Junfu Liang1,2, Ying Sun2, Ziqing Ye2, Yanchun Sun2, Lei Xu3, Zhen Zhou1, Brian Thomsen4, Jianying Li5, Zhonghua Sun6, Zhanming Fan1. 1. Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd., Chaoyang District, Beijing, 100029, China. 2. Department of Radiology, Beijing Huairou Hospital, No. 9 Yongtai North Street, Huairou District, Beijing, 101400, China. 3. Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd., Chaoyang District, Beijing, 100029, China. leixu2001@hotmail.com. 4. GE Healthcare, Milwaukee, WI, USA. 5. CT Laboratory, GE Healthcare China, Beijing, China. 6. Department of Medical Radiation Sciences, Curtin University, Perth, WA, 6845, Australia.
Abstract
OBJECTIVE: To assess the effect of a second-generation motion correction algorithm on the diagnostic accuracy of coronary computed tomography angiography (CCTA) using a 256-detector row CT in patients with increased heart rates. METHODS: Eighty-one consecutive symptomatic cardiac patients with increased heart rates (≥ 75 beats per min) were enrolled. All patients underwent CCTA and invasive coronary angiography (ICA). CCTA was performed with a 256-detector row CT using prospectively ECG-triggered single-beat protocol. Images were reconstructed using standard (STD) algorithm, first-generation intra-cycle motion correction (MC1) algorithm, and second-generation intra-cycle motion correction (MC2) algorithm. The image quality of coronary artery segments was assessed by two experienced radiologists using a 4-point scale (1: non-diagnostic and 4: excellent), according to the 18-segment model. Diagnostic performance for segments with significant lumen stenosis (≥ 50%) was compared between STD, MC1, and MC2 by using ICA as the reference standard. RESULTS: The mean effective dose of CCTA was 1.0 mSv. On per-segment level, the overall image quality score and interpretability were improved to 3.56 ± 0.63 and 99.2% due to the use of MC2, as compared to 2.81 ± 0.85 and 92.5% with STD and 3.21 ± 0.79 and 97.2% with MC1. On per-segment level, compared to STD and MC1, MC2 improved the sensitivity (92.2% vs. 79.2%, 80.7%), specificity (97.8% vs. 82.1%, 90.8%), positive predictive value (89.9% vs. 48.4%, 65.1%), negative predictive value (98.3% vs. 94.9%, 95.7%), and diagnostic accuracy (96.8% vs. 81.5%, 89.0%). CONCLUSION: A second-generation intra-cycle motion correction algorithm for single-beat CCTA significantly improves image quality and diagnostic accuracy in patients with increased heart rate. KEY POINTS: • A second-generation motion correction (MC2) algorithm can further improve the image quality of all coronary arteries than a first-generation motion correction (MC1). • MC2 algorithm can significantly reduce the number of false positive segments compared to standard and MC1 algorithm.
OBJECTIVE: To assess the effect of a second-generation motion correction algorithm on the diagnostic accuracy of coronary computed tomography angiography (CCTA) using a 256-detector row CT in patients with increased heart rates. METHODS: Eighty-one consecutive symptomatic cardiac patients with increased heart rates (≥ 75 beats per min) were enrolled. All patients underwent CCTA and invasive coronary angiography (ICA). CCTA was performed with a 256-detector row CT using prospectively ECG-triggered single-beat protocol. Images were reconstructed using standard (STD) algorithm, first-generation intra-cycle motion correction (MC1) algorithm, and second-generation intra-cycle motion correction (MC2) algorithm. The image quality of coronary artery segments was assessed by two experienced radiologists using a 4-point scale (1: non-diagnostic and 4: excellent), according to the 18-segment model. Diagnostic performance for segments with significant lumen stenosis (≥ 50%) was compared between STD, MC1, and MC2 by using ICA as the reference standard. RESULTS: The mean effective dose of CCTA was 1.0 mSv. On per-segment level, the overall image quality score and interpretability were improved to 3.56 ± 0.63 and 99.2% due to the use of MC2, as compared to 2.81 ± 0.85 and 92.5% with STD and 3.21 ± 0.79 and 97.2% with MC1. On per-segment level, compared to STD and MC1, MC2 improved the sensitivity (92.2% vs. 79.2%, 80.7%), specificity (97.8% vs. 82.1%, 90.8%), positive predictive value (89.9% vs. 48.4%, 65.1%), negative predictive value (98.3% vs. 94.9%, 95.7%), and diagnostic accuracy (96.8% vs. 81.5%, 89.0%). CONCLUSION: A second-generation intra-cycle motion correction algorithm for single-beat CCTA significantly improves image quality and diagnostic accuracy in patients with increased heart rate. KEY POINTS: • A second-generation motion correction (MC2) algorithm can further improve the image quality of all coronary arteries than a first-generation motion correction (MC1). • MC2 algorithm can significantly reduce the number of false positive segments compared to standard and MC1 algorithm.
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