Cardiac CT blooming artifacts: clinical significance, root causes and potential solutions

Pack, Jed D.; Xu, Mufeng; Wang, Ge; Baskaran, Lohendran; Min, James K.; Man, Bruno De

doi:10.1186/s42492-022-00125-0

Cited by 26 publications

(10 citation statements)

References 53 publications

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“… 25–28 Novel high-resolution hardware (photon-counting CT), high-resolution reconstructions, subtraction techniques, and post-processing with deep learning de-blooming algorithms can also effectively decrease this artefact, improving the diagnostic accuracy of CCTA. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

Coronary bypass surgery guided by computed tomography in a low-risk population

Serruys,

Kageyama,

Pompilio

et al. 2024

European Heart Journal

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Background and Aims In patients with three-vessel disease and/or left main disease, selecting revascularization strategy based on coronary computed tomography angiography (CCTA) has a high level of virtual agreement with treatment decisions based on invasive coronary angiography (ICA). Methods In this study, coronary artery bypass grafting (CABG) procedures were planned based on CCTA without knowledge of ICA. The CABG strategy was recommended by a central core laboratory assessing the anatomy and functionality of the coronary circulation. The primary feasibility endpoint was the percentage of operations performed without access to the ICA. The primary safety endpoint was graft patency on 30-day follow-up CCTA. Secondary endpoints included topographical adequacy of grafting, major adverse cardiac and cerebrovascular (MACCE), and major bleeding events at 30 days. The study was considered positive if the lower boundary of confidence intervals (CI) for feasibility was ≥75% (NCT04142021). Results The study enrolled 114 patients with a mean (standard deviation) anatomical SYNTAX score and Society of Thoracic Surgery score of 43.6 (15.3) and 0.81 (0.63), respectively. Unblinding ICA was required in one case yielding a feasibility of 99.1% (95% CI 95.2%–100%). The concordance and agreement in revascularization planning between the ICA- and CCTA-Heart Teams was 82.9% with a moderate kappa of 0.58 (95% CI 0.50–0.66) and between the CCTA-Heart Team and actual treatment was 83.7% with a substantial kappa of 0.61 (95% CI 0.53–0.68). The 30-day follow-up CCTA in 102 patients (91.9%) showed an anastomosis patency rate of 92.6%, whilst MACCE was 7.2% and major bleeding 2.7%. Conclusions CABG guided by CCTA is feasible and has an acceptable safety profile in a selected population of complex coronary artery disease.

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Section: Discussionmentioning

confidence: 99%

Coronary bypass surgery guided by computed tomography in a low-risk population

Serruys,

Kageyama,

Pompilio

et al. 2024

European Heart Journal

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“…On coronary CT angiography (CCTA), calcifications can cause an illuminated white blurriness, which complicates grading the degree of occlusion of the coronary lumen. This is called “blooming”, a partial volume artifact caused by limited spatial resolution of CT scanners and complicates delineating the edges of high-density objects (i.e., bone or calcification) [ 23 ].…”

Section: Methods Of Cac Assessment and Quantification On Non-gated Ctmentioning

confidence: 99%

The Clear Value of Coronary Artery Calcification Evaluation on Non-Gated Chest Computed Tomography for Cardiac Risk Stratification

Groen,

Jukema,

van Dijkman

et al. 2024

Cardiol Ther

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To enhance risk stratification in patients suspected of coronary artery disease, the assessment of coronary artery calcium (CAC) could be incorporated, especially when CAC can be readily assessed on previously performed non-gated chest computed tomography (CT). Guidelines recommend reporting on patients’ extent of CAC on these non-cardiac directed exams and various studies have shown the diagnostic and prognostic value. However, this method is still little applied, and no current consensus exists in clinical practice. This review aims to point out the clinical utility of different kinds of CAC assessment on non-gated CTs. It demonstrates that these scans indeed represent a merely untapped and underestimated resource for risk stratification in patients with stable chest pain or an increased risk of cardiovascular events. To our knowledge, this is the first review to describe the clinical utility of different kinds of visual CAC evaluation on non-gated unenhanced chest CT. Various methods of CAC assessment on non-gated CT are discussed and compared in terms of diagnostic and prognostic value. Furthermore, the application of these non-gated CT scans in the general practice of cardiology is discussed. The clinical utility of coronary calcium assessed on non-gated chest CT, according to the current literature, is evident. This resource of information for cardiac risk stratification needs no specific requirements for scan protocol, and is radiation-free and cost-free. However, some gaps in research remain. In conclusion, the integration of CAC on non-gated chest CT in general cardiology should be promoted and research on this method should be encouraged.

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“…Calcium-blooming and metal artifacts are caused by volume averaging, motion, and beam hardening [ 58 ]. These artifacts are significantly mitigated in PCDs thanks to the improved spatial resolution and the consequent decrease in partial volume effects and thanks to the improved material decomposition allowing for accurate separation of the high-density materials (such as metals) from the surrounding soft tissues [ 59 ].…”

Section: Benefits Of Pcdsmentioning

confidence: 99%

Cardiovascular Applications of Photon-Counting CT Technology: A Revolutionary New Diagnostic Step

Meloni,

Cademartiri,

Positano

et al. 2023

JCDD

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Photon-counting computed tomography (PCCT) is an emerging technology that can potentially transform clinical CT imaging. After a brief description of the PCCT technology, this review summarizes its main advantages over conventional CT: improved spatial resolution, improved signal and contrast behavior, reduced electronic noise and artifacts, decreased radiation dose, and multi-energy capability with improved material discrimination. Moreover, by providing an overview of the existing literature, this review highlights how the PCCT benefits have been harnessed to enhance and broaden the diagnostic capabilities of CT for cardiovascular applications, including the detection of coronary artery calcifications, evaluation of coronary plaque extent and composition, evaluation of coronary stents, and assessment of myocardial tissue characteristics and perfusion.

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Cardiac CT blooming artifacts: clinical significance, root causes and potential solutions

Cited by 26 publications

References 53 publications

Coronary bypass surgery guided by computed tomography in a low-risk population

Coronary bypass surgery guided by computed tomography in a low-risk population

The Clear Value of Coronary Artery Calcification Evaluation on Non-Gated Chest Computed Tomography for Cardiac Risk Stratification

Cardiovascular Applications of Photon-Counting CT Technology: A Revolutionary New Diagnostic Step

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