Automatic segmentation of coronary tree in CT angiography images

The aim of this study was to assess the applicability of low-dose thoracic computed tomography (CT) in the diagnosis of rib fractures.A total of 37 trauma patients were selected for CT scanning using a noise index (NI) model. Each patient was scanned at both NI = 11 and NI = 26, while the other scanning parameters were kept the same. The scanning dose length product (DLP) and effective dose (ED) were recorded after each examination. Two radiologists diagnosed the rib fractures by degree (I, II, III, and IV) using Bone Reading software and axial images. Image quality was scored by 2 experienced radiologists using a 5-point scale. The numbers and degrees of rib fractures for different NIs were recorded and tested using the Chi-squared test. The interobserver differences were determined by kappa statistics.The CTDIvols and EDs for NI = 11 and NI = 26 were 9.82 ± 4.78, 5.75 ± 2.75, and 2.14 ± 1.19 and 1.24 ± 0.73, respectively; the latter was decreased by 78.2% and 78.4% relative to the former. Low-dose thoracic CT was feasible for the auxiliary diagnosis of rib fractures using Bone Reading software (P > .05). There was perfect interobserver concordance in terms of diagnostic acceptability (kappa = 0.931, 0.905).The use of an appropriate low-dose CT scanning technique is satisfactory for the assessment and diagnosis of rib fractures.

“…[ 12 – 18 ] Meanwhile, as time goes on, more and more image processing technologies come into view. [ 19 – 21 ]…”

Section: Introductionmentioning

confidence: 99%

Low-dose CT examination for rib fracture evaluation

Jin

et al. 2018

“…Gao et al developed an automatic approach to segment the three-dimensional coronary tree from CTA images. [31] Further study is needed to investigate the 3D CTA for the visualization of CCC with automatic segmentation of coronary tree.…”

Section: Discussionmentioning

confidence: 99%

A noninvasive and highly sensitive approach for the assessment of coronary collateral circulation by 192-slice third-generation dual-source computed tomography

Chen¹,

Zhang²,

Li³

et al. 2019

The coronary collateral circulation (CCC) is an alternative source of blood supply when the original vessels fail to provide sufficient blood. The accurate detection of CCC is critical for the treatment of ischemic heart disease, especially when the stent surgery is not an option. The assessment of minute vessels such as coronary collateral arteries is challenging. The objective of this study was to assess the feasibility of detection and classification of CCC using the192-slice third-generation dual-source computed tomography angiography (192-slice DSCT CTA).Eight hundred patients (450 men and 350 women, mean age: 56 ± 11 years) with complete or subtotal occlusion of at least 1 major coronary artery were enrolled for our study. February 2016 and September 2018, the patient both 192-slice DSCT CTA and conventional coronary angiography (CAG) were performed in all enrolled patients. The interval between two approaches for a given patient was 6.1 ± 3.7 days (Range: 1–15). The diagnostic accuracy of 192-slice DSCT CTA was evaluated by comparing it with that of CAG. The identified CCC was graded according to the Rentrop classification.The prevalence among patients of having at least 1 CCC was 43.8%. The sensitivity for detecting CCC by 192-slice DSCT was 91.7% (95% CI: 88.3% to 94.3%), specificity was 95.5% (95% CI: 93.1% to 97.2%), positive predictive value was 94.3% (95% CI: 91.5% to 96.2%), and negative predictive value was 93.3% (95% CI: 90.9% to 95.3%). Cohen-Kappa analysis showed that the consistency of the correct classification of CCC using CAG and 192-slice DSCT was very high with the kappa coefficient (κ) of 0.94 (95% CI: 0.91–0.96, P value = .01). Additionally, the radiation dose for 192-slice DSCT was as low as 0.42 ± 0.04 mSv (range, 0.35–0.43 mSv).The 192-slice DSCT CTA is a reliable and sensitive non-invasive method for the evaluation of CCC with low radiation doses.

“…Prompt and accurate diagnosis of compromised myocardial perfusion is crucial and has been the focus of upcoming research to improve the performance of diagnostic imaging. [ 14 , 15 ] As mentioned earlier, symptoms of CAD and pulmonary hypertension often overlap, making the clinical differentiation of these entities challenging. Left undiagnosed and untreated, pulmonary hypertension may have a debilitating effect on the lives of patients; studies have shown that the symptoms of pulmonary hypertension can adversely affect the physical, emotional, and social factors governing patient health-related quality of life.…”

Section: Discussionmentioning

confidence: 99%

Adding value to myocardial perfusion SPECT/CT studies that include coronary calcium CT

Marcus

Santhanam²,

Kruse

et al. 2018

The aim of the present study was to evaluate the incidence of undiagnosed pulmonary arterial dilatation using the gated computed tomography (CT) images acquired in patients with an otherwise normal 99mTc-sestamibi single-photon-emission CT (SPECT)/CT myocardial perfusion study.This was a retrospective review of 200 consecutive patients (100 men, mean age 58.7 years) who underwent a myocardial perfusion 99mTc-sestamibi SPECT/CT study with normal perfusion and with gated CT images acquired for coronary calcium scoring. The CT images were reviewed using a previously validated mean main pulmonary artery diameter (mPAD) measurement method which has been correlated with pulmonary arterial hypertension (PAH). Clinical information on multiple comorbidities was also retrieved. Previously reported mPAD cutoffs (>29.5 and >31.5 mm) were used to stratify patients.Indications for the study included dyspnea on exertion (58.9%), preoperative workup (22.3%), and chest pain (13.9%). The mean mPAD measurement was 26.3 mm (±0.5). There was a significant correlation between body mass index and mPAD (correlation coefficient [ρ]: 0.28; P < .001). About 23% (46/200) of patients had mPAD > 29.5 mm and 15.0% (30/200) of patients had mPAD > 31.5 mm. From previous work, these cutoffs have a sensitivity and specificity for PAH of 70.8%, 79.4% and 52.0%, 90.2%, respectively. Among patients undergoing a preoperative myocardial perfusion study, 35.6% (16/45) patients had mPAD > 29.5 mm and 26.7% (12/45) patients had mPAD > 31.5 mm. There was a higher prevalence of congestive heart failure (62.5% vs 19.6%; P < .001) and hypertension (78.3% vs 21.7%; P < .02) in patients with mPAD > 29.5 mm. Similarly, there was a high prevalence of congestive heart failure (P < .001), hyperlipidemia (P < .04), and hypertension (P < .04) in patients with mPAD > 31.5 mm.Incidental pulmonary arterial dilatation (mPAD ≥ 29.5 mm) can be detected in a large number of patients with normal myocardial perfusion scintigraphy and correlates with multiple different comorbidities. The mPAD can be measured in all patients undergoing gated imaging as part of a myocardial perfusion study, and PAH may be considered as an alternative explanation for symptoms in some patients without perfusion deficits. The data to make this potential diagnosis is already being acquired and represents an opportunity to add value to the interpretations of otherwise negative myocardial perfusion studies.