1
|
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.
Collapse
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
| |
Collapse
|
2
|
Yang W, Yu L, Yu Y, Dai X, Yang W, Zhang J. Novel motion correction algorithm improves diagnostic performance of CT fractional flow reserve. Eur J Radiol 2024; 176:111538. [PMID: 38838412 DOI: 10.1016/j.ejrad.2024.111538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/23/2024] [Accepted: 05/28/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES This study aimed to investigate the diagnostic performance of computed tomography (CT) fractional flow reserve (CT-FFR) derived from standard images (STD) and images processed via first-generation (SnapShot Freeze, SSF1) and second-generation (SnapShot Freeze 2, SSF2) motion correction algorithms. METHODS 151 patients who underwent coronary CT angiography (CCTA) and invasive coronary angiography (ICA)/FFR within 3 months were retrospectively included. CCTA images were reconstructed using an iterative reconstruction technique and then further processed through SSF1 and SSF2 algorithms. All images were divided into three groups: STD, SSF1, and SSF2. Obstructive stenosis was defined as a diameter stenosis of ≥ 50 % in the left main artery or ≥ 70 % in other epicardial vessels. Stenosis with an FFR of ≤ 0.8 or a diameter stenosis of ≥ 90 % (as revealed via ICA) was considered ischemic. In patients with multiple lesions, the lesion with lowest CT-FFR was used for patient-level analysis. RESULTS The overall quality score in SSF2 group (median = 3.67) was markedly higher than that in STD (median = 3) and SSF1 (median = 3) groups (P < 0.001). The best correlation (r = 0.652, P < 0.001) and consistency (mean difference = 0.04) between the CT-FFR and FFR values were observed in the SSF2 group. At the per-lesion level, CT-FFRSSF2 outperformed CT-FFRSSF1 in diagnosing ischemic lesions (area under the curve = 0.887 vs. 0.795, P < 0.001). At the per-patient level, the SSF2 group also demonstrated the highest diagnostic performance. CONCLUSION The SSF2 algorithm significantly improved CCTA image quality and enhanced its diagnostic performance for evaluating stenosis severity and CT-FFR calculations.
Collapse
Affiliation(s)
- Wenli Yang
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, #85 Wujin Rd, Shanghai, China
| | - Lihua Yu
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, #85 Wujin Rd, Shanghai, China
| | - Yarong Yu
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, #85 Wujin Rd, Shanghai, China
| | - Xu Dai
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, #85 Wujin Rd, Shanghai, China
| | - Wenyi Yang
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, #85 Wujin Rd, Shanghai, China
| | - Jiayin Zhang
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, #85 Wujin Rd, Shanghai, China.
| |
Collapse
|
3
|
Yamaguchi S, Ichikawa Y, Takafuji M, Sakuma H, Kitagawa K. Usefulness of second-generation motion correction algorithm in improving delineation and reducing motion artifact of coronary computed tomography angiography. J Cardiovasc Comput Tomogr 2024; 18:281-290. [PMID: 38429130 DOI: 10.1016/j.jcct.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND The purpose of this study was to investigate the usefulness of second-generation intra-cycle motion correction algorithm (SnapShot Freeze 2, GE Healthcare, MC2) in improving the delineation and interpretability of coronary arteries in coronary computed tomography angiography (CCTA) compared to first-generation intra-cycle motion correction algorithm (SnapShot Freeze, GE Healthcare, MC1). METHODS Fifty consecutive patients with known or suspected coronary artery disease who underwent CCTA on a 256-slice CT scanner were retrospectively studied. CCTA were reconstructed with three different algorithms: no motion correction (NMC), MC1, and MC2. The delineation of coronary arteries on CCTA was qualitatively rated on a 5-point scale from 1 (nondiagnostic) to 5 (excellent) by two radiologists blinded to the reconstruction method and the patient information. RESULTS On a per-vessel basis, the delineation scores of coronary arteries were significantly higher on MC2 images compared to MC1 images (median [interquartile range], right coronary artery, 5.0 [4.5-5.0] vs 4.5 [4.0-5.0]; left anterior descending artery, 5.0 [4.5-5.0] vs 4.5 [3.5-5.0]; left circumflex artery, 5.0 [4.5-5.0] vs 4.5 [3.9-5.0]; all p < 0.05). On a per-segment basis, for both 2 observers, the delineation scores on segment 1, 2, 8, 9, 10, 12 and 13 on MC2 images were significantly better than those on MC1 images (p < 0.05). The percentage of interpretable segments (rated score 3 or greater) on NMC, MC1, and MC2 images was 90.5-91.9%, 97.4-97.9%, and 100.0%, respectively. CONCLUSION Second-generation intra-cycle motion correction algorithm improves the delineation and interpretability of coronary arteries in CCTA compared to first-generation algorithm.
Collapse
Affiliation(s)
- Shintaro Yamaguchi
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
| | - Yasutaka Ichikawa
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
| | - Masafumi Takafuji
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
| | - Hajime Sakuma
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
| | - Kakuya Kitagawa
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
| |
Collapse
|
4
|
Szczykutowicz TP. Computed Tomography Angiography: Principles and Advances. Radiol Clin North Am 2024; 62:371-383. [PMID: 38553175 DOI: 10.1016/j.rcl.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
This review describes current state-of-the-art computed tomography technology required to address human-physiology-based challenges unique to angiographic imaging. Challenges are based on the need to image a bolus of contrast agent traversing inside rapidly moving structures. This article reviews the latest methods to optimize contrast timing and minimize motion.
Collapse
Affiliation(s)
- Timothy P Szczykutowicz
- University of Wisconsin Madison, 1005 WIMR, 1111 Highland Avenue, Madison, WI 53705, USA. https://twitter.com/Prof_TimStick
| |
Collapse
|
5
|
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.
Collapse
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.
| |
Collapse
|
6
|
Yan C, Liu J, Min J, Zhou H, Gu J, Zhou G, Chen C, Yang C, Zeng M. Radiation Dose and Image quality of coronary CT angiography performed with whole-heart coverage CT scanner with 0.25s rotation time in patients with irregular heart rhythm. Heliyon 2024; 10:e25320. [PMID: 38375311 PMCID: PMC10875372 DOI: 10.1016/j.heliyon.2024.e25320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 12/25/2023] [Accepted: 01/24/2024] [Indexed: 02/21/2024] Open
Abstract
Objectives To evaluate radiation exposure, image quality, and diagnostic performance of coronary CT angiography (CCTA) using the invasive coronary angiography (ICA) as the reference standard in patients with irregular heart rhythm on a 0.25 s rotation time, 16 cm coverage, single-beat, CT scanner with AI-assisted motion correction. Methods CCTA data-sheets of 427 patients using a CT scanner with an ECG monitoring system and motion correction algorithm were collected retrospectively. All the patients were divided into two groups: regular heart rhythm (357 patients) and irregular heart rhythm (70 patients). 22 patients in irregular heart rhythm underwent ICA. Image quality and effective dose in both groups were evaluated and compared. Image quality was evaluated on 5-point scales. The diagnostic performance of CCTA in irregular heart rhythm group was compared with the results of ICA. Results The image quality in both groups was similar (4.34 ± 0.47 vs 4.37 ± 0.48, p > 0.05). No significant difference was observed in effective dose between two groups (2.7 ± 0.7 vs 2.9 ± 1.3, p > 0.05). The diagnostic accuracy was 90.91% in a patient-based analysis, 96.97% in a vessel-based analysis, and 98.61% in a segment-based analysis. In irregular heart rhythm group, gender was an important factor affecting the number of CCTA scans in a single examination and the radiation dose exposed to the patient. Conclusions For patients with irregular heart rhythm, a CT scanner with an ECG monitoring system and motion correction algorithm can not only reduce the radiation dose to the same level as patients with normal heart rhythms, but also ensure that the images with high diagnostic accuracy.
Collapse
Affiliation(s)
- Cheng Yan
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Jing Liu
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 20032, China
| | - Ji Min
- Shanghai United Imaging Healthcare, Shanghai, 201800, China
| | - Heng Zhou
- University of Shanghai for Science and Technology, Shanghai, 200093, China
| | - Junying Gu
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Guofeng Zhou
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Caizhong Chen
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Chun Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| |
Collapse
|
7
|
Yin W, Xu R, Zhao B, Liu S, Wang M. Influence of a new motion correction algorithm (CardioCapture) on the correlation between heart rate and optimal reconstruction phase. Heliyon 2023; 9:e20588. [PMID: 37829800 PMCID: PMC10565690 DOI: 10.1016/j.heliyon.2023.e20588] [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: 11/15/2022] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
Purpose To investigate the effect of a new motion correction algorithm (CardioCapture) on the correlation between heart rate and optimal reconstruction phase by evaluating the impact of wide detector CT combined with CardioCapture on CCTA image quality. Materials and methods All cases were examined from April 2021 to September 2021. Two experienced radiologists scored these images on a four-point Likert scale. First, all images were divided into eight groups according to HR (at an interval of 5 bpm). The subjective score of images, the frequency of used CardioCapture, and the proportion of the diastolic reconstruction phase were compared in each group. Then, all cases were divided into two groups, one group was reconstructed using the automatic temporal reconstruction algorithm (Ephase) only, and the other group was reconstructed using the Ephase with the CardioCapture. The relationship between HR and the diastolic reconstruction phase was analyzed by the receiver operator characteristic curve (ROC). Result The data of 515 patients were studied. With the increase in HR, the subjective image score decreased, the frequency of CardioCapture increased, and the phase ratio of diastolic reconstruction decreased. When the HR was less than 70 bpm, the percentage of excellence image in each group surpassed 94.90%. The highest utilization rate of CardioCapture was 65.22%, and the lowest proportion of diastolic reconstruction was 72.46%. When 70 bpm < HR ≤ 75 bpm, the image excellence rate was 90.43%, the CardioCapture utilization rate was 82.05%, and the diastolic reconstruction rate was 56.41%.When 75 bpm < HR ≤ 80 bpm, the image excellence rate was 87.91%, the CardioCapture utilization rate was 80.65%, and the diastolic reconstruction was 6.45%.When the HR > 80 bpm, the image excellence rate was 80.00%, the CardioCapture utilization rate was 75.00%, and the diastolic reconstruction rate was 22.50%. The best cut-off point between HR and the diastolic reconstruction ROC curve in the groups without CardioCapture was 65 bpm, while that in groups with CardioCapture was 68 bpm. Conclusion The CardioCapture can effectively improve the image quality of CCTA with high HR. By maintaining the HR below 68 bpm and utilizing the prospective ECG-gated narrow phase axial scan, it is possible to ensure optimal image quality and concurrently reduce radiation dose.
Collapse
Affiliation(s)
- Wei Yin
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, NO.168 Chang-hai Road, Shanghai, 200433, China
| | - Ruimin Xu
- Department of Anorectal, Shanghai Pudong New Area Hospital of Traditional Chinese Medicine, NO.340 Xiu-chuan Road, Shanghai, 201200, China
| | - Binghui Zhao
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, NO.168 Chang-hai Road, Shanghai, 200433, China
| | - Shuilian Liu
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, NO.168 Chang-hai Road, Shanghai, 200433, China
| | - Minjie Wang
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, NO.168 Chang-hai Road, Shanghai, 200433, China
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Ondrejkovic M, Salat D, Cambal D, Klepanec A. Radiation dose and image quality of CT coronary angiography in patients with high heart rate or irregular heart rhythm using a 16-cm wide detector CT scanner. Medicine (Baltimore) 2022; 101:e30583. [PMID: 36123855 PMCID: PMC9478320 DOI: 10.1097/md.0000000000030583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aim of the study was to evaluate the effect of high and irregular heart rate on the image quality and on the radiation exposure using a 256-row, 16-cm wide detector computed tomography (CT) system. Between March and December 2019, 349 patients undergoing CT coronary angiography (CTCA) were prospectively enrolled. Patients were divided into 2 study groups; Group 1 included patients with a regular heart rate of ≤70 bpm, while Group 2 included patients with an irregular heart rhythm or heart rate of >70 bpm. In all patients, image quality score and radiation dose were analyzed and recorded. In Group 1, there were a total of 195 patients, while in Group 2, there were 154 patients. Of the 349 patients, 299 of them had a regular heart rhythm (85.7%) and 50 (14.3%) had an irregular heart rhythm. Mean heart rate during scanning was 59 ± 7 bpm in Group 1 and 80 ± 12 bpm in Group 2. Mean effective dose of CTCA in Group 1 (1.2 ± 0.8 mSv) was lower than in Group 2 (1.9 ± 1.2 mSv, P < .001). Mean image quality (Likert score) of Group 1 was significantly higher than in Group 2 (4.1 vs 3.4, P < .001). CT scanner with 16-cm wide detector enables low-radiation exposure during CTCA even at high heart rate or irregular heart rhythm. Good CTCA image quality and low dose are related to low heart rate.
Collapse
Affiliation(s)
| | - Dusan Salat
- University of St. Cyril and Methodius of Trnava, Trnava, Slovakia
| | - Daniel Cambal
- Department of Cardiology, University Hospital Trnava, Trnava, Slovakia
| | - Andrej Klepanec
- Department of Radiology, University Hospital Trnava, Trnava, Slovakia
- *Correspondence: Andrej Klepanec, Department of Radiology, University Hospital Trnava, Andreja Zarnova 11, Trnava, Slovakia (e-mail: )
| |
Collapse
|
10
|
Jin L, Gao P, Wang K, Li J, Li M. Intraindividual evaluation of effects of image filter function on image quality in coronary computed tomography angiography. Front Cardiovasc Med 2022; 9:840735. [PMID: 36186969 PMCID: PMC9521173 DOI: 10.3389/fcvm.2022.840735] [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: 12/21/2021] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives To evaluate whether applying image filters (smooth 3D+ and edge-2) improves image quality in coronary CT angiography (CCTA). Methods Ninety patients (routine group) with suspected coronary artery diseases based on 16-cm wide coverage detector CT findings were retrospectively enrolled at a chest pain center from December 2019 to September 2021. Two image filters, smooth 3D+ and edge-2 available on the Advantage Workstation (AW) were subsequently applied to the images to generate the research group (SE group). Quantitative parameters, including CT value, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), image sharpness and image quality score, and diagnostic accuracy were compared between the two groups. Results A total of 900 segments from 270 coronary arteries in 90 patients were analyzed. SNR, CNR, and image sharpness for vessels and image quality scores in the SE group were significantly better than those in the routine group (all p < 0.001). The SE group showed a slightly higher negative predictive value (NPV) on the left anterior descending artery and right coronary artery (RCA) stenosis evaluations, as well as total NPV. The SE group also showed slightly higher sensitivity and accuracy than the routine group on RCA stenosis evaluation. Conclusion The use of an image filter combining smooth 3D+ and edge-2 on an AW could improve the image quality of CCTA and increase radiologists' diagnostic confidence.
Collapse
Affiliation(s)
- Liang Jin
- Radiology Department, Huadong Hospital, Affiliated to Fudan University, Shanghai, China
| | - Pan Gao
- Radiology Department, Huadong Hospital, Affiliated to Fudan University, Shanghai, China
| | - Kun Wang
- Radiology Department, Huadong Hospital, Affiliated to Fudan University, Shanghai, China
| | - Jianying Li
- CT Research Center, GE Healthcare China, Beijing, China
| | - Ming Li
- Radiology Department, Huadong Hospital, Affiliated to Fudan University, Shanghai, China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| |
Collapse
|
11
|
Xiao HJ, Zhan AL, Huang QW, Huang RG, Lin WH. Accuracy and image quality of wide-detector revolution CT angiography combined with prospective ECG-triggered CT angiography in the diagnosis of congenital aortic arch anomalies in Chinese children. Front Pediatr 2022; 10:1017428. [PMID: 36533235 PMCID: PMC9755195 DOI: 10.3389/fped.2022.1017428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To explore the accuracy and image quality of wide-detector revolution CT angiography combined with prospective ECG-triggered CT angiography in the diagnosis of congenital aortic arch anomalies in Chinese children. METHODS From January 2020 to July 2022, the clinical data of 57 children with congenital aortic arch anomalies confirmed by surgery were collected. All patients underwent CT angiography (CTA) with Revolution CT and transthoracic echocardiography (TTE) before the operation. The accuracy of CTA and TTE in the diagnosis of aortic arch anomalies was compared with the surgical results. RESULT The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CTA and TTE for congenital aortic arch anomalies (including intracardiac and extracardiac structural abnormalities) were 92.2% and 85.5%, 99.4%, and 99.1%, 97.4% and 95.6%, 98.1% and 96.9%, and 97.2% and 95.2%, respectively. Regarding extracardiac structural malformations, the sensitivity of CTA was 100%, whereas that of TTE was 78.6% (P < 0.001). Regarding intracardiac structural malformations, the sensitivity of CTA was 84.5%, whereas that of TTE was 92.5% (P < 0.001). Regarding satisfaction with the images in aortic arch anomalies, surgeons noted that the CTA images were more useful for diagnosis and operation planning compared with TTE. CONCLUSION Wide-detector revolution CT angiography combined with prospective ECG triggering can be routinely used to assess congenital aortic arch anomalies, providing adequate image quality and high diagnostic accuracy. However, limitations in the identification of intracardiac structural abnormalities are noted.
Collapse
Affiliation(s)
- Hui-Jun Xiao
- Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - A-Lai Zhan
- Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Qing-Wen Huang
- Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Rui-Gang Huang
- Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Wei-Hua Lin
- Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| |
Collapse
|
12
|
Mander GT, Dobeli K, Steffensen C, Munn Z. Diagnostic accuracy of prospectively gated, 128-slice or greater CTCA at high heart rates: a systematic review and meta-analysis. J Med Radiat Sci 2021; 68:435-445. [PMID: 34235885 PMCID: PMC8656183 DOI: 10.1002/jmrs.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Prospectively gated 64-slice CT coronary angiography (CTCA) may be contraindicated for heart rates (HRs) over 65 beats per minute (bpm) due to reduced diagnostic sensitivity. Newer CT scanners typically provide 128 or more slices and superior temporal resolution compared with older models; consequently, diagnostic accuracy for current technology prospectively gated CTCA may be adequate at HRs above 65 bpm. The aim of this systematic review was to investigate the diagnostic accuracy of CTCA using 128-slice or greater CT technology when compared with conventional coronary angiography for patients with HRs >65 bpm. METHODS A systematic search of PubMed, CINAHL, EMBASE and Scopus was performed as well as unpublished databases, sources and reference lists. Titles and abstracts were screened by two independent reviewers. Full-text screening was then performed. Studies that determined diagnostic accuracy of coronary artery stenosis in adult patients with high heart rates utilising prospectively gated 128 detector or greater scanners were included. Studies that were included in the review underwent critical appraisal using the QUADAS-2 tool. RESULTS Ten studies were included in the systematic review, with nine of these included in a diagnostic test accuracy meta-analysis, including six of which reported data at the patient level. Meta-analysis indicated very high pooled sensitivity 100% (95% CI 0.99, 1.00); however, pooled specificity was less at 79% (95% CI 0.69, 0.88). CONCLUSIONS Prospectively gated CT coronary angiography may be justifiable at heart rates above 65 bpm if performed on a 128-slice or greater CT unit. Caution regarding the implication of a positive result is recommended due to reduced specificity. Further evidence is required before consideration of a new higher heart threshold.
Collapse
Affiliation(s)
- Gordon T.W. Mander
- Toowoomba HospitalDarling Downs HealthQueensland HealthToowoombaQueenslandAustralia
- Faculty of Health SciencesJoanna Briggs InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Karen Dobeli
- Royal Brisbane and Women’s HospitalMetro North Hospital and Health ServiceQueensland HealthHerstonQueenslandAustralia
| | - Caitlin Steffensen
- Faculty of Health SciencesJoanna Briggs InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Philips Australia and New ZealandBrisbaneQueenslandAustralia
| | - Zachary Munn
- Faculty of Health SciencesJoanna Briggs InstituteUniversity of AdelaideAdelaideSouth AustraliaAustralia
| |
Collapse
|
13
|
Image quality and diagnostic performance evaluation in transcatheter aortic valve implantation candidates with atrial fibrillation using a whole-heart coverage CT scanner. Eur Radiol 2021; 32:1034-1043. [PMID: 34338842 DOI: 10.1007/s00330-021-08187-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/09/2021] [Accepted: 06/29/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate the image quality and diagnostic performance for obstructive coronary artery disease of transcatheter aortic valve implantation (TAVI) patients with atrial fibrillation (AF) during TAVI planning CT using a whole-heart coverage CT scanner. METHODS Eighty-eight consecutive TAVI candidates with AF (50 men, 74 ± 6 years) who underwent both TAVI planning CT and invasive coronary catheter angiography (ICA) were retrospectively analyzed. With ICA results as the reference standard, the accuracy of TAVI planning CT for lesion detection on a per-vessel and per-patient level was calculated. Meanwhile, image quality, contrast volume, and effective dose (ED) were evaluated. A 5-point visual scale (1-5) was used to assess the subjective image quality. The CT value and signal-to-noise ratio were measured for the left main coronary artery (LM), left anterior descending (LAD), left circumflex (LCX), and right coronary arteries (RCA). RESULTS The ED for CCTA was 3.25 ± 1.39 mSv and contrast volume was 58.14 ± 12.34 mL. A total of 1371 (1371/1408 = 97.4%) segments with diameter > 1.5 mm were analyzed. For the subjective evaluation, the mean score was 3.99 ± 0.96 for overall image quality. The mean CT values in LM, RCA, LCX, and LAD were all above 400 HU. For the detection of > 50% stenosis, TAVI planning CT provided on the per-vessel and per-patient basis 97.06% and 100% in sensitivity, 96.23% and 89.06% in specificity, 99.7% and 100% in negative predictive value, and 73.3% and 77.4% in positive predictive value, respectively. CONCLUSION TAVI planning CT with whole-heart coverage demonstrates good CCTA image quality and a high sensitivity and NPV in excluding obstructive CAD in TAVI candidates with AF. KEY POINTS • Transcatheter aortic valve implantation planning (TAVI) CT with whole-heart coverage enables good image quality of CCTA in TAVI candidates with atrial fibrillation. • Obstructive coronary artery disease may be excluded with high accuracy in transcatheter aortic valve implantation (TAVI) candidates with atrial fibrillation with the usage of whole-heart coverage TAVI planning CT.
Collapse
|
14
|
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.
Collapse
|
15
|
Cardiac-CT with the newest CT scanners: An incoming screening tool for competitive athletes? Clin Imaging 2021; 78:74-92. [PMID: 33773447 DOI: 10.1016/j.clinimag.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 02/18/2021] [Accepted: 03/05/2021] [Indexed: 11/20/2022]
Abstract
Competitive athletes of all skill levels are at risk of sudden cardiac death (SCD) due to certain heart conditions. Prior to engagement in high-intensity athletics, it is necessary to screen for these conditions in order to prevent sudden cardiac death. Cardiac-CT angiography (CCTA) is a reliable tool to rule out the leading causes of SCD by providing an exceptional overview of vascular and cardiac morphology. This allows CCTA to be a powerful resource in identifying cardiac anomalies in selected patients (i.e. unclear symptoms or findings at ECG or echocardiography) as well as to exclude significant coronary artery disease (CAD). With the advancement of technology over the last few years, the latest generations of computed tomography (CT) scanners provide better image quality at lower radiation exposures. With the amount of radiation exposure per scan now reaching the sub-millisievert range, the number of CT examinations it is supposed to increase greatly, also in the athlete's population. It is thus necessary for radiologists to have a clear understanding of how to make and interpret a CCTA examination so that these studies may be performed in a responsible and radiation conscious manner especially when used in the younger populations. Our work aims to illustrate the main radiological findings of CCTAs and highlight their clinical impact with some case studies. We also briefly describe critical features of state-of-the-art CT scanners that optimize different acquisitions to obtain the best quality at the lowest possible dose.
Collapse
|
16
|
Qian W, Liu W, Zhu Y, Wang J, Chen Y, Meng H, Chen L, Xu Y, Zhu X. Influence of heart rate and coronary artery calcification on image quality and diagnostic performance of coronary CT angiography: comparison between 96-row detector dual source CT and 256-row multidetector CT. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2021; 29:529-539. [PMID: 33749627 DOI: 10.3233/xst-210837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND CT-derived fractional flow reserve (FFRCT) and diagnostic accuracy rely on good image quality during coronary CT angiography (CCTA). OBJECTIVE To investigate whether heart rate (HR) and coronary artery calcium (CAC) score decrease image quality and diagnostic performance of two advanced CT scanners including 96-row detector dual source CT (DSCT) and 256-row multidetector CT (MDCT). METHODS First, 79 patients who underwent CCTA (42 with DSCT and 37 with MDCT) and invasive coronary angiography (ICA) are enrolled. Next, coronary segments with excellent image quality are evaluated and the percentage is calculated. Then, diagnostic accuracy in detecting significant diameter stenosis is presented with ICA as the reference standard. RESULTS Compared with the DSCT, the percentage of coronary segments with excellent image quality is lower (P = 0.010) while diagnostic accuracy on per-segment level is improved (P = 0.037) using MDCT. CAC score≥400 is the only independent factor influencing the percentage of coronary segments with excellent image quality [odds ratio (OR): DSCT, 3.096 and MDCT, 1.982] and segmental diagnostic accuracy (OR: DSCT, 2.630 and MDCT, 2.336) for both scanners. HR≥70 bpm (OR: 5.506) is the independent factor influencing the percentage of coronary segments with excellent image quality with MDCT. CONCLULSION During CCTA, CAC score≥400 still decreases the proportion of coronary segments with excellent image quality and diagnostic accuracy with advanced CT scanners. HR≥70 bpm is another factor causing image quality decreasing with MDCT.
Collapse
Affiliation(s)
- Wen Qian
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wangyan Liu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yinsu Zhu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jun Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yang Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Haoyu Meng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Leilei Chen
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yi Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaomei Zhu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
17
|
Achieving Low Radiation Dose in "One-Stop" Myocardial Computed Tomography Perfusion Imaging in Coronary Artery Disease Using 16-cm Wide Detector CT. Acad Radiol 2020; 27:1531-1539. [PMID: 31859211 DOI: 10.1016/j.acra.2019.11.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/20/2019] [Accepted: 11/20/2019] [Indexed: 02/08/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate the feasibility of "one-stop" myocardial computed tomography perfusion (CTP) imaging (combined anatomy, perfusion, and function) in coronary artery disease using 16-cm wide detector CT, compared to conventional coronary CT angiography (CCTA). MATERIALS AND METHODS 442 patients with suspected coronary artery disease were randomly divided into two groups. Patients in group A underwent "one-stop" CTP, whereas group B underwent conventional CCTA. Image quality of CT images was assessed. Radiation and contrast medium doses and scan time of the two groups were recorded. Group A was further divided into four subgroups according to the degree of coronary artery stenosis, for which transmural perfusion ratio (TPR) and left ventricular ejection fraction (LVEF) were measured. RESULTS Scan time was 73.1 ± 7.3 (s) longer in group A than in group B with 11.7% reduction of radiation dose (p < 0.001) and no significant difference in image quality was noted. Significant differences regarding the minimum TPR (F = 24.657, p < 0.001) and LVEF (χ2 =36.98, p < 0.001) were observed among four subgroups. A negative correlation was found between the degree of coronary artery stenosis and TPR of the corresponding myocardial segments (r = -0.55, p < 0.001). Patients with moderate to severe arterial stenosis exhibited a decreased LVEF compared to those with normal coronary arteries (48.0% vs 56.5%, p < 0.001). CONCLUSION Compared to conventional CCTA, our new developed "one-stop" CTP may provide more comprehensive information on myocardial perfusion, coronary artery stenosis, and LV cardiac function with reduced radiation and contrast medium doses.
Collapse
|
18
|
Further Improving Image Quality of Cardiovascular Computed Tomography Angiography for Children With High Heart Rates Using Second-Generation Motion Correction Algorithm. J Comput Assist Tomogr 2020; 44:790-795. [PMID: 32936580 DOI: 10.1097/rct.0000000000001035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The state-of-art motion correction algorithm is inadequate for correcting motion artifacts in coronary arteries in cardiovascular computed tomography angiography (CCTA) for children with high heart rates, and even less effective for heart structures beyond coronary arteries. PURPOSE This study aimed to evaluate the effectiveness of a second-generation, whole-heart motion correction algorithm in improving the heart image quality of CCTA for children with high heart rates. MATERIALS AND METHODS Forty-two consecutive symptomatic cardiac patients with high heart rates (122.6 ± 18.8 beats/min) were enrolled. All patients underwent CCTA on a 256-row CT using a prospective electrocardiogram-triggered single-beat protocol. Images were reconstructed using a standard algorithm (STD), state-of-the-art first-generation coronary artery motion correction algorithm (MC1), and second-generation, whole-heart motion correction algorithm (MC2). The image quality of the origin of left coronary, right coronary, aortic valve, pulmonary valve, mitral valve, tricuspid valve, aorta root, pulmonary artery root, ventricular septum (VS), and atrial septum (AS) was assessed by 2 experienced radiologists using a 4-point scale (1, nondiagnostic; 2, detectable; 3, measurable; and 4, excellent); nonparametric test was used to analyze and compare the differences among 3 groups; and post hoc multiple comparisons were used between different methods. RESULTS There were group differences for cardiac structures except VS and AS, with MC2 having the best image quality and STD having the worst image quality. Post hoc multiple comparisons showed that MC2 was better than MC1 and STD in all structures except VS and AS where all 3 algorithms performed equally, whereas MC1 was better than STD only in the origin of left coronary, right coronary, and mitral valve. CONCLUSIONS A second-generation, whole-heart motion correction algorithm further significantly improves cardiac image quality beyond the coronaries in CCTA for pediatric patients with high heart rates.
Collapse
|
19
|
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.
Collapse
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.
| |
Collapse
|
20
|
Kang EJ. Clinical Applications of Wide-Detector CT Scanners for Cardiothoracic Imaging: An Update. Korean J Radiol 2020; 20:1583-1596. [PMID: 31854147 PMCID: PMC6923215 DOI: 10.3348/kjr.2019.0327] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/23/2019] [Indexed: 12/21/2022] Open
Abstract
Technical developments in multidetector computed tomography (CT) have increased the number of detector rows on the z-axis, and 16-cm wide-area-coverage CT scanners have enabled volumetric scanning of the entire heart. Beyond coronary arterial imaging, such innovations offer several advantages during clinical imaging in the cardiothoracic area. The wide-detector CT scanner markedly reduces the image acquisition time to less than 1 second for coronary CT angiography, thereby decreasing the volume of contrast material and radiation dose required for the examination. It also eliminates stair-step artifacts, allowing robust improvements in myocardial function and perfusion imaging. Additionally, new imaging techniques for the cardiothoracic area, including subtraction imaging and free-breathing scans, have been developed and further improved by using the wide-detector CT scanner. This article investigates the technical developments in wide-detector CT scanners, summarizes their clinical applications in the cardiothoracic area, and provides a review of the recent literature.
Collapse
Affiliation(s)
- Eun Ju Kang
- Department of Radiology, College of Medicine, Dong-A University, Busan, Korea.
| |
Collapse
|
21
|
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.
Collapse
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.
| |
Collapse
|
22
|
Jin L, Gao Y, Shan Y, Sun Y, Li M, Wang Z. Qualitative and quantitative image analysis of 16 cm wide-coverage computed tomography compared to new-generation dual-source CT. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2020; 28:527-539. [PMID: 32333574 DOI: 10.3233/xst-190624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Diagnostic quality of computed tomography (CT) images depends on numerous factors. Recently, two different modalities were introduced for coronary CT angiography (CCTA). OBJECTIVE This study aims to compare the performance of 16 cm wide-coverage detector CT (WDCT) using the snapshot freeze technique with a new-generation dual-source CT (DSCT) with 66 ms temporal resolution for CCTA. METHODS Total 101 patients with suspected coronary heart disease were enrolled. Of these, 50 and 51 patients were examined on WDCT and DSCT, respectively. CT values, image noise, signal-to-noise ratio, and contrast-to-noise ratio were measured. The image processing efficiency was recorded, followed by statistical comparison of diagnostic accuracy and radiation dose. RESULTS Ninety-nine patients (98.02%) had satisfactory diagnostic image quality. DSCT was significantly better than WDCT in terms of quantitative image quality, image processing efficiency, and qualitative analysis (P < 0.05). However, radiation dose was significantly lower on WDCT (P < 0.05) as compared to DSCT. CONCLUSIONS Image processing efficiency and image quality of CCTA was higher on DSCT compared to WDCT due to the limitation of maximal tube current of WDCT.
Collapse
Affiliation(s)
- Liang Jin
- Department of Radiology, Huadong Hospital (Affiliated to Fudan University), Shanghai, China
| | - Yiyi Gao
- Department of Radiology, Huadong Hospital (Affiliated to Fudan University), Shanghai, China
| | - Yuqing Shan
- Department of Radiology, Rizhao People's Hospital, Rizhao, China
| | - Yingli Sun
- Department of Radiology, Huadong Hospital (Affiliated to Fudan University), Shanghai, China
| | - Ming Li
- Department of Radiology, Huadong Hospital (Affiliated to Fudan University), Shanghai, China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| | - Zhizhong Wang
- Department of Radiology, Caoxian People's Hospital, Fumin Avenue, Caoxian Development Zone, Heze, China
| |
Collapse
|
23
|
Abstract
Background 3D printing has shown great promise in cardiovascular disease, with reports mainly focusing on pre-surgical planning and medical education. Research on utilization of 3D printed models in simulating coronary stenting has not been reported. In this study, we presented our experience of placing coronary stents into personalized 3D printed coronary models with the aim of determining stent lumen visibility with images reconstructed with different postprocessing views and algorithms. Methods A total of six coronary stents with diameter ranging from 2.5 to 4.0 mm were placed into 3 patient-specific 3D printed coronary models for simulation of coronary stenting. The 3D printed models were placed in a plastic container and scanned on a 192-slice third generation dual-source CT scanner with images reconstructed with soft (Bv36) and sharp (Bv59) kernel algorithms. Thick and thin slab maximum-intensity projection (MIP) images were also generated from the original CT data for comparison of stent lumen visibility. Stent lumen diameter was measured on 2D axial and MIP images, while stent diameter was measured on 3D volume rendering images. 3D virtual intravascular endoscopy (VIE) images were generated to provide intraluminal views of the coronary wall and stent appearances. Results All of these stents were successfully placed into the right and left coronary arteries but 2 of them did not obtain wall apposition along the complete length. The stent lumen visibility ranged from 54 to 97%, depending on the stent location in the coronary arteries. The mean stent lumen diameters measured on 2D axial, thin and thick slab MIP images were found to be significantly smaller than the actual size (P<0.01). Thick slab MIP images resulted in measured stent lumen diameters smaller than those from thin slab MIP images, with significant differences noticed in most of the measurements (4 out of 6 stents) (P<0.05), and no significant differences in the remaining 2 stents (P=0.19-0.38). In contrast, 3D volume rendering images allowed for more accurate measurements with measured stent diameters close to the actual dimensions in most of these coronary stents, except for the stent placed at the right coronary artery in one of the models due to insufficient expansion of the stent. Images reconstructed with sharp kernel Bv59 significantly improved stent lumen visibility when compared to the smooth Bv36 kernel (P=0.01). 3D VIE was successfully generated in all of the datasets with clear visualization of intraluminal views of the stents in relation to the coronary wall. Conclusions This preliminary report shows the feasibility of using 3D printed coronary artery models in coronary stenting for investigation of optimal coronary CT angiography protocols. Future studies should focus on placement of more stents with a range of stent diameters in the quest to reduce the need for invasive angiography for surveillance.
Collapse
Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Western Australia, 6845, Australia
| | - Shirley Jansen
- Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia 6009, Australia.,Curtin Medical School, Curtin University, Perth, Western Australia 6845, Australia.,Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia 6009, Australia.,Heart and Vascular Research Institute, Harry Perkins Institute for Medical Research, Perth, Western Australia 6009, Australia
| |
Collapse
|
24
|
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.
Collapse
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
| |
Collapse
|
25
|
Effects of different CT angiography technology-based nursing methods on patients with coronary artery heart diseases. J Infect Public Health 2019; 13:2045-2048. [PMID: 31296480 DOI: 10.1016/j.jiph.2019.06.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/16/2019] [Accepted: 06/21/2019] [Indexed: 12/27/2022] Open
Abstract
To study the nursing effects of different CT angiography (CTA) technology-based nursing methods on patients with coronary artery heart diseases (CHD), CHD patients treated in Dongying People's Hospital were selected as the research objects and were divided into the control group and the observation group. Different coronary CTA nursing methods, i.e. the routine nursing and the psychological nursing, were performed to the control group and the observation group respectively. During the experiment, patients performed self-evaluations, which included the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). Biological indicators of patients, including heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP), were measured before and after patients accepted different nursing methods. In addition, the quality of coronary CTA images was evaluated. The results showed that HR, DBP, SBP, SAS scores, and SDS scores of patients in the observation group were obviously lower than those in the control group, and the differences were statistically significant, besides, the image quality of the observation group was significantly greater than that of the control group, which was helpful for diagnosis and had statistical significances. Therefore, it is proved that the psychological nursing of CHD patients can effectively reduce the negative emotions of patients, such as anxiety and depression, which is conducive to CTA and can assist clinical diagnosis. The results provide a basis and ideas for more accurate research in the future.
Collapse
|
26
|
Influence of virtual monochromatic spectral image at different energy levels on motion artifact correction in dual-energy spectral coronary CT angiography. Jpn J Radiol 2019; 37:636-641. [PMID: 31270660 DOI: 10.1007/s11604-019-00852-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 06/28/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE To investigate the influence of virtual monochromatic spectral (VMS) CT images at different energy levels on the effectiveness of a motion correction technique (SSF) in dual-energy Spectral coronary CT angiography (CCTA). MATERIALS AND METHODS 29 cases suspected of or diagnosed with coronary artery disease underwent Spectral CCTA using a prospective ECG triggering with 250 ms padding time. SSF was applied to the determined least-motion phase to generate 6 additional sets of VMS images with energy levels from 40 to 100 keV. CT value and standard deviation (SD) in the aortic root and epicardial adipose tissue were measured. Image quality of the RCA, LAD and LCX was evaluated on a per-vessel basis in each patient. Two reviewers evaluated the artery using the score of the segment. RESULTS The low energy VMS images increased CT value and image noise compared with higher-energy VMS images, except 90 keV and 100 keV. The CNR of 40-70 keV were higher than those of 80-100 keV (P < 0.05). The image quality scores for images at 50-80 keV were higher than those of 40, 90, and 100 keV (P < 0.05), and the VMS image quality at 50 keV and 60 keV with SSF was the highest. CONCLUSION SSF can effectively reduce the motion artifacts when coronary vessels have suitable contrast enhancement which can be achieved by adjusting energy levels of VMS images.
Collapse
|
27
|
Park JB, Jeong YJ, Lee G, Lee NK, Kim JY, Lee JW. Influence of Heart Rate and Innovative Motion-Correction Algorithm on Coronary Artery Image Quality and Measurement Accuracy Using 256-Detector Row Computed Tomography Scanner: Phantom Study. Korean J Radiol 2019; 20:94-101. [PMID: 30627025 PMCID: PMC6315068 DOI: 10.3348/kjr.2018.0251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/03/2018] [Indexed: 12/30/2022] Open
Abstract
Objective To investigate the efficacy of motion-correction algorithm (MCA) in improving coronary artery image quality and measurement accuracy using an anthropomorphic dynamic heart phantom and 256-detector row computed tomography (CT) scanner. Materials and Methods An anthropomorphic dynamic heart phantom was scanned under a static condition and under heart rate (HR) simulation of 50–120 beats per minute (bpm), and the obtained images were reconstructed using conventional algorithm (CA) and MCA. We compared the subjective image quality of coronary arteries using a four-point scale (1, excellent; 2, good; 3, fair; 4, poor) and measurement accuracy using measurement errors of the minimal luminal diameter (MLD) and minimal luminal area (MLA). Results Compared with CA, MCA significantly improved the subjective image quality at HRs of 110 bpm (1.3 ± 0.3 vs. 1.9 ± 0.8, p = 0.003) and 120 bpm (1.7 ± 0.7 vs. 2.3 ± 0.6, p = 0.006). The measurement error of MLD significantly decreased on using MCA at 110 bpm (11.7 ± 5.9% vs. 18.4 ± 9.4%, p = 0.013) and 120 bpm (10.0 ± 7.3% vs. 25.0 ± 16.5%, p = 0.013). The measurement error of the MLA was also reduced using MCA at 110 bpm (19.2 ± 28.1% vs. 26.4 ± 21.6%, p = 0.028) and 120 bpm (17.9 ± 17.7% vs. 34.8 ± 19.6%, p = 0.018). Conclusion Motion-correction algorithm can improve the coronary artery image quality and measurement accuracy at a high HR using an anthropomorphic dynamic heart phantom and 256-detector row CT scanner.
Collapse
Affiliation(s)
- Jeong Bin Park
- Department of Radiology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Yeon Joo Jeong
- Department of Radiology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Geewon Lee
- Department of Radiology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Nam Kyung Lee
- Department of Radiology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jin You Kim
- Department of Radiology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ji Won Lee
- Department of Radiology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| |
Collapse
|
28
|
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.
Collapse
|