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Sun Z, Silberstein J, Vaccarezza M. Cardiovascular Computed Tomography in the Diagnosis of Cardiovascular Disease: Beyond Lumen Assessment. J Cardiovasc Dev Dis 2024; 11:22. [PMID: 38248892 PMCID: PMC10816599 DOI: 10.3390/jcdd11010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Cardiovascular CT is being widely used in the diagnosis of cardiovascular disease due to the rapid technological advancements in CT scanning techniques. These advancements include the development of multi-slice CT, from early generation to the latest models, which has the capability of acquiring images with high spatial and temporal resolution. The recent emergence of photon-counting CT has further enhanced CT performance in clinical applications, providing improved spatial and contrast resolution. CT-derived fractional flow reserve is superior to standard CT-based anatomical assessment for the detection of lesion-specific myocardial ischemia. CT-derived 3D-printed patient-specific models are also superior to standard CT, offering advantages in terms of educational value, surgical planning, and the simulation of cardiovascular disease treatment, as well as enhancing doctor-patient communication. Three-dimensional visualization tools including virtual reality, augmented reality, and mixed reality are further advancing the clinical value of cardiovascular CT in cardiovascular disease. With the widespread use of artificial intelligence, machine learning, and deep learning in cardiovascular disease, the diagnostic performance of cardiovascular CT has significantly improved, with promising results being presented in terms of both disease diagnosis and prediction. This review article provides an overview of the applications of cardiovascular CT, covering its performance from the perspective of its diagnostic value based on traditional lumen assessment to the identification of vulnerable lesions for the prediction of disease outcomes with the use of these advanced technologies. The limitations and future prospects of these technologies are also discussed.
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Affiliation(s)
- Zhonghua Sun
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6102, Australia
| | - Jenna Silberstein
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
| | - Mauro Vaccarezza
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6102, Australia
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Artificial Intelligence (Enhanced Super-Resolution Generative Adversarial Network) for Calcium Deblooming in Coronary Computed Tomography Angiography: A Feasibility Study. Diagnostics (Basel) 2022; 12:diagnostics12040991. [PMID: 35454039 PMCID: PMC9027004 DOI: 10.3390/diagnostics12040991] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 12/22/2022] Open
Abstract
Background: The presence of heavy calcification in the coronary artery always presents a challenge for coronary computed tomography angiography (CCTA) in assessing the degree of coronary stenosis due to blooming artifacts associated with calcified plaques. Our study purpose was to use an advanced artificial intelligence (enhanced super-resolution generative adversarial network [ESRGAN]) model to suppress the blooming artifact in CCTA and determine its effect on improving the diagnostic performance of CCTA in calcified plaques. Methods: A total of 184 calcified plaques from 50 patients who underwent both CCTA and invasive coronary angiography (ICA) were analysed with measurements of coronary lumen on the original CCTA, and three sets of ESRGAN-processed images including ESRGAN-high-resolution (ESRGAN-HR), ESRGAN-average and ESRGAN-median with ICA as the reference method for determining sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: ESRGAN-processed images improved the specificity and PPV at all three coronary arteries (LAD-left anterior descending, LCx-left circumflex and RCA-right coronary artery) compared to original CCTA with ESRGAN-median resulting in the highest values being 41.0% (95% confidence interval [CI]: 30%, 52.7%) and 26.9% (95% CI: 22.9%, 31.4%) at LAD; 41.7% (95% CI: 22.1%, 63.4%) and 36.4% (95% CI: 28.9%, 44.5%) at LCx; 55% (95% CI: 38.5%, 70.7%) and 47.1% (95% CI: 38.7%, 55.6%) at RCA; while corresponding values for original CCTA were 21.8% (95% CI: 13.2%, 32.6%) and 22.8% (95% CI: 20.8%, 24.9%); 12.5% (95% CI: 2.6%, 32.4%) and 27.6% (95% CI: 24.7%, 30.7%); 17.5% (95% CI: 7.3%, 32.8%) and 32.7% (95% CI: 29.6%, 35.9%) at LAD, LCx and RCA, respectively. There was no significant effect on sensitivity and NPV between the original CCTA and ESRGAN-processed images at all three coronary arteries. The area under the receiver operating characteristic curve was the highest with ESRGAN-median images at the RCA level with values being 0.76 (95% CI: 0.64, 0.89), 0.81 (95% CI: 0.69, 0.93), 0.82 (95% CI: 0.71, 0.94) and 0.86 (95% CI: 0.76, 0.96) corresponding to original CCTA and ESRGAN-HR, average and median images, respectively. Conclusions: This feasibility study shows the potential value of ESRGAN-processed images in improving the diagnostic value of CCTA for patients with calcified plaques.
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Sun Z, Ng CKC, Wong YH, Yeong CH. 3D-Printed Coronary Plaques to Simulate High Calcification in the Coronary Arteries for Investigation of Blooming Artifacts. Biomolecules 2021; 11:biom11091307. [PMID: 34572520 PMCID: PMC8468360 DOI: 10.3390/biom11091307] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022] Open
Abstract
The diagnostic value of coronary computed tomography angiography (CCTA) is significantly affected by high calcification in the coronary arteries owing to blooming artifacts limiting its accuracy in assessing the calcified plaques. This study aimed to simulate highly calcified plaques in 3D-printed coronary models. A combination of silicone + 32.8% calcium carbonate was found to produce 800 HU, representing extensive calcification. Six patient-specific coronary artery models were printed using the photosensitive polyurethane resin and a total of 22 calcified plaques with diameters ranging from 1 to 4 mm were inserted into different segments of these 3D-printed coronary models. The coronary models were scanned on a 192-slice CT scanner with 70 kV, pitch of 1.4, and slice thickness of 1 mm. Plaque attenuation was measured between 1100 and 1400 HU. Both maximum-intensity projection (MIP) and volume rendering (VR) images (wide and narrow window widths) were generated for measuring the diameters of these calcified plaques. An overestimation of plaque diameters was noticed on both MIP and VR images, with measurements on the MIP images close to those of the actual plaque sizes (<10% deviation), and a large measurement discrepancy observed on the VR images (up to 50% overestimation). This study proves the feasibility of simulating extensive calcification in coronary arteries using a 3D printing technique to develop calcified plaques and generate 3D-printed coronary models.
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6845, Australia;
- Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia
- Correspondence: ; Tel.: +61-8-9266-7509; Fax: +61-8-9266-2377
| | - Curtise Kin Cheung Ng
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6845, Australia;
- Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia
| | - Yin How Wong
- Faculty of Health & Medical Sciences, School of Medicine, Taylor’s University, No. 1, Jalan Taylor’s, Subang Jaya 47500, Malaysia; (Y.H.W.); (C.H.Y.)
| | - Chai Hong Yeong
- Faculty of Health & Medical Sciences, School of Medicine, Taylor’s University, No. 1, Jalan Taylor’s, Subang Jaya 47500, Malaysia; (Y.H.W.); (C.H.Y.)
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Nagatani Y, Moriya H, Noma S, Sato S, Tsukagoshi S, Yamashiro T, Koyama M, Tomiyama N, Ono Y, Murayama S, Murata K, Koyama M, Narumi Y, Yanagawa M, Honda O, Tomiyama N, Ohno Y, Sugimura K, Sakuma K, Moriya H, Tada A, Kanazawa S, Sakai F, Nishimoto Y, Noma S, Tsuchiya N, Tsubakimoto M, Yamashiro T, Murayama S, Sato S, Nagatani Y, Nitta N, Murata K. Association of Focal Radiation Dose Adjusted on Cross Sections with Subsolid Nodule Visibility and Quantification on Computed Tomography Images Using AIDR 3D: Comparison Among Scanning at 84, 42, and 7 mAs. Acad Radiol 2018; 25:1156-1166. [PMID: 29735355 DOI: 10.1016/j.acra.2018.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 12/17/2022]
Abstract
RATIONALE AND OBJECTIVES The objectives of this study were to compare the visibility and quantification of subsolid nodules (SSNs) on computed tomography (CT) using adaptive iterative dose reduction using three-dimensional processing between 7 and 42 mAs and to assess the association of size-specific dose estimate (SSDE) with relative measured value change between 7 and 84 mAs (RMVC7-84) and relative measured value change between 42 and 84 mAs (RMVC42-84). MATERIALS AND METHODS As a Japanese multicenter research project (Area-detector Computed Tomography for the Investigation of Thoracic Diseases [ACTIve] study), 50 subjects underwent chest CT with 120 kV, 0.35 second per location and three tube currents: 240 mA (84 mAs), 120 mA (42 mAs), and 20 mA (7 mAs). Axial CT images were reconstructed using adaptive iterative dose reduction using three-dimensional processing. SSN visibility was assessed with three grades (1, obscure, to 3, definitely visible) using CT at 84 mAs as reference standard and compared between 7 and 42 mAs using t test. Dimension, mean CT density, and particular SSDE to the nodular center of 71 SSNs and volume of 58 SSNs (diameter >5 mm) were measured. Measured values (MVs) were compared using Wilcoxon signed-rank tests among CTs at three doses. Pearson correlation analyses were performed to assess the association of SSDE with RMVC7-84: 100 × (MV at 7 mAs - MV at 84 mAs)/MV at 84 mAs and RMVC42-84. RESULTS SSN visibilities were similar between 7 and 42 mAs (2.76 ± 0.45 vs 2.78 ± 0.40) (P = .67). For larger SSNs (>8 mm), MVs were similar among CTs at three doses (P > .05). For smaller SSNs (<8 mm), dimensions and volumes on CT at 7 mAs were larger and the mean CT density was smaller than 42 and 84 mAs, and SSDE had mild negative correlations with RMVC7-84 (P < .05). CONCLUSIONS Comparable quantification was demonstrated irrespective of doses for larger SSNs. For smaller SSNs, nodular exaggerating effect associated with decreased SSDE on CT at 7 mAs compared to 84 mAs could result in comparable visibilities to CT at 42 mAs.
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Tang YC, Liu YC, Hsu MY, Tsai HY, Chen CM. Adaptive Iterative Dose Reduction 3D Integrated with Automatic Tube Current Modulation for CT Coronary Artery Calcium Quantification: Comparison to Traditional Filtered Back Projection in an Anthropomorphic Phantom and Patients. Acad Radiol 2018; 25:1010-1017. [PMID: 29395796 DOI: 10.1016/j.acra.2017.12.018] [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] [Received: 09/05/2017] [Revised: 12/20/2017] [Accepted: 12/23/2017] [Indexed: 01/05/2023]
Abstract
RATIONALE AND OBJECTIVES We aimed to evaluate integrated adaptive iterative dose reduction 3D (AIDR 3D) algorithm in automatic tube current modulation (ATCM) for the quantification of coronary artery calcium score (CACS) and cardiac risk stratification. MATERIALS AND METHODS A thoracic phantom with calcium inserts of known densities was scanned with filtered back projection (FBP) and AIDR 3D algorithms in small- and medium-sized phantoms. Twenty-four patients underwent two consecutive scans of CACS with FBP and AIDR 3D algorithms. The absolute Agatston score, Agatston score risk, volume score, and Agatston score percentile-based risk were compared, and concordance coefficients and agreement plots were made. RESULTS Agatston and volume scores were significantly different between the phantom sizes (P < .01). There were no significant differences in the Agatston scores between FBP and AIDR 3D for the medium phantoms (P = .25). In the patients, there were no significant differences in Agatston and volume scores between FBP and AIDR 3D (P = .06 and P = .09, respectively). The correlation coefficients of Agatston and volume scores with AIDR 3D were excellent compared to those of FBP. There were no significant differences in Agatston score risk and Agatston score percentile-based risk between FBP and AIDR 3D (P = .74 and P = 1, respectively). There was mean dose reduction of 57.8% ± 18.6% for AIDR 3D. CONCLUSION The absolute Agatston score differed between FBP and AIDR 3D reconstructions. However, the cardiac risk categorizations of the two methods were comparable. An integrated AIDR 3D algorithm with automatic tube current modulation enables radiation dose savings at a consistent noise level without sacrificing CACS.
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Takaoka H, Funabashi N, Ozawa K, Uehara M, Sano K, Komuro I, Kobayashi Y. Improved Diagnosis of Detection of Late Enhancement in Left Ventricular Myocardium Using 2nd Generation 320-Slice CT Reconstructed with FIRST in Non-Ischemic Cardiomyopathy. Int Heart J 2018; 59:542-549. [PMID: 29681572 DOI: 10.1536/ihj.17-210] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Forward Projected Model-based Iterative Reconstruction SoluTion (FIRST) is a new reconstruction technique using CT, which provides successful reconstruction of high-quality CT images, especially in low contrast imaging. To evaluate improvements in the diagnostic accuracy of the detection of abnormal late enhancement (LE) in left-ventricular myocardium (LVM) using 320-slice CT with FIRST, we compared this modality with previous CT methods in patients with non-ischemic cardiomyopathy or a cardiac tumor.This was a retrospective study of 88 patients (56 males; 57 ± 15 years) suspected of having non-ischemic myocardial disease or a cardiac tumor. The first 52 consecutive patients (Group 1) underwent 16-slice CT at 140 kV tube voltage and an average tube current of 337 ± 20 mA, and 1.5 T MRI. The next 18 patients (Group 2) underwent 1st generation 320-slice CT at 120 kV tube voltage and an average tube current of 255 ± 106 mA, and 1.5T MRI; the remaining 18 patients (Group 3) underwent 2nd generation 320-slice CT with FIRST, at 80 kV tube voltage and a tube current of 800 mA, and 1.5T or 3T MRI.On patient-based analysis, no significant differences were observed between the 3 groups. For segment-based analysis, the specificity and overall accuracy were significantly higher (both P < 0.05) in Group 3 than in Group 1. Positive predictive value (PPV) was significantly higher in Group 3 than in Groups 1 and 2.The diagnostic accuracy of LE on CT for detecting myocardial fibrosis determined by late gadolinium-enhanced MRI was improved with the use of 2nd generation 320-slice CT with FIRST, in particular regarding specificity, PPV, and overall accuracy.
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Affiliation(s)
- Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine
| | - Nobusada Funabashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine
| | - Koya Ozawa
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine
| | - Masae Uehara
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Koichi Sano
- Department of Cardiology, Eastern Chiba Medical Center
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine
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Dose reduction techniques in coronary calcium scoring: The effect of iterative reconstruction combined with low tube voltage on calcium scores in a thoracic phantom. Eur J Radiol 2017; 93:229-235. [PMID: 28668419 DOI: 10.1016/j.ejrad.2017.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/13/2017] [Accepted: 06/01/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To define a dose-reduced coronary calcium CT protocol that provides similar calcium score values as a conventional 120kVp protocol. METHODS A thorax phantom containing 100 calcifications was scanned with the reference protocol (120kVp, 90 ref mAs, FBP) and 30 dose-reduced protocols (70-110kVp, 90 ref mAs, FBP and iterative reconstruction (IR) levels 1-5) with 3rd generation dual-source CT. For protocols that yielded similar detectability and calcium scores as the reference protocol, additional scans were acquired at reduced ref mAs. Kendall's τb and independent-samples-median test were used to determine trends and differences in contrast/signal-to-noise ratio (CNR and SNR), dose and calcium scores. RESULTS The detectability and calcium scores decreased at increasing IR levels (τb<-0.825, p<0.001) and increasing tube voltage (τb<-0.679, p<0.001). For 90kVp-IR3 and 100kVp-IR1, similar detectability and calcium score was found compared to the reference protocol (p>0.206). For these protocols, lower tube currents did not affect the detectability and Agatston score (p>0.206), while CNR and SNR were similar/higher compared to the reference protocol (0.008<p<0.206). Dose reduction was 60.6% (90kVp-IR3) and 43.6% (100kVp-IR1). CONCLUSIONS The protocol of 90kVp-IR3 and 100kVp-IR1 yielded similar calcium detectability, Agatston score and image quality as the reference protocol, with dose reduction up to 60.6%.
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den Harder AM, Wolterink JM, Willemink MJ, Schilham AM, de Jong PA, Budde RP, Nathoe HM, Išgum I, Leiner T. Submillisievert coronary calcium quantification using model-based iterative reconstruction: A within-patient analysis. Eur J Radiol 2016; 85:2152-2159. [DOI: 10.1016/j.ejrad.2016.09.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 09/26/2016] [Accepted: 09/29/2016] [Indexed: 11/16/2022]
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Sun Z, Ng CKC, Xu L, Fan Z, Lei J. Coronary CT Angiography in Heavily Calcified Coronary Arteries: Improvement of Coronary Lumen Visualization and Coronary Stenosis Assessment With Image Postprocessing Methods. Medicine (Baltimore) 2015; 94:e2148. [PMID: 26632895 PMCID: PMC4674198 DOI: 10.1097/md.0000000000002148] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
To compare the diagnostic value of coronary CT angiography (CCTA) with use of 2 image postprocessing methods (CCTA_S) and (CCTA_OS) and original data (CCTA_O) for the assessment of heavily calcified plaques. Fifty patients (41 men, 9 women; mean age 61.9 years ± 9.1) with suspected coronary artery disease who underwent CCTA and invasive coronary angiography (ICA) examinations were included in the study. Image data were postprocessed with "sharpen" and smooth reconstruction algorithms in comparison with the original data without undergoing any image postprocessing to determine the effects on suppressing blooming artifacts due to heavy calcification in the coronary arteries. Minimal lumen diameter and degree of stenosis were measured and compared between CCTA_S, CCTA_OS, and CCTA_O with ICA as the reference method. The area under the curve (AUC) by receiver-operating characteristic curve analysis (ROC) was also compared among these 3 CCTA techniques. On a per-vessel assessment, the sensitivity, specificity, positive predictive value and negative predictive value, and 95% confidence interval (CI) were 100% (95% CI: 89%, 100%), 33% (95% CI: 22%, 45%), 41% (95% CI: 30%, 53%), 100% (95% CI: 85%, 100%) for CCTA_O, 94% (95% CI: 79%, 99%), 66% (95% CI: 54%, 77%), 57% (95% CI: 43%, 70%), and 95% (95% CI: 85%, 99%) for CCTA_S, 94% (95% CI: 79%, 99%), 44% (95% CI: 32%, 57%), 44% (95% CI: 32%, 57%), and 97% (95% CI: 79%, 99%) for CCTA_OS, respectively. The AUC by ROC curve analysis for CCTA_S showed significant improvement for detection of >50% coronary stenosis in left anterior descending coronary artery compared to that of CCTA_OS and CCTA_O methods (P < 0.05), with no significance differences for detection of coronary stenosis in the left circumflex and right coronary arteries (P > 0.05).CCTA with "sharpen" reconstruction reduces blooming artifacts from heavy calcification, thus, leading to significant improvement of specificity and positive predictive value of CCTA in patients with heavily calcified plaques. However, specificity is still moderate and additional functional imaging may be needed.
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Affiliation(s)
- Zhonghua Sun
- From the Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia, Australia (ZS, CKCN), Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (LX, ZF), and Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Yunnan, China (JL)
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Szilveszter B, Elzomor H, Károlyi M, Kolossváry M, Raaijmakers R, Benke K, Celeng C, Bartykowszki A, Bagyura Z, Lux Á, Merkely B, Maurovich-Horvat P. The effect of iterative model reconstruction on coronary artery calcium quantification. Int J Cardiovasc Imaging 2015; 32:153-60. [DOI: 10.1007/s10554-015-0740-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 08/11/2015] [Indexed: 01/07/2023]
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Lung nodule detection performance in five observers on computed tomography (CT) with adaptive iterative dose reduction using three-dimensional processing (AIDR 3D) in a Japanese multicenter study: Comparison between ultra-low-dose CT and low-dose CT by receiver-operating characteristic analysis. Eur J Radiol 2015; 84:1401-12. [PMID: 25892051 DOI: 10.1016/j.ejrad.2015.03.012] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/03/2015] [Accepted: 03/08/2015] [Indexed: 12/21/2022]
Abstract
PURPOSE To compare lung nodule detection performance (LNDP) in computed tomography (CT) with adaptive iterative dose reduction using three dimensional processing (AIDR3D) between ultra-low dose CT (ULDCT) and low dose CT (LDCT). MATERIALS AND METHODS This was part of the Area-detector Computed Tomography for the Investigation of Thoracic Diseases (ACTIve) Study, a multicenter research project being conducted in Japan. Institutional Review Board approved this study and informed consent was obtained. Eighty-three subjects (body mass index, 23.3 ± 3.2) underwent chest CT at 6 institutions using identical scanners and protocols. In a single visit, each subject was scanned using different tube currents: 240, 120 and 20 mA (3.52, 1.74 and 0.29 mSv, respectively). Axial CT images with 2-mm thickness/increment were reconstructed using AIDR3D. Standard of reference (SOR) was determined based on CT images at 240 mA by consensus reading of 2 board-certificated radiologists as to the presence of lung nodules with the longest diameter (LD) of more than 3mm. Another 5 radiologists independently assessed and recorded presence/absence of lung nodules and their locations by continuously-distributed rating in CT images at 20 mA (ULDCT) and 120 mA (LDCT). Receiver-operating characteristic (ROC) analysis was used to evaluate LNDP of both methods in total and also in subgroups classified by LD (>4, 6 and 8 mm) and nodular characteristics (solid and ground glass nodules). RESULTS For SOR, 161 solid and 60 ground glass nodules were identified. No significant difference in LNDP for entire solid nodules was demonstrated between both methods, as area under ROC curve (AUC) was 0.844 ± 0.017 in ULDCT and 0.876 ± 0.026 in LDCT (p=0.057). For ground glass nodules with LD 8mm or more, LNDP was similar between both methods, as AUC 0.899 ± 0.038 in ULDCT and 0.941 ± 0.030 in LDCT. (p=0.144). CONCLUSION ULDCT using AIDR3D with an equivalent radiation dose to chest x-ray could have comparable LNDP to LDCT with AIDR3D except for smaller ground glass nodules in cases with normal range body habitus.
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Funabashi N, Irie R, Namihira Y, Morimoto R, Aiba M, Ozawa K, Takaoka H, Ohta J, Masuda Y, Kobayashi Y. Influence of tube voltage and heart rate on the Agatston calcium score using an in vitro, novel ECG-gated dual energy reconstruction 320 slice CT technique. Int J Cardiol 2014; 180:218-20. [PMID: 25463370 DOI: 10.1016/j.ijcard.2014.11.164] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 11/23/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Nobusada Funabashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
| | - Ryosuke Irie
- Radiological Department, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Yasuaki Namihira
- Radiological Department, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Ryo Morimoto
- Radiological Department, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Miki Aiba
- Radiological Department, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Koya Ozawa
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Joji Ohta
- Radiological Department, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Yoshitada Masuda
- Radiological Department, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
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Yamashiro T, Miyara T, Honda O, Kamiya H, Murata K, Ohno Y, Tomiyama N, Moriya H, Koyama M, Noma S, Kamiya A, Tanaka Y, Murayama S. Adaptive Iterative Dose Reduction Using Three Dimensional Processing (AIDR3D) improves chest CT image quality and reduces radiation exposure. PLoS One 2014; 9:e105735. [PMID: 25153797 PMCID: PMC4143266 DOI: 10.1371/journal.pone.0105735] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 07/28/2014] [Indexed: 11/18/2022] Open
Abstract
Objective To assess the advantages of Adaptive Iterative Dose Reduction using Three Dimensional Processing (AIDR3D) for image quality improvement and dose reduction for chest computed tomography (CT). Methods Institutional Review Boards approved this study and informed consent was obtained. Eighty-eight subjects underwent chest CT at five institutions using identical scanners and protocols. During a single visit, each subject was scanned using different tube currents: 240, 120, and 60 mA. Scan data were converted to images using AIDR3D and a conventional reconstruction mode (without AIDR3D). Using a 5-point scale from 1 (non-diagnostic) to 5 (excellent), three blinded observers independently evaluated image quality for three lung zones, four patterns of lung disease (nodule/mass, emphysema, bronchiolitis, and diffuse lung disease), and three mediastinal measurements (small structure visibility, streak artifacts, and shoulder artifacts). Differences in these scores were assessed by Scheffe's test. Results At each tube current, scans using AIDR3D had higher scores than those without AIDR3D, which were significant for lung zones (p<0.0001) and all mediastinal measurements (p<0.01). For lung diseases, significant improvements with AIDR3D were frequently observed at 120 and 60 mA. Scans with AIDR3D at 120 mA had significantly higher scores than those without AIDR3D at 240 mA for lung zones and mediastinal streak artifacts (p<0.0001), and slightly higher or equal scores for all other measurements. Scans with AIDR3D at 60 mA were also judged superior or equivalent to those without AIDR3D at 120 mA. Conclusion For chest CT, AIDR3D provides better image quality and can reduce radiation exposure by 50%.
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Affiliation(s)
- Tsuneo Yamashiro
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan
- * E-mail:
| | - Tetsuhiro Miyara
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan
| | - Osamu Honda
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hisashi Kamiya
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan
| | - Kiyoshi Murata
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Yoshiharu Ohno
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hiroshi Moriya
- Department of Radiology, Ohara General Hospital, Fukushima-shi, Fukushima, Japan
| | - Mitsuhiro Koyama
- Department of Radiology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Satoshi Noma
- Department of Radiology, Tenri Hospital, Tenri, Nara, Japan
| | - Ayano Kamiya
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan
| | - Yuko Tanaka
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan
- Center for Clinical Training, Fujieda Municipal General Hospital, Fujieda, Shizuoka, Japan
| | - Sadayuki Murayama
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan
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14
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The impact of CT radiation dose reduction and iterative reconstruction algorithms from four different vendors on coronary calcium scoring. Eur Radiol 2014; 24:2201-12. [DOI: 10.1007/s00330-014-3217-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 04/18/2014] [Accepted: 05/05/2014] [Indexed: 12/28/2022]
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15
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van Osch JAC, Mouden M, van Dalen JA, Timmer JR, Reiffers S, Knollema S, Greuter MJW, Ottervanger JP, Jager PL. Influence of iterative image reconstruction on CT-based calcium score measurements. Int J Cardiovasc Imaging 2014; 30:961-7. [PMID: 24676668 DOI: 10.1007/s10554-014-0409-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 03/21/2014] [Indexed: 01/07/2023]
Abstract
Iterative reconstruction techniques for coronary CT angiography have been introduced as an alternative for traditional filter back projection (FBP) to reduce image noise, allowing improved image quality and a potential for dose reduction. However, the impact of iterative reconstruction on the coronary artery calcium score is not fully known. In 112 consecutive stable patients with suspected coronary artery disease, the coronary calcium scores were assessed. Comparisons were made between the Agatston, volume and mass scores obtained with traditional FBP, and by using adaptive statistical iterative reconstruction (ASIR). A significant reduction of the Agatston score, volume score and mass score was observed for ASIR when compared to FBP, with median differences of resp. 26, 5 mm(3) and 1 mg. Using the ASIR reconstruction, the number of patients with a calcium score of zero increased by 13 %. Iterative CT reconstruction significantly reduces the Agatston, volume and mass scores. Since the calcium score is used as a prognostic tool for coronary artery disease, caution must be taken when using iterative reconstruction.
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16
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Ozawa K, Funabashi N, Takaoka H, Uehara M, Fujimoto Y, Kobayashi Y. 320-slice CT-based finding of aortic wall tissue invasion into left-main coronary artery does not have relationship with coronary risk factors and coronary arteriosclerosis and stenosis. Int J Cardiol 2014; 172:e207-9. [PMID: 24452227 DOI: 10.1016/j.ijcard.2013.12.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 12/26/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Koya Ozawa
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Nobusada Funabashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
| | - Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Masae Uehara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Yoshihide Fujimoto
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
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