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Abstract
In 1971, the first patient CT examination by Ambrose and Hounsfield paved the way for not only volumetric imaging of the brain but of the entire body. From the initial 5-minute scan for a 180° rotation to today's 0.24-second scan for a 360° rotation, CT technology continues to reinvent itself. This article describes key historical milestones in CT technology from the earliest days of CT to the present, with a look toward the future of this essential imaging modality. After a review of the beginnings of CT and its early adoption, the technical steps taken to decrease scan times-both per image and per examination-are reviewed. Novel geometries such as electron-beam CT and dual-source CT have also been developed in the quest for ever-faster scans and better in-plane temporal resolution. The focus of the past 2 decades on radiation dose optimization and management led to changes in how exposure parameters such as tube current and tube potential are prescribed such that today, examinations are more customized to the specific patient and diagnostic task than ever before. In the mid-2000s, CT expanded its reach from gray-scale to color with the clinical introduction of dual-energy CT. Today's most recent technical innovation-photon-counting CT-offers greater capabilities in multienergy CT as well as spatial resolution as good as 125 μm. Finally, artificial intelligence is poised to impact both the creation and processing of CT images, as well as automating many tasks to provide greater accuracy and reproducibility in quantitative applications.
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Affiliation(s)
- Cynthia H. McCollough
- Department of Radiology, Mayo Clinic, 200 First St SW Rochester, MN, United States 55905
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The Impact of Novel Reconstruction Algorithms on Calcium Scoring: Results on a Dedicated Cardiac CT Scanner. Diagnostics (Basel) 2023; 13:diagnostics13040789. [PMID: 36832277 PMCID: PMC9955482 DOI: 10.3390/diagnostics13040789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/27/2023] [Accepted: 02/10/2023] [Indexed: 02/22/2023] Open
Abstract
Contemporary reconstruction algorithms yield the potential of reducing radiation exposure by denoising coronary computed tomography angiography (CCTA) datasets. We aimed to assess the reliability of coronary artery calcium score (CACS) measurements with an advanced adaptive statistical iterative reconstruction (ASIR-CV) and model-based adaptive filter (MBAF2) designed for a dedicated cardiac CT scanner by comparing them to the gold-standard filtered back projection (FBP) calculations. We analyzed non-contrast coronary CT images of 404 consecutive patients undergoing clinically indicated CCTA. CACS and total calcium volume were quantified and compared on three reconstructions (FBP, ASIR-CV, and MBAF2+ASIR-CV). Patients were classified into risk categories based on CACS and the rate of reclassification was assessed. Patients were categorized into the following groups based on FBP reconstructions: 172 zero CACS, 38 minimal (1-10), 87 mild (11-100), 57 moderate (101-400), and 50 severe (400<). Overall, 19/404 (4.7%) patients were reclassified into a lower-risk group with MBAF2+ASIR-CV, while 8 additional patients (27/404, 6.7%) shifted downward when applying stand-alone ASIR-CV. The total calcium volume with FBP was 7.0 (0.0-133.25) mm3, 4.0 (0.0-103.5) mm3 using ASIR-CV, and 5.0 (0.0-118.5) mm3 with MBAF2+ASIR-CV (all comparisons p < 0.001). The concomitant use of ASIR-CV and MBAF2 may allow the reduction of noise levels while maintaining similar CACS values as FBP measurements.
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Coronary CTA Amidst the COVID-19 Pandemic: A Quicker Examination Protocol with Preserved Image Quality Using a Dedicated Cardiac Scanner. Diagnostics (Basel) 2023; 13:diagnostics13030406. [PMID: 36766511 PMCID: PMC9914678 DOI: 10.3390/diagnostics13030406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
There has been an ongoing debate on the means to minimize the time patients spend at health care providers during the COVID-19 pandemic. We propose a strategy relying solely on intravenous (i.v.) beta-blocker administration for heart-rate (HR) control prior to coronary CT angiography (CCTA). We aimed to assess a potential difference in CCTA image quality (IQ) after implementation of a modified strategy compared to our standard protocol of oral premedication during the first wave of COVID-19. We analyzed CCTA examinations conducted one year before (n = 1511) and after (n = 1064) implementation of this new regime. Examinations were performed both on our 256-slice multidetector CT (MDCT) and dedicated cardiac CT (DCCT) scanners. We used a four-point Likert scale (excellent/good/moderate/non-diagnostic) for IQ assessment of the coronaries. We detected a significant increase in mean HR during examinations on both CT scanners (MDCT: 62.4 ± 10.0 vs. 65.3 ± 9.7, p < 0.001; DCCT: 61.7 ± 15.2 vs. 65.0 ± 10.7, p < 0.001). The rate of moderate/non-diagnostic IQ significantly increased on the MDCT (192/1005, 19.1% vs. 144/466, 30.9%, p < 0.001), while this ratio did not change significantly on the DCCT (62/506, 12.3% vs. 84/598, 14.0%, p = 0.38). The improved temporal resolution of DCCT allows the stand-alone use of i.v. premedication with preserved IQ; hence, the duration of visits can be shortened.
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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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Kolossváry M, Reid AB, Baggiano A, Nagpal P, Canan A, Al'Aref SJ, Andreini D, Cavalcante JL, de Cecco CN, Chelliah A, Chen MY, Choi AD, Dey D, Fairbairn T, Ferencik M, Gransar H, Hecht H, Leipsic J, Lu MT, Marwan M, Maurovich-Horvat P, Ng MY, Nicol ED, Pontone G, Vliegenthart R, Whelton SP, Williams MC, Arbab-Zadeh A, Farooqi KM, Weir-McCall J, Feuchtner G, Villines TC. The Journal of cardiovascular computed tomography: A year in review 2021. J Cardiovasc Comput Tomogr 2022; 16:266-276. [PMID: 35370125 DOI: 10.1016/j.jcct.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This review aims to summarize original articles published in the Journal of Cardiovascular Computed Tomography (JCCT) for the year 2021, focusing on those that had the most scientific and educational impact. The JCCT continues to expand; the number of submissions, published manuscripts, cited articles, article downloads, social media presence, and impact factor continues to increase. The articles selected by the Editorial Board of the JCCT in this review focus on coronary artery disease, coronary physiology, structural heart disease, and technical advances in cardiovascular CT. In addition, we highlight key consensus documents and guidelines published in the Journal in 2021. The Journal recognizes the tremendous work done by each author and reviewer this year - thank you.
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Affiliation(s)
- Márton Kolossváry
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Anna B Reid
- University of Manchester NHS Foundation Trust, Manchester, UK
| | | | - Prashant Nagpal
- Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Arzu Canan
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Subhi J Al'Aref
- Department of Medicine, Division of Cardiology. University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Daniele Andreini
- Centro Cardiologico Monzino IRCCS, Milan, Italy; Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - João L Cavalcante
- Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Carlo N de Cecco
- Department of Radiology and Imaging Sciences, Division of Cardiothoracic Imaging, Emory University, Atlanta, GA, USA
| | - Anjali Chelliah
- Department of Pediatrics, Division of Cardiology, Goryeb Children's Hospital/Atlantic Health System, Morristown, NJ, USA; Department of Pediatrics, Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Marcus Y Chen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Andrew D Choi
- The George Washington University School of Medicine, Washington, DC, USA
| | - Damini Dey
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Timothy Fairbairn
- Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Maros Ferencik
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Heidi Gransar
- Department of Imaging, Cardiac Imaging Research, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Harvey Hecht
- Ican School of Medicine at Mount Sinai, Mount Sinai Morningside Medical Center, NYC, USA
| | - Jonathan Leipsic
- Department of Radiology and Medicine (Cardiology), University of British Columbia, Canada
| | - Michael T Lu
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mohamed Marwan
- Department of Cardiology, Friedrich-Alexander-Universität, Erlangen-Nürnberg, Germany
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Hungary; Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Ming-Yen Ng
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong SAR, China
| | - Edward D Nicol
- Departments of Cardiology and Radiology, Royal Brompton Hospital, London UK; School of Bioengineering and Imaging Sciences, Kings College, London, UK
| | | | - Rozemarijn Vliegenthart
- Department of Radiology, University of Groningen/University Medical Center Groningen, Groningen, the Netherlands
| | - Seamus P Whelton
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | | | - Armin Arbab-Zadeh
- Department of Medicine/Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - Kanwal M Farooqi
- Department of Pediatrics, Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Gudrun Feuchtner
- Innsbruck Medical University, Dept. Radiology, Innsbruck, Austria
| | - Todd C Villines
- Division of Cardiovascular Medicine, University of Virginia Health System, Charlottesville, VA, USA.
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Vecsey-Nagy M, Jermendy ÁL, Suhai FI, Panajotu A, Csőre J, Borzsák S, Fontanini DM, Kolossváry M, Vattay B, Boussoussou M, Csobay-Novák C, Merkely B, Maurovich-Horvat P, Szilveszter B. Model-based adaptive filter for a dedicated cardiovascular CT scanner: Assessment of image noise, sharpness and quality. Eur J Radiol 2021; 145:110032. [PMID: 34800835 DOI: 10.1016/j.ejrad.2021.110032] [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: 07/04/2021] [Revised: 10/29/2021] [Accepted: 11/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Filtered back projection (FBP) and adaptive statistical iterative reconstruction (ASIR) are ubiquitously applied in the reconstruction of coronary CT angiography (CCTA) datasets. However, currently no data is available on the impact of a model-based adaptive filter (MBAF2), recently developed for a dedicated cardiac scanner. PURPOSE Our aim was to determine the effect of MBAF2 on subjective and objective image quality parameters of coronary arteries on CCTA. METHODS Images of 102 consecutive patients referred for CCTA were evaluated. Four reconstructions of coronary images (FBP, ASIR, MBAF2, ASIR + MBAF2) were co-registered and cross-section were assessed for qualitative (graininess, sharpness, overall image quality) and quantitative [image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)] image quality parameters. Image noise and signal were measured in the aortic root and the left main coronary artery, respectively. Graininess, sharpness, and overall image quality was assessed on a 4-point Likert scale. RESULTS As compared to FBP, ASIR, and MBAF2, ASIR + MBAF2 resulted in reduced image noise [53.1 ± 12.3, 30.6 ± 8.5, 36.3 ± 4.2, 26.3 ± 4.0 Hounsfield units (HU), respectively; p < 0.001], improved SNR (8.4 ± 2.6, 14.1 ± 3.6, 11.8 ± 2.3, 16.3 ± 3.3 HU, respectively; p < 0.001) and CNR (9.4 ± 2.7, 15.9 ± 4.0, 13.3 ± 2.5, 18.3 ± 3.5 HU, respectively; p < 0.001). No difference in sharpness was observed amongst the reconstructions (p = 0.08). Although ASIR + MBAF2 was non-superior to ASIR regarding overall image quality (p = 0.99), it performed better than FBP (p < 0.001) and MBAF2 (p < 0.001) alone. CONCLUSION The combination of ASIR and MBAF2 resulted in reduced image noise and improved SNR and CNR. The implementation of MBAF2 in clinical practice may result in improved noise reduction performance and could potentiate radiation dose reduction.
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Affiliation(s)
- Milán Vecsey-Nagy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary.
| | - Ádám Levente Jermendy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
| | - Ferenc Imre Suhai
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
| | - Alexisz Panajotu
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
| | - Judit Csőre
- Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
| | - Sarolta Borzsák
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
| | | | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
| | - Borbála Vattay
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
| | - Melinda Boussoussou
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
| | - Csaba Csobay-Novák
- Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary; Medical Imaging Centre, Semmelweis University, 78.a Ulloi av., 1082 Budapest, Hungary
| | - Bálint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68. Varosmajor st., 1122 Budapest, Hungary
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