
| | - Emily K Koons
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, United States of America
| | - Jamison E Thorne
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, United States of America
| | - Prabhakar Rajiah
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, United States of America
| | - Thomas A Foley
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, United States of America
| | - Joel G Fletcher
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, United States of America
| | - Cynthia H McCollough
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, United States of America
| | - Shuai Leng
- Department of Radiology, Mayo Clinic, Rochester, MN, 55901, United States of America
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Matsumoto Y, Fujioka C, Yokomachi K, Kitera N, Nishimaru E, Kiguchi M, Higaki T, Kawashita I, Tatsugami F, Nakamura Y, Awai K. Evaluation of the second-generation whole-heart motion correction algorithm (SSF2) used to demonstrate the aortic annulus on cardiac CT. Sci Rep 2023; 13:3636. [PMID: 36869155 PMCID: PMC9984533 DOI: 10.1038/s41598-023-30786-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 03/01/2023] [Indexed: 03/05/2023] Open
Abstract
The main purpose of pre-transcatheter aortic valve implantation (TAVI) cardiac computed tomography (CT) for patients with severe aortic stenosis is aortic annulus measurements. However, motion artifacts present a technical challenge because they can reduce the measurement accuracy of the aortic annulus. Therefore, we applied the recently developed second-generation whole-heart motion correction algorithm (SnapShot Freeze 2.0, SSF2) to pre-TAVI cardiac CT and investigated its clinical utility by stratified analysis of the patient's heart rate during scanning. We found that SSF2 reconstruction significantly reduced aortic annulus motion artifacts and improved the image quality and measurement accuracy compared to standard reconstruction, especially in patients with high heart rate or a 40% R-R interval (systolic phase). SSF2 may contribute to improving the measurement accuracy of the aortic annulus.
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Affiliation(s)
- Yoriaki Matsumoto
- Department of Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan.
| | - Chikako Fujioka
- Department of Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Kazushi Yokomachi
- Department of Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Nobuo Kitera
- Department of Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Eiji Nishimaru
- Department of Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Masao Kiguchi
- Department of Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Toru Higaki
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Ikuo Kawashita
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Fuminari Tatsugami
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Yuko Nakamura
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
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Degtiarova G, Mikulicic F, Vontobel J, Garefa C, Keller LS, Boehm R, Ciancone D, Gebhard C, Pazhenkottil AP, Kaufmann PA, Buechel RR. Post-hoc motion correction for coronary computed tomography angiography without additional radiation dose - Improved image quality and interpretability for “free”. IMAGING 2022. [DOI: 10.1556/1647.2022.00060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
AbstractObjectiveTo evaluate the impact of a motion-correction (MC) algorithm, applicable post-hoc and not dependent on extended padding, on the image quality and interpretability of coronary computed tomography angiography (CCTA).MethodsNinety consecutive patients undergoing CCTA on a latest-generation 256-slice CT device were prospectively included. CCTA was performed with prospective electrocardiogram-triggering and the shortest possible acquisition window (without padding) at 75% of the R-R-interval. All datasets were reconstructed without and with MC of the coronaries. The latter exploits the minimal padding inherent in cardiac CT scans with this device due to data acquisition also during the short time interval needed for the tube to reach target currents and voltage (“free” multiphase). Two blinded readers independently assessed image quality on a 4-point Likert scale for all segments.ResultsA total of 1,030 coronary segments were evaluated. Application of MC both with automatic and manual coronary centerline tracking resulted in a significant improvement in image quality as compared to the standard reconstruction without MC (mean Likert score 3.67 [3.50;3.81] vs 3.58 [3.40;3.73], P = 0.005, and 3.7 [3.55;3.82] vs 3.58 [3.40;3.73], P < 0.001, respectively). Furthermore, MC significantly reduced the proportion of non-evaluable segments and patients with at least one non-evaluable coronary segment from 2% to as low as 0.3%, and from 14% to as low as 3%. Reduction of motion artifacts was predominantly observed in the right coronary artery.ConclusionsA post-hoc device-specific MC algorithm improves image quality and interpretability of prospectively electrocardiogram-triggered CCTA and reduces the proportion of non-evaluable scans without any additional radiation dose exposure.
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Affiliation(s)
- Ganna Degtiarova
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Fran Mikulicic
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Jan Vontobel
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Chrysoula Garefa
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Lukas S. Keller
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Reto Boehm
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Domenico Ciancone
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Catherine Gebhard
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Aju P. Pazhenkottil
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Philipp A. Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Ronny R. Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
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Ren P, He Y, Zhu Y, Zhang T, Cao J, Wang Z, Yang Z. Motion artefact reduction in coronary CT angiography images with a deep learning method. BMC Med Imaging 2022; 22:184. [DOI: 10.1186/s12880-022-00914-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The aim of this study was to investigate the ability of a pixel-to-pixel generative adversarial network (GAN) to remove motion artefacts in coronary CT angiography (CCTA) images.
Methods
Ninety-seven patients who underwent single-cardiac-cycle multiphase CCTA were retrospectively included in the study, and raw CCTA images and SnapShot Freeze (SSF) CCTA images were acquired. The right coronary artery (RCA) was investigated because its motion artefacts are the most prominent among the artefacts of all coronary arteries. The acquired data were divided into a training dataset of 40 patients, a verification dataset of 30 patients and a test dataset of 27 patients. A pixel-to-pixel GAN was trained to generate improved CCTA images from the raw CCTA imaging data using SSF CCTA images as targets. The GAN’s ability to remove motion artefacts was evaluated by the structural similarity (SSIM), Dice similarity coefficient (DSC) and circularity index. Furthermore, the image quality was visually assessed by two radiologists.
Results
The circularity was significantly higher for the GAN-generated images than for the raw images of the RCA (0.82 ± 0.07 vs. 0.74 ± 0.11, p < 0.001), and there was no significant difference between the GAN-generated images and SSF images (0.82 ± 0.07 vs. 0.82 ± 0.06, p = 0.96). Furthermore, the GAN-generated images achieved the SSIM of 0.87 ± 0.06, significantly better than those of the raw images 0.83 ± 0.08 (p < 0.001). The results for the DSC showed that the overlap between the GAN-generated and SSF images was significantly higher than the overlap between the GAN-generated and raw images (0.84 ± 0.08 vs. 0.78 ± 0.11, p < 0.001). The motion artefact scores of the GAN-generated CCTA images of the pRCA and mRCA were significantly higher than those of the raw CCTA images (3 [4–3] vs 4 [5–4], p = 0.022; 3 [3–2] vs 5[5–4], p < 0.001).
Conclusions
A GAN can significantly reduce the motion artefacts in CCTA images of the middle segment of the RCA and has the potential to act as a new method to remove motion artefacts in coronary CCTA images.
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Vecsey-Nagy M, Jermendy ÁL, Kolossváry M, Vattay B, Boussoussou M, Suhai FI, Panajotu A, Csőre J, Borzsák S, Fontanini DM, Csobay-Novák C, Merkely B, Maurovich-Horvat P, Szilveszter B. Heart Rate-Dependent Degree of Motion Artifacts in Coronary CT Angiography Acquired by a Novel Purpose-Built Cardiac CT Scanner. J Clin Med 2022; 11:jcm11154336. [PMID: 35893427 PMCID: PMC9369248 DOI: 10.3390/jcm11154336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Although reaching target heart rate (HR) before coronary CT angiography (CCTA) is still of importance, adequate HR control remains a challenge for many patients. Purpose-built cardiac scanners may provide optimal image quality at higher HRs by further improving temporal resolution. We aimed to compare the amount of motion artifacts on CCTA acquired using a dedicated cardiac CT (DCCT) compared to a conventional multidetector CT (MDCT) scanner. We compared 80 DCCT images to 80 MDCT scans matched by sex, age, HR, and coronary dominance. Image quality was graded on a per-patient, per-vessel and per-segment basis. Motion artifacts were assessed using Likert scores (1: non-diagnostic, 2: severe artifacts, 3: mild artifacts, 4: no artifacts). Patients were stratified into four groups according to HR (<60/min, 60−65/min, 66−70/min and >70/min). Overall, 2328 coronary segments were evaluated. DCCT demonstrated superior overall image quality compared to MDCT (3.7 ± 0.4 vs. 3.3 ± 0.7, p < 0.001). DCCT images yielded higher Likert scores in all HR ranges, which was statistically significant in the 60−65/min, 66−70/min and >70/min ranges (3.9 ± 0.2 vs. 3.7 ± 0.2, p = 0.008; 3.5 ± 0.5 vs. 3.1 ± 0.6, p = 0.048 and 3.5 ± 0.4 vs. 2.7 ± 0.7, p < 0.001, respectively). Using a dedicated cardiac scanner results in fewer motion artifacts, which may allow optimal image quality even in cases of high HRs.
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Affiliation(s)
- Milán Vecsey-Nagy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (Á.L.J.); (M.K.); (B.V.); (M.B.); (F.I.S.); (A.P.); (S.B.); (P.M.-H.); (B.S.)
- Correspondence:
| | - Ádám Levente Jermendy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (Á.L.J.); (M.K.); (B.V.); (M.B.); (F.I.S.); (A.P.); (S.B.); (P.M.-H.); (B.S.)
| | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (Á.L.J.); (M.K.); (B.V.); (M.B.); (F.I.S.); (A.P.); (S.B.); (P.M.-H.); (B.S.)
| | - Borbála Vattay
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (Á.L.J.); (M.K.); (B.V.); (M.B.); (F.I.S.); (A.P.); (S.B.); (P.M.-H.); (B.S.)
| | - Melinda Boussoussou
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (Á.L.J.); (M.K.); (B.V.); (M.B.); (F.I.S.); (A.P.); (S.B.); (P.M.-H.); (B.S.)
| | - Ferenc Imre Suhai
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (Á.L.J.); (M.K.); (B.V.); (M.B.); (F.I.S.); (A.P.); (S.B.); (P.M.-H.); (B.S.)
| | - Alexisz Panajotu
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (Á.L.J.); (M.K.); (B.V.); (M.B.); (F.I.S.); (A.P.); (S.B.); (P.M.-H.); (B.S.)
| | - Judit Csőre
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (J.C.); (D.M.F.); (C.C.-N.); (B.M.)
| | - Sarolta Borzsák
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (Á.L.J.); (M.K.); (B.V.); (M.B.); (F.I.S.); (A.P.); (S.B.); (P.M.-H.); (B.S.)
| | | | - Csaba Csobay-Novák
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (J.C.); (D.M.F.); (C.C.-N.); (B.M.)
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (J.C.); (D.M.F.); (C.C.-N.); (B.M.)
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (Á.L.J.); (M.K.); (B.V.); (M.B.); (F.I.S.); (A.P.); (S.B.); (P.M.-H.); (B.S.)
- Medical Imaging Centre, Semmelweis University, 1082 Budapest, Hungary
| | - Bálint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (Á.L.J.); (M.K.); (B.V.); (M.B.); (F.I.S.); (A.P.); (S.B.); (P.M.-H.); (B.S.)
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The effect of scan and patient parameters on the diagnostic performance of AI for detecting coronary stenosis on coronary CT angiography. Clin Imaging 2022; 84:149-158. [DOI: 10.1016/j.clinimag.2022.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 11/23/2022]
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Validation of Second-Generation Motion-Correction Software for Computed Tomography Coronary Angiography With Novel Quantitative Approach. J Comput Assist Tomogr 2021; 45:403-407. [PMID: 33797442 DOI: 10.1097/rct.0000000000001145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Computed tomography of the coronary arteries (CTCA) is an important diagnostic tool. However, motion degradation is sometimes a challenge to interpretation and quantification, particularly with elevated heart rates. Here, a novel quantitative method is presented as part of an evaluation of one particular motion correction algorithm. METHODS Computed tomography of the coronary arteries scans from 49 patients, with heart rates of >70 bpm, were identified with motion artifacts in multiple coronary segments. At these foci (196), an objective measure of motion degradation, defined here by cross-section eccentricity, was determined before and after image processing with second-generation GE SnapShot Freeze software (SSF-2.0). In addition, a subjective scoring was applied by an expert cardiothoracic radiologist both before and after processing. RESULTS An overall decrease in vessel eccentricity strongly correlated (P < 0.001) with processing of the images by motion-correction software. A concurrent overall increase in subjective vessel clarity correlated (P < 0.001) with application of the software as well. CONCLUSIONS A novel quantitative method (and subjective analysis) for evaluation of CTCA motion has been described and applied to validation of SSF-2.0 motion-correction software. Both the technique and software demonstrate promise for robust clinical utility in CTCA evaluation.
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10
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Chen Z, Contijoch F, Schluchter A, Grady L, Schaap M, Stayman W, Pack J, McVeigh E. Precise measurement of coronary stenosis diameter with CCTA using CT number calibration. Med Phys 2019; 46:5514-5527. [PMID: 31603567 PMCID: PMC7700731 DOI: 10.1002/mp.13862] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/26/2019] [Accepted: 10/03/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Coronary x-ray computed tomography angiography (CCTA) continues to develop as a noninvasive method for the assessment of coronary vessel geometry and the identification of physiologically significant lesions. The uncertainty of quantitative lesion diameter measurement due to limited spatial resolution and vessel motion reduces the accuracy of CCTA diagnoses. In this paper, we introduce a new technique called computed tomography (CT)-number-Calibrated Diameter to improve the accuracy of the vessel and stenosis diameter measurements with CCTA. METHODS A calibration phantom containing cylindrical holes (diameters spanning from 0.8 mm through 4.0 mm) capturing the range of diameters found in human coronary vessels was three-dimensional printed. We also printed a human stenosis phantom with 17 tubular channels having the geometry of lesions derived from patient data. We acquired CT scans of the two phantoms with seven different imaging protocols. Calibration curves relating vessel intraluminal maximum voxel value (maximum CT number of a voxel, described in Hounsfield Units, HU) to true diameter, and full-width-at-half maximum (FWHM) to true diameter were constructed for each CCTA protocol. In addition, we acquired scans with a small constant motion (15 mm/s) and used a motion correction reconstruction (Snapshot Freeze) algorithm to correct motion artifacts. We applied our technique to measure the lesion diameter in the 17 lesions in the stenosis phantom and compared the performance of CT-number-Calibrated Diameter to the ground truth diameter and a FWHM estimate. RESULTS In all cases, vessel intraluminal maximum voxel value vs diameter was found to have a simple functional form based on the two-dimensional point spread function yielding a constant maximum voxel value region above a cutoff diameter, and a decreasing maximum voxel value vs decreasing diameter below a cutoff diameter. After normalization, focal spot size and reconstruction kernel were the principal determinants of cutoff diameter and the rate of maximum voxel value reduction vs decreasing diameter. The small constant motion had a significant effect on the CT number calibration; however, the motion-correction algorithm returned the maximum voxel value vs diameter curve to that of stationary vessels. The CT number Calibration technique showed better performance than FWHM estimation of diameter, yielding a high accuracy in the tested range (0.8 mm through 2.5 mm). We found a strong linear correlation between the smallest diameter in each of 17 lesions measured by CT-number-Calibrated Diameter (DC ) and ground truth diameter (Dgt ), (DC = 0.951 × Dgt + 0.023 mm, r = 0.998 with a slope very close to 1.0 and intercept very close to 0 mm. CONCLUSIONS Computed tomography-number-Calibrated Diameter is an effective method to enhance the accuracy of the estimate of small vessel diameters and degree of coronary stenosis in CCTA.
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Affiliation(s)
- Zhennong Chen
- Department of Bioengineering, UC San Diego School of Engineering, La Jolla CA 92037-0412
| | - Francisco Contijoch
- Department of Bioengineering, UC San Diego School of Engineering, La Jolla CA 92037-0412
- Department of Radiology, UC San Diego School of Medicine, La Jolla CA 92123
| | - Andrew Schluchter
- Department of Bioengineering, UC San Diego School of Engineering, La Jolla CA 92037-0412
| | - Leo Grady
- HeartFlow, Inc, Redwood City, CA 94063
| | | | - Web Stayman
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore MD 21205
| | - Jed Pack
- GE Global Research, Niskayuna, NY
| | - Elliot McVeigh
- Department of Bioengineering, UC San Diego School of Engineering, La Jolla CA 92037-0412
- Department of Radiology, UC San Diego School of Medicine, La Jolla CA 92123
- Department of Cardiology, UC San Diego School of Medicine, La Jolla CA 92123
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Yang CC, Law WY, Lu KM, Wu TH. Relationship between heart rate and optimal reconstruction phase in coronary CT angiography performed on a 256-slice multidetector CT. Br J Radiol 2019; 92:20180945. [PMID: 31322906 DOI: 10.1259/bjr.20180945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the relationship between heart rate (HR) and optimal reconstruction phase in prospectively electrocardiogram (ECG)-triggered coronary CT angiography (CCTA) performed on a newly introduced 256-slice multidetector CT (MDCT). METHODS All the cases were selected retrospectively from the patients scheduled for CCTA in our department between January and April 2017. The scanner selected the optimal exposure phase based on 10 s ECG recordings. To ensure the success of CCTA, the operator also checked patient's age, breathing control, emotional status and past medical history to decide whether the automatically selected scan phase needs manual adjustment or not. Images were reconstructed in 1% steps of the R-R interval to determine the cardiac phase with least coronary motion. If CCTA images showed moderate motion blurring or discontinuity in the course of coronary segments, a cardiac motion correction algorithm was applied to the reconstructed images. Subjective diagnostic image quality was evaluated with 4-point grading scale. RESULTS A total of 87 consecutive CCTA examinations were investigated in this study. Diastolic reconstruction was applied to all vessel segments in patients with HR <63 bpm, where 36.5 and 77.8% of vessel segments were reconstructed with the use of motion correction in HR ≤57 and 58-62 bpm, respectively. As for patients with HR ≥63 bpm, 89.3 and 71.7% of vessel segments were reconstructed in diastole in HR 63-67 and ≥68 bpm, respectively, while 81 and 100% of vessel segments were reconstructed with the use of motion correction in the same HR groups. CONCLUSION Based on our results, a HR less than 67 bpm can be used to identify appropriate patients for diastolic reconstruction. Although the motion correction algorithm is an effective approach to reduce the impact of cardiac motion in CCTA, HR control is still important to optimize the image quality of CCTA. The relationship between HR and optimal reconstruction phase established in this study could be further used to tailor the ECG pulsing window for dose reduction in patients undergoing CCTA performed on the 256-slice MDCT. ADVANCES IN KNOWLEDGE The HR thresholds to identify patients who are the best suitable candidates for diastolic or systolic reconstruction are scanner specific. This study investigated the relationship between HR and optimal reconstruction phase in prospectively ECG-triggered CCTA for a newly introduced 256-slice MDCT. Once the relationship is established, it could be used to tailor the ECG pulsing window for radiation dose reduction.
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Affiliation(s)
- Ching-Ching Yang
- 1Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Yip Law
- 2Department of Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Kun-Mu Lu
- 2Department of Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Tung-Hsin Wu
- 3Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
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Diagnostic performance of free-breathing coronary computed tomography angiography without heart rate control using 16-cm z-coverage CT with motion-correction algorithm. J Cardiovasc Comput Tomogr 2019; 13:113-117. [DOI: 10.1016/j.jcct.2019.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/14/2018] [Accepted: 01/03/2019] [Indexed: 11/17/2022]
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Second-generation motion correction algorithm improves diagnostic accuracy of single-beat coronary CT angiography in patients with increased heart rate. Eur Radiol 2019; 29:4215-4227. [PMID: 30617487 DOI: 10.1007/s00330-018-5929-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/05/2018] [Accepted: 11/28/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To assess the effect of a second-generation motion correction algorithm on the diagnostic accuracy of coronary computed tomography angiography (CCTA) using a 256-detector row CT in patients with increased heart rates. METHODS Eighty-one consecutive symptomatic cardiac patients with increased heart rates (≥ 75 beats per min) were enrolled. All patients underwent CCTA and invasive coronary angiography (ICA). CCTA was performed with a 256-detector row CT using prospectively ECG-triggered single-beat protocol. Images were reconstructed using standard (STD) algorithm, first-generation intra-cycle motion correction (MC1) algorithm, and second-generation intra-cycle motion correction (MC2) algorithm. The image quality of coronary artery segments was assessed by two experienced radiologists using a 4-point scale (1: non-diagnostic and 4: excellent), according to the 18-segment model. Diagnostic performance for segments with significant lumen stenosis (≥ 50%) was compared between STD, MC1, and MC2 by using ICA as the reference standard. RESULTS The mean effective dose of CCTA was 1.0 mSv. On per-segment level, the overall image quality score and interpretability were improved to 3.56 ± 0.63 and 99.2% due to the use of MC2, as compared to 2.81 ± 0.85 and 92.5% with STD and 3.21 ± 0.79 and 97.2% with MC1. On per-segment level, compared to STD and MC1, MC2 improved the sensitivity (92.2% vs. 79.2%, 80.7%), specificity (97.8% vs. 82.1%, 90.8%), positive predictive value (89.9% vs. 48.4%, 65.1%), negative predictive value (98.3% vs. 94.9%, 95.7%), and diagnostic accuracy (96.8% vs. 81.5%, 89.0%). CONCLUSION A second-generation intra-cycle motion correction algorithm for single-beat CCTA significantly improves image quality and diagnostic accuracy in patients with increased heart rate. KEY POINTS • A second-generation motion correction (MC2) algorithm can further improve the image quality of all coronary arteries than a first-generation motion correction (MC1). • MC2 algorithm can significantly reduce the number of false positive segments compared to standard and MC1 algorithm.
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Kruggel F. A Simple Measure for Acuity in Medical Images. IEEE TRANSACTIONS ON IMAGE PROCESSING : A PUBLICATION OF THE IEEE SIGNAL PROCESSING SOCIETY 2018; 27:5225-5233. [PMID: 29994711 DOI: 10.1109/tip.2018.2851673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
An automatic and objective assessment of image quality is important in an era, where large-scale processing of imaging data from multi-center studies becomes commonplace. Based on a comprehensive statistical image model that includes noise and blur, a measure for image acuity is derived here as the ratio of the maximal gradient magnitude and the intensity difference at a boundary. Acuity may be affected by the object under study, the image acquisition, reconstruction processes, and any post-processing steps. The acuity measure presented here is post-hoc, intuitive to understand, simple to compute, and easily integrates with other standard measures of image quality. Three applications in medical imaging are included where our acuity measure is useful in the objective and automatic assessment of image quality.
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Diagnostic Performance of a Novel Coronary CT Angiography Algorithm: Prospective Multicenter Validation of an Intracycle CT Motion Correction Algorithm for Diagnostic Accuracy. AJR Am J Roentgenol 2018; 210:1208-1215. [PMID: 29667891 DOI: 10.2214/ajr.17.18670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Motion artifact can reduce the diagnostic accuracy of coronary CT angiography (CCTA) for coronary artery disease (CAD). The purpose of this study was to compare the diagnostic performance of an algorithm dedicated to correcting coronary motion artifact with the performance of standard reconstruction methods in a prospective international multicenter study. SUBJECTS AND METHODS Patients referred for clinically indicated invasive coronary angiography (ICA) for suspected CAD prospectively underwent an investigational CCTA examination free from heart rate-lowering medications before they underwent ICA. Blinded core laboratory interpretations of motion-corrected and standard reconstructions for obstructive CAD (≥ 50% stenosis) were compared with ICA findings. Segments unevaluable owing to artifact were considered obstructive. The primary endpoint was per-subject diagnostic accuracy of the intracycle motion correction algorithm for obstructive CAD found at ICA. RESULTS Among 230 patients who underwent CCTA with the motion correction algorithm and standard reconstruction, 92 (40.0%) had obstructive CAD on the basis of ICA findings. At a mean heart rate of 68.0 ± 11.7 beats/min, the motion correction algorithm reduced the number of nondiagnostic scans compared with standard reconstruction (20.4% vs 34.8%; p < 0.001). Diagnostic accuracy for obstructive CAD with the motion correction algorithm (62%; 95% CI, 56-68%) was not significantly different from that of standard reconstruction on a per-subject basis (59%; 95% CI, 53-66%; p = 0.28) but was superior on a per-vessel basis: 77% (95% CI, 74-80%) versus 72% (95% CI, 69-75%) (p = 0.02). The motion correction algorithm was superior in subgroups of patients with severely obstructive (≥ 70%) stenosis, heart rate ≥ 70 beats/min, and vessels in the atrioventricular groove. CONCLUSION The motion correction algorithm studied reduces artifacts and improves diagnostic performance for obstructive CAD on a per-vessel basis and in selected subgroups on a per-subject basis.
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Image Quality, Overall Evaluability, and Effective Radiation Dose of Coronary Computed Tomography Angiography With Prospective Electrocardiographic Triggering Plus Intracycle Motion Correction Algorithm in Patients With a Heart Rate Over 65 Beats Per Minute. J Thorac Imaging 2018; 33:225-231. [PMID: 29346192 DOI: 10.1097/rti.0000000000000320] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Recently, a new intracycle motion correction algorithm (MCA) was introduced to reduce motion artifacts from heart rate (HR) in coronary computed tomography angiography (cCTA). The aim of the study was to evaluate the image quality, overall evaluability, and effective radiation dose (ED) of cCTA with prospective electrocardiographic (ECG) triggering plus MCA as compared with standard protocol with retrospective ECG triggering in patients with HR≥65 bpm. MATERIALS AND METHODS One hundred consecutive patients (67±10 y) scheduled for cCTA with 65<HR<80 bpm were retrospectively analyzed. The patients were assigned to 2 groups undergoing prospective (group 1) or retrospective (group 2) triggered cCTA. The study protocol was approved by the Institutional Ethics Committee and a written informed consent was obtained from all patients. Image noise, signal to noise ratio, contrast to noise ratio, Likert image quality score (score 1, nondiagnostic; score 2, adequate; score 3, good; score 4, excellent), overall image evaluability, and ED were measured and compared between the 2 groups. Both vessel-based and patient-based analyses were evaluated. Student test or Wilcoxon test were used to evaluate differences of continuous variables, whereas the χ test was used to study differences with regard to categorical data. A P-value <0.05 was considered statistically significant. RESULTS cCTA was successfully performed in all patients. In a segment-based model, group 1 compared with group 2 showed a lower rate of overall artifacts (67% vs. 83%; P<0.001) and motion artifacts (49% vs. 66%; P<0.001), resulting in a better Likert image quality score (2.83±1.03 vs. 2.37±1.02; P<0.01) and overall evaluability (85% vs. 75%; P<0.01). Group 1 showed a lower ED as compared with group 2 (3.1±1.9 vs. 11.9±3.3 mSv; P<0.01). CONCLUSION MCA and cCTA with prospective ECG-triggering acquisition in patients with high HR improves image quality and overall evaluability compared with cCTA with standard retrospective ECG triggering.
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Impact of SSF on Diagnostic Performance of Coronary Computed Tomography Angiography Within 1 Heart Beat in Patients With High Heart Rate Using a 256-Row Detector Computed Tomography. J Comput Assist Tomogr 2018; 42:54-61. [DOI: 10.1097/rct.0000000000000641] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Reduction of Coronary Motion Artifacts in Prospectively Electrocardiography-Gated Coronary Computed Tomography Angiography Using Monochromatic Imaging at Various Energy Levels in Combination With a Motion Correction Algorithm on Single-Source Fast Tube Voltage Switching Dual-Energy Computed Tomography: A Phantom Experiment. Invest Radiol 2017; 51:513-9. [PMID: 27257865 DOI: 10.1097/rli.0000000000000263] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to assess the effect of monochromatic imaging at various energy levels in combination with a motion correction algorithm (MCA) in single-source dual-energy coronary computed tomography angiography (CCTA) with fast switching of tube voltage on the reduction of coronary motion artifacts (CMA) in a phantom setting. MATERIALS AND METHODS Using this dual-energy computed tomography technique with a phantom comprising models of coronary vessels filled with contrast medium and pulsating at constant heart rates of 60 to 100 beats per minute, we reconstructed monochromatic images of CCTA obtained at 50 to 90 keV with and without use of MCA. Cardiac motion was modeled by simulating the in vivo time-volume curve of the left ventricle. Two independent readers graded CMA in 9 coronary segments using a 5-point scale (1, poor; 3 to 5, interpretable; 5, excellent). At each heart rate, we compared the average score of CMA between images obtained at 50 to 90 keV with and without use of MCA using Wilcoxon signed rank test, and we compared the score among images obtained at 50 to 90 keV with use of MCA using Kruskal-Wallis and post hoc tests. We also compared the percentages of image interpretability and improvement in image interpretability among images obtained at 50 to 90 keV with use of MCA. RESULTS With the use of MCA, the average score of CMA was significantly higher for images obtained at each energy level from 50 to 70 keV (P < 0.05) and was comparable at 80 and 90 keV, and it was comparable among those obtained at 50 to 70 keV. With its use, the percentages of image interpretability were similarly high at 50 to 70 keV at 60 to 80 beats per minute (78%-100%), and they were higher at 50 to 60 keV (72%-83%) than at 70 keV at 90 to 100 beats per minute (50%-56%). The percentages of improved image interpretability with MCA were similarly high at 50 to 70 keV at 60 to 80 beats per minute (56%-100%), and they were higher at 50 to 60 keV (62%-77%) than at 70 keV at 90 to 100 beats per minute (36%-43%). The percentages of image interpretability and improved image interpretability with MCA were insufficient at 80 and 90 keV. CONCLUSIONS Coronary motion artifacts were significantly reduced in images of monochromatic CCTA obtained at 50 to 70 keV in combination with MCA compared with those obtained without MCA, and the percentages of image interpretability and improved image interpretability with use of MCA were relatively high at 50 to 70 keV, and particularly at 50 to 60 keV, even at 90 to 100 beats per minute.
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Xing Y, Zhao Y, Guo N, Pan CX, Azati G, Wang YW, Liu WY. Effect of a Novel Intracycle Motion Correction Algorithm on Dual-Energy Spectral Coronary CT Angiography: A Study with Pulsating Coronary Artery Phantom at High Heart Rates. Korean J Radiol 2017; 18:881-887. [PMID: 29089820 PMCID: PMC5639153 DOI: 10.3348/kjr.2017.18.6.881] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 05/02/2017] [Indexed: 02/02/2023] Open
Abstract
Objective Using a pulsating coronary artery phantom at high heart rate settings, we investigated the efficacy of a motion correction algorithm (MCA) to improve the image quality in dual-energy spectral coronary CT angiography (CCTA). Materials and Methods Coronary flow phantoms were scanned at heart rates of 60–100 beats/min at 10-beats/min increments, using dual-energy spectral CT mode. Virtual monochromatic images were reconstructed from 50 to 90 keV at 10-keV increments. Two blinded observers assessed image quality using a 4-point Likert Scale (1 = non-diagnostic, 4 = excellent) and the fraction of interpretable segments using MCA versus conventional algorithm (CA). Comparison of variables was performed with the Wilcoxon rank sum test and McNemar test. Results At heart rates of 70, 80, 90, and 100 beats/min, images with MCA were rated as higher image scores compared to those with CA on monochromatic levels of 50, 60, and 70 keV (each p < 0.05). Meanwhile, at a heart rate of 90 beats/min, image interpretability was improved by MCA at a monochromatic level of 60 keV (p < 0.05) and 70 keV (p < 0.05). At a heart rate of 100 beats/min, image interpretability was improved by MCA at monochromatic levels of 50 keV (from 69.4% to 86.1%, p < 0.05), 60 keV (from 55.6% to 83.3%, p < 0.05) and 70 keV (from 33.3% to 69.3%, p < 0.05). Conclusion Low-keV monochromatic images combined with MCA improves image quality and image interpretability in CCTAs at high heart rates.
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Affiliation(s)
- Yan Xing
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China
| | - Yuan Zhao
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China
| | - Ning Guo
- CT Imaging Research Center, GE Healthcare, Beijing 100176, China
| | - Cun-Xue Pan
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China
| | - Gulina Azati
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China
| | - Yan-Wei Wang
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China
| | - Wen-Ya Liu
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China
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Suh YJ, Kim YJ, Kim JY, Chang S, Im DJ, Hong YJ, Choi BW. A whole-heart motion-correction algorithm: Effects on CT image quality and diagnostic accuracy of mechanical valve prosthesis abnormalities. J Cardiovasc Comput Tomogr 2017; 11:474-481. [PMID: 28966103 DOI: 10.1016/j.jcct.2017.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/16/2017] [Accepted: 09/19/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND We aimed to determine the effect of a whole-heart motion-correction algorithm (new-generation snapshot freeze, NG SSF) on the image quality of cardiac computed tomography (CT) images in patients with mechanical valve prostheses compared to standard images without motion correction and to compare the diagnostic accuracy of NG SSF and standard CT image sets for the detection of prosthetic valve abnormalities. METHODS A total of 20 patients with 32 mechanical valves who underwent wide-coverage detector cardiac CT with single-heartbeat acquisition were included. The CT image quality for subvalvular (below the prosthesis) and valvular regions (valve leaflets) of mechanical valves was assessed by two observers on a four-point scale (1 = poor, 2 = fair, 3 = good, and 4 = excellent). Paired t-tests or Wilcoxon signed rank tests were used to compare image quality scores and the number of diagnostic phases (image quality score≥3) between the standard image sets and NG SSF image sets. Diagnostic performance for detection of prosthetic valve abnormalities was compared between two image sets with the final diagnosis set by re-operation or clinical findings as the standard reference. RESULTS NG SSF image sets had better image quality scores than standard image sets for both valvular and subvalvular regions (P < 0.05 for both). The number of phases that were of diagnostic image quality per patient was significantly greater in the NG SSF image set than standard image set for both valvular and subvalvular regions (P < 0.0001). Diagnostic performance of NG SSF image sets for the detection of prosthetic abnormalities (20 pannus and two paravalvular leaks) was greater than that of standard image sets (P < 0.05). CONCLUSION Application of NG SSF can improve CT image quality and diagnostic accuracy in patients with mechanical valves compared to standard images.
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Affiliation(s)
- Young Joo Suh
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Young Jin Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea.
| | - Jin Young Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Suyon Chang
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Dong Jin Im
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Yoo Jin Hong
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Byoung Wook Choi
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
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Contijoch F, Stayman JW, McVeigh ER. The impact of small motion on the visualization of coronary vessels and lesions in cardiac CT: A simulation study. Med Phys 2017; 44:3512-3524. [PMID: 28432820 DOI: 10.1002/mp.12295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 02/27/2017] [Accepted: 04/16/2017] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Coronary x-ray computed tomography angiography (CCTA) is used to non-invasively assess coronary artery geometry and has, combined with computational modeling, demonstrated the potential to identify physiologically significant lesions. These measurements require robust and accurate coronary imaging and delineation of vessels despite the presence of small motion. This simulation study characterizes the impact of small, uncorrected vessel drifts during data acquisition on the assessment of vessel intensity, diameter, and shape. METHODS We developed a digital phantom and simulated projection data for a clinical scanner geometry for a range of vessel drifts that can occur during relative vessel stasis (0 to 2 mm per 360° gantry rotation) for vessels between 0.2 and 3.0 mm in diameter (covering 0% through 93% stenosis of a 3 mm vessel). In addition to the impact of vessel drift, we evaluated the performance of half-scan acquisitions (relative to full-scans) over a range of gantry positions. The performance of FDK reconstructions was compared to an iterative technique and potential improvement in sampling from focal spot deflection and quarter detector offset was compared. RESULTS At rest, vessel intensity and diameter were accurately obtained in vessels greater than 1.5 mm with all vessels appearing circular in shape (major-to-minor axis ratio ~1). Vessels between 1.5 and 0.2 mm in diameter demonstrated a rapid decrease in signal intensity with full width half maximum (FWHM) vessel diameters remaining above 0.75 mm as true vessel diameter decreased. Uncorrected vessel motion resulted in decreased vessel intensity, increased vessel diameter, and distortion of vessel shape. The extent of these changes depended on both the position of the gantry as well as the reconstruction approach (half- vs. full-scan). FDK reconstruction results depended on choice of filter with Ram-Lak results yielding comparable performance to an unconstrained iterative reconstruction. Focal spot deflection and quarter detector offset did not result in large changes in performance, likely due to the high sampling density near the isocenter. CONCLUSIONS Despite improvement in gantry speed and acquisition of coronary images during cardiac phases that have relatively stationary vessels, small coronary drifts (0-2 mm per 360° rotation) have been reported and if uncorrected, can present challenges to visual grading and computational modeling of stenoses because vessels will appear dimmer, larger, and more ellipsoidal in shape. The impact of a particular motion depends on the gantry position, the use of half vs. full-scan acquisitions, and the reconstruction technique.
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Affiliation(s)
- Francisco Contijoch
- Department of Medicine, Division of Cardiology, UC San Diego School of Medicine, La Jolla, CA, 92123, USA
| | - J Webster Stayman
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Elliot R McVeigh
- Department of Medicine, Division of Cardiology, UC San Diego School of Medicine, La Jolla, CA, 92123, USA.,Department of Bioengineering, UC San Diego School of Engineering, La Jolla, CA, 92037-0412, USA.,Department of Radiology, UC San Diego School of Medicine, La Jolla, CA, 92123, USA
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Sheta HM, Egstrup K, Husic M, Heinsen LJ, Nieman K, Lambrechtsen J. Impact of a motion correction algorithm on image quality in patients undergoing CT angiography: A randomized controlled trial. Clin Imaging 2016; 42:1-6. [PMID: 27838576 DOI: 10.1016/j.clinimag.2016.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/20/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
Abstract
AIMS To investigate the motion correction algorithm Snapshot-Freeze (SSF) compared to standard reconstruction (STD) in patients randomized to receive beta-blockers (BB) or no beta-blockers (non-BB) before coronary CT, and to investigate if SSF can replace BB. METHODS One hundred and forty patients scheduled for coronary CT were randomized. All images were reconstructed by the SSF and STD algorithms. Image quality was evaluated according to Likert score (1: excellent, 2: good, 3: adequate, 4: non-diagnostic) and presence of artifacts was noted. RESULTS Images from 64 patients in the BB group (mean HR 56±4bpm) and 51 patients in the non-BB group (mean HR 67±7bpm) were analyzed. Twenty five patients were excluded because of tachycardia, bradycardia or reconstruction errors in SSF. SSF increased the number of excellent images in both groups compared to the STD algorithm (BB: 59% vs.44%; non-BB: 25% vs. 8%), but the number of non-diagnostic images was not significantly reduced. SSF reduced motion artifacts (BB: 11% vs. 31%; non-BB: 49% vs. 75%), but despite this reduction, motion artifacts in non-BB were still more frequent compared to the BB group analyzed by STD (49% vs. 31%). CONCLUSION SSF improves image quality and reduces motion artifacts, but does not compensate for the absence of BB.
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Affiliation(s)
- Hussam M Sheta
- Department of Medical Research, OUH Svendborg Hospital, Institute of Regional Health Research, Valdemarsgade 53, 5700 Svendborg, Denmark.
| | - Kenneth Egstrup
- Department of Medical Research, OUH Svendborg Hospital, Institute of Regional Health Research, Valdemarsgade 53, 5700 Svendborg, Denmark
| | - Mirza Husic
- Department of Medical Research, OUH Svendborg Hospital, Institute of Regional Health Research, Valdemarsgade 53, 5700 Svendborg, Denmark
| | - Laurits J Heinsen
- Department of Medical Research, OUH Svendborg Hospital, Institute of Regional Health Research, Valdemarsgade 53, 5700 Svendborg, Denmark
| | - Koen Nieman
- Erasmus University Medical Centre Rotterdam, 's-Gravendijkwal 230, 3015 CE Rotterdam, Netherlands
| | - Jess Lambrechtsen
- Institute of Regional Health Research, OUH Svendborg Sygehus, Valdemarsgade 53, 5700 Svendborg, Denmark
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Tan SK, Yeong CH, Ng KH, Abdul Aziz YF, Sun Z. Recent Update on Radiation Dose Assessment for the State-of-the-Art Coronary Computed Tomography Angiography Protocols. PLoS One 2016; 11:e0161543. [PMID: 27552224 PMCID: PMC4994944 DOI: 10.1371/journal.pone.0161543] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/08/2016] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES This study aimed to measure the absorbed doses in selected organs for prospectively ECG-triggered coronary computed tomography angiography (CCTA) using five different generations CT scanners in a female adult anthropomorphic phantom and to estimate the effective dose (HE). MATERIALS AND METHODS Prospectively ECG-triggered CCTA was performed using five commercially available CT scanners: 64-detector-row single source CT (SSCT), 2 × 32-detector-row-dual source CT (DSCT), 2 × 64-detector-row DSCT and 320-detector-row SSCT scanners. Absorbed doses were measured in 34 organs using pre-calibrated optically stimulated luminescence dosimeters (OSLDs) placed inside a standard female adult anthropomorphic phantom. HE was calculated from the measured organ doses and compared to the HE derived from the air kerma-length product (PKL) using the conversion coefficient of 0.014 mSv∙mGy-1∙cm-1 for the chest region. RESULTS Both breasts and lungs received the highest radiation dose during CCTA examination. The highest HE was received from 2 × 32-detector-row DSCT scanner (6.06 ± 0.72 mSv), followed by 64-detector-row SSCT (5.60 ± 0.68 and 5.02 ± 0.73 mSv), 2 × 64-detector-row DSCT (1.88 ± 0.25 mSv) and 320-detector-row SSCT (1.34 ± 0.48 mSv) scanners. HE calculated from the measured organ doses were about 38 to 53% higher than the HE derived from the PKL-to-HE conversion factor. CONCLUSION The radiation doses received from a prospectively ECG-triggered CCTA are relatively small and are depending on the scanner technology and imaging protocols. HE as low as 1.34 and 1.88 mSv can be achieved in prospectively ECG-triggered CCTA using 320-detector-row SSCT and 2 × 64-detector-row DSCT scanners.
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Affiliation(s)
- Sock Keow Tan
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Chai Hong Yeong
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Kwan Hoong Ng
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Yang Faridah Abdul Aziz
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Zhonghua Sun
- Department of Medical Radiation Sciences, Curtin University, Perth, WA 6845, Australia
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Aghayev A, Murphy DJ, Keraliya AR, Steigner ML. Recent developments in the use of computed tomography scanners in coronary artery imaging. Expert Rev Med Devices 2016; 13:545-53. [PMID: 27140944 DOI: 10.1080/17434440.2016.1184968] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Within the past decade, substantial evolution of Coronary CT Angiography (CCTA) has affected evaluation and management of coronary artery disease. In particular, technical advancement of hardware technology and image reconstruction of CT scanners have played an important role in this context making it possible to acquire abundant data with excellent temporal and spatial resolution within a shorter scan time. In addition, a concern related to the high radiation exposure in the initial noninvasive coronary artery imaging has triggered improvement in dose reduction techniques. AREAS COVERED In this review article, we have focused on recent technological developments in CT scanners and the impact of these developments on CCTA parameters. Expert Commentary: CCTA plays an important role in coronary artery disease management, and technical development of the CT scanners can be expected to address and remedy technical limitations.
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Affiliation(s)
- Ayaz Aghayev
- a Department of Radiology , Brigham and Women's Hospital , Boston , MA , USA
| | - David J Murphy
- a Department of Radiology , Brigham and Women's Hospital , Boston , MA , USA
| | - Abhishek R Keraliya
- a Department of Radiology , Brigham and Women's Hospital , Boston , MA , USA
| | - Michael L Steigner
- a Department of Radiology , Brigham and Women's Hospital , Boston , MA , USA
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FitzGerald P, Bennett J, Carr J, Edic PM, Entrikin D, Gao H, Iatrou M, Jin Y, Liu B, Wang G, Wang J, Yin Z, Yu H, Zeng K, De Man B. Cardiac CT: A system architecture study. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2016; 24:43-65. [PMID: 26890906 PMCID: PMC7017544 DOI: 10.3233/xst-160537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND We are interested in exploring dedicated, high-performance cardiac CT systems optimized to provide the best tradeoff between system cost, image quality, and radiation dose. OBJECTIVE We sought to identify and evaluate a broad range of CT architectures that could provide an optimal, dedicated cardiac CT solution. METHODS We identified and evaluated thirty candidate architectures using consistent design choices. We defined specific evaluation metrics related to cost and performance. We then scored the candidates versus the defined metrics. Lastly, we applied a weighting system to combine scores for all metrics into a single overall score for each architecture. CT experts with backgrounds in cardiovascular radiology, x-ray physics, CT hardware and CT algorithms performed the scoring and weighting. RESULTS We found nearly a twofold difference between the most and the least promising candidate architectures. Architectures employed by contemporary commercial diagnostic CT systems were among the highest-scoring candidates. We identified six architectures that show sufficient promise to merit further in-depth analysis and comparison. CONCLUSION Our results suggest that contemporary diagnostic CT system architectures outperform most other candidates that we evaluated, but the results for a few alternatives were relatively close. We selected six representative high-scoring candidates for more detailed design and further comparative evaluation.
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Affiliation(s)
- Paul FitzGerald
- CT Systems and Applications Laboratory, GE Global Research Center, 1 Research Circle, Niskayuna, NY, USA
- Corresponding author: Paul FitzGerald, 1 Research Circle, Niskayuna, NY 12309, USA. Tel.: +1 518 387 7752; Fax: +1 518 387 5975;
| | - James Bennett
- Biomedical Imaging Division, VT-WFU School of Biomedical Engineering and Sciences, Virginia Tech., Blacksburg, VA, USA
| | - Jeffrey Carr
- Department of Radiology, Division of Radiologic Sciences, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Peter M. Edic
- CT Systems and Applications Laboratory, GE Global Research Center, 1 Research Circle, Niskayuna, NY, USA
| | - Daniel Entrikin
- Department of Radiology, Division of Radiologic Sciences, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Hewei Gao
- CT Systems and Applications Laboratory, GE Global Research Center, 1 Research Circle, Niskayuna, NY, USA
| | - Maria Iatrou
- CT Systems and Applications Laboratory, GE Global Research Center, 1 Research Circle, Niskayuna, NY, USA
| | - Yannan Jin
- CT Systems and Applications Laboratory, GE Global Research Center, 1 Research Circle, Niskayuna, NY, USA
| | - Baodong Liu
- Department of Radiology, Division of Radiologic Sciences, Wake Forest University Health Sciences, Winston-Salem, NC, USA
- Biomedical Imaging Division, VT-WFU School of Biomedical Engineering and Sciences, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Ge Wang
- Biomedical Imaging Division, VT-WFU School of Biomedical Engineering and Sciences, Virginia Tech., Blacksburg, VA, USA
- Biomedical Imaging Division, VT-WFU School of Biomedical Engineering and Sciences, Wake Forest University Health Sciences, Winston-Salem, NC, USA
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Jiao Wang
- CT Systems and Applications Laboratory, GE Global Research Center, 1 Research Circle, Niskayuna, NY, USA
| | - Zhye Yin
- CT Systems and Applications Laboratory, GE Global Research Center, 1 Research Circle, Niskayuna, NY, USA
| | - Hengyong Yu
- Department of Radiology, Division of Radiologic Sciences, Wake Forest University Health Sciences, Winston-Salem, NC, USA
- Biomedical Imaging Division, VT-WFU School of Biomedical Engineering and Sciences, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Kai Zeng
- CT Systems and Applications Laboratory, GE Global Research Center, 1 Research Circle, Niskayuna, NY, USA
| | - Bruno De Man
- CT Systems and Applications Laboratory, GE Global Research Center, 1 Research Circle, Niskayuna, NY, USA
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Improvement of Image Quality and Diagnostic Performance by an Innovative Motion-Correction Algorithm for Prospectively ECG Triggered Coronary CT Angiography. PLoS One 2015; 10:e0142796. [PMID: 26571417 PMCID: PMC4646467 DOI: 10.1371/journal.pone.0142796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 10/27/2015] [Indexed: 11/19/2022] Open
Abstract
Objective To investigate the effect of a novel motion-correction algorithm (Snap-short Freeze, SSF) on image quality and diagnostic accuracy in patients undergoing prospectively ECG-triggered CCTA without administering rate-lowering medications. Materials and Methods Forty-six consecutive patients suspected of CAD prospectively underwent CCTA using prospective ECG-triggering without rate control and invasive coronary angiography (ICA). Image quality, interpretability, and diagnostic performance of SSF were compared with conventional multisegment reconstruction without SSF, using ICA as the reference standard. Results All subjects (35 men, 57.6 ± 8.9 years) successfully underwent ICA and CCTA. Mean heart rate was 68.8±8.4 (range: 50–88 beats/min) beats/min without rate controlling medications during CT scanning. Overall median image quality score (graded 1–4) was significantly increased from 3.0 to 4.0 by the new algorithm in comparison to conventional reconstruction. Overall interpretability was significantly improved, with a significant reduction in the number of non-diagnostic segments (690 of 694, 99.4% vs 659 of 694, 94.9%; P<0.001). However, only the right coronary artery (RCA) showed a statistically significant difference (45 of 46, 97.8% vs 35 of 46, 76.1%; P = 0.004) on a per-vessel basis in this regard. Diagnostic accuracy for detecting ≥50% stenosis was improved using the motion-correction algorithm on per-vessel [96.2% (177/184) vs 87.0% (160/184); P = 0.002] and per-segment [96.1% (667/694) vs 86.6% (601/694); P <0.001] levels, but there was not a statistically significant improvement on a per-patient level [97.8 (45/46) vs 89.1 (41/46); P = 0.203]. By artery analysis, diagnostic accuracy was improved only for the RCA [97.8% (45/46) vs 78.3% (36/46); P = 0.007]. Conclusion The intracycle motion correction algorithm significantly improved image quality and diagnostic interpretability in patients undergoing CCTA with prospective ECG triggering and no rate control.
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Wick CA, McClellan JH, Arepalli CD, Auffermann WF, Henry TS, Khosa F, Coy AM, Tridandapani S. Characterization of cardiac quiescence from retrospective cardiac computed tomography using a correlation-based phase-to-phase deviation measure. Med Phys 2015; 42:983-93. [PMID: 25652511 DOI: 10.1118/1.4906246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Accurate knowledge of cardiac quiescence is crucial to the performance of many cardiac imaging modalities, including computed tomography coronary angiography (CTCA). To accurately quantify quiescence, a method for detecting the quiescent periods of the heart from retrospective cardiac computed tomography (CT) using a correlation-based, phase-to-phase deviation measure was developed. METHODS Retrospective cardiac CT data were obtained from 20 patients (11 male, 9 female, 33-74 yr) and the left main, left anterior descending, left circumflex, right coronary artery (RCA), and interventricular septum (IVS) were segmented for each phase using a semiautomated technique. Cardiac motion of individual coronary vessels as well as the IVS was calculated using phase-to-phase deviation. As an easily identifiable feature, the IVS was analyzed to assess how well it predicts vessel quiescence. Finally, the diagnostic quality of the reconstructed volumes from the quiescent phases determined using the deviation measure from the vessels in aggregate and the IVS was compared to that from quiescent phases calculated by the CT scanner. Three board-certified radiologists, fellowship-trained in cardiothoracic imaging, graded the diagnostic quality of the reconstructions using a Likert response format: 1 = excellent, 2 = good, 3 = adequate, 4 = nondiagnostic. RESULTS Systolic and diastolic quiescent periods were identified for each subject from the vessel motion calculated using the phase-to-phase deviation measure. The motion of the IVS was found to be similar to the aggregate vessel (AGG) motion. The diagnostic quality of the coronary vessels for the quiescent phases calculated from the aggregate vessel (PAGG) and IVS (PIV S) deviation signal using the proposed methods was comparable to the quiescent phases calculated by the CT scanner (PCT). The one exception was the RCA, which improved for PAGG for 18 of the 20 subjects when compared to PCT (PCT = 2.48; PAGG = 2.07, p = 0.001). CONCLUSIONS A method for quantifying the motion of specific coronary vessels using a correlation-based, phase-to-phase deviation measure was developed and tested on 20 patients receiving cardiac CT exams. The IVS was found to be a suitable predictor of vessel quiescence. The diagnostic quality of the quiescent phases detected by the proposed methods was comparable to those calculated by the CT scanner. The ability to quantify coronary vessel quiescence from the motion of the IVS can be used to develop new CTCA gating techniques and quantify the resulting potential improvement in CTCA image quality.
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Affiliation(s)
- Carson A Wick
- School of Electrical and Computer Engineering, Georgia Institute of Technology, 777 Atlantic Drive Northwest, Atlanta, Georgia 30332
| | - James H McClellan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, 777 Atlantic Drive Northwest, Atlanta, Georgia 30332
| | - Chesnal D Arepalli
- Department of Radiology, University of British Columbia, 3350-950 West 10th Avenue, Vancouver, British Columbia V5Z 4E3, Canada
| | - William F Auffermann
- Department of Radiology and Imaging Sciences, Emory University, Division of Cardiothoracic Imaging, 1364 Clifton Road Northeast, Suite 309, Atlanta, Georgia 30322
| | - Travis S Henry
- Department of Radiology and Imaging Sciences, Emory University, Division of Cardiothoracic Imaging, 1364 Clifton Road Northeast, Suite 309, Atlanta, Georgia 30322
| | - Faisal Khosa
- Department of Radiology and Imaging Sciences, Emory University, Division of Emergency Radiology, 550 Peachtree Street Northeast, Atlanta, Georgia 30308
| | - Adam M Coy
- School of Medicine, Emory University, 100 Woodruff Circle, Atlanta, Georgia 30322
| | - Srini Tridandapani
- Department of Radiology and Imaging Sciences, Emory University, Winship Cancer Institute, 1701 Uppergate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 and School of Electrical and Computer Engineering, Georgia Institute of Technology, 777 Atlantic Drive Northwest, Atlanta, Georgia 30332
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Impact of an intra-cycle motion correction algorithm on overall evaluability and diagnostic accuracy of computed tomography coronary angiography. Eur Radiol 2015; 26:147-56. [PMID: 25953001 DOI: 10.1007/s00330-015-3793-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 03/15/2015] [Accepted: 04/13/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the impact of a novel intra-cycle motion correction algorithm (MCA) on overall evaluability and diagnostic accuracy of cardiac computed tomography coronary angiography (CCT). METHODS From a cohort of 900 consecutive patients referred for CCT for suspected coronary artery disease (CAD), we enrolled 160 (18 %) patients (mean age 65.3 ± 11.7 years, 101 male) with at least one coronary segment classified as non-evaluable for motion artefacts. The CCT data sets were evaluated using a standard reconstruction algorithm (SRA) and MCA and compared in terms of subjective image quality, evaluability and diagnostic accuracy. RESULTS The mean heart rate during the examination was 68.3 ± 9.4 bpm. The MCA showed a higher Likert score (3.1 ± 0.9 vs. 2.5 ± 1.1, p < 0.001) and evaluability (94%vs.79 %, p < 0.001) than the SRA. In a 45-patient subgroup studied by clinically indicated invasive coronary angiography, specificity, positive predictive value and accuracy were higher in MCA vs. SRA in segment-based and vessel-based models, respectively (87%vs.73 %, 50%vs.34 %, 85%vs.73 %, p < 0.001 and 62%vs.28 %, 66%vs.51 % and 75%vs.57 %, p < 0.001). In a patient-based model, MCA showed higher accuracy vs. SCA (93%vs.76 %, p < 0.05). CONCLUSIONS MCA can significantly improve subjective image quality, overall evaluability and diagnostic accuracy of CCT. KEY POINTS Cardiac computed tomographic coronary angiography (CCT) allows non-invasive evaluation of coronary arteries. Intra-cycle motion correction algorithm (MCA) allows for compensation of coronary motion. An MCA improves image quality, CCT evaluability and diagnostic accuracy.
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Andreini D, Pontone G, Mushtaq S, Bertella E, Conte E, Segurini C, Baggiano A, Bartorelli AL, Annoni A, Formenti A, Petullà M, Beltrama V, Fiorentini C, Pepi M. Low-dose CT coronary angiography with a novel IntraCycle motion-correction algorithm in patients with high heart rate or heart rate variability. Eur Heart J Cardiovasc Imaging 2015; 16:1093-100. [PMID: 25762564 DOI: 10.1093/ehjci/jev033] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 02/03/2015] [Indexed: 01/10/2023] Open
Abstract
AIMS Motion artefacts due to high or irregular heart rate (HR) are common limitations of coronary computed tomography (CT) angiography (CCTA). The aim of the study was to evaluate the impact of a new motion-correction (MC) algorithm used in conjunction with low-dose prospective ECG-triggering CCTA on motion artefacts, image quality, and coronary assessability. METHODS AND RESULTS Among 380 patients undergoing CCTA for suspected CAD, we selected 120 patients with pre-scanning HR >70 bpm or HR variability (HRv) >10 bpm during scanning irrespective of pre-scanning HR or both conditions. In patients with pre-scanning HR <65 or ≥65 bpm, prospective ECG triggering with padding of 80 ms (58 cases) or padding of 200 ms (62 cases) was used, respectively. Mean pre-scanning HR and HRv were 70 ± 7 and 10.9 ± 4 bpm, respectively. Overall, the mean effective dose was 3.4 ± 1.3 mSv, while a lower dose (2.4 ± 0.9 mSv) was measured for padding of 80 ms. In a segment-based analysis, coronary assessability was significantly higher (P < 0.0001) with MC (97%) when compared with standard (STD) reconstruction (81%) due to a significant reduction (P < 0.0001) in severe artefacts (54 vs. 356 cases, respectively). An artefact sub-analysis showed significantly lower number of motion artefacts and artefacts related to chest movement with MC (16 and 4 cases) than with STD reconstruction (286 and 24 cases, P < 0.0001 and P < 0.05, respectively). The number of coronary segments ranked among those of excellent image quality was significantly higher with MC (P < 0.001). CONCLUSIONS The MC algorithm improves CCTA image quality and coronary assessability in patients with high HR and HRv, despite low radiation dose.
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Affiliation(s)
- Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via C. Parea 4, Milan 20138, Italy
| | | | | | | | | | | | | | - Antonio L Bartorelli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via C. Parea 4, Milan 20138, Italy
| | | | | | | | | | - Cesare Fiorentini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via C. Parea 4, Milan 20138, Italy
| | - Mauro Pepi
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
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Functional relevance of coronary artery disease by cardiac magnetic resonance and cardiac computed tomography: myocardial perfusion and fractional flow reserve. BIOMED RESEARCH INTERNATIONAL 2015; 2015:297696. [PMID: 25692133 PMCID: PMC4323071 DOI: 10.1155/2015/297696] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/31/2014] [Indexed: 01/17/2023]
Abstract
Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality and it is responsible for an increasing resource burden. The identification of patients at high risk for adverse events is crucial to select those who will receive the greatest benefit from revascularization. To this aim, several non-invasive functional imaging modalities are usually used as gatekeeper to invasive coronary angiography, but the diagnostic yield of elective invasive coronary angiography remains unfortunately low. Stress myocardial perfusion imaging by cardiac magnetic resonance (stress-CMR) has emerged as an accurate technique for diagnosis and prognostic stratification of the patients with known or suspected CAD thanks to high spatial and temporal resolution, absence of ionizing radiation, and the multiparametric value including the assessment of cardiac anatomy, function, and viability. On the other side, cardiac computed tomography (CCT) has emerged as unique technique providing coronary arteries anatomy and more recently, due to the introduction of stress-CCT and noninvasive fractional flow reserve (FFR-CT), functional relevance of CAD in a single shot scan. The current review evaluates the technical aspects and clinical experience of stress-CMR and CCT in the evaluation of functional relevance of CAD discussing the strength and weakness of each approach.
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Cho I, Elmore K, Ó Hartaigh B, Schulman-Marcus J, Granser H, Valenti V, Xiong G, Carrascosa PM, Min JK. Heart-rate dependent improvement in image quality and diagnostic accuracy of coronary computed tomographic angiography by novel intracycle motion correction algorithm. Clin Imaging 2014; 39:421-6. [PMID: 25649255 DOI: 10.1016/j.clinimag.2014.11.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 11/18/2014] [Accepted: 11/20/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND To determine the effect of a novel intracycle motion correction algorithm (MCA) on diagnostic accuracy of coronary computed tomographic angiography. METHODS Coronary artery phantom models were scanned at static and heart rate (HR) simulation of 60-100 beat/min and reconstructed with a conventional algorithm and MCA. RESULTS Among 144 coronary segments, improvements in image interpretability, quality, and diagnostic accuracy by MCA were observed for HRs of 80 and 100 (P<.05 for all), but not for HR of 60. CONCLUSION Novel intracycle MCA demonstrates improved HR-dependent image interpretability, and quality and accuracy, particularly at higher HRs.
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Affiliation(s)
- Iksung Cho
- Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA; Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Kimberly Elmore
- Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA
| | - Bríain Ó Hartaigh
- Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA
| | - Josh Schulman-Marcus
- Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA
| | - Heidi Granser
- Departments of Imaging and Medicine, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Valentina Valenti
- Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA
| | - Guanglei Xiong
- Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA
| | | | - James K Min
- Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
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Li Q, Li P, Su Z, Yao X, Wang Y, Wang C, Du X, Li K. Effect of a novel motion correction algorithm (SSF) on the image quality of coronary CTA with intermediate heart rates: Segment-based and vessel-based analyses. Eur J Radiol 2014; 83:2024-32. [DOI: 10.1016/j.ejrad.2014.08.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/11/2014] [Accepted: 08/04/2014] [Indexed: 10/24/2022]
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