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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.
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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.
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Aeschlimann FA, Raimondi F, Leiner T, Aquaro GD, Saadoun D, Grotenhuis HB. Overview of imaging in adult- and childhood-onset Takayasu arteritis. J Rheumatol 2021; 49:346-357. [PMID: 34853087 DOI: 10.3899/jrheum.210368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 11/22/2022]
Abstract
Takayasu Arteritis is an idiopathic large vessel vasculitis, that affects young adults and children and can lead to ischemia and end-organ damage. Vascular imaging is crucial for diagnosis, assessment of disease extent and management of the disease. In this article, we critically review evidence for the clinical use of the different imaging modalities conventional angiography, magnetic resonance imaging, computed tomography, Doppler ultrasound and 18fluorodeoxyglucose positron emission tomography. We thereby focus on their clinical applicability, challenges and specific use in children.
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Affiliation(s)
- Florence A Aeschlimann
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
| | - Francesca Raimondi
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
| | - Tim Leiner
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
| | - Giovanni Donato Aquaro
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
| | - David Saadoun
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
| | - Heynric B Grotenhuis
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
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Baş S, Alkara U, Aliyev B. Evaluation of complex congenital heart disease with prospective ECG-gated cardiac CT in a single heartbeat at low tube voltage (70 kV) and adaptive statistical iterative reconstruction in infants: a single center experience. Int J Cardiovasc Imaging 2021; 38:413-422. [PMID: 34487310 DOI: 10.1007/s10554-021-02390-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
The purpose of this study is to evaluate the radiation dose, image quality, and diagnostic accuracy of prospective ECG-gated cardiac CT at 70 kV and adaptive statistical iterative reconstruction (ASIR), with a single source, 512 slice MDCT in the diagnosis of complex congenital heart disease in infants. We retrospectively evaluated 47 infants (ages 1 day to 353 days) with prospective ECG-gated cardiac CT that was performed on a single source 512 slice CT at low tube voltage (70 kV) using a wide detector aperture, adaptive statistical iterative reconstruction algorithm (ASIR), and specific reconstruction software reducing coronary motion artifacts (SnapShot Freeze). All cardiac images were obtained during the first pass of contrast material through the anatomic structures of interest and the targets for the center of the acquisition window were set 45% of the R-R interval during one cardiac cycle without sedation and breath-hold. The median effective dose measured in our study was 0.64 ± 0.16 mSv. The average subjective overall image quality score was 4.34 ± 0.31 (range 3-5). For the determination of objective image quality, Mean Noise (HU), SNR, and CNR values emerged as 20.8, 28.7(for pulmonary artery), and 27.1, respectively. Diagnostic accuracy was 100% for the main purposes for the main clinical indication. During cardiac CT examination, pathologies in addition to cardiac anomalies were found in 9/47 of cases (7 severe airway obstructions,1 posterior diaphragmatic hernia, 1 vertebral anomaly). Prospective ECG-gated cardiac CT scan at 70 kV and ASIR in infants with complex CHD provides low radiation dose (submillisievert) in a single heartbeat with a good objective and subjective image quality. It also provides important benefits in the diagnosis of additional pathology.
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Affiliation(s)
- Serap Baş
- Gaziosmanpaşa Hospital, Department of Radiology, Istanbul Yeni Yuzyil University, Merkez Mah. Çukurçeşme Cad. No:51 Gaziosmapaşa, 34245, Istanbul, Turkey.
| | - Utku Alkara
- Gaziosmanpaşa Hospital, Department of Radiology, Istanbul Yeni Yuzyil University, Merkez Mah. Çukurçeşme Cad. No:51 Gaziosmapaşa, 34245, Istanbul, Turkey
| | - Bahruz Aliyev
- Gaziosmanpaşa Hospital, Department of Pediatric Cardiology, Istanbul Yeni Yuzyil University, Istanbul, Turkey
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Warin Fresse K, Isorni MA, Dacher JN, Pontana F, Gorincour G, Boddaert N, Jacquier A, Raimondi F. Cardiac computed tomography angiography in the paediatric population: Expert consensus from the Filiale de cardiologie pédiatrique et congénitale (FCPC) and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV). Arch Cardiovasc Dis 2020; 113:579-586. [PMID: 32522436 DOI: 10.1016/j.acvd.2020.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 12/30/2022]
Abstract
This paper aims to provide a paediatric cardiac computed tomography angiography expert panel consensus based on the opinions of experts from the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) and the Filiale de cardiologie pédiatrique congénitale (FCPC). This expert panel consensus includes recommendations for indications, patient preparation, computed tomography angiography radiation dose reduction techniques and postprocessing techniques. We think that to realize its full potential and to avoid pitfalls, cardiac computed tomography angiography in children with congenital heart disease requires training and experience. Moreover, paediatric cardiac computed tomography angiography protocols should be standardized to acquire optimal images in this population with the lowest radiation dose possible, to prevent unnecessary radiation exposure. We also provide a suggested structured report and a list of acquisition protocols and technical parameters in relation to specific vendors.
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Affiliation(s)
- Karine Warin Fresse
- Imagerie cardiovasculaire fédération des cardiopathies congénitales, CHU de Nantes HGRL, 44093 Nantes, France
| | - Marc Antoine Isorni
- Unité de radiologie diagnostique et thérapeutique, hôpital Marie-Lannelongue, 92350 Le Plessis Robinson, France
| | - Jean Nicolas Dacher
- Cardiac MR/CT Unit, University Hospital, 76031 Rouen, France; Inserm U1096, UFR Médecine-Pharmacie, 76183 Rouen, France
| | - François Pontana
- Inserm UMR 1011, Department of Cardiovascular Radiology, EGID (European Genomic Institute for Diabetes), université de Lille, Institut Cœur-Poumon, Institut Pasteur de Lille, CHU de Lille, FR3508, 59000 Lille, France
| | - Guillaume Gorincour
- Image(2), institut méditerranéen d'imagerie médicale appliquée à la gynecologie, grossesse et enfance, 13008 Marseille, France
| | - Nathalie Boddaert
- Paediatric Radiology Unit, Hôpital Universitaire Necker-Enfants Malades, 75743 Paris, France
| | - Alexis Jacquier
- Department of Radiology, University of Marseille Méditerranée, CHU La Timone, Marseille, France
| | - Francesca Raimondi
- Unité médicochirurgicale de cardiologie congénitale et pédiatrique, centre de référence des maladies cardiaques congénitales complexes (M3C), hôpital universitaire Necker-Enfants-Malades, 149, rue de Sèvres, 75743 Paris cedex 15, France.
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9
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Warin-Fresse K, Isornii MA, Dacher JN, Pontana F, Gorincour G, Boddaert N, Jacquier A, Raimondi F. Pediatric cardiac computed tomography angiography: Expert consensus from the Filiale de Cardiologie Pédiatrique et Congénitale (FCPC) and the Société Française d'Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV). Diagn Interv Imaging 2020; 101:335-345. [PMID: 32029386 DOI: 10.1016/j.diii.2020.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/11/2020] [Accepted: 01/15/2020] [Indexed: 02/06/2023]
Abstract
This article was designed to provide a pediatric cardiac computed tomography angiography (CCTA) expert panel consensus based on opinions of experts of the Société Française d'Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV) and of the Filiale de Cardiologie Pédiatrique Congénitale (FCPC). This expert panel consensus includes recommendations for indications, patient preparation, CTA radiation dose reduction techniques, and post-processing techniques. The consensus was based on data from available literature (original papers, reviews and guidelines) and on opinions of a group of specialists with extensive experience in the use of CT imaging in congenital heart disease. In order to reach high potential and avoid pitfalls, CCTA in children with congenital heart disease requires training and experience. Moreover, pediatric cardiac CCTA protocols should be standardized to acquire optimal images in this population with the lowest radiation dose possible to prevent unnecessary radiation exposure. We also provided a suggested structured report and a list of acquisition protocols and technical parameters in relation to specific vendors.
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Affiliation(s)
- K Warin-Fresse
- Department of Cardiovascular Imaging, CHU Nantes HGRL, 44093 Nantes, France
| | - M-A Isornii
- Department of Radiology, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France
| | - J-N Dacher
- Department of Radiology, Rouen University Hospital, 76031 Rouen, France; Inserm U1096, UFR Médecine-Pharmacie, University of Rouen, 76000 Rouen, France
| | - F Pontana
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU Lille, INSERM UMR 1011, Institut Pasteur de Lille, EGID, FR3508, Univ Lille, 59000 Lille, France
| | - G Gorincour
- Image2, Mediterranean Institute of Medical Imaging, 13008 Marseille, France
| | - N Boddaert
- Pediatric Radiology Unit, Hôpital Universitaire Necker Enfants-Malades, 75015 Paris, France; Université de Paris, Descartes-Paris 5, 75006 Paris, France
| | - A Jacquier
- Department of Radiology, University of Marseille Méditerranée, CHU la Timone, 13000 Marseille, France
| | - F Raimondi
- Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, 75015 Paris, France.
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