Accuracy of prospectively ECG-triggered very low-dose coronary dual-source CT angiography using iterative reconstruction for the detection of coronary artery stenosis: comparison with invasive catheterization

Layritz, Christian; Schmid, Jasmin; Achenbach, Stephan; Ulzheimer, Stefan; Wuest, Wolfgang; May, Matthias; Ropers, Dieter; Klinghammer, Lutz; Daniel, Werner G.; Pflederer, Tobias; Lell, Michael

doi:10.1093/ehjci/jeu113

Cited by 66 publications

(23 citation statements)

References 30 publications

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“…Most recent clinical trials for CCTA focused on assessing its accuracy and comparability for identification of CHD (16,17), or its effect on management of low-risk patients presenting to the emergency department with acute chest pain (18). However, few (if any) randomized studies directly compared the various anatomic and functional testing options in patients with stable chest pain using clinical endpoints.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Strategies for the Evaluation of Chest Pain

Fordyce

Newby

Douglas

2016

Journal of the American College of Cardiology

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SCOT-HEART and PROMISE represent the 2 largest and most comprehensive cardiovascular imaging outcome trials in patients with stable chest pain, and provide significant insights into patient diagnosis, management, and outcomes. These trials are particularly timely, given the well-recognized knowledge gaps and widespread use of noninvasive imaging. The overall goal of this review is to distill the data generated from these 2 pivotal trials to better inform the practicing clinician in the selection of noninvasive testing for stable chest pain. Similarities and differences between SCOT-HEART and PROMISE are highlighted, and clinical and practical implications discussed. Both trials show that CCTA should have a greater role in the diagnostic pathway of patients with stable chest pain.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Strategies for the Evaluation of Chest Pain

Fordyce

Newby

Douglas

2016

Journal of the American College of Cardiology

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“…An early, prospective, multi-center study, the ERASIR study, found comparable image quality between CTA reconstructed with ASIR and FBP, with the best results at 40-60% ASIR and 44% radiation dose reduction (4). Other retrospective studies showed lower noise, equivalent image quality and dose savings of 24-54% for ASIR (5-7), 82% for VEO (8), 50% for AIDR-3D (5,9), 62% for IRIS (10), 52-80% for SAFIRE (11)(12)(13)(14), 52% for ADMIRE (15,16), 39-63% for iDose 4 (17)(18)(19)(20)(21) and 80% for IMR (22). FIRST showed 28% dose reduction compared to AIDR-3D (23).…”

Section: Decreased Radiation Dosementioning

confidence: 90%

The role of advanced reconstruction algorithms in cardiac CT

Halliburton

Tanabe

Partovi

et al. 2017

Cardiovasc. Diagn. Ther.

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Advanced non-linear iterative reconstruction (IR) algorithms have been introduced by all vendors as an alternative to traditional, linear filtered back projection (FBP) reconstruction ( Table 1). FBP is a simple reconstruction technique that requires relatively little computational processing, but is associated with higher noise and poor contrast resolution. Noise can be reduced in FBP only by increasing the radiation dose. IR algorithms operate by initially generating an expected dataset based on modeling, which is then compared to the actual, acquired dataset. Noise is detected and removed by using the difference between the anticipated and actual datasets using a process of iterative steps. All commercial IR algorithms employ statistics-model based de-noising in the image domain, raw (projection) data domain, or both. Statistics model-based algorithms operate by assigning a lower value to data with higher statistical uncertainty (noise). Some IR algorithms, described as partial model-based, additionally employ models of scanner geometry to estimate the acquired data. Full model-based IR algorithms, employ complete system models that include simulation of X-ray interaction with the imaged object. Statistics-model based algorithms can be utilized to either improve image quality at the same radiation dose or maintain image quality at a lower radiation dose compared to FBP. However, combining dose management with image quality improvements simultaneously is limited. Model-based IR can provide image quality improvements at lower doses. Model-based algorithms are also more likely to reduce other artifacts in addition to noise as well as improve spatial resolution.Although IR algorithms have been utilized in nuclear medicine for several decades, widespread use in CT is recent and facilitated by advances in computational processing. Cardiovascular CT imagers were early adopters of IR algorithms because most cardiovascular clinical targets are robust to changes in noise. Rigorous validation has come from both retrospective and prospective studies demonstrating non-inferiority of coronary CT data acquired at lower doses and reconstructed with IR techniques compared to standard dose data reconstructed with FBP. Other clinical studies have validated the diagnostic utility of low-dose coronary CT angiograms (CTA) reconstructed with IR algorithms using invasive coronary angiography (ICA) as a standard of reference (1-3).

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“…To help mitigate this effect, a number of dose-saving steps can be taken. These include the use of ECG-based tube current modulation, scanning at reduced kilovoltage (kVp), such as 80/100 kVp rather than 120 kVp, reducing scan z-axis coverage, and the use of advanced image reconstruction techniques such as iterative reconstruction [4, 40, 41]. The role of CMR in the primary diagnosis of IE is limited, but it is a useful imaging choice when different aortic valve pathology such as tumour or thrombus is suspected.…”

Section: Aortic Valve Endocarditismentioning

confidence: 99%

Cross-sectional imaging of aortic infections

et al. 2016

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Aortic infections are uncommon clinical entities, but are associated with high rates of morbidity and mortality. In this review, we focus on the cross-sectional imaging appearance of aortic infections, including aortic valve endocarditis, pyogenic aortitis, mycotic aneurysm and aortic graft infections, with an emphasis on CT, MRI and PET/CT appearance. Teaching Points • Aortic infections are associated with high morbidity and mortality. • CT, MRI and FDG PET/CT play complementary roles in aortic infection imaging. • Radiologists should be vigilant for aortic infection manifestations to ensure timely diagnosis.

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Accuracy of prospectively ECG-triggered very low-dose coronary dual-source CT angiography using iterative reconstruction for the detection of coronary artery stenosis: comparison with invasive catheterization

Abstract: Raw data-based IR significantly improves image quality in very low-dose prospectively ECG-triggered coronary dual-source CTA when compared with standard reconstruction using FBP.

Cited by 66 publications

References 30 publications

Diagnostic Strategies for the Evaluation of Chest Pain

Diagnostic Strategies for the Evaluation of Chest Pain

The role of advanced reconstruction algorithms in cardiac CT

Cross-sectional imaging of aortic infections

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