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Preuß D, Garcia G, Laule M, Dewey M, Rief M. Myocardial CT perfusion imaging for the detection of obstructive coronary artery disease: multisegment reconstruction does not improve diagnostic performance. Eur Radiol Exp 2022; 6:5. [PMID: 35099638 PMCID: PMC8804122 DOI: 10.1186/s41747-021-00256-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 12/02/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Multisegment reconstruction (MSR) was introduced to shorten the temporal reconstruction window of computed tomography (CT) and thereby reduce motion artefacts. We investigated whether MSR of myocardial CT perfusion (CTP) can improve diagnostic performance in detecting obstructive coronary artery disease (CAD) compared with halfscan reconstruction (HSR). METHODS A total of 134 patients (median age 65.7 years) with clinical indication for invasive coronary angiography and without cardiac surgery prospectively underwent static CTP. In 93 patients with multisegment acquisition, we retrospectively performed both MSR and HSR and searched both reconstructions for perfusion defects. Subgroups with known (n = 68) or suspected CAD (n = 25) and high heart rate (n = 30) were analysed. The area under the curve (AUC) was compared applying DeLong approach using ≥ 50% stenosis on invasive coronary angiography as reference standard. RESULTS Per-patient analysis revealed the overall AUC of MSR (0.65 [95% confidence interval 0.53, 0.78]) to be inferior to that of HSR (0.79 [0.69, 0.88]; p = 0.011). AUCs of MSR and HSR were similar in all subgroups analysed (known CAD 0.62 [0.45, 0.79] versus 0.72 [0.57, 0.86]; p = 0.157; suspected CAD 0.80 [0.63, 0.97] versus 0.89 [0.77, 1.00]; p = 0.243; high heart rate 0.46 [0.19, 0.73] versus 0.55 [0.33, 0.77]; p = 0.389). Median stress radiation dose was higher for MSR than for HSR (6.67 mSv versus 3.64 mSv, p < 0.001). CONCLUSIONS MSR did not improve diagnostic performance of myocardial CTP imaging while increasing radiation dose compared with HSR. TRIAL REGISTRATION CORE320: clinicaltrials.gov NCT00934037, CARS-320: NCT00967876.
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Affiliation(s)
- Daniel Preuß
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Gonzalo Garcia
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Michael Laule
- Department of Cardiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Marc Dewey
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Matthias Rief
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany.
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Kashani H, Wright G, Ursani A, Liu G, Hashemi M, Paul N. Restricting motion effects in CT coronary angiography. Br J Radiol 2019; 92:20190384. [PMID: 31479307 DOI: 10.1259/bjr.20190384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Evaluation of coronary CT image blur using multi segment reconstruction algorithm. METHODS Cardiac motion was simulated in a Catphan. CT coronary angiography was performed using 320 × 0.5 mm detector array and 275 ms gantry rotation. 1, 2 and 3 segment reconstruction algorithm, three heart rates (60, 80 and 100bpm), two peak displacements (4, 8 mm) and three cardiac phases (55, 35, 75%) were used. Wilcoxon test compared image blur from the different reconstruction algorithms. RESULTS Image blur for 1, 2 and 3 segments in: 60 bpm, 75% R-R interval and 8 mm peak displacement: 0.714, 0.588, 0.571 mm (1.18, 0.6, 0.4 mm displacement) 80 bpm, 35% R-R interval and 8 mm peak displacement: 0.869, 0.606, 0.606 mm (1.57, 0.79,0.52 mm displacement) 100 bpm, 35% R-R interval and 4 mm peak displacement: 0.645, 0.588, 0.571 mm (0.98, 0.49, 0.33 mm displacement). The median image blur overall for 1 and 2 segments was 0.714 mm and 0.588 mm respectively (p < 0.0001). CONCLUSION Two-segment reconstruction significantly reduces image blur. ADVANCES IN KNOWLEDGE Multisegment reconstruction algorithms during CT coronary angiography are a useful method to reduce image blur, improve visualization of the coronary artery wall and help the early detection of the plaque.
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Affiliation(s)
- Hany Kashani
- Institute of Medical Science, University of Toronto, Toronto, ON
| | - Graham Wright
- Department of Medical biophysics, University of Toronto, Toronto, ON
| | - Ali Ursani
- Department of Medical Imaging, University of Toronto, Toronto, ON
| | - Garry Liu
- Department of Medical biophysics, University of Toronto, Toronto, ON
| | - Masoud Hashemi
- Department of Medical Imaging, University of Toronto, Toronto, ON
| | - Narinder Paul
- Department of Medical Imaging, University of Toronto, Toronto, ON.,Department of Biomedical Engineering, University of Toronto, Toronto, ON.,Department of Medical Imaging, University of Western Ontario, London, ON
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Herrmann J, Hoffman EA, Kaczka DW. Frequency-Selective Computed Tomography: Applications During Periodic Thoracic Motion. IEEE TRANSACTIONS ON MEDICAL IMAGING 2017; 36:1722-1732. [PMID: 28436852 PMCID: PMC5639881 DOI: 10.1109/tmi.2017.2694887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We seek to use computed tomography (CT) to characterize regional lung parenchymal deformation during high-frequency and multi-frequency oscillatory ventilation. Periodic motion of thoracic structures results in artifacts of CT images obtained by standard reconstruction algorithms, especially for frequencies exceeding that of the X-ray source rotation. In this paper, we propose an acquisition and reconstruction technique for high-resolution imaging of the thorax during periodic motion. Our technique relies on phase-binning projections according to the frequency of subject motion relative to the scanner rotation, prior to volumetric reconstruction. The mathematical theory and limitations of the proposed technique are presented, and then validated in a simulated phantom as well as a living porcine subject during oscillatory ventilation. The 4-D image sequences obtained using this frequency-selective reconstruction technique yielded high-spatio-temporal resolution of the thorax during periodic motion. We conclude that the frequency-based selection of CT projections is ideal for characterizing dynamic deformations of thoracic structures that are ordinarily obscured by motion artifact using conventional reconstruction techniques.
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Abbara S, Blanke P, Maroules CD, Cheezum M, Choi AD, Han BK, Marwan M, Naoum C, Norgaard BL, Rubinshtein R, Schoenhagen P, Villines T, Leipsic J. SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI). J Cardiovasc Comput Tomogr 2016; 10:435-449. [PMID: 27780758 DOI: 10.1016/j.jcct.2016.10.002] [Citation(s) in RCA: 586] [Impact Index Per Article: 73.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 10/09/2016] [Indexed: 01/20/2023]
Abstract
In response to recent technological advancements in acquisition techniques as well as a growing body of evidence regarding the optimal performance of coronary computed tomography angiography (coronary CTA), the Society of Cardiovascular Computed Tomography Guidelines Committee has produced this update to its previously established 2009 "Guidelines for the Performance of Coronary CTA" (1). The purpose of this document is to provide standards meant to ensure reliable practice methods and quality outcomes based on the best available data in order to improve the diagnostic care of patients. Society of Cardiovascular Computed Tomography Guidelines for the Interpretation is published separately (2). The Society of Cardiovascular Computed Tomography Guidelines Committee ensures compliance with all existing standards for the declaration of conflict of interest by all authors and reviewers for the purpose ofclarity and transparency.
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Affiliation(s)
- Suhny Abbara
- University of Texas Southwestern Medical Center, Dallas, TX, United States.
| | - Philipp Blanke
- Department of Radiology and Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Michael Cheezum
- Cardiology Service Ft. Belvoir Community Hospital, Ft. Belvoir, VA, United States
| | - Andrew D Choi
- Division of Cardiology and Department of Radiology, The George Washington University School of Medicine, Washington DC, United States
| | - B Kelly Han
- Minneapolis Heart Institute and Children's Heart Clinic, Minneapolis, MN, United States
| | - Mohamed Marwan
- Cardiology Department, University Hospital, Erlangen, Germany
| | - Chris Naoum
- Concord Hospital, The University of Sydney, Sydney, Australia
| | - Bjarne L Norgaard
- Department of Cardiology B, Aarhus University Hospital-Skejby, Aarhus N, Denmark
| | - Ronen Rubinshtein
- Lady Davis Carmel Medical Center & Rappaport School of Medicine- Technion- IIT, Haifa, Israel
| | - Paul Schoenhagen
- Cardiovascular Imaging, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, United States
| | - Todd Villines
- Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Jonathon Leipsic
- Department of Radiology and Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
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Impact of a motion correction algorithm on quality and diagnostic utility in unselected patients undergoing coronary CT angiography. Clin Imaging 2016; 40:217-21. [PMID: 26995573 DOI: 10.1016/j.clinimag.2015.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 10/10/2015] [Accepted: 10/18/2015] [Indexed: 11/23/2022]
Abstract
AIMS The aims of the study were to investigate the diagnostic utility of motion correction reconstruction algorithm Snapshot Freeze (SSF) compared to the standard reconstruction algorithm (STD) in coronary computed tomography angiography (CCTA) images where a prescan heart-rate-lowering protocol is fully integrated. METHODS CCTA was performed in 140 patients. Two independent blinded readers made image evaluation of the SSF and STD images. RESULTS SSF reduced the motion artifacts (30% vs. 41%; P<.05) and improved the image quality ("excellent" images: 52% vs. 42%; P=.022), but did not influence diagnostic utility ("nondiagnostic" images: 10% vs. 14%; P=.104). CONCLUSION The use of the SSF algorithm reduced the presence of motion artifacts and improved image quality, but did not influence the diagnostic utility.
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Lee H, Kim JA, Lee JS, Suh J, Paik SH, Park JS. Impact of a vendor-specific motion-correction algorithm on image quality, interpretability, and diagnostic performance of daily routine coronary CT angiography: influence of heart rate on the effect of motion-correction. Int J Cardiovasc Imaging 2014; 30:1603-12. [DOI: 10.1007/s10554-014-0499-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 07/12/2014] [Indexed: 10/25/2022]
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Contrast agent bolus tracking with a fixed threshold or a manual fast start for coronary CT angiography. Eur Radiol 2014; 24:1229-38. [DOI: 10.1007/s00330-014-3148-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 12/27/2022]
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Sun Z, Almoudi M. Coronary computed tomography angiography: an overview of clinical applications. Interv Cardiol 2013. [DOI: 10.2217/ica.12.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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An initial randomised study assessing free-breathing CCTA using 320-detector CT. Eur Radiol 2012; 23:1199-209. [PMID: 23138388 DOI: 10.1007/s00330-012-2703-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 09/25/2012] [Accepted: 10/11/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To evaluate the feasibility of free-breathing coronary computed tomography angiography (CCTA) in adults using with a 320-detector multidetector CT (MDCT). METHODS In 74 patients who underwent CCTA, 37 CCTA examinations were performed during free-breathing, and the remaining 37 CCTA examinations were produced with the standard breath-holding method. The quality scores for 16 segments of all coronary arteries were analysed and defined as: 1 (excellent), 2 (good), and 3 (poor). The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and effective radiation dose of each image were compared between the two methods. RESULTS No significant differences were observed in the quality scores between the breath-holding and free-breathing methods (1.10 ± 0.31 vs. 1.12 ± 0.33; P = 0.443). The SNR and CNR were not significantly different between the two methods. The overall mean effective radiation dose revealed no significant difference between the two methods (P = 0.585). CONCLUSIONS Free-breathing CCTA using 320-detector MDCT showed no significant difference in image quality compared with standard breath-holding CCTA. For patients with difficulties of breath-holding or non-negligible apnoea-related heart rate variability, free-breathing CCTA can be an alternative solution for coronary artery evaluation. KEY POINTS • Cardiac CT is becoming widely used and some patients are inevitably breathless. • Multidetector CT (e.g. 320) offers new opportunities for the breathless patient. • Free breathing images yielded similar image quality to those obtained using breath-holding. • However, a possibility of higher radiation dose precludes its routine application.
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Kang EJ, Lee KN, Kim DW, Kim BS, Choi S, Park BH, Oh JY. Triple rule-out acute chest pain evaluation using a 320-row-detector volume CT: a comparison of the wide-volume and helical modes. Int J Cardiovasc Imaging 2012; 28 Suppl 1:7-13. [DOI: 10.1007/s10554-012-0072-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 05/10/2012] [Indexed: 11/27/2022]
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Elojeimy S, Tipnis S, Huda W. Relationship between radiographic techniques (kilovolt and milliampere-second) and CTDI(VOL). RADIATION PROTECTION DOSIMETRY 2010; 141:43-49. [PMID: 20406742 DOI: 10.1093/rpd/ncq138] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
To investigate the relationship between radiographic techniques (i.e. kilovolt and milliampere-second) and the corresponding volume computed tomography dose index (CTDI(vol)). Data were obtained for CTDI(vol) for head and body phantoms from the ImPACT CT patient dosimetry calculator for 43 scanners from four major vendors of medical imaging equipment (i.e. GE, Philips, Siemens and Toshiba). CTDI(vol) were obtained with the largest X-ray beam width, and using a CT pitch of unity. For each scanner, relative values of CTDI(vol) were also computed as a function of X-ray tube voltage, normalised to unity at 120 kV. The average CTDI(vol) for 43 commercial scanners was 167 + or - 44 microGy (mA s)(-1) for the head phantom and 78 + or - 22 microGy (mA s)(-1) for the body phantom. The 90th percentile CTDI(vol) values are approximately twice the corresponding 10th percentile values for both head and body phantoms. Over the last 20 y, the head phantom CTDI(vol) has increased approximately 50 % and the body phantom CTDI(vol) has increased approximately 90 %. For both, the head phantom and the body phantom, CTDI(vol) is proportional to kilovolt(2.6). CT output must be specified using CTDI(vol) because for a fixed kilovolt and milliampere-second, CT scanner outputs (CTDI(vol)) differ by about a factor of 2. Increasing the X-ray tube voltage from 80 to 140 kV increases CTDI(vol) by about a factor of 4.
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Affiliation(s)
- Saeed Elojeimy
- Department of Radiology and Radiological Science, 96 Jonathan Lucas Street, MSC 323, Medical University of South Carolina, Charleston, SC 29425-3230, USA
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