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Sone M, Orii M, Ota Y, Chiba T, Schuijf JD, Akino N, Yoshioka K. Energy-integrating detector based ultra-high-resolution CT with deep learning reconstruction for the assessment of calcified lesions in coronary artery disease. J Cardiovasc Comput Tomogr 2024:S1934-5925(24)00448-9. [PMID: 39379200 DOI: 10.1016/j.jcct.2024.09.014] [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: 04/21/2024] [Revised: 09/01/2024] [Accepted: 09/30/2024] [Indexed: 10/10/2024]
Abstract
BACKGROUND The aim of this study to compare of the image quality of calcified lesions in coronary artery disease between deep learning reconstruction (DLR) and model-based iterative reconstruction (MBIR) on energy-integrating detector (EID) based ultra-high-resolution CT (UHRCT). METHODS We performed a phantom study on EID-based UHRCT using a dedicated insert for calcifications and obtained the derivative values for DLR and MBIR. In the clinical study, the derivative values were compared between DLR and MBIR across 73 calcified lesions in 62 patients. Edge sharpness of calcifications and contrast resolution at the coronary lumen side were quantified by the maximum and minimum derivative values. Two radiologists independently analyzed image quality of the calcified lesions using a 5-point Likert scale. RESULTS In the phantom study, the edge sharpness of the 3-mm calcifications on DLR (median, 924 HU/mm; IQR, 580-1741 HU/mm) was significantly higher than on MBIR (median, 835 HU/mm; IQR, 484-1552; p < 0.001). In the clinical study, the image quality of the calcified lesions was significantly better on DLR with significantly reduced reconstruction time (p < 0.001). The contrast resolution at the coronary lumen side on DLR (median, -99.1 HU/mm; IQR, -209 to -34.3 HU/mm) was significantly higher than on MBIR (median, -41.8 HU/mm; IQR, -121 to 22.3 HU/mm, p < 0.001) although the edge sharpness of calcifications was similar between DLR and MBIR (p = 0.794) in the clinical setting. CONCLUSION EID-based UHRCT reconstructed using DLR represents better image quality of calcified lesions in coronary artery disease compared with MBIR, with significantly reduced reconstruction time.
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Affiliation(s)
- Misato Sone
- Department of Radiology, Iwate Medical University, Yahaba, Japan
| | - Makoto Orii
- Department of Radiology, Iwate Medical University, Yahaba, Japan.
| | - Yoshitaka Ota
- Center for Radiological Science, Iwate Medical University, Yahaba, Japan
| | - Takuya Chiba
- Center for Radiological Science, Iwate Medical University, Yahaba, Japan
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Emoto T, Nagayama Y, Takada S, Sakabe D, Shigematsu S, Goto M, Nakato K, Yoshida R, Harai R, Kidoh M, Oda S, Nakaura T, Hirai T. Super-resolution deep-learning reconstruction for cardiac CT: impact of radiation dose and focal spot size on task-based image quality. Phys Eng Sci Med 2024; 47:1001-1014. [PMID: 38884668 DOI: 10.1007/s13246-024-01423-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 04/04/2024] [Indexed: 06/18/2024]
Abstract
This study aimed to evaluate the impact of radiation dose and focal spot size on the image quality of super-resolution deep-learning reconstruction (SR-DLR) in comparison with iterative reconstruction (IR) and normal-resolution DLR (NR-DLR) algorithms for cardiac CT. Catphan-700 phantom was scanned on a 320-row scanner at six radiation doses (small and large focal spots at 1.4-4.3 and 5.8-8.8 mGy, respectively). Images were reconstructed using hybrid-IR, model-based-IR, NR-DLR, and SR-DLR algorithms. Noise properties were evaluated through plotting noise power spectrum (NPS). Spatial resolution was quantified with task-based transfer function (TTF); Polystyrene, Delrin, and Bone-50% inserts were used for low-, intermediate, and high-contrast spatial resolution. The detectability index (d') was calculated. Image noise, noise texture, edge sharpness of low- and intermediate-contrast objects, delineation of fine high-contrast objects, and overall quality of four reconstructions were visually ranked. Results indicated that among four reconstructions, SR-DLR yielded the lowest noise magnitude and NPS peak, as well as the highest average NPS frequency, TTF50%, d' values, and visual rank at each radiation dose. For all reconstructions, the intermediate- to high-contrast spatial resolution was maximized at 4.3 mGy, while the lowest noise magnitude and highest d' were attained at 8.8 mGy. SR-DLR at 4.3 mGy exhibited superior noise performance, intermediate- to high-contrast spatial resolution, d' values, and visual rank compared to the other reconstructions at 8.8 mGy. Therefore, SR-DLR may yield superior diagnostic image quality and facilitate radiation dose reduction compared to the other reconstructions, particularly when combined with small focal spot scanning.
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Affiliation(s)
- Takafumi Emoto
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
| | - Sentaro Takada
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Daisuke Sakabe
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Shinsuke Shigematsu
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Makoto Goto
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Kengo Nakato
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Ryuya Yoshida
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Ryota Harai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
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Scarpa Matuck BR, Akino N, Bakhshi H, Cox C, Ebrahimihoor E, Ishida M, Lemos PA, Lima JAC, Matheson MB, Orii M, Ostovaneh A, Ostovaneh MR, Schuijf JD, Szarf G, Trost JC, Yoshioka K, Arbab-Zadeh A. Ultra-high-resolution CT vs. invasive angiography for detecting hemodynamically significant coronary artery disease: Rationale and methods of the CORE-PRECISION multicenter study. J Cardiovasc Comput Tomogr 2024; 18:444-449. [PMID: 38702271 DOI: 10.1016/j.jcct.2024.04.012] [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: 03/12/2024] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Direct coronary arterial evaluation via computed tomography (CT) angiography is the most accurate noninvasive test for the diagnosis of coronary artery disease (CAD). However, diagnostic accuracy is limited in the setting of severe coronary calcification or stents. Ultra-high-resolution CT (UHR-CT) may overcome this limitation, but no rigorous study has tested this hypothesis. METHODS The CORE-PRECISION is an international, multicenter, prospective diagnostic accuracy study testing the non-inferiority of UHR-CT compared to invasive coronary angiography (ICA) for identifying patients with hemodynamically significant CAD. The study will enroll 150 patients with history of CAD, defined as prior documentation of lumen obstruction, stenting, or a calcium score ≥400, who will undergo UHR-CT before clinically prompted ICA. Assessment of hemodynamically significant CAD by UHR-CT and ICA will follow clinical standards. The reference standard will be the quantitative flow ratio (QFR) with <0.8 defined as abnormal. All data will be analyzed in independent core laboratories. RESULTS The primary outcome will be the comparative diagnostic accuracy of UHR-CT vs. ICA for detecting hemodynamically significant CAD on a patient level. Secondary analyses will focus on vessel level diagnostic accuracy, quantitative stenosis analysis, automated contour detection, in-depth plaque analysis, and others. CONCLUSION CORE-PRECISION aims to investigate if UHR-CT is non-inferior to ICA for detecting hemodynamically significant CAD in high-risk patients, including those with severe coronary calcification or stents. We anticipate this study to provide valuable insights into the utility of UHR-CT in this challenging population and for its potential to establish a new standard for CAD assessment.
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Affiliation(s)
- Bruna R Scarpa Matuck
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Naruomi Akino
- Canon Medical Systems Corporation, Otawara, Tochigi, Japan
| | - Hooman Bakhshi
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christopher Cox
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Elnaz Ebrahimihoor
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Masaru Ishida
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan
| | - Pedro A Lemos
- Department of Cardiology, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Joao A C Lima
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew B Matheson
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Makoto Orii
- Department of Radiology, Iwate Medical University, Yahaba, Japan
| | - Aysa Ostovaneh
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mohammad R Ostovaneh
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Gilberto Szarf
- Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Jeffrey C Trost
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Armin Arbab-Zadeh
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Yoshida K, Tanabe Y, Hosokawa T, Morikawa T, Fukuyama N, Kobayashi Y, Kouchi T, Kawaguchi N, Matsuda M, Kido T, Kido T. Coronary computed tomography angiography for clinical practice. Jpn J Radiol 2024; 42:555-580. [PMID: 38453814 PMCID: PMC11139719 DOI: 10.1007/s11604-024-01543-1] [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: 07/14/2023] [Accepted: 01/28/2024] [Indexed: 03/09/2024]
Abstract
Coronary artery disease (CAD) is a common condition caused by the accumulation of atherosclerotic plaques. It can be classified into stable CAD or acute coronary syndrome. Coronary computed tomography angiography (CCTA) has a high negative predictive value and is used as the first examination for diagnosing stable CAD, particularly in patients at intermediate-to-high risk. CCTA is also adopted for diagnosing acute coronary syndrome, particularly in patients at low-to-intermediate risk. Myocardial ischemia does not always co-exist with coronary artery stenosis, and the positive predictive value of CCTA for myocardial ischemia is limited. However, CCTA has overcome this limitation with recent technological advancements such as CT perfusion and CT-fractional flow reserve. In addition, CCTA can be used to assess coronary artery plaques. Thus, the indications for CCTA have expanded, leading to an increased demand for radiologists. The CAD reporting and data system (CAD-RADS) 2.0 was recently proposed for standardizing CCTA reporting. This RADS evaluates and categorizes patients based on coronary artery stenosis and the overall amount of coronary artery plaque and links this to patient management. In this review, we aimed to review the major trials and guidelines for CCTA to understand its clinical role. Furthermore, we aimed to introduce the CAD-RADS 2.0 including the assessment of coronary artery stenosis, plaque, and other key findings, and highlight the steps for CCTA reporting. Finally, we aimed to present recent research trends including the perivascular fat attenuation index, artificial intelligence, and the advancements in CT technology.
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Affiliation(s)
- Kazuki Yoshida
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Yuki Tanabe
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
| | - Takaaki Hosokawa
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Tomoro Morikawa
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Naoki Fukuyama
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Yusuke Kobayashi
- Department of Radiology, Matsuyama Red Cross Hospital, Bunkyocho, Matsuyama, Ehime, Japan
| | - Takanori Kouchi
- Department of Radiology, Juzen General Hospital, Kitashinmachi, Niihama, Ehime, Japan
| | - Naoto Kawaguchi
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Megumi Matsuda
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Tomoyuki Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
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Higaki T, Tatsugami F, Ohana M, Nakamura Y, Kawashita I, Awai K. Super resolution deep learning reconstruction for coronary CT angiography: A structured phantom study. Eur J Radiol Open 2024; 12:100570. [PMID: 38828096 PMCID: PMC11140562 DOI: 10.1016/j.ejro.2024.100570] [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: 03/05/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose Super-resolution deep-learning-based reconstruction: SR-DLR is a newly developed and clinically available deep-learning-based image reconstruction method that can improve the spatial resolution of CT images. The image quality of the output from non-linear image reconstructions, such as DLR, is known to vary depending on the structure of the object being scanned, and a simple phantom cannot explicitly evaluate the clinical performance of SR-DLR. This study aims to accurately investigate the quality of the images reconstructed by SR-DLR by utilizing a structured phantom that simulates the human anatomy in coronary CT angiography. Methods The structural phantom had ribs and vertebrae made of plaster, a left ventricle filled with dilute contrast medium, a coronary artery with simulated stenosis, and an implanted stent graft. By scanning the structured phantom, we evaluated noise and spatial resolution on the images reconstructed with SR-DLR and conventional reconstructions. Results The spatial resolution of SR-DLR was higher than conventional reconstructions; the 10 % modulation transfer function of hybrid IR (HIR), DLR, and SR-DLR were 0.792-, 0.976-, and 1.379 cycle/mm, respectively. At the same time, image noise was lowest (HIR: 21.1-, DLR: 19.0-, and SR-DLR: 13.1 HU). SR-DLR could accurately assess coronary artery stenosis and the lumen of the implanted stent graft. Conclusions SR-DLR can obtain CT images with high spatial resolution and lower noise without special CT equipments, and will help diagnose coronary artery disease in CCTA and other CT examinations that require high spatial resolution.
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Affiliation(s)
- Toru Higaki
- Graduate School of Advanced Science and Engineering, Hiroshima University, Japan
| | - Fuminari Tatsugami
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | | | - Yuko Nakamura
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Ikuo Kawashita
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Kazuo Awai
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
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Kitera N, Fujioka C, Higaki T, Nishimaru E, Yokomachi K, Matsumoto Y, Kiguchi M, Ohashi K, Kasai H, Awai K. [Validation of Optimal Imaging Conditions for Coronary Computed Tomography Angiography Using High-definition Mode and Deep Learning Image Reconstruction Algorithm]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2024; 80:499-509. [PMID: 38508756 DOI: 10.6009/jjrt.2024-1353] [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: 03/22/2024]
Abstract
PURPOSE To verify the optimal imaging conditions for coronary computed tomography angiography (CCTA) examinations when using high-definition (HD) mode and deep learning image reconstruction (DLIR) in combination. METHOD A chest phantom and an in-house phantom using 3D printer were scanned with a 256-row detector CT scanner. The scan parameters were as follows - acquisition mode: ON (HD mode) and OFF (normal resolution [NR] mode), rotation time: 0.28 s/rotation, beam coverage width: 160 mm, and the radiation dose was adjusted based on CT-AEC. Image reconstruction was performed using ASiR-V (Hybrid-IR), TrueFidelity Image (DLIR), and HD-Standard (HD mode) and Standard (NR mode) reconstruction kernels. The task-based transfer function (TTF) and noise power spectrum (NPS) were measured for image evaluation, and the detectability index (d') was calculated. Visual evaluation was also performed on an in-house coronary phantom. RESULT The in-plane TTF was better for the HD mode than for the NR mode, while the z-axis TTF was lower for DLIR than for Hybrid-IR. The NPS values in the high-frequency region were higher for the HD mode compared to those for the NR mode, and the NPS was lower for DLIR than for Hybrid-IR. The combination of HD mode and DLIR showed the best value for in-plane d', whereas the combination of NR mode and DLIR showed the best value for z-axis d'. In the visual evaluation, the combination of NR mode and DLIR showed the best values from a noise index of 45 HU. CONCLUSION The optimal combination of HD mode and DLIR depends on the image noise level, and the combination of NR mode and DLIR was the best imaging condition under noisy conditions.
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Affiliation(s)
- Nobuo Kitera
- Department of Radiology, Hiroshima University Hospital
| | | | - Toru Higaki
- Graduate School of Advanced Science and Engineering, Hiroshima University
| | | | | | | | - Masao Kiguchi
- Department of Radiology, Hiroshima University Hospital
| | - Kazuya Ohashi
- Department of Radiology, Nagoya City University Hospital
| | - Harumasa Kasai
- Department of Radiology, Nagoya City University Hospital
| | - Kazuo Awai
- Graduate School of Biomedical and Health Sciences, Hiroshima University
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Frenzel M, Ucar FA, Brockmann C, Altmann S, Abello MAM, Uphaus T, Ringel F, Korczynski O, Mukhopadhyay A, Sanner AP, Schmidtmann I, Brockmann MA, Othman AE. Comparison of Ultra-High-Resolution and Normal-Resolution CT-Angiography for Intracranial Aneurysm Detection in Patients with Subarachnoid Hemorrhage. Acad Radiol 2024; 31:1594-1604. [PMID: 37821348 DOI: 10.1016/j.acra.2023.08.035] [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: 07/16/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 10/13/2023]
Abstract
RATIONALE AND OBJECTIVES Ruptured intracranial aneurysms (IAs) are the leading cause for atraumatic subarachnoid hemorrhage. In case of aneurysm rupture, patients may face life-threatening complications and require aneurysm occlusion. Detection of the aneurysm in computed tomography (CT) imaging is therefore essential for patient outcome. This study provides an evaluation of the diagnostic accuracy of Ultra-High-Resolution Computed Tomography Angiography (UHR-CTA) and Normal-Resolution Computed Tomography Angiography (NR-CTA) concerning IA detection and characterization. MATERIALS AND METHODS Consecutive patients with atraumatic subarachnoid hemorrhage who received Digital Subtraction Angiography (DSA) and either UHR-CTA or NR-CTA were retrospectively included. Three readers evaluated CT-Angiography regarding image quality, diagnostic confidence and presence of IAs. Sensitivity and specificity were calculated on patient-level and segment-level with reference standard DSA-imaging. CTA patient radiation exposure (effective dose) was compared. RESULTS One hundred and eight patients were identified (mean age = 57.8 ± 14.1 years, 65 women). UHR-CTA revealed significantly higher image quality and diagnostic confidence (P < 0.001) for all readers and significantly lower effective dose (P < 0.001). Readers correctly classified ≥55/56 patients on UHR-CTA and ≥44/52 patients on NR-CTA. We noted significantly higher patient-level sensitivity for UHR-CTA compared to NR-CTA for all three readers (reader 1: 41/41 [100%] vs. 28/34 [82%], reader 2: 41/41 [100%] vs. 30/34 [88%], reader 3: 41/41 [100%] vs. 30/34 [88%], P ≤ 0.04). Segment-level analysis also revealed significantly higher sensitivity for UHR-CTA compared to NR-CTA for all three readers (reader 1: 47/49 [96%] vs. 34/45 [76%], reader 2: 47/49 [96%] vs. 37/45 [82%], reader 3: 48/49 [98%] vs. 37/45 [82%], P ≤ 0.04). Specificity was comparable for both techniques. CONCLUSION We found Ultra-High-Resolution CT-Angiography to provide higher sensitivity than Normal-Resolution CT-Angiography for the detection of intracranial aneurysms in patients with aneurysmal subarachnoid hemorrhage while improving image quality and reducing patient radiation exposure.
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Affiliation(s)
- Marius Frenzel
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (M.F., F.A.U., C.B., S.A., M.A.M., O.K., A.P.S., M.A.B., A.E.O.)
| | - Felix A Ucar
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (M.F., F.A.U., C.B., S.A., M.A.M., O.K., A.P.S., M.A.B., A.E.O.)
| | - Carolin Brockmann
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (M.F., F.A.U., C.B., S.A., M.A.M., O.K., A.P.S., M.A.B., A.E.O.)
| | - Sebastian Altmann
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (M.F., F.A.U., C.B., S.A., M.A.M., O.K., A.P.S., M.A.B., A.E.O.)
| | - Mario A Mercado Abello
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (M.F., F.A.U., C.B., S.A., M.A.M., O.K., A.P.S., M.A.B., A.E.O.)
| | - Timo Uphaus
- Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (T.U.)
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (F.R.)
| | - Oliver Korczynski
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (M.F., F.A.U., C.B., S.A., M.A.M., O.K., A.P.S., M.A.B., A.E.O.)
| | | | - Antoine P Sanner
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (M.F., F.A.U., C.B., S.A., M.A.M., O.K., A.P.S., M.A.B., A.E.O.); Technical University, Darmstadt, Germany (A.M., A.P.S.)
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (I.S.)
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (M.F., F.A.U., C.B., S.A., M.A.M., O.K., A.P.S., M.A.B., A.E.O.)
| | - Ahmed E Othman
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (M.F., F.A.U., C.B., S.A., M.A.M., O.K., A.P.S., M.A.B., A.E.O.).
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Kawai H, Motoyama S, Sarai M, Sato Y, Matsuyama T, Matsumoto R, Takahashi H, Katagata A, Kataoka Y, Ida Y, Muramatsu T, Ohno Y, Ozaki Y, Toyama H, Narula J, Izawa H. Coronary computed tomography angiographic detection of in-stent restenosis via deep learning reconstruction: a feasibility study. Eur Radiol 2024; 34:2647-2657. [PMID: 37672056 DOI: 10.1007/s00330-023-10110-7] [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: 01/13/2023] [Revised: 05/30/2023] [Accepted: 06/25/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVES Evaluation of in-stent restenosis (ISR), especially for small stents, remains challenging during computed tomography (CT) angiography. We used deep learning reconstruction to quantify stent strut thickness and lumen vessel diameter at the stent and compared it with values obtained using conventional reconstruction strategies. METHODS We examined 166 stents in 85 consecutive patients who underwent CT and invasive coronary angiography (ICA) within 3 months of each other from 2019-2021 after percutaneous coronary intervention with coronary stent placement. The presence of ISR was defined as percent diameter stenosis ≥ 50% on ICA. We compared a super-resolution deep learning reconstruction, Precise IQ Engine (PIQE), and a model-based iterative reconstruction, Forward projected model-based Iterative Reconstruction SoluTion (FIRST). All images were reconstructed using PIQE and FIRST and assessed by two blinded cardiovascular radiographers. RESULTS PIQE had a larger full width at half maximum of the lumen and smaller strut than FIRST. The image quality score in PIQE was higher than that in FIRST (4.2 ± 1.1 versus 2.7 ± 1.2, p < 0.05). In addition, the specificity and accuracy of ISR detection were better in PIQE than in FIRST (p < 0.05 for both), with particularly pronounced differences for stent diameters < 3.0 mm. CONCLUSION PIQE provides superior image quality and diagnostic accuracy for ISR, even with stents measuring < 3.0 mm in diameter. CLINICAL RELEVANCE STATEMENT With improvements in the diagnostic accuracy of in-stent stenosis, CT angiography could become a gatekeeper for ICA in post-stenting cases, obviating ICA in many patients after recent stenting with infrequent ISR and allowing non-invasive ISR detection in the late phase. KEY POINTS • Despite CT technology advancements, evaluating in-stent stenosis severity, especially in small-diameter stents, remains challenging. • Compared with conventional methods, the Precise IQ Engine uses deep learning to improve spatial resolution. • Improved diagnostic accuracy of CT angiography helps avoid invasive coronary angiography after coronary artery stenting.
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Affiliation(s)
- Hideki Kawai
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Sadako Motoyama
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Masayoshi Sarai
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yoshihiro Sato
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Takahiro Matsuyama
- Department of Radiology, Fujita Health University, Toyoake, Aichi, Japan
| | - Ryota Matsumoto
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Hiroshi Takahashi
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Akio Katagata
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Yumi Kataoka
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Yoshihiro Ida
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Takashi Muramatsu
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yoshiharu Ohno
- Department of Radiology, Fujita Health University, Toyoake, Aichi, Japan
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University, Toyoake, Japan
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University, Toyoake, Aichi, Japan
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, NY, USA
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
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9
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Ucar FA, Frenzel M, Kronfeld A, Altmann S, Sanner AP, Mercado MAA, Uphaus T, Brockmann MA, Othman AE. Improvement of Neurovascular Imaging Using Ultra-High-Resolution Computed Tomography Angiography. Clin Neuroradiol 2024; 34:189-199. [PMID: 37831106 PMCID: PMC10881789 DOI: 10.1007/s00062-023-01348-1] [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: 07/24/2023] [Accepted: 08/23/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To evaluate diagnostic image quality of ultra-high-resolution computed tomography angiography (UHR-CTA) in neurovascular imaging as compared to normal resolution CT-angiography (NR-CTA). MATERIAL AND METHODS In this retrospective single-center study brain and neck CT-angiography was performed using an ultra-high-resolution computed tomography scanner (n = 82) or a normal resolution CT scanner (NR-CTA; n = 73). Ultra-high-resolution images were reconstructed with a 1024 × 1024 matrix and a slice thickness of 0.25 mm, whereas NR-CT images were reconstructed with a 512 × 512 matrix and a slice thickness of 0.5 mm. Three blinded neuroradiologists assessed overall image quality, artifacts, image noise, overall contrast and diagnostic confidence using a 4-point Likert scale. Furthermore, the visualization and delineation of supra-aortic arteries with an emphasis on the visualization of small intracerebral vessels was assessed using a cerebral vascular score, also utilizing a 4-point Likert scale. Quantitative analyses included signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), noise and the steepness of gray value transition. Radiation exposure was determined by comparison of computed tomography dose index (CTDIvol), dose length product (DLP) and mean effective dose. Interrater agreement was evaluated via determining Fleiss-Kappa. RESULTS Ultra-high-resolution CT-angiography (UHR-CTA) yielded excellent image quality with superior quantitative (SNR: p < 0.001, CNR: p < 0.001, steepness of gray value transition: p < 0.001) and qualitative results (overall image quality: 4 (Inter quartile range (IQR) = 4-4); p < 0.001, diagnostic confidence: 4 (IQR = 4-4); p < 0.001) compared to NR-CT (overall image quality: 3 (IQR = 3-3), diagnostic confidence: 3 (IQR = 3-4)). Furthermore, UHR-CT enabled significantly superior delineation and visualization of all vascular segments, from proximal extracranial vessels to the smallest peripheral cerebral branches (e.g. , UHR-CTA PICA 4 (3-4) vs. NR-CTA PICA: 3 (2-3); UHR-CTA P4: 4 (IQR = 3-4) vs. NR-CTA P4: 2 (IQR = 2-3); UHR-CTA M4: 4 (IQR = 4-4) vs. NR-CTA M4: 3 (IQR = 2-3); UHR-CTA A4: 4 (IQR = 3-4) vs. NR-CTA A4: 2 (IQR = 2-3); all p < 0.001). Noteworthy, a reduced mean effective dose was observed when applying UHR-CT (NR-CTA: 1.8 ± 0.3 mSv; UHR-CTA: 1.5 ± 0.5 mSv; p < 0.001). CONCLUSION Ultra-high-resolution CT-angiography improves image quality in neurovascular imaging allowing the depiction and evaluation of small peripheral cerebral arteries. It may thus improve the detection of pathologies in small cerebrovascular lesions and the resulting diagnosis.
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Affiliation(s)
- Felix A Ucar
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Marius Frenzel
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Andrea Kronfeld
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Sebastian Altmann
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Antoine P Sanner
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
- Department of Computer Science, Fraunhofer IGD, Technical University Darmstadt, Fraunhoferstraße 5, 64283, Darmstadt, Germany
| | | | - Timo Uphaus
- Department of Neurology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Ahmed E Othman
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
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10
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Çap M, Ramasamy A, Parasa R, Tanboga IH, Maung S, Morgan K, Yap NAL, Abou Gamrah M, Sokooti H, Kitslaar P, Reiber JHC, Dijkstra J, Torii R, Moon JC, Mathur A, Baumbach A, Pugliese F, Bourantas CV. Efficacy of human experts and an automated segmentation algorithm in quantifying disease pathology in coronary computed tomography angiography: A head-to-head comparison with intravascular ultrasound imaging. J Cardiovasc Comput Tomogr 2024; 18:142-153. [PMID: 38143234 DOI: 10.1016/j.jcct.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/26/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Coronary computed tomography angiography (CCTA) analysis is currently performed by experts and is a laborious process. Fully automated edge-detection methods have been developed to expedite CCTA segmentation however their use is limited as there are concerns about their accuracy. This study aims to compare the performance of an automated CCTA analysis software and the experts using near-infrared spectroscopy-intravascular ultrasound imaging (NIRS-IVUS) as a reference standard. METHODS Fifty-one participants (150 vessels) with chronic coronary syndrome who underwent CCTA and 3-vessel NIRS-IVUS were included. CCTA analysis was performed by an expert and an automated edge detection method and their estimations were compared to NIRS-IVUS at a segment-, lesion-, and frame-level. RESULTS Segment-level analysis demonstrated a similar performance of the two CCTA analyses (conventional and automatic) with large biases and limits of agreement compared to NIRS-IVUS estimations for the total atheroma (ICC: 0.55 vs 0.25, mean difference:192 (-102-487) vs 243 (-132-617) and percent atheroma volume (ICC: 0.30 vs 0.12, mean difference: 12.8 (-5.91-31.6) vs 20.0 (0.79-39.2). Lesion-level analysis showed that the experts were able to detect more accurately lesions than the automated method (68.2 % and 60.7 %) however both analyses had poor reliability in assessing the minimal lumen area (ICC 0.44 vs 0.36) and the maximum plaque burden (ICC 0.33 vs 0.33) when NIRS-IVUS was used as the reference standard. CONCLUSIONS Conventional and automated CCTA analyses had similar performance in assessing coronary artery pathology using NIRS-IVUS as a reference standard. Therefore, automated segmentation can be used to expedite CCTA analysis and enhance its applications in clinical practice.
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Affiliation(s)
- Murat Çap
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK; Department of Cardiology, University of Health Sciences Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey.
| | - Anantharaman Ramasamy
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Ramya Parasa
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK; Department of Cardiology, The Essex Cardiothoracic Centre, Basildon, UK
| | - Ibrahim H Tanboga
- Istanbul Nisantasi University Medical School, Department of Cardiology & Biostatistics, Istanbul, Turkey
| | - Soe Maung
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Kimberley Morgan
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Nathan A L Yap
- Barts and the London School of Medicine and Dentistry, London, UK
| | | | | | | | - Johan H C Reiber
- Medis Medical Imaging, Leiden, the Netherlands; Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jouke Dijkstra
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ryo Torii
- Department of Mechanical Engineering, University College London, London, UK
| | - James C Moon
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Institute of Cardiovascular Sciences, University College London, London, UK
| | - Anthony Mathur
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Andreas Baumbach
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Francesca Pugliese
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Christos V Bourantas
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK; Institute of Cardiovascular Sciences, University College London, London, UK.
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11
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Koons EK, Rajiah PS, Thorne JE, Weber NM, Kasten HJ, Shanblatt ER, McCollough CH, Leng S. Coronary artery stenosis quantification in patients with dense calcifications using ultra-high-resolution photon-counting-detector computed tomography. J Cardiovasc Comput Tomogr 2024; 18:56-61. [PMID: 37945454 PMCID: PMC10922101 DOI: 10.1016/j.jcct.2023.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND To quantify differences in coronary artery stenosis severity in patients with calcified lesions between conventional energy-integrating detector (EID) CT and ultra-high-resolution (UHR) photon-counting-detector (PCD) CT. METHODS Patients undergoing clinically indicated coronary CT angiography were prospectively recruited and scanned first on an EID-CT (SOMATOM Force, Siemens Healthineers) and then a PCD-CT (NAEOTOM Alpha, Siemens Healthineers) on the same day. EID-CT was performed with standard mode (192 × 0.6 mm detector collimation) following our clinical protocol. PCD-CT scans were performed under UHR mode (120 × 0.2 mm detector collimation). For each patient, left main, left anterior descending, right coronary artery, and circumflex were reviewed and the most severe stenosis from dense calcification for each coronary was quantified using commercial software. Additionally, each measured stenosis was assigned a severity category based on percent diameter stenosis, and changes in severity category across EID-CT and PCD-CT were assessed. RESULTS A total of 23 patients were enrolled, with 34 coronary artery stenoses analyzed. Stenosis was significantly reduced in PCD-CT compared to EID-CT (p < 0.001), resulting in an average of 11% (SD = 11%) reduction in percent diameter stenosis. Among the 34 lesions, 15 changed in stenosis severity category: 3 went from moderate to minimal, 1 from moderate to mild, 9 from mild to minimal, and 2 from minimal to mild with the use of PCD-CT compared to EID-CT. CONCLUSION Use of UHR PCD-CT decreased percent diameter stenosis by an average of 11% relative to EID-CT, resulting in 13 of 34 stenoses being downgraded in stenosis severity category, potentially sparing patients from unnecessary intervention.
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Affiliation(s)
- Emily K Koons
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA; Department of Biomedical Engineering and Physiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | | | - Jamison E Thorne
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Nikkole M Weber
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Holly J Kasten
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | | | | | - Shuai Leng
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
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12
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Flohr T, Schmidt B, Ulzheimer S, Alkadhi H. Cardiac imaging with photon counting CT. Br J Radiol 2023; 96:20230407. [PMID: 37750856 PMCID: PMC10646663 DOI: 10.1259/bjr.20230407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/27/2023] Open
Abstract
CT of the heart, in particular ECG-controlled coronary CT angiography (cCTA), has become clinical routine due to rapid technical progress with ever new generations of CT equipment. Recently, CT scanners with photon-counting detectors (PCD) have been introduced which have the potential to address some of the remaining challenges for cardiac CT, such as limited spatial resolution and lack of high-quality spectral data. In this review article, we briefly discuss the technical principles of photon-counting detector CT, and we give an overview on how the improved spatial resolution of photon-counting detector CT and the routine availability of spectral data can benefit cardiac applications. We focus on coronary artery calcium scoring, cCTA, and on the evaluation of the myocardium.
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Affiliation(s)
- Thomas Flohr
- Siemens Healthcare GmbH, Computed Tomography, Forchheim, Germany
| | - Bernhard Schmidt
- Siemens Healthcare GmbH, Computed Tomography, Forchheim, Germany
| | - Stefan Ulzheimer
- Siemens Healthcare GmbH, Computed Tomography, Forchheim, Germany
| | - Hatem Alkadhi
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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13
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Nagayama Y, Emoto T, Kato Y, Kidoh M, Oda S, Sakabe D, Funama Y, Nakaura T, Hayashi H, Takada S, Uchimura R, Hatemura M, Tsujita K, Hirai T. Improving image quality with super-resolution deep-learning-based reconstruction in coronary CT angiography. Eur Radiol 2023; 33:8488-8500. [PMID: 37432405 DOI: 10.1007/s00330-023-09888-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/22/2023] [Accepted: 04/23/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVES To evaluate the effect of super-resolution deep-learning-based reconstruction (SR-DLR) on the image quality of coronary CT angiography (CCTA). METHODS Forty-one patients who underwent CCTA using a 320-row scanner were retrospectively included. Images were reconstructed with hybrid (HIR), model-based iterative reconstruction (MBIR), normal-resolution deep-learning-based reconstruction (NR-DLR), and SR-DLR algorithms. For each image series, image noise, and contrast-to-noise ratio (CNR) at the left main trunk, right coronary artery, left anterior descending artery, and left circumflex artery were quantified. Blooming artifacts from calcified plaques were measured. Image sharpness, noise magnitude, noise texture, edge smoothness, overall quality, and delineation of the coronary wall, calcified and noncalcified plaques, cardiac muscle, and valves were subjectively ranked on a 4-point scale (1, worst; 4, best). The quantitative parameters and subjective scores were compared among the four reconstructions. Task-based image quality was assessed with a physical evaluation phantom. The detectability index for the objects simulating the coronary lumen, calcified plaques, and noncalcified plaques was calculated from the noise power spectrum (NPS) and task-based transfer function (TTF). RESULTS SR-DLR yielded significantly lower image noise and blooming artifacts with higher CNR than HIR, MBIR, and NR-DLR (all p < 0.001). The best subjective scores for all the evaluation criteria were attained with SR-DLR, with significant differences from all other reconstructions (p < 0.001). In the phantom study, SR-DLR provided the highest NPS average frequency, TTF50%, and detectability for all task objects. CONCLUSION SR-DLR considerably improved the subjective and objective image qualities and object detectability of CCTA relative to HIR, MBIR, and NR-DLR algorithms. CLINICAL RELEVANCE STATEMENT The novel SR-DLR algorithm has the potential to facilitate accurate assessment of coronary artery disease on CCTA by providing excellent image quality in terms of spatial resolution, noise characteristics, and object detectability. KEY POINTS • SR-DLR designed for CCTA improved image sharpness, noise property, and delineation of cardiac structures with reduced blooming artifacts from calcified plaques relative to HIR, MBIR, and NR-DLR. • In the task-based image-quality assessments, SR-DLR yielded better spatial resolution, noise property, and detectability for objects simulating the coronary lumen, coronary calcifications, and noncalcified plaques than other reconstruction techniques. • The image reconstruction times of SR-DLR were shorter than those of MBIR, potentially serving as a novel standard-of-care reconstruction technique for CCTA performed on a 320-row CT scanner.
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Affiliation(s)
- Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
| | - Takafumi Emoto
- Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yuki Kato
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Daisuke Sakabe
- Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yoshinori Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Hidetaka Hayashi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Sentaro Takada
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Ryutaro Uchimura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Masahiro Hatemura
- Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
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14
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Tatsugami F, Nakaura T, Yanagawa M, Fujita S, Kamagata K, Ito R, Kawamura M, Fushimi Y, Ueda D, Matsui Y, Yamada A, Fujima N, Fujioka T, Nozaki T, Tsuboyama T, Hirata K, Naganawa S. Recent advances in artificial intelligence for cardiac CT: Enhancing diagnosis and prognosis prediction. Diagn Interv Imaging 2023; 104:521-528. [PMID: 37407346 DOI: 10.1016/j.diii.2023.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023]
Abstract
Recent advances in artificial intelligence (AI) for cardiac computed tomography (CT) have shown great potential in enhancing diagnosis and prognosis prediction in patients with cardiovascular disease. Deep learning, a type of machine learning, has revolutionized radiology by enabling automatic feature extraction and learning from large datasets, particularly in image-based applications. Thus, AI-driven techniques have enabled a faster analysis of cardiac CT examinations than when they are analyzed by humans, while maintaining reproducibility. However, further research and validation are required to fully assess the diagnostic performance, radiation dose-reduction capabilities, and clinical correctness of these AI-driven techniques in cardiac CT. This review article presents recent advances of AI in the field of cardiac CT, including deep-learning-based image reconstruction, coronary artery motion correction, automatic calcium scoring, automatic epicardial fat measurement, coronary artery stenosis diagnosis, fractional flow reserve prediction, and prognosis prediction, analyzes current limitations of these techniques and discusses future challenges.
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Affiliation(s)
- Fuminari Tatsugami
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masahiro Yanagawa
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Shohei Fujita
- Departmen of Radiology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Rintaro Ito
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Mariko Kawamura
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawaharacho, Sakyoku, Kyoto, 606-8507, Japan
| | - Daiju Ueda
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Yusuke Matsui
- Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Akira Yamada
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital N15, W5, Kita-Ku, Sapporo 060-8638, Japan
| | - Tomoyuki Fujioka
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Taiki Nozaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-0016, Japan
| | - Takahiro Tsuboyama
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Kenji Hirata
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
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15
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Tatsugami F, Higaki T, Kawashita I, Fukumoto W, Nakamura Y, Matsuura M, Lee TC, Zhou J, Cai L, Kitagawa T, Nakano Y, Awai K. Improvement of Spatial Resolution on Coronary CT Angiography by Using Super-Resolution Deep Learning Reconstruction. Acad Radiol 2023; 30:2497-2504. [PMID: 36681533 DOI: 10.1016/j.acra.2022.12.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/21/2023]
Abstract
RATIONALE AND OBJECTIVES Our objective was to compare the image quality of coronary CT angiography reconstructed with super-resolution deep learning reconstruction (SR-DLR) and with hybrid iterative reconstruction (IR) images. MATERIALS AND METHODS This retrospective study included 100 patients who underwent coronary CT angiography using a 320-detector-row CT scanner. The CT images were reconstructed with hybrid IR and SR-DLR. The standard deviation of the CT number was recorded and the CT attenuation profile across the left main coronary artery was generated to calculate the contrast-to-noise ratio (CNR) and measure the edge rise slope (ERS). Overall image quality was evaluated and plaque detectability was assessed on a 4-point scale (1 = poor, 4 = excellent). For reference, invasive coronary angiography of 14 patients was used. RESULTS The mean image noise on SR-DLR was significantly lower than on hybrid IR images (15.6 vs 22.9 HU; p < 0.01). The mean CNR was significantly higher and the ERS was steeper on SR-DLR- compared to hybrid IR images (CNR: 32.4 vs 20.4, p < 0.01; ERS: 300.0 vs 198.2 HU/mm, p < 0.01). The image quality score was better on SR-DLR- than on hybrid IR images (3.6 vs 3.1; p < 0.01). SR-DLR increased the detectability of plaques with < 50% stenosis (p < 0.01). CONCLUSION SR-DLR was superior to hybrid IR with respect to the image noise, the sharpness of coronary artery margins, and plaque detectability.
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Affiliation(s)
- Fuminari Tatsugami
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan.
| | - Toru Higaki
- Graduate School of Advanced Science and Engineering, Hiroshima University, Higashi-Hiroshima City, Hiroshima, Japan
| | - Ikuo Kawashita
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Wataru Fukumoto
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Yuko Nakamura
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | | | | | - Jian Zhou
- Canon Medical Research USA, Vernon Hills, Illinois
| | - Liang Cai
- Canon Medical Research USA, Vernon Hills, Illinois
| | - Toshiro Kitagawa
- Department of Cardiovascular Medicine, Hiroshima University, Hiroshima City, Hiroshima, Japan
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University, Hiroshima City, Hiroshima, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
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16
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Sato H, Fujimoto S, Tomizawa N, Inage H, Yokota T, Kudo H, Fan R, Kawamoto K, Honda Y, Kobayashi T, Minamino T, Kogure Y. Impact of a Deep Learning-based Super-resolution Image Reconstruction Technique on High-contrast Computed Tomography: A Phantom Study. Acad Radiol 2023; 30:2657-2665. [PMID: 36690564 DOI: 10.1016/j.acra.2022.12.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/17/2022] [Accepted: 12/24/2022] [Indexed: 01/23/2023]
Abstract
RATIONALE AND OBJECTIVES Deep-learning-based super-resolution image reconstruction (DLSRR) is a novel image reconstruction technique that is expected to contribute to improvement in spatial resolution as well as noise reduction through learning from high-resolution computed tomography (CT). This study aims to evaluate image quality obtained with DLSRR and assess its clinical potential. MATERIALS AND METHODS CT images of a Mercury CT 4.0 phantom were obtained using a 320-row multi-detector scanner at tube currents of 100, 200, and 300 mA. Image data were reconstructed by filtered back projection (FBP), hybrid iterative reconstruction (HIR), model-based iterative reconstruction (MBIR), deep-learning-based image reconstruction (DLR), and DLSRR at image reconstruction strength levels of mild, standard, and strong. Noise power spectrum (NPS), task transfer function (TTF), and detectability index were calculated. RESULTS The magnitude of the noise-reducing effect in comparison with FBP was in the order MBIR CONCLUSION The present results suggest that DLSRR can achieve greater noise reduction and improved spatial resolution in the high-contrast region compared with conventional DLR and iterative reconstruction techniques.
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Affiliation(s)
- Hideyuki Sato
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Shinichiro Fujimoto
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Nobuo Tomizawa
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hidekazu Inage
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Takuya Yokota
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Hikaru Kudo
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Ruiheng Fan
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Keiichi Kawamoto
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Yuri Honda
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Takayuki Kobayashi
- Department of Radiological Technology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yosuke Kogure
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
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17
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Orii M, Sone M, Osaki T, Ueyama Y, Chiba T, Sasaki T, Yoshioka K. Super-resolution deep learning reconstruction at coronary computed tomography angiography to evaluate the coronary arteries and in-stent lumen: an initial experience. BMC Med Imaging 2023; 23:171. [PMID: 37904089 PMCID: PMC10617195 DOI: 10.1186/s12880-023-01139-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/25/2023] [Indexed: 11/01/2023] Open
Abstract
A super-resolution deep learning reconstruction (SR-DLR) algorithm trained using data acquired on the ultrahigh spatial resolution computed tomography (UHRCT) has the potential to provide better image quality of coronary arteries on the whole-heart, single-rotation cardiac coverage on a 320-detector row CT scanner. However, the advantages of SR-DLR at coronary computed tomography angiography (CCTA) have not been fully investigated. The present study aimed to compare the image quality of the coronary arteries and in-stent lumen between SR-DLR and model-based iterative reconstruction (MBIR). We prospectively enrolled 70 patients (median age, 69 years; interquartile range [IQR], 59-75 years; 50 men) who underwent CCTA using a 320-detector row CT scanner between January and August 2022. The image noise in the ascending aorta, left atrium, and septal wall of the ventricle was measured, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the proximal coronary arteries were calculated. Of the twenty stents, stent strut thickness and luminal diameter were quantitatively evaluated. The image noise on SR-DLR was significantly lower than that on MBIR (median 22.1 HU; IQR, 19.3-24.9 HU vs. 27.4 HU; IQR, 24.2-31.2 HU, p < 0.01), whereas the SNR (median 16.3; IQR, 11.8-21.8 vs. 13.7; IQR, 9.9-18.4, p = 0.01) and CNR (median 24.4; IQR, 15.5-30.2 vs. 19.2; IQR, 14.1-23.2, p < 0.01) on SR-DLR were significantly higher than that on MBIR. Stent struts were significantly thinner (median, 0.68 mm; IQR, 0.61-0.78 mm vs. 0.81 mm; IQR, 0.72-0.96 mm, p < 0.01) and in-stent lumens were significantly larger (median, 1.84 mm; IQR, 1.65-2.26 mm vs. 1.52 mm; IQR, 1.28-2.25 mm, p < 0.01) on SR-DLR than on MBIR. Although further large-scale studies using invasive coronary angiography as the reference standard, comparative studies with UHRCT, and studies in more challenging population for CCTA are needed, this study's initial experience with SR-DLR would improve the utility of CCTA in daily clinical practice due to the better image quality of the coronary arteries and in-stent lumen at CCTA compared with conventional MBIR.
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Affiliation(s)
- Makoto Orii
- Department of Radiology, Iwate Medical University, 2-1-1, Idaidori, Yahaba, 028-3695, Japan.
| | - Misato Sone
- Department of Radiology, Iwate Medical University, 2-1-1, Idaidori, Yahaba, 028-3695, Japan
| | - Takeshi Osaki
- Department of Radiology, Iwate Medical University, 2-1-1, Idaidori, Yahaba, 028-3695, Japan
| | - Yuta Ueyama
- Center for Radiological Science, Iwate Medical University, 2-1-1, Idaidori, Yahaba, 028-3695, Japan
| | - Takuya Chiba
- Center for Radiological Science, Iwate Medical University, 2-1-1, Idaidori, Yahaba, 028-3695, Japan
| | - Tadashi Sasaki
- Center for Radiological Science, Iwate Medical University, 2-1-1, Idaidori, Yahaba, 028-3695, Japan
| | - Kunihiro Yoshioka
- Department of Radiology, Iwate Medical University, 2-1-1, Idaidori, Yahaba, 028-3695, Japan
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18
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Takafuji M, Kitagawa K, Mizutani S, Hamaguchi A, Kisou R, Iio K, Ichikawa K, Izumi D, Sakuma H. Super-Resolution Deep Learning Reconstruction for Improved Image Quality of Coronary CT Angiography. Radiol Cardiothorac Imaging 2023; 5:e230085. [PMID: 37693207 PMCID: PMC10485715 DOI: 10.1148/ryct.230085] [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: 03/26/2023] [Revised: 05/29/2023] [Accepted: 06/20/2023] [Indexed: 09/12/2023]
Abstract
Purpose To investigate image noise and edge sharpness of coronary CT angiography (CCTA) with super-resolution deep learning reconstruction (SR-DLR) compared with conventional DLR (C-DLR) and to evaluate agreement in stenosis grading using CCTA with that from invasive coronary angiography (ICA) as the reference standard. Materials and Methods This retrospective study included 58 patients (mean age, 69.0 years ± 12.8 [SD]; 38 men, 20 women) who underwent CCTA using 320-row CT between April and September 2022. All images were reconstructed with two different algorithms: SR-DLR and C-DLR. Image noise, signal-to-noise ratio, edge sharpness, full width at half maximum (FWHM) of stent, and agreement in stenosis grading with that from ICA were compared. Stenosis was visually graded from 0 to 5, with 5 indicating occlusion. Results SR-DLR significantly decreased image noise by 31% compared with C-DLR (12.6 HU ± 2.3 vs 18.2 HU ± 1.9; P < .001). Signal-to-noise ratio and edge sharpness were significantly improved by SR-DLR compared with C-DLR (signal-to-noise ratio, 38.7 ± 8.3 vs 26.2 ± 4.6; P < .001; edge sharpness, 560 HU/mm ± 191 vs 463 HU/mm ± 164; P < .001). The FWHM of stent was significantly thinner on SR-DLR (0.72 mm ± 0.22) than on C-DLR (1.01 mm ± 0.21; P < .001). Agreement in stenosis grading between CCTA and ICA was improved on SR-DLR compared with C-DLR (weighted κ = 0.83 vs 0.77). Conclusion SR-DLR improved vessel sharpness, image noise, and accuracy of coronary stenosis grading compared with the C-DLR technique.Keywords: CT Angiography, Cardiac, Coronary Arteries Supplemental material is available for this article. © RSNA, 2023.
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Affiliation(s)
- Masafumi Takafuji
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Kakuya Kitagawa
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Sachio Mizutani
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Akane Hamaguchi
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Ryosuke Kisou
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Kotaro Iio
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Kazuhide Ichikawa
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Daisuke Izumi
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Hajime Sakuma
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
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Lell M, Kachelrieß M. Computed Tomography 2.0: New Detector Technology, AI, and Other Developments. Invest Radiol 2023; 58:587-601. [PMID: 37378467 PMCID: PMC10332658 DOI: 10.1097/rli.0000000000000995] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/04/2023] [Indexed: 06/29/2023]
Abstract
ABSTRACT Computed tomography (CT) dramatically improved the capabilities of diagnostic and interventional radiology. Starting in the early 1970s, this imaging modality is still evolving, although tremendous improvements in scan speed, volume coverage, spatial and soft tissue resolution, as well as dose reduction have been achieved. Tube current modulation, automated exposure control, anatomy-based tube voltage (kV) selection, advanced x-ray beam filtration, and iterative image reconstruction techniques improved image quality and decreased radiation exposure. Cardiac imaging triggered the demand for high temporal resolution, volume acquisition, and high pitch modes with electrocardiogram synchronization. Plaque imaging in cardiac CT as well as lung and bone imaging demand for high spatial resolution. Today, we see a transition of photon-counting detectors from experimental and research prototype setups into commercially available systems integrated in patient care. Moreover, with respect to CT technology and CT image formation, artificial intelligence is increasingly used in patient positioning, protocol adjustment, and image reconstruction, but also in image preprocessing or postprocessing. The aim of this article is to give an overview of the technical specifications of up-to-date available whole-body and dedicated CT systems, as well as hardware and software innovations for CT systems in the near future.
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20
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Hasegawa H, Nango N, Machida M. Evaluation of Trabecular Microstructure of Cancellous Bone Using Quarter-Detector Computed Tomography. Diagnostics (Basel) 2023; 13:diagnostics13071240. [PMID: 37046458 PMCID: PMC10093188 DOI: 10.3390/diagnostics13071240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Quarter-detector computed tomography (QDCT) is an ultra-high-spatial-resolution imaging technique. This study aimed to verify the validity of trabecular structure evaluation using a QDCT scanner in the diagnosis of osteoporosis. We used a cancellous bone specimen image of the second lumbar vertebrae of an adult male with moderate osteoporosis. To obtain QDCT images, we created a three-dimensional model from micro-CT images of the specimen. Statistical analysis was performed on the relationship between micro-CT and QDCT imaging modalities. The differences between micro-CT and QDCT were assessed based on their significance with respect to the calculated mean measurements using the Mann–Whitney test. Single regression analysis was performed using linear regression, with micro-CT and QDCT as the explanatory and objective variables, respectively, to determine the relationship of the measured values between the two modalities. By applying the necessary correction to the micro-CT measured values, it is possible to perform an analysis equivalent to micro-CT, which offers higher spatial resolution than QDCT. We found evidence that if QDCT can be used, trabecular structure evaluation may contribute to image diagnosis to evaluate practical bone fragility.
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21
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Takahashi M, Takaoka H, Ota J, Yashima S, Kinoshita M, Suzuki-Eguchi N, Sasaki H, Goto H, Aoki S, Kitahara H, Sano K, Kobayashi Y. An Increased Diagnostic Accuracy of Significant Coronary Artery Stenosis Using 320-slice Computed Tomography with Model-based Iterative Reconstruction in Cases with Severely Calcified Coronary Arteries. Intern Med 2023; 62:169-176. [PMID: 35676040 PMCID: PMC9908388 DOI: 10.2169/internalmedicine.9509-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Objective High-quality images can be obtained with 320-slice computed tomography (CT) with model-based iterative reconstruction (MBIR). We therefore investigated the diagnostic accuracy of 320-slice CT with MBIR for detecting significant coronary artery stenosis. Methods This was a retrospective study of 160 patients who underwent coronary CT and invasive coronary angiography (ICA). The first 100 consecutive patients (Group 1) underwent 320-slice CT without MBIR or small-focus scanning. The next 60 consecutive patients (Group 2) underwent 320-slice CT with both MBIR and small-focus scanning. Patients who underwent coronary artery bypass surgery were excluded. The diagnostic performance of 320-slice CT without MBIR or small-focus scanning and 320-slice CT with both of them, with ICA regarded as a reference standard, was compared to detect significant coronary artery stenosis (≥70% on CT, ≥75% on ICA). Results In a patient-based analysis, the sensitivity, specificity, and overall accuracy of detection of significant stenosis on CT against ICA were 95%, 85%, and 91% in Group 1, and 93%, 83%, and 90% in Group 2, respectively. No significant differences were observed between the two groups in the patient- and segment-based analyses. However, among cases with a severe coronary artery calcium score >400 (31 cases in Group 1 and 28 in Group 2), the specificity and overall accuracy were significantly higher (all p<0.01) in Group 2 than in Group 1 according to the segment-based analysis. Conclusion The diagnostic accuracy of the detection of coronary artery stenosis on CT was improved using 320-slice CT with MBIR.
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Affiliation(s)
- Manami Takahashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Joji Ota
- Department of Radiology, Chiba University Hospital, Japan
| | - Satomi Yashima
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Makiko Kinoshita
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Noriko Suzuki-Eguchi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Haruka Sasaki
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hiroki Goto
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Shuhei Aoki
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hideki Kitahara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Koichi Sano
- Department of Cardiovascular Medicine, Eastern Chiba Medical Center, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
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Ramasamy A, Hamid A Khan A, Cooper J, Simon J, Maurovich-Horvat P, Bajaj R, Kitslaar P, Amersey R, Jain A, Deaner A, Reiber JH, Moon JC, Dijkstra J, Serruys PW, Mathur A, Baumbach A, Torii R, Pugliese F, Bourantas CV. Implications of computed tomography reconstruction algorithms on coronary atheroma quantification: Comparison with intravascular ultrasound. J Cardiovasc Comput Tomogr 2023; 17:43-51. [PMID: 36270952 DOI: 10.1016/j.jcct.2022.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/03/2022] [Accepted: 09/17/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Advances in coronary computed tomography angiography (CCTA) reconstruction algorithms are expected to enhance the accuracy of CCTA plaque quantification. We aim to evaluate different CCTA reconstruction approaches in assessing vessel characteristics in coronary atheroma using intravascular ultrasound (IVUS) as the reference standard. METHODS Matched cross-sections (n = 7241) from 50 vessels in 15 participants with chronic coronary syndrome who prospectively underwent CCTA and 3-vessel near-infrared spectroscopy-IVUS were included. Twelve CCTA datasets per patient were reconstructed using two different kernels, two slice thicknesses (0.75 mm and 0.50 mm) and three different strengths of advanced model-based iterative reconstruction (IR) algorithms. Lumen and vessel wall borders were manually annotated in every IVUS and CCTA cross-section which were co-registered using dedicated software. Image quality was sub-optimal in the reconstructions with a sharper kernel, so these were excluded. Intraclass correlation coefficient (ICC) and repeatability coefficient (RC) were used to compare the estimations of the 6 CT reconstruction approaches with those derived by IVUS. RESULTS Segment-level analysis showed good agreement between CCTA and IVUS for assessing atheroma volume with approach 0.50/5 (slice thickness 0.50 mm and highest strength 5 ADMIRE IR) being the best (total atheroma volume ICC: 0.91, RC: 0.67, p < 0.001 and percentage atheroma volume ICC: 0.64, RC: 14.06, p < 0.001). At lesion-level, there was no difference between the CCTA reconstructions for detecting plaques (accuracy range: 0.64-0.67; p = 0.23); however, approach 0.50/5 was superior in assessing IVUS-derived lesion characteristics associated with plaque vulnerability (minimum lumen area ICC: 0.64, RC: 1.31, p < 0.001 and plaque burden ICC: 0.45, RC: 32.0, p < 0.001). CONCLUSION CCTA reconstruction with thinner slice thickness, smooth kernel and highest strength advanced IR enabled more accurate quantification of the lumen and plaque at a segment-, and lesion-level analysis in coronary atheroma when validated against intravascular ultrasound. CLINICALTRIALS gov (NCT03556644).
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Affiliation(s)
- Anantharaman Ramasamy
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Ameer Hamid A Khan
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Jackie Cooper
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Judit Simon
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Retesh Bajaj
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Pieter Kitslaar
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Medis Medical Imaging, Leiden, the Netherlands
| | - Rajiv Amersey
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Ajay Jain
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Andrew Deaner
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Johan Hc Reiber
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Medis Medical Imaging, Leiden, the Netherlands
| | - James C Moon
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Institute of Cardiovascular Sciences, University College London, London, UK
| | - Jouke Dijkstra
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Patrick W Serruys
- Faculty of Medicine, National Heart & Lung Institute, Imperial College London, UK; Department of Cardiology, National University of Ireland, Galway, Ireland
| | - Anthony Mathur
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Andreas Baumbach
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Ryo Torii
- Department of Mechanical Engineering, University College London, London, UK
| | - Francesca Pugliese
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK
| | - Christos V Bourantas
- Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK; Institute of Cardiovascular Sciences, University College London, London, UK.
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23
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Ohno Y, Akino N, Fujisawa Y, Kimata H, Ito Y, Fujii K, Kataoka Y, Ida Y, Oshima Y, Hamabuchi N, Shigemura C, Watanabe A, Obama Y, Hanamatsu S, Ueda T, Ikeda H, Murayama K, Toyama H. Comparison of lung CT number and airway dimension evaluation capabilities of ultra-high-resolution CT, using different scan modes and reconstruction methods including deep learning reconstruction, with those of multi-detector CT in a QIBA phantom study. Eur Radiol 2022; 33:368-379. [PMID: 35841417 DOI: 10.1007/s00330-022-08983-1] [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: 12/02/2021] [Revised: 06/05/2022] [Accepted: 06/22/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Ultra-high-resolution CT (UHR-CT), which can be applied normal resolution (NR), high-resolution (HR), and super-high-resolution (SHR) modes, has become available as in conjunction with multi-detector CT (MDCT). Moreover, deep learning reconstruction (DLR) method, as well as filtered back projection (FBP), hybrid-type iterative reconstruction (IR), and model-based IR methods, has been clinically used. The purpose of this study was to directly compare lung CT number and airway dimension evaluation capabilities of UHR-CT using different scan modes with those of MDCT with different reconstruction methods as investigated in a lung density and airway phantom design recommended by QIBA. MATERIALS AND METHODS Lung CT number, inner diameter (ID), inner area (IA), and wall thickness (WT) were measured, and mean differences between measured CT number, ID, IA, WT, and standard reference were compared by means of Tukey's HSD test between all UHR-CT data and MDCT reconstructed with FBP as 1.0-mm section thickness. RESULTS For each reconstruction method, mean differences in lung CT numbers and all airway parameters on 0.5-mm and 1-mm section thickness CTs obtained with SHR and HR modes showed significant differences with those obtained with the NR mode on UHR-CT and MDCT (p < 0.05). Moreover, the mean differences on all UHR-CTs obtained with SHR, HR, or NR modes were significantly different from those of 1.0-mm section thickness MDCTs reconstructed with FBP (p < 0.05). CONCLUSION Scan modes and reconstruction methods used for UHR-CT were found to significantly affect lung CT number and airway dimension evaluations as did reconstruction methods used for MDCT. KEY POINTS • Scan and reconstruction methods used for UHR-CT showed significantly higher CT numbers and smaller airway dimension evaluations as did those for MDCT in a QIBA phantom study (p < 0.05). • Mean differences in lung CT number for 0.25-mm, 0.5-mm, and 1.0-mm section thickness CT images obtained with SHR and HR modes were significantly larger than those for CT images at 1.0-mm section thickness obtained with MDCT and reconstructed with FBP (p < 0.05). • Mean differences in inner diameter (ID), inner area (IA), and wall thickness (WT) measured with SHR and HR modes on 0.5- and 1.0-mm section thickness CT images were significantly smaller than those obtained with NR mode on UHR-CT and MDCT (p < 0.05).
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Affiliation(s)
- Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. .,Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
| | - Naruomi Akino
- Canon Medical Systems Corporation, Otawara, Tochigi, Japan
| | | | - Hirona Kimata
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yuya Ito
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Kenji Fujii
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yumi Kataoka
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Yoshihiro Ida
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Yuka Oshima
- Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Nayu Hamabuchi
- Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Chika Shigemura
- Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Ayumi Watanabe
- Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Yuki Obama
- Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Satomu Hanamatsu
- Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Hirotaka Ikeda
- Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Kazuhiro Murayama
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
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Takahara K, Ohno Y, Fukaya K, Matsukiyo R, Nukaya T, Takenaka M, Zennami K, Ichino M, Fukami N, Sasaki H, Kusaka M, Toyama H, Sumitomo M, Shiroki R. Novel Intraoperative Navigation Using Ultra-High-Resolution CT in Robot-Assisted Partial Nephrectomy. Cancers (Basel) 2022; 14:cancers14082047. [PMID: 35454953 PMCID: PMC9032210 DOI: 10.3390/cancers14082047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Successful surgery in robot-assisted partial nephrectomy (RAPN), especially for highly complex tumors, relies on a detailed understanding of the anatomical relations of the tumor absolute and relative to the urinary tract and the vascular structures, including the renal pedicle. Intraoperative navigation with accurate information regarding tumor position relative to the surrounding urinary vascular structures undoubtedly assists the surgeon during RAPN. In this report, we performed RAPN with intraoperative navigation using a novel computed tomography scanner (UHR-CT) and compared its perioperative and short-term functional outcomes to those of area-detector CT (ADCT). We found that this novel navigation system using UHR-CT provided a shorter warm ischemia time and lower estimated blood loss than ADCT, and concluded this could be a useful tool for patients who undergo RAPN. This is the first report to evaluate the feasibility and usefulness of UHR-CT for intraoperative navigation during RAPN. Abstract To assess the perioperative and short-term functional outcomes of robot-assisted partial nephrectomy (RAPN) with intraoperative navigation using an ultra-high-resolution computed tomography (UHR-CT) scanner, we retrospectively analyzed 323 patients who underwent RAPN using an UHR-CT or area-detector CT (ADCT). Perioperative outcomes and the postoperative preservation ratio of estimated glomerular filtration rate (eGFR) were compared. After the propensity score matching, we evaluated 99 patients in each group. Although the median warm ischemia time (WIT) was less than 25 min in both groups, it was significantly shorter in the UHR-CT group than in the ADCT group (15 min vs. 17 min, p = 0.032). Moreover, the estimated blood loss (EBL) was significantly lower in the UHR-CT group than in the ADCT group (33 mL vs. 50 mL, p = 0.028). However, there were no significant intergroup differences in the postoperative preservation ratio of eGFR at 3 or 6 months of follow-up (ADCT 91.8% vs. UHR-CT 93.5%, p = 0.195; and ADCT 91.7% vs. UHR-CT 94.0%, p = 0.160, respectively). Although no differences in short-term renal function were observed in intraoperative navigation for RAPN in this propensity score–matched cohort, this study is the first to demonstrate that UHR-CT resulted in a shorter WIT and lower EBL than ADCT.
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Affiliation(s)
- Kiyoshi Takahara
- Department of Urology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (K.F.); (T.N.); (M.T.); (K.Z.); (M.I.); (H.S.); (M.S.); (R.S.)
- Correspondence: ; Tel.: +81-562-93-2884
| | - Yoshiharu Ohno
- Department of Radiology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (Y.O.); (R.M.); (H.T.)
| | - Kosuke Fukaya
- Department of Urology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (K.F.); (T.N.); (M.T.); (K.Z.); (M.I.); (H.S.); (M.S.); (R.S.)
| | - Ryo Matsukiyo
- Department of Radiology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (Y.O.); (R.M.); (H.T.)
| | - Takuhisa Nukaya
- Department of Urology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (K.F.); (T.N.); (M.T.); (K.Z.); (M.I.); (H.S.); (M.S.); (R.S.)
| | - Masashi Takenaka
- Department of Urology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (K.F.); (T.N.); (M.T.); (K.Z.); (M.I.); (H.S.); (M.S.); (R.S.)
| | - Kenji Zennami
- Department of Urology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (K.F.); (T.N.); (M.T.); (K.Z.); (M.I.); (H.S.); (M.S.); (R.S.)
| | - Manabu Ichino
- Department of Urology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (K.F.); (T.N.); (M.T.); (K.Z.); (M.I.); (H.S.); (M.S.); (R.S.)
| | - Naohiko Fukami
- Department of Urology, Okazaki Medical Center, Fujita Health University, Okazaki 444-0827, Japan; (N.F.); (M.K.)
| | - Hitomi Sasaki
- Department of Urology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (K.F.); (T.N.); (M.T.); (K.Z.); (M.I.); (H.S.); (M.S.); (R.S.)
| | - Mamoru Kusaka
- Department of Urology, Okazaki Medical Center, Fujita Health University, Okazaki 444-0827, Japan; (N.F.); (M.K.)
| | - Hiroshi Toyama
- Department of Radiology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (Y.O.); (R.M.); (H.T.)
| | - Makoto Sumitomo
- Department of Urology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (K.F.); (T.N.); (M.T.); (K.Z.); (M.I.); (H.S.); (M.S.); (R.S.)
| | - Ryoichi Shiroki
- Department of Urology, Fujita-Health University School of Medicine, Nagoya 470-1192, Japan; (K.F.); (T.N.); (M.T.); (K.Z.); (M.I.); (H.S.); (M.S.); (R.S.)
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Importance of the heart rate in ultra-high-resolution coronary CT angiography with 0.35 s gantry rotation time. Jpn J Radiol 2022; 40:781-790. [PMID: 35396666 DOI: 10.1007/s11604-022-01265-2] [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: 10/25/2021] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE We investigated the effects of the heart rate (HR) on the motion artifact in coronary computed tomography angiography (CCTA) with ultra-high-resolution-CT (U-HRCT), and we clarified the upper limit of optimal HR in CCTA with U-HRCT in a comparison with conventional-resolution-CT (CRCT) on a cardiac phantom and in patients with CCTA. MATERIALS AND METHODS A pulsating cardiac phantom equipped with coronary models was scanned at static and HR simulations of 40-90 beats/min (bpm) at 10-bpm intervals using U-HRCT and CRCT, respectively. The sharpness and lumen diameter of the coronary model were quantitatively compared between U-HRCT and CRCT stratified by HR in the phantom study. We also assessed the visual inspections of clinical images in CCTA with U-HRCT. RESULTS At the HRs ≤ 60 bpm, the error of the lumen diameter of the U-HRCT tended to be smaller than that of the CRCT. However, at the HRs > 60 bpm, the inverse was shown. For the image sharpness, the U-HRCT was significantly superior to the CRCT (p < 0.05). In the visual assessment, the scores were negatively correlated with HRs in patients (Spearman r = - 0.71, p < 0.01). A receiver-operating characteristic analysis revealed the HR of 61 bpm as the optimal cutoff of the non-diagnostic image quality, with an area under the curve of 0.87, 95% sensitivity, and 71% specificity. CONCLUSION At HRs ≤ 60 bpm, U-HRCT was more accurate in the imaging of coronary arteries than CRCT. The upper limit of the optimal HR in CCTA with U-HRCT was approx. 60 bpm.
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26
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Colin E, Plyer A, Golzio M, Meyer N, Favre G, Orlik X. Imaging of the skin microvascularization using spatially depolarized dynamic speckle. JOURNAL OF BIOMEDICAL OPTICS 2022; 27:JBO-210355GR. [PMID: 35478040 PMCID: PMC9043838 DOI: 10.1117/1.jbo.27.4.046003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 04/05/2022] [Indexed: 05/29/2023]
Abstract
SIGNIFICANCE We propose a technique devoted to real-time high-resolution imaging of skin microvascularization. AIM The process utilizes the temporal variation of the spatially depolarized optical speckle field generated by moving red blood cells when illuminated with fully polarized coherent light. APPROACH Polarimetric filtering prevents the contribution of surface scattering from reaching the camera and thus favors the detection of multiscattered photons from the deeper layers of the skin. RESULTS Full-field images reveal the microvasculature with a spatial resolution of 80 μm. The acquisition speed allows for real-time applications. CONCLUSIONS We demonstrate the ability of this method to determine in 1 s a stable and reliable microvascular activity, enabling numerous clinical applications that require quantitative measurements.
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Affiliation(s)
- Elise Colin
- Paris Saclay University, DTIS, ONERA, Palaiseau, France
- ITAE Medical Research, Pechabou, France
| | - Aurélien Plyer
- Paris Saclay University, DTIS, ONERA, Palaiseau, France
- ITAE Medical Research, Pechabou, France
| | | | | | - Gilles Favre
- Centre de Recherches en Cancérologie de Toulouse, Inserm UMR1037, CNRS UMR5071, Université Toulouse 3, Toulouse, France
- Institut Universitaire du Cancer de Toulouse-Oncopole, Institut Claudius Regaud, Toulouse, France
| | - Xavier Orlik
- ITAE Medical Research, Pechabou, France
- Toulouse University, ONERA/DOTA, Toulouse, France
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27
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Schuijf JD, Lima JA, Boedeker KL, Takagi H, Tanaka R, Yoshioka K, Arbab-Zadeh A. CT imaging with ultra-high-resolution: opportunities for cardiovascular imaging in clinical practice. J Cardiovasc Comput Tomogr 2022; 16:388-396. [DOI: 10.1016/j.jcct.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 10/19/2022]
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28
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Yamada M, Yamada Y, Nakahara T, Okuda S, Abe T, Kuribayashi S, Jinzaki M. Accuracy of ultra-high-resolution computed tomography with a 0.3-mm detector for quantitative assessment of coronary artery stenosis grading in comparison with conventional computed tomography: A phantom study. J Cardiovasc Comput Tomogr 2021; 16:239-244. [PMID: 34906436 DOI: 10.1016/j.jcct.2021.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 10/15/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The development of ultra-high-resolution CT (U-HRCT) is expected to improve the accuracy of coronary stenosis evaluation. This study aimed to evaluate the accuracy of the stenosis severities of coronary artery phantoms estimated using U-HRCT by comparing them to those estimated with conventional CT. METHODS Coronary artery phantoms with non-calcified and calcified lesions were scanned with conventional CT (64-row × 0.625 mm) and U-HRCT (32-row × 0.3125 mm). The coronary artery phantoms had lumen diameters of 2.0, 3.0, and 4.0 mm with non-calcified lesions representing 0%, 25%, 50%, and 75% stenosis and 3.0 and 4.0 mm with calcified lesions representing 0%, 25%, 50%, and 75% stenosis. The lumen diameters at the stenotic and non-stenotic regions were measured, and the stenosis severities were compared with the true values. RESULTS For non-calcified lesions, conventional CT significantly underestimated the stenosis severity in the phantom showing 75% stenosis with lumen diameters of 2.0 and 3.0 mm (p < 0.05), while the estimated stenosis severities were not significantly different from the true values at all settings with U-HRCT. For the calcified lesions, conventional CT overestimated the stenosis severities at all settings (p < 0.05), while U-HRCT yielded estimations closer to the true values, although still with some overestimation (p < 0.05). CONCLUSION By using U-HRCT, the estimated stenosis severities of the coronary artery with non-calcified lesion become almost equal to the true value, while those with calcified lesion are still overestimated although they become closer to the true value.
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Affiliation(s)
- Minoru Yamada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takehiro Nakahara
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shigeo Okuda
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takayuki Abe
- Keio University School of Medicine, Clinical and Translational Research Center, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Yokohama City University School of Data Science, 22-2, Seto, Kanazawa, Yokohama, Kanagawa, 236-0027, Japan
| | - Sachio Kuribayashi
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; HIMEDIC Imaging Center at Lake Yamanaka, XIV Yamanakako B2F, 562-12 Hirano, Yamanashi, 401-0502, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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Comparison of visibility of in-stent restenosis between conventional- and ultra-high spatial resolution computed tomography: coronary arterial phantom study. Jpn J Radiol 2021; 40:279-288. [PMID: 34586581 DOI: 10.1007/s11604-021-01200-x] [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: 05/19/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purposes of this experimental study were to compare the quantitative and qualitative visibility of in-stent restenosis between conventional-resolution CT (CRCT) and ultra-high-resolution CT (U-HRCT) and to investigate the effects of the image reconstruction techniques on the visualization of in-stent restenosis. MATERIALS AND METHODS A vessel tube with non-calcified plaque in a 3.0-mm stent was scanned by using CRCT and U-HRCT at 4 stent directions (0, 30, 60, and 90 degrees) to the through-plane direction. Hybrid iterative reconstruction (HIR); model-based iterative reconstruction (MBIR); deep-learning-based reconstruction (DLR) were used as reconstruction methods. The lumen size was assessed using the full width at half maximum method, and image quality was visually evaluated using 4-point scale. RESULTS U-HRCT had the significantly wider lumen sizes and narrower stent strut thickness than CRCT in three types of the reconstruction methods (P < 0.01). The lumen sizes for U-HRCT with 90 degrees were narrower than those with the other angle directions regardless of the reconstruction methods. Visual score was significantly higher for U-HRCT than CRCT (3.2 ± 0.7 vs 2.0 ± 0.4, P < 0.001). CONCLUSIONS U-HRCT quantitatively and qualitatively provided better visualization of in-stent restenosis compared to CRCT. Image quality of U-HRCT may be affected by stent angle.
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30
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Computed tomography of coronary artery atherosclerosis: A review. J Med Imaging Radiat Sci 2021; 52:S19-S39. [PMID: 34479831 DOI: 10.1016/j.jmir.2021.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/29/2021] [Accepted: 08/06/2021] [Indexed: 11/23/2022]
Abstract
Coronary artery atherosclerosis resulting in ischemic cardiac disease is the leading cause of mortality in the United States. In symptomatic patients, invasive diagnostic methods like catheter angiography, intravascular ultrasound, or vascular endoscopy may be used. However, for primary prevention of atherosclerotic coronary artery disease in asymptomatic patients, non-invasive methods are more commonly utilized like stress imaging, single-photon emission computed tomography (SPECT) and coronary artery calcification scoring. Coronary computed tomographic angiography (CCTA) is an excellent diagnostic tool for detection of coronary artery plaque and ability to identify resultant stenoses with an excellent negative predictive value which can potentially result in optimal exclusion of the presence of coronary artery disease. Long term follow up after a negative CCTA has repeatedly demonstrated very low incidence of future adverse coronary events, attesting its predictive value. CCTA based management is associated with improved CAD outcome in stable angina. Coronary CTA is valuable in acute chest pain evaluation in the emergency department helping in better triage. CT perfusion and CT-FFR are both very promising tools for assessment of hemodynamic significance of coronary artery stenosis.
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31
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Shanbhag SM, Chen MY. Ultra-High-Resolution Coronary CT Angiography: The "Final Frontier"-Are We There Yet? Radiol Cardiothorac Imaging 2021; 3:e210196. [PMID: 34498013 PMCID: PMC8415137 DOI: 10.1148/ryct.2021210196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/14/2021] [Accepted: 07/14/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Sujata M. Shanbhag
- From the National Heart, Lung, and Blood Institute, National
Institutes of Health, Building 10, Room B1D47, 10 Center Drive, Bethesda, MD
20892-1046
| | - Marcus Y. Chen
- From the National Heart, Lung, and Blood Institute, National
Institutes of Health, Building 10, Room B1D47, 10 Center Drive, Bethesda, MD
20892-1046
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32
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Latina J, Shabani M, Kapoor K, Whelton SP, Trost JC, Sesso J, Demehri S, Mahesh M, Lima JAC, Arbab-Zadeh A. Ultra-High-Resolution Coronary CT Angiography for Assessment of Patients with Severe Coronary Artery Calcification: Initial Experience. Radiol Cardiothorac Imaging 2021; 3:e210053. [PMID: 34498007 PMCID: PMC8415143 DOI: 10.1148/ryct.2021210053] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/14/2021] [Accepted: 07/08/2021] [Indexed: 11/11/2022]
Abstract
PURPOSE Conventional CT technology yields only modest accuracy of coronary artery stenosis assessment in severely calcified lesions. Reported herein are this study's initial observations on the potential of ultra-high-resolution CT (UHR-CT) for evaluating severely calcified coronary arterial lesions. MATERIALS AND METHODS Fifteen patients 45 years of age or older, with history of coronary artery disease, referred for invasive coronary angiography, were prospectively enrolled. Patients underwent UHR-CT within 30 days prior to cardiac catheterization. Image noise levels and diagnostic confidence (level 1-5) using UHR-CT were compared with reconstructed images simulating conventional CT technology. Stenosis assessment for the major coronary arteries and the left main coronary artery with UHR-CT and invasive angiography were compared. Results from clinically driven coronary CT using conventional technology were considered for comparison when available. RESULTS Mean patient age was 67 years (range, 53-79 years). Thirteen patients were men, nine had obesity. Radiation dose was 9.3 mSv owing to expanded x-ray exposure to accommodate research software application (70%-99% of R-R cycle). Overall image noise was considerably greater for UHR-CT (50.9 ± 7.8 [standard deviation]) versus conventional CT image reconstruction (19.5 ± 8.3, P < .01), yet diagnostic confidence scores for UHR-CT were high (4.3 ± 0.9). Average calcium score in patients without stents (n = 6) was 1205, and of 86 vessels evaluated, 22 had 70% or greater stenosis depicted with invasive angiography (26%). Stenosis comparison with invasive angiography yielded 86% (19 of 22) sensitivity and 88% (56 of 64) specificity (95% CI: 65%, 97%; and 77%, 95%, respectively). CONCLUSION Initial observations suggest UHR-CT may be effective in overcoming the limitation of conventional CT for accurately evaluating coronary artery stenoses in severely calcified vessels.Keywords: CT-Angiography, Coronary Arteries, ArteriosclerosisClinical trial registration no. NCT04272060See also commentary by Shanbhag and Chen in this issue.© RSNA, 2021.
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Affiliation(s)
- Jacqueline Latina
- From the Division of Cardiology, Department of Medicine, and
Department of Radiology, Johns Hopkins University School of Medicine, 600 N
Wolfe St, Halsted 562, Baltimore, MD 21287-0025
| | - Mahsima Shabani
- From the Division of Cardiology, Department of Medicine, and
Department of Radiology, Johns Hopkins University School of Medicine, 600 N
Wolfe St, Halsted 562, Baltimore, MD 21287-0025
| | - Karan Kapoor
- From the Division of Cardiology, Department of Medicine, and
Department of Radiology, Johns Hopkins University School of Medicine, 600 N
Wolfe St, Halsted 562, Baltimore, MD 21287-0025
| | - Seamus P. Whelton
- From the Division of Cardiology, Department of Medicine, and
Department of Radiology, Johns Hopkins University School of Medicine, 600 N
Wolfe St, Halsted 562, Baltimore, MD 21287-0025
| | - Jeffrey C. Trost
- From the Division of Cardiology, Department of Medicine, and
Department of Radiology, Johns Hopkins University School of Medicine, 600 N
Wolfe St, Halsted 562, Baltimore, MD 21287-0025
| | - Jaclyn Sesso
- From the Division of Cardiology, Department of Medicine, and
Department of Radiology, Johns Hopkins University School of Medicine, 600 N
Wolfe St, Halsted 562, Baltimore, MD 21287-0025
| | - Shadpour Demehri
- From the Division of Cardiology, Department of Medicine, and
Department of Radiology, Johns Hopkins University School of Medicine, 600 N
Wolfe St, Halsted 562, Baltimore, MD 21287-0025
| | - Mahadevappa Mahesh
- From the Division of Cardiology, Department of Medicine, and
Department of Radiology, Johns Hopkins University School of Medicine, 600 N
Wolfe St, Halsted 562, Baltimore, MD 21287-0025
| | - João A. C. Lima
- From the Division of Cardiology, Department of Medicine, and
Department of Radiology, Johns Hopkins University School of Medicine, 600 N
Wolfe St, Halsted 562, Baltimore, MD 21287-0025
| | - Armin Arbab-Zadeh
- From the Division of Cardiology, Department of Medicine, and
Department of Radiology, Johns Hopkins University School of Medicine, 600 N
Wolfe St, Halsted 562, Baltimore, MD 21287-0025
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Shirasaka T, Kojima T, Funama Y, Sakai Y, Kondo M, Mikayama R, Hamasaki H, Kato T, Ushijima Y, Asayama Y, Nishie A. Image quality improvement with deep learning-based reconstruction on abdominal ultrahigh-resolution CT: A phantom study. J Appl Clin Med Phys 2021; 22:286-296. [PMID: 34159736 PMCID: PMC8292685 DOI: 10.1002/acm2.13318] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 04/15/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022] Open
Abstract
Purpose In an ultrahigh‐resolution CT (U‐HRCT), deep learning‐based reconstruction (DLR) is expected to drastically reduce image noise without degrading spatial resolution. We assessed a new algorithm's effect on image quality at different radiation doses assuming an abdominal CT protocol. Methods For the normal‐sized abdominal models, a Catphan 600 was scanned by U‐HRCT with 100%, 50%, and 25% radiation doses. In all acquisitions, DLR was compared to model‐based iterative reconstruction (MBIR), filtered back projection (FBP), and hybrid iterative reconstruction (HIR). For the quantitative assessment, we compared image noise, which was defined as the standard deviation of the CT number, and spatial resolution among all reconstruction algorithms. Results Deep learning‐based reconstruction yielded lower image noise than FBP and HIR at each radiation dose. DLR yielded higher image noise than MBIR at the 100% and 50% radiation doses (100%, 50%, DLR: 15.4, 16.9 vs MBIR: 10.2, 15.6 Hounsfield units: HU). However, at the 25% radiation dose, the image noise in DLR was lower than that in MBIR (16.7 vs. 26.6 HU). The spatial frequency at 10% of the modulation transfer function (MTF) in DLR was 1.0 cycles/mm, slightly lower than that in MBIR (1.05 cycles/mm) at the 100% radiation dose. Even when the radiation dose decreased, the spatial frequency at 10% of the MTF of DLR did not change significantly (50% and 25% doses, 0.98 and 0.99 cycles/mm, respectively). Conclusion Deep learning‐based reconstruction performs more consistently at decreasing dose in abdominal ultrahigh‐resolution CT compared to all other commercially available reconstruction algorithms evaluated.
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Affiliation(s)
- Takashi Shirasaka
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Tsukasa Kojima
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuki Sakai
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Masatoshi Kondo
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Ryoji Mikayama
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroshi Hamasaki
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Toyoyuki Kato
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Yasuhiro Ushijima
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshiki Asayama
- Department of Advanced Imaging and Interventional Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akihiro Nishie
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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The accuracy of coronary CT angiography in patients with coronary calcium score above 1000 Agatston Units: Comparison with quantitative coronary angiography. J Cardiovasc Comput Tomogr 2021; 15:412-418. [PMID: 33775584 DOI: 10.1016/j.jcct.2021.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/13/2021] [Accepted: 03/14/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND High amounts of coronary artery calcium (CAC) pose challenges in interpretation of coronary CT angiography (CCTA). The accuracy of stenosis assessment by CCTA in patients with very extensive CAC is uncertain. METHODS Retrospective study was performed including patients who underwent clinically directed CCTA with CAC score >1000 and invasive coronary angiography within 90 days. Segmental stenosis on CCTA was graded by visual inspection with two-observer consensus using categories of 0%, 1-24%, 25-49%, 50-69%, 70-99%, 100% stenosis, or uninterpretable. Blinded quantitative coronary angiography (QCA) was performed on all segments with stenosis ≥25% by CCTA. The primary outcome was vessel-based agreement between CCTA and QCA, using significant stenosis defined by diameter stenosis ≥70%. Secondary analyses on a per-patient basis and inclusive of uninterpretable segments were performed. RESULTS 726 segments with stenosis ≥25% in 346 vessels within 119 patients were analyzed. Median coronary calcium score was 1616 (1221-2118). CCTA identification of QCA-based stenosis resulted in a per-vessel sensitivity of 79%, specificity of 75%, positive predictive value (PPV) of 45%, negative predictive value (NPV) of 93%, and accuracy 76% (68 false positive and 15 false negative). Per-patient analysis had sensitivity 94%, specificity 55%, PPV 63%, NPV 92%, and accuracy 72% (30 false-positive and 3 false-negative). Inclusion of uninterpretable segments had variable effect on sensitivity and specificity, depending on whether they are considered as significant or non-significant stenosis. CONCLUSIONS In patients with very extensive CAC (>1000 Agatston units), CCTA retained a negative predictive value > 90% to identify lack of significant stenosis on a per-vessel and per-patient level, but frequently overestimated stenosis.
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Diagnostic value of deep learning reconstruction for radiation dose reduction at abdominal ultra-high-resolution CT. Eur Radiol 2021; 31:4700-4709. [PMID: 33389036 DOI: 10.1007/s00330-020-07566-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 10/01/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES We evaluated lower dose (LD) hepatic dynamic ultra-high-resolution computed tomography (U-HRCT) images reconstructed with deep learning reconstruction (DLR), hybrid iterative reconstruction (hybrid-IR), or model-based IR (MBIR) in comparison with standard-dose (SD) U-HRCT images reconstructed with hybrid-IR as the reference standard to identify the method that allowed for the greatest radiation dose reduction while preserving the diagnostic value. METHODS Evaluated were 72 patients who had undergone hepatic dynamic U-HRCT; 36 were scanned with the standard radiation dose (SD group) and 36 with 70% of the SD (lower dose [LD] group). Hepatic arterial and equilibrium phase (HAP, EP) images were reconstructed with hybrid-IR in the SD group, and with hybrid-IR, MBIR, and DLR in the LD group. One radiologist recorded the standard deviation of attenuation in the paraspinal muscle as the image noise. The overall image quality was assessed by 3 other radiologists; they used a 5-point confidence scale ranging from 1 (unacceptable) to 5 (excellent). Superiority and equivalence with prespecified margins were assessed. RESULTS With respect to the image noise, in the HAP and EP, LD DLR and LD MBIR images were superior to SD hybrid-IR images; LD hybrid-IR images were neither superior nor equivalent to SD hybrid-IR images. With respect to the quality scores, only LD DLR images were superior to SD hybrid-IR images. CONCLUSIONS DLR preserved the quality of abdominal U-HRCT images even when scanned with a reduced radiation dose. KEY POINTS • Lower dose DLR images were superior to the standard-dose hybrid-IR images quantitatively and qualitatively at abdominal U-HRCT. • Neither hybrid-IR nor MBIR may allow for a radiation dose reduction at abdominal U-HRCT without compromising the image quality. • Because DLR allows for a reduction in the radiation dose and maintains the image quality even at the thinnest slice section, DLR should be applied to abdominal U-HRCT scans.
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Kwan AC, Pourmorteza A, Stutman D, Bluemke DA, Lima JAC. Next-Generation Hardware Advances in CT: Cardiac Applications. Radiology 2020; 298:3-17. [PMID: 33201793 DOI: 10.1148/radiol.2020192791] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Impending major hardware advances in cardiac CT include three areas: ultra-high-resolution (UHR) CT, photon-counting CT, and phase-contrast CT. Cardiac CT is a particularly demanding CT application that requires a high degree of temporal resolution, spatial resolution, and soft-tissue contrast in a moving structure. In this review, cardiac CT is used to highlight the strengths of these technical advances. UHR CT improves visualization of calcified and stented vessels but may result in increased noise and radiation exposure. Photon-counting CT uses multiple photon energies to reduce artifacts, improve contrast resolution, and perform material decomposition. Finally, phase-contrast CT uses x-ray refraction properties to improve spatial and soft-tissue contrast. This review describes these hardware advances in CT and their relevance to cardiovascular imaging.
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Affiliation(s)
- Alan C Kwan
- From the Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, AHSP, Suite A3600, Los Angeles, CA 90048-0750 (A.C.K.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Winship Cancer Institute, Emory University, Atlanta, Ga (A.P.); Department of Biomedical Engineering, Georgia Institute of Technology-Emory University, Atlanta, Ga (A.P.); Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Md (D.S.); Extreme Light Infrastructure-Nuclear Physics, Bucharest-Magurele, Romania (D.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.); and Department of Cardiology, The Johns Hopkins Hospital, Baltimore, Md (J.A.C.L.)
| | - Amir Pourmorteza
- From the Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, AHSP, Suite A3600, Los Angeles, CA 90048-0750 (A.C.K.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Winship Cancer Institute, Emory University, Atlanta, Ga (A.P.); Department of Biomedical Engineering, Georgia Institute of Technology-Emory University, Atlanta, Ga (A.P.); Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Md (D.S.); Extreme Light Infrastructure-Nuclear Physics, Bucharest-Magurele, Romania (D.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.); and Department of Cardiology, The Johns Hopkins Hospital, Baltimore, Md (J.A.C.L.)
| | - Dan Stutman
- From the Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, AHSP, Suite A3600, Los Angeles, CA 90048-0750 (A.C.K.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Winship Cancer Institute, Emory University, Atlanta, Ga (A.P.); Department of Biomedical Engineering, Georgia Institute of Technology-Emory University, Atlanta, Ga (A.P.); Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Md (D.S.); Extreme Light Infrastructure-Nuclear Physics, Bucharest-Magurele, Romania (D.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.); and Department of Cardiology, The Johns Hopkins Hospital, Baltimore, Md (J.A.C.L.)
| | - David A Bluemke
- From the Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, AHSP, Suite A3600, Los Angeles, CA 90048-0750 (A.C.K.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Winship Cancer Institute, Emory University, Atlanta, Ga (A.P.); Department of Biomedical Engineering, Georgia Institute of Technology-Emory University, Atlanta, Ga (A.P.); Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Md (D.S.); Extreme Light Infrastructure-Nuclear Physics, Bucharest-Magurele, Romania (D.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.); and Department of Cardiology, The Johns Hopkins Hospital, Baltimore, Md (J.A.C.L.)
| | - João A C Lima
- From the Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, AHSP, Suite A3600, Los Angeles, CA 90048-0750 (A.C.K.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Winship Cancer Institute, Emory University, Atlanta, Ga (A.P.); Department of Biomedical Engineering, Georgia Institute of Technology-Emory University, Atlanta, Ga (A.P.); Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Md (D.S.); Extreme Light Infrastructure-Nuclear Physics, Bucharest-Magurele, Romania (D.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.); and Department of Cardiology, The Johns Hopkins Hospital, Baltimore, Md (J.A.C.L.)
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Matsukiyo R, Ohno Y, Matsuyama T, Nagata H, Kimata H, Ito Y, Ogawa Y, Murayama K, Kato R, Toyama H. Deep learning-based and hybrid-type iterative reconstructions for CT: comparison of capability for quantitative and qualitative image quality improvements and small vessel evaluation at dynamic CE-abdominal CT with ultra-high and standard resolutions. Jpn J Radiol 2020; 39:186-197. [PMID: 33037956 DOI: 10.1007/s11604-020-01045-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/11/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To determine the image quality improvement including vascular structures using deep learning reconstruction (DLR) for ultra-high-resolution CT (UHR-CT) and area-detector CT (ADCT) compared to a commercially available hybrid-iterative reconstruction (IR) method. MATERIALS AND METHOD Thirty-two patients suspected of renal cell carcinoma underwent dynamic contrast-enhanced (CE) CT using UHR-CT or ADCT systems. CT value and contrast-to-noise ratio (CNR) on each CT dataset were assessed with region of interest (ROI) measurements. For qualitative assessment of improvement for vascular structure visualization, each artery was assessed using a 5-point scale. To determine the utility of DLR, CT values and CNRs were compared among all UHR-CT data by means of ANOVA followed by Bonferroni post hoc test, and same values on ADCT data were also compared between hybrid IR and DLR methods by paired t test. RESULTS For all arteries except the aorta, the CT value and CNR of the DLR method were significantly higher compared to those of the hybrid-type IR method in both CT systems reconstructed as 512 or 1024 matrixes (p < 0.05). CONCLUSION DLR has a higher potential to improve the image quality resulting in a more accurate evaluation for vascular structures than hybrid IR for both UHR-CT and ADCT.
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Affiliation(s)
- Ryo Matsukiyo
- Department of Radiology, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. .,Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
| | - Takahiro Matsuyama
- Department of Radiology, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Hiroyuki Nagata
- Department of Radiology, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Hirona Kimata
- Canon Medical Systems Corporation, 1385 Shimoishigami, Otawara-shi, Tochigi, 324-8550, Japan
| | - Yuya Ito
- Canon Medical Systems Corporation, 1385 Shimoishigami, Otawara-shi, Tochigi, 324-8550, Japan
| | - Yukihiro Ogawa
- Canon Medical Systems Corporation, 1385 Shimoishigami, Otawara-shi, Tochigi, 324-8550, Japan
| | - Kazuhiro Murayama
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Ryoichi Kato
- Department of Radiology, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
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Kubo Y, Ito K, Sone M, Nagasawa H, Onishi Y, Umakoshi N, Hasegawa T, Akimoto T, Kusumoto M. Diagnostic Value of Model-Based Iterative Reconstruction Combined with a Metal Artifact Reduction Algorithm during CT of the Oral Cavity. AJNR Am J Neuroradiol 2020; 41:2132-2138. [PMID: 32972957 DOI: 10.3174/ajnr.a6767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/07/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Metal artifacts reduce the quality of CT images and increase the difficulty of interpretation. This study compared the ability of model-based iterative reconstruction and hybrid iterative reconstruction to improve CT image quality in patients with metallic dental artifacts when both techniques were combined with a metal artifact reduction algorithm. MATERIALS AND METHODS This retrospective clinical study included 40 patients (men, 31; women, 9; mean age, 62.9 ± 12.3 years) with oral and oropharyngeal cancer who had metallic dental fillings or implants and underwent contrast-enhanced ultra-high-resolution CT of the neck. Axial CT images were reconstructed using hybrid iterative reconstruction and model-based iterative reconstruction, and the metal artifact reduction algorithm was applied to all images. Finally, hybrid iterative reconstruction + metal artifact reduction algorithms and model-based iterative reconstruction + metal artifact reduction algorithm data were obtained. In the quantitative analysis, SDs were measured in ROIs over the apex of the tongue (metal artifacts) and nuchal muscle (no metal artifacts) and were used to calculate the metal artifact indexes. In a qualitative analysis, 3 radiologists blinded to the patients' conditions assessed the image-quality scores of metal artifact reduction and structural depictions. RESULTS Hybrid iterative reconstruction + metal artifact reduction algorithms and model-based iterative reconstruction + metal artifact reduction algorithms yielded significantly different metal artifact indexes of 82.2 and 73.6, respectively (95% CI, 2.6-14.7; P < .01). The latter algorithms resulted in significant reduction in metal artifacts and significantly improved structural depictions(P < .01). CONCLUSIONS Model-based iterative reconstruction + metal artifact reduction algorithms significantly reduced the artifacts and improved the image quality of structural depictions on neck CT images.
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Affiliation(s)
- Y Kubo
- From the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan .,Department of Cancer Medicine (Y.K., T.A.), Jikei University Graduate School of Medicine, Tokyo, Japan
| | - K Ito
- From the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
| | - M Sone
- From the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
| | - H Nagasawa
- From the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
| | - Y Onishi
- From the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
| | - N Umakoshi
- From the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
| | - T Hasegawa
- From the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
| | - T Akimoto
- Department of Cancer Medicine (Y.K., T.A.), Jikei University Graduate School of Medicine, Tokyo, Japan.,Division of Radiation Oncology and Particle Therapy (T.A.), National Cancer Center Hospital East, Kashiwa, Japan
| | - M Kusumoto
- From the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
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Fukumoto W, Nagaoka M, Higaki T, Tatsugami F, Nakamura Y, Oostveen L, Klein W, Prokop M, Awai K. Measurement of coronary artery calcium volume using ultra-high-resolution computed tomography: A preliminary phantom and cadaver study. Eur J Radiol Open 2020; 7:100253. [PMID: 32964073 PMCID: PMC7490539 DOI: 10.1016/j.ejro.2020.100253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/24/2020] [Indexed: 11/26/2022] Open
Abstract
Small calcifications were moe accurately detectable on SHR- than NR images. The mean CAC volume was significantly higher on SHR- than NR images of the cadavers. SHR imaging may facilitate the accurate quantification of the CAC.
Objectives In this phantom- and cadaver study we investigated the differences of coronary artery calcium (CAC) volume on ultra-high-resolution computed tomography (U-HRCT) scans and conventional CT. Methods We scanned a coronary calcium phantom and the coronary arteries of five cadavers using U-HRCT in normal- and super-high resolution (NR, SHR) mode. The NR mode was similar to conventional CT; 896 detector channels, a matrix size of 512, and a slice thickness of 0.5 mm were applied. In SHR mode, we used 1792 detector channels, a matrix size of 1024, and a slice thickness of 0.25 mm. The CAC volume on NR- and SHR images were recorded. Differences in the physical- and the calculated CAC volume were defined as the error value and compared between NR- and SHR images of the phantom. Differences between the CAC volume on NR- and SHR scans of the cadavers were also recorded. Results The mean error value was lower on SHR- than NR images of the phantom (14.0 %, SD 11.1 vs 20.1 %, SD 15.2, p = 0.01). The mean CAC volume was significantly higher on SHR- than NR images of the cadavers (153.4 mm3, SD 161.0 vs 144.7 mm3, SD 164.8, p < 0.01). Conclusions As small calcifications were more clearly visualized on U-HRCT images in SHR mode than on conventional (NR) CT scans, SHR imaging may facilitate the accurate quantification of the CAC.
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Key Words
- AEC, automatic exposure control
- CAC, coronary artery calcium
- CTDI, CT dose index
- Cadaver
- Coronary artery calcium scores
- DLP, dose-length product
- ERD, edge rise distance
- ERS, edge rise slope
- FOV, field of view
- FWHM, full-width at half maximum
- HA, hydroxyapatite
- HU, hounsfield units
- LAD, left anterior descending
- LCX, left circumflex
- NR, normal resolution
- RCA, right coronary artery
- ROI, region of interest
- SD, standard deviation
- SHR, super-high resolution
- U-HRCT, ultra-high-resolution CT
- Ultra-high-resolution CT
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Affiliation(s)
- Wataru Fukumoto
- Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Japan
- Corresponding author at: Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan.
| | | | - Toru Higaki
- Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Japan
| | - Fuminari Tatsugami
- Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Japan
| | - Yuko Nakamura
- Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Japan
| | - Luuk Oostveen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, the Netherlands
| | - Willemijn Klein
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, the Netherlands
| | - Mathias Prokop
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, the Netherlands
| | - Kazuo Awai
- Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Japan
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Usui Y, Kurokawa R, Maeda E, Mori H, Amemiya S, Sato J, Ino K, Torigoe R, Abe O. Evaluation of peripheral bronchiole visualization using model-based iterative reconstruction in quarter-detector computed tomography. PLoS One 2020; 15:e0239459. [PMID: 32946530 PMCID: PMC7500691 DOI: 10.1371/journal.pone.0239459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 09/07/2020] [Indexed: 12/23/2022] Open
Abstract
This study aimed to evaluate the visualization of peripheral bronchioles in normal lungs via quarter-detector computed tomography (QDCT). Visualization of bronchioles within 10 mm from the pleura is considered a sign of bronchiectasis. However, it is not known peripheral bronchioles how close to the pleura in normal lungs can be tracked using QDCT. This study included 228 parts in 76 lungs from 38 consecutive patients who underwent QDCT. Reconstruction was performed with different thicknesses, increments, and matrix sizes: 0.5-mm thickness and increment with 512 and 1024 matrixes (Group5 and Group10, respectively) and 0.25-mm thickness and increment with 1024 matrix (Group10Thin). The distance between the most peripheral bronchiole visible and the pleura was determined in the three groups. The distance between the peripheral bronchial duct ends and the nearest pleural surface were significantly shorter in the order of Group10Thin, Group10, and Group5, and the mean distances from the pleura in Group10Thin and Group10 were shorter than 10 mm. These findings suggest the visualization of peripheral bronchioles in QDCT was better with a 1024 axial matrix than with a 512 matrix, and with a 0.25-mm slice thickness/increment than with a 0.5-mm slice thickness/increment. Our study also indicates bronchioles within 10 mm of the pleura do not necessarily indicate pathology.
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Affiliation(s)
- Yukiko Usui
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- * E-mail:
| | - Eriko Maeda
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Harushi Mori
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shiori Amemiya
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jiro Sato
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Ino
- Department of Radiation Technology, The University of Tokyo Hospital, Tokyo, Japan
| | - Rumiko Torigoe
- Canon Medical Systems Corporation, Otawara, Tochigi Prefecture, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Narita K, Nakamura Y, Higaki T, Akagi M, Honda Y, Awai K. Deep learning reconstruction of drip-infusion cholangiography acquired with ultra-high-resolution computed tomography. Abdom Radiol (NY) 2020; 45:2698-2704. [PMID: 32248261 DOI: 10.1007/s00261-020-02508-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Deep learning reconstruction (DLR) introduces deep convolutional neural networks into the reconstruction flow. We examined the clinical applicability of drip-infusion cholangiography (DIC) acquired on an ultra-high-resolution CT (U-HRCT) scanner reconstructed with DLR in comparison to hybrid and model-based iterative reconstruction (hybrid-IR, MBIR). METHODS This retrospective, single-institution study included 30 patients seen between January 2018 and November 2019. A radiologist recorded the standard deviation of attenuation in the paraspinal muscle as the image noise and calculated the contrast-to-noise ratio (CNR) in the common bile duct. The overall visual image quality of the bile duct on thick-slab maximum intensity projections was assessed by two other radiologists and graded on a 5-point confidence scale ranging from 1 (not delineated) to 5 (clearly delineated). The difference among hybrid-IR, MBIR, and DLR images was compared. RESULTS The image noise was significantly lower on DLR than hybrid-IR and MBIR images and the CNR and the overall visual image quality of the bile duct were significantly higher on DLR than on hybrid-IR and MBIR images (all: p < 0.001). CONCLUSION DLR resulted in significant quantitative and qualitative improvement of DIC acquired with U-HRCT.
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Affiliation(s)
- Keigo Narita
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yuko Nakamura
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Toru Higaki
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Motonori Akagi
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yukiko Honda
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kazuo Awai
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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Nakamoto A, Hori M, Onishi H, Ota T, Fukui H, Ogawa K, Yano K, Tatsumi M, Tomiyama N. Ultra-high-resolution CT urography: Importance of matrix size and reconstruction technique on image quality. Eur J Radiol 2020; 130:109148. [PMID: 32623268 DOI: 10.1016/j.ejrad.2020.109148] [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: 04/06/2020] [Revised: 06/02/2020] [Accepted: 06/19/2020] [Indexed: 01/15/2023]
Abstract
PURPOSE To evaluate the image quality of CT urography (CTU) obtained with ultra-high-resolution CT (U-HRCT) reconstructed with hybrid iterative reconstruction (IR) and model-based IR algorithms. METHOD Forty-eight patients who underwent CTU using the U-HRCT system were enrolled in this retrospective study. Excretory phase images were reconstructed with three protocols: Protocol A: 1024-matrix, 0.25 mm-thickness, and model-based IR; Protocol B: 1024-matrix, 0.25 mm-thickness, and hybrid IR; Protocol C: 512-matrix, 0.5 mm-thickness, and model-based IR. Objective image noise and contrast-to-noise ratio (CNR) of the renal pelvis were compared among the protocols. Three-dimensional maximum intensity projection CTU images were generated from each image data set, and image quality was evaluated by two radiologists. RESULTS Protocol C yielded the lowest objective image noise and highest CNR, whereas Protocol A had highest image noise and lowest CNR (P < 0.01). Regarding the detailed delineation of urinary tract structures on the images, the mean visual score was significantly higher for Protocol A than for Protocols B and C (P < 0.001), and the mean score for subjective image noise was significantly lower for Protocol A than for Protocols B and C (P < 0.001). CONCLUSIONS CTU with a 1024-matrix and model-based IR depicted the structures of the urinary system in the most detail.
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Affiliation(s)
- Atsushi Nakamoto
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Masatoshi Hori
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Hiromitsu Onishi
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Takashi Ota
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Hideyuki Fukui
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Kazuya Ogawa
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Keigo Yano
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Mitsuaki Tatsumi
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Noriyuki Tomiyama
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
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From CT to artificial intelligence for complex assessment of plaque-associated risk. Int J Cardiovasc Imaging 2020; 36:2403-2427. [PMID: 32617720 DOI: 10.1007/s10554-020-01926-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/25/2020] [Indexed: 02/07/2023]
Abstract
The recent technological developments in the field of cardiac imaging have established coronary computed tomography angiography (CCTA) as a first-line diagnostic tool in patients with suspected coronary artery disease (CAD). CCTA offers robust information on the overall coronary circulation and luminal stenosis, also providing the ability to assess the composition, morphology, and vulnerability of atherosclerotic plaques. In addition, the perivascular adipose tissue (PVAT) has recently emerged as a marker of increased cardiovascular risk. The addition of PVAT quantification to standard CCTA imaging may provide the ability to extract information on local inflammation, for an individualized approach in coronary risk stratification. The development of image post-processing tools over the past several years allowed CCTA to provide a significant amount of data that can be incorporated into machine learning (ML) applications. ML algorithms that use radiomic features extracted from CCTA are still at an early stage. However, the recent development of artificial intelligence will probably bring major changes in the way we integrate clinical, biological, and imaging information, for a complex risk stratification and individualized therapeutic decision making in patients with CAD. This review aims to present the current evidence on the complex role of CCTA in the detection and quantification of vulnerable plaques and the associated coronary inflammation, also describing the most recent developments in the radiomics-based machine learning approach for complex assessment of plaque-associated risk.
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Tsubamoto M, Hata A, Yanagawa M, Honda O, Miyata T, Yoshida Y, Nakayama A, Kikuchi N, Uranishi A, Tsukagoshi S, Watanabe Y, Tomiyama N. Ultra high-resolution computed tomography with 1024-matrix: Comparison with 512-matrix for the evaluation of pulmonary nodules. Eur J Radiol 2020; 128:109033. [PMID: 32416552 DOI: 10.1016/j.ejrad.2020.109033] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 04/16/2020] [Accepted: 04/19/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To determine whether a 1024-matrix provides superior image quality for the evaluation of pulmonary nodules. MATERIALS AND METHODS Prospective evaluation conducted between December 2017 and April 2018, during which CT images showing lung nodules of more than 6 mm and less than 30 mmm were reconstructed with 2 different protocols: 0.5-mm thickness, 512 × 512 matrix, 34.5-cm field of view (FOV) (0.5-512 protocol); and 2-mm thickness, 1024 × 1024 matrix, 34.5-cm FOV (2-1024 protocol). Lung nodule characteristics such as margin, lobulation, pleural indentation, spiculation as well as peripheral vessels and bronchioles visibility and overall image quality were evaluated by three chest radiologists, using a 5-point scale. Image noise was evaluated by measuring the standard deviation in the region of interest for each image. RESULTS A total of 89 nodules were evaluated. The 2-1024 protocol performed significantly better for the subjective evaluation of pulmonary nodules (p = 0.006 ∼ p < 0.0001). However, image noise was significantly higher both subjectively and objectively (p = 0.036, p < 0.0001). CONCLUSION The use of a 2-1024 protocol does not increase the amount of images and allows better assessment of pulmonary nodules, despite noise increase.
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Affiliation(s)
- Mitsuko Tsubamoto
- Department of Future Diagnostic Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Akinori Hata
- Department of Future Diagnostic Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masahiro Yanagawa
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Osamu Honda
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tomo Miyata
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yuriko Yoshida
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Akiko Nakayama
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Noriko Kikuchi
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Ayumi Uranishi
- Department of CT System Division, Canon Medical Systems Corporation, 1385, Shimoishigami, Otawara, Tochigi, 324-8550, Japan
| | - Shinsuke Tsukagoshi
- Department of CT System Division, Canon Medical Systems Corporation, 1385, Shimoishigami, Otawara, Tochigi, 324-8550, Japan
| | - Yoshiyuki Watanabe
- Department of Future Diagnostic Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Noriyuki Tomiyama
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
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Tanaka R, Yoshioka K, Abiko A. Updates on Computed Tomography Imaging in Aortic Aneurysms and Dissection. Ann Vasc Dis 2020; 13:23-27. [PMID: 32273918 PMCID: PMC7140160 DOI: 10.3400/avd.ra.19-00127] [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] [Indexed: 12/03/2022] Open
Abstract
Computed tomography (CT) is a primary imaging modality for the diagnosis of aortic diseases, because of its minimal invasiveness and agility. Prompt and accurate diagnosis is crucial especially for acute aortic diseases, and the guidelines for acute aortic dissection recommend the use of CT for initial diagnosis. For the follow-up observation of longstanding aortic diseases, the strategy of imaging management by CT must be different from that for emergency and acute phases. In this review, we document the differences in characteristics and clinical course between aortic aneurysm and aortic dissection and explain the use of recent CT techniques in diagnosing short- and longstanding aortic diseases.
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Affiliation(s)
- Ryoichi Tanaka
- Division of Dental Radiology, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University
- Department of Radiology, Iwate Medical University
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46
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Sun Z. Use of Three-dimensional Printing in the Development of Optimal Cardiac CT Scanning Protocols. Curr Med Imaging 2020; 16:967-977. [PMID: 32107994 DOI: 10.2174/1573405616666200124124140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 01/01/2023]
Abstract
Three-dimensional (3D) printing is increasingly used in medical applications with most of the studies focusing on its applications in medical education and training, pre-surgical planning and simulation, and doctor-patient communication. An emerging area of utilising 3D printed models lies in the development of cardiac computed tomography (CT) protocols for visualisation and detection of cardiovascular disease. Specifically, 3D printed heart and cardiovascular models have shown potential value in the evaluation of coronary plaques and coronary stents, aortic diseases and detection of pulmonary embolism. This review article provides an overview of the clinical value of 3D printed models in these areas with regard to the development of optimal CT scanning protocols for both diagnostic evaluation of cardiovascular disease and reduction of radiation dose. The expected outcomes are to encourage further research towards this direction.
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Western Australia, 6845, Australia
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47
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Miyata T, Yanagawa M, Hata A, Honda O, Yoshida Y, Kikuchi N, Tsubamoto M, Tsukagoshi S, Uranishi A, Tomiyama N. Influence of field of view size on image quality: ultra-high-resolution CT vs. conventional high-resolution CT. Eur Radiol 2020; 30:3324-3333. [PMID: 32072253 PMCID: PMC7248011 DOI: 10.1007/s00330-020-06704-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/03/2020] [Indexed: 12/03/2022]
Abstract
Objectives This study was conducted in order to compare the effect of field of view (FOV) size on image quality between ultra-high-resolution CT (U-HRCT) and conventional high-resolution CT (HRCT). Methods Eleven cadaveric lungs were scanned with U-HRCT and conventional HRCT and reconstructed with five FOVs (40, 80, 160, 240, and 320 mm). Three radiologists evaluated and scored the images. Three image evaluations were performed, comparing the image quality with the five FOVs with respect to the 160-mm FOV. The first evaluation was performed on conventional HRCT images, and the second evaluation on U-HRCT images. Images were scored on normal structure, abnormal findings, and overall image quality. The third evaluation was a comparison of the images obtained with conventional HRCT and U-HRCT, with scoring performed on overall image quality. Quantitative evaluation of noise was performed by setting ROIs. Results In conventional HRCT, image quality was improved when the FOV was reduced to 160 mm. In U-HRCT, image quality, except for noise, improved when the FOV was reduced to 80 mm. In the third evaluation, overall image quality was improved in U-HRCT over conventional HRCT at all FOVs. Noise of U-HRCT increased with respect to conventional HRCT when the FOV was reduced from 160 to 40 mm. However, at 240- and 320-mm FOVs, the noise of U-HRCT and conventional HRCT showed no differences. Conclusions In conventional HRCT, image quality did not improve when the FOV was reduced below 160 mm. However, in U-HRCT, image quality improved even when the FOV was reduced to 80 mm. Key Points • Reducing the size of the field of view to 160 mm improves diagnostic imaging quality in high-resolution CT. • In ultra-high-resolution CT, improvements in image quality can be obtained by reducing the size of the field of view to 80 mm. • Ultra-high-resolution CT produces images of higher quality compared with conventional HRCT irrespective of the size of the field of view. Electronic supplementary material The online version of this article (10.1007/s00330-020-06704-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tomo Miyata
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
| | - Masahiro Yanagawa
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Akinori Hata
- Department of Future Diagnostic Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Osamu Honda
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Yuriko Yoshida
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Noriko Kikuchi
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Mitsuko Tsubamoto
- Department of Future Diagnostic Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Shinsuke Tsukagoshi
- Department of CT Systems, Canon Medical Systems Corp., Otawara, Tochigi, Japan
| | - Ayumi Uranishi
- Department of CT Systems, Canon Medical Systems Corp., Otawara, Tochigi, Japan
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
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Assessment of the healing process after percutaneous implantation of a cardiovascular device: a systematic review. Int J Cardiovasc Imaging 2019; 36:385-394. [PMID: 31745743 DOI: 10.1007/s10554-019-01734-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/10/2019] [Indexed: 01/16/2023]
Abstract
The healing process, occurring after intra-cardiac and intra-vascular device implantation, starts with fibrin condensation and attraction of inflammatory cells, followed by the formation of fibrous tissue that slowly covers the device. The duration of this process is variable and may be incomplete, which can lead to thrombus formation, dislodgement of the device or stenosis. To better understand this process and the neotissue formation, animal models were developed: small (rats and rabbits) and large (sheep, pigs, dogs and baboons) animal models for intra-vascular device implantation; sheep and pigs for intra-cardiac device implantation. After intra-vascular and intra-cardiac device implantation in these animal models, in vitro techniques, i.e. histology, which is the gold standard and scanning electron microscopy, were used to assess the device coverage, characterize the cell constitution and detect complications such as thrombosis. In humans, optical coherence tomography and intra-vascular ultrasounds are both invasive modalities used after stent implantation to assess the structure of the vessels, atheroma plaque and complications. Non-invasive techniques (computed tomography and magnetic resonance imaging) are in development in humans and animal models for tissue characterization (fibrosis), device remodeling evaluation and device implantation complications (thrombosis and stenosis). This review aims to (1) present the experimental models used to study this process on cardiac devices; (2) focus on the in vitro techniques and invasive modalities used currently in humans for intra-vascular and intra-cardiac devices and (3) assess the future developments of non-invasive techniques in animal models and humans for intra-cardiac devices.
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van Rosendael AR, Bax JJ, Arbab-Zadeh A. Noninvasive assessment of coronary atherosclerosis by cardiac computed tomography for risk stratifying patients with suspected coronary heart disease. J Cardiovasc Comput Tomogr 2019; 13:235-241. [PMID: 31563581 DOI: 10.1016/j.jcct.2019.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/01/2019] [Accepted: 08/19/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Alexander R van Rosendael
- From the Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA; The Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Jeroen J Bax
- From the Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA; The Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Armin Arbab-Zadeh
- The Department of Medicine-Division of Cardiology Johns Hopkins University School of Medicine, Baltimore, MD, USA
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DeFilippis AP, Chapman AR, Mills NL, de Lemos JA, Arbab-Zadeh A, Newby LK, Morrow DA. Assessment and Treatment of Patients With Type 2 Myocardial Infarction and Acute Nonischemic Myocardial Injury. Circulation 2019; 140:1661-1678. [PMID: 31416350 PMCID: PMC6855329 DOI: 10.1161/circulationaha.119.040631] [Citation(s) in RCA: 194] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Although coronary thrombus overlying a disrupted atherosclerotic plaque has long been considered the hallmark and the primary therapeutic target for acute myocardial infarction (MI), multiple other mechanisms are now known to cause or contribute to MI. It is further recognized that an MI is just one of many types of acute myocardial injury. The Fourth Universal Definition of Myocardial Infarction provides a taxonomy for acute myocardial injury, including 5 subtypes of MI and nonischemic myocardial injury. The diagnosis of MI is reserved for patients with myocardial ischemia as the cause of myocardial injury, whether attributable to acute atherothrombosis (type 1 MI) or supply/demand mismatch without acute atherothrombosis (type 2 MI). Myocardial injury in the absence of ischemia is categorized as acute or chronic nonischemic myocardial injury. However, optimal evaluation and treatment strategies for these etiologically distinct diagnoses have yet to be defined. Herein, we review the epidemiology, risk factor associations, and diagnostic tools that may assist in differentiating between nonischemic myocardial injury, type 1 MI, and type 2 MI. We identify limitations, review new research, and propose a framework for the diagnostic and therapeutic approach for patients who have suspected MI or other causes of myocardial injury.
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Affiliation(s)
- Andrew P DeFilippis
- Division of Cardiovascular Medicine, Department of Medicine, University of Louisville School of Medicine, KY (A.P.D.).,Johns Hopkins University, Baltimore, MD (A.P.D., A.A.-Z.)
| | - Andrew R Chapman
- BHF/University Centre for Cardiovascular Science (A.R.C., N.L.M.), University of Edinburgh, UK
| | - Nicholas L Mills
- BHF/University Centre for Cardiovascular Science (A.R.C., N.L.M.), University of Edinburgh, UK.,Usher Institute of Population Health Sciences and Informatics (N.L.M.), University of Edinburgh, UK
| | - James A de Lemos
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (J.A.d.L.)
| | | | - L Kristin Newby
- Division of Cardiology, Department of Medicine, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (L.K.N.)
| | - David A Morrow
- Division of Cardiology, Department of Medicine, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (L.K.N.)
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