Improved visualization of the coronary arteries using motion correction during vasodilator stress CT myocardial perfusion imaging.
Algorithms
Artifacts
Computed Tomography Angiography
/ methods
Contrast Media
/ pharmacology
Coronary Angiography
/ methods
Coronary Artery Disease
/ diagnostic imaging
Female
Heart Rate
/ drug effects
Humans
Male
Middle Aged
Motion
Myocardial Perfusion Imaging
/ methods
Prospective Studies
Radiation Dosage
Radiation Exposure
Radiographic Image Interpretation, Computer-Assisted
/ methods
Tomography, X-Ray Computed
/ methods
Vasodilator Agents
/ pharmacology
Coronary computed tomography
Myocardial perfusion imaging
Noninvasive coronary angiography
Vasodilator stress testing
Journal
European journal of radiology
ISSN: 1872-7727
Titre abrégé: Eur J Radiol
Pays: Ireland
ID NLM: 8106411
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
27
11
2018
revised:
12
01
2019
accepted:
11
02
2019
entrez:
22
4
2019
pubmed:
22
4
2019
medline:
22
6
2019
Statut:
ppublish
Résumé
Vasodilator stress computed tomography perfusion (sCTP) imaging is complementary to coronary CT angiography (CCTA), used to determine the hemodynamic significance of coronary artery disease. However, it requires a separate image acquisition due to motion artifacts caused by higher heart rates during stress, resulting in increased iodine contrast dose and radiation. We sought to determine whether a novel motion correction algorithm applied to stress images would improve the visualization of the coronary arteries to potentially allow CCTA + sCTP evaluation in a single scan. 28 patients referred for clinically indicated CCTA (iCT, Philips) underwent sCTP imaging (retrospective-gating with dose modulation; 100 kVp and 250 mA; 5.2 ± 4.3 mSv) after regadenoson (0.4 mg, Astellas). Stress images were reconstructed using standard filtered back-projection (FBP) and also processed to generate interaction-free coronary motion-compensated back-projection reconstructions (MCR). Each coronary artery from standard FBP and MCR images was viewed side-by-side by a reader blinded to the reconstruction technique, who graded severity of motion artifact by segment (scale 0-5, with 3 as the threshold for diagnostic quality) and to measure signal-to-noise and contrast-to-noise ratios (SNR, CNR). Visualization scores were higher with MCR for all coronary segments, including 14/86 (16%) segments deemed as non-diagnostic on FBP images. SNR (7 ± 2) and CNR (15 ± 8) were unchanged by motion-correction (7 ± 3, p = 0.88 and 15 ± 5, p = 0.94, respectively). MCR improves the visualization of coronary anatomy on sCTP images without degrading image characteristics. This algorithm is an important step towards the combined assessment of coronary anatomy and myocardial perfusion in a single scan, which will reduce study time, radiation exposure and contrast dose.
Sections du résumé
BACKGROUND
BACKGROUND
Vasodilator stress computed tomography perfusion (sCTP) imaging is complementary to coronary CT angiography (CCTA), used to determine the hemodynamic significance of coronary artery disease. However, it requires a separate image acquisition due to motion artifacts caused by higher heart rates during stress, resulting in increased iodine contrast dose and radiation. We sought to determine whether a novel motion correction algorithm applied to stress images would improve the visualization of the coronary arteries to potentially allow CCTA + sCTP evaluation in a single scan.
METHODS
METHODS
28 patients referred for clinically indicated CCTA (iCT, Philips) underwent sCTP imaging (retrospective-gating with dose modulation; 100 kVp and 250 mA; 5.2 ± 4.3 mSv) after regadenoson (0.4 mg, Astellas). Stress images were reconstructed using standard filtered back-projection (FBP) and also processed to generate interaction-free coronary motion-compensated back-projection reconstructions (MCR). Each coronary artery from standard FBP and MCR images was viewed side-by-side by a reader blinded to the reconstruction technique, who graded severity of motion artifact by segment (scale 0-5, with 3 as the threshold for diagnostic quality) and to measure signal-to-noise and contrast-to-noise ratios (SNR, CNR).
RESULTS
RESULTS
Visualization scores were higher with MCR for all coronary segments, including 14/86 (16%) segments deemed as non-diagnostic on FBP images. SNR (7 ± 2) and CNR (15 ± 8) were unchanged by motion-correction (7 ± 3, p = 0.88 and 15 ± 5, p = 0.94, respectively).
CONCLUSIONS
CONCLUSIONS
MCR improves the visualization of coronary anatomy on sCTP images without degrading image characteristics. This algorithm is an important step towards the combined assessment of coronary anatomy and myocardial perfusion in a single scan, which will reduce study time, radiation exposure and contrast dose.
Identifiants
pubmed: 31005158
pii: S0720-048X(19)30061-0
doi: 10.1016/j.ejrad.2019.02.010
pmc: PMC8240649
mid: NIHMS1711968
pii:
doi:
Substances chimiques
Contrast Media
0
Vasodilator Agents
0
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-5Subventions
Organisme : NHLBI NIH HHS
ID : T32 HL007381
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.
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