Practical approaches to overcoming artifacts in coronary CT angiography

Lesser, John R.; Flygenring, Bjorn; Knickelbine, Tom; Longe, Terrence F.; Schwartz, Robert S.

doi:10.1016/j.jcct.2008.11.006

Cited by 22 publications

(17 citation statements)

References 12 publications

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“…38 Strategies to tackle arrhythmia depend on the type of acquisition: (i) for retrospective spiral acquisitions, arrhythmia-induced artefacts can be countered with retrospective editing of the reconstruction phases based on the continuous ECG registration during the acquisition; (ii) for prospective and high-pitch spiral scans, the acquisition is automatically suspended and delayed to a following heartbeat when HR changes are detected. 37 The in-plane spatial resolution of CT theoretically approximates the 0.1 mm and 0.2 mm spatial resolution of intravascular ultrasound and catheter angiography, respectively. However, in clinical practice, the in-plane spatial resolution is limited to approximately 0.5 mm by the use of smoothing convolution reconstruction algorithms.…”

Section: Software Solutionsmentioning

confidence: 94%

“…Moreover, in retrospective gated acquisitions, there is a complex relationship between the cardiac cycle duration (HR), the rotation speed and multisegment reconstruction. 36,37 Other recently introduced motion-reducing software algorithms include automated boundary detection and algorithms using information from adjacent cardiac phases within a single cardiac cycle to characterize vessel motion ( Figure 8). As such, actual vessel position is determined at the target phase and adaptively compensated to reduce unexpected motion.…”

Section: Software Solutionsmentioning

confidence: 99%

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Image quality in coronary CT angiography: challenges and technical solutions

Ghekiere

Salgado

Buls

et al. 2017

BJR

114

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Multidetector CT angiography (CTA) has become a widely accepted examination for non-invasive evaluation of the heart and coronary arteries. Despite its ongoing success and worldwide clinical implementation, it remains an often-challenging procedure in which image quality, and hence diagnostic value, is determined by both technical and patient-related factors. Thorough knowledge of these factors is important to obtain high-quality examinations. In this review, we discuss several key elements that may adversely affect coronary CTA image quality as well as potential measures that can be taken to mitigate their impact. In addition, several recent vendor-specific advances and future directions to improve image quality are discussed. INTRODUCTIONThe high negative-predictive value of coronary CT angiography (CTA) makes it a suitable tool for excluding significant coronary artery disease.1 Coronary CTA is technically complex and places a greater emphasis on scanning technologies than any other type of CT examination. Indeed, coronary arteries both have small calibre and varying degrees of motion during the cardiac cycle.2 Image quality can be degraded by many patient-and technique-related factors. Image artefacts are causes for misinterpretation, making the diagnostic accuracy of coronary CTA to a great extent dependent on their recognition and operator-awareness.2,3 Potential problems related to these artefacts include insufficient tissue contrast, limited spatial and temporal resolution and inadequate volume coverage. The aim of this review was to discuss these technical issues, important recent vendorspecific solutions as well as future directions.

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Section: Software Solutionsmentioning

confidence: 94%

Section: Software Solutionsmentioning

confidence: 99%

Image quality in coronary CT angiography: challenges and technical solutions

Ghekiere

Salgado

Buls

et al. 2017

BJR

114

View full text Add to dashboard Cite

show abstract

“…In ectopy, an isolated area of discontinuity is seen, whereas in other arrhythmias, multiple discontinuities are seen. In oblique planes, the registration lines may not be apparent, and this artifact can be mistaken for a lesion (14). Stair-step artifacts may be present in the absence of motion blurring in the xy plane.…”

Section: Cardiac Motionmentioning

confidence: 99%

Artifacts at Cardiac CT: Physics and Solutions

et al. 2016

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Computed tomography is vulnerable to a wide variety of artifacts, including patient- and technique-specific artifacts, some of which are unique to imaging of the heart. Motion is the most common source of artifacts and can be caused by patient, cardiac, or respiratory motion. Cardiac motion artifacts can be reduced by decreasing the heart rate and variability and the duration of data acquisition; adjusting the placement of the data window within a cardiac cycle; performing single-heartbeat scanning; and using multisegment reconstruction, motion-correction algorithms, and electrocardiographic editing. Respiratory motion artifacts can be minimized with proper breath holding and shortened scan duration. Partial volume averaging is caused by the averaging of attenuation values from all tissue contained within a voxel and can be reduced by improving the spatial resolution, using a higher x-ray energy, or displaying images with a wider window width. Beam-hardening artifacts are caused by the polyenergetic nature of the x-ray beam and can be reduced by using x-ray filtration, applying higher-energy x-rays, altering patient position, modifying contrast material protocols, and applying certain reconstruction algorithms. Metal artifacts are complex and have multiple causes, including x-ray scatter, underpenetration, motion, and attenuation values that exceed the typical dynamic range of Hounsfield units. Quantum mottle or noise is caused by insufficient penetration of tissue and can be improved by increasing the tube current or peak tube potential, reconstructing thicker sections, increasing the rotation time, using appropriate patient positioning, and applying iterative reconstruction algorithms. RSNA, 2016.

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“…Dual source detectors comprise duplicated X-ray tubes and detectors, thereby reducing the gantry rotation required for image reconstruction and improving temporal resolution. This enables coronary CT angiography across a single heart beat (high-pitch mode) utilising a fast CT-table movement examination with prospectively ECG-triggered, helical acquisition mode [24,50]. Meanwhile, CT scanners with wide array detectors (256-320 detector rows) have concurrently been able to increase the craniocaudal coverage up to 16 cm without table movement-allowing for visualisation of the whole heart within a single gantry rotation.…”

Section: Cardiac Computed Tomographymentioning

confidence: 99%

A new look at the heart—novel imaging techniques

Johnston

Krafft

Russe

et al. 2017

Herzschr Elektrophys

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The development and successful implementation of cutting-edge imaging technologies to visualise cardiac anatomy and function is a key component of effective diagnostic efforts in cardiology. Here, we describe a number of recent exciting advances in the field of cardiology spanning from macro- to micro- to nano-scales of observation, including magnetic resonance imaging, computed tomography, optical mapping, photoacoustic imaging, and electron tomography. The methodologies discussed are currently making the transition from scientific research to routine clinical use, albeit at different paces. We discuss the most likely trajectory of this transition into clinical research and standard diagnostics, and highlight the key challenges and opportunities associated with each of the methodologies.

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Practical approaches to overcoming artifacts in coronary CT angiography

Cited by 22 publications

References 12 publications

Image quality in coronary CT angiography: challenges and technical solutions

Image quality in coronary CT angiography: challenges and technical solutions

Artifacts at Cardiac CT: Physics and Solutions

A new look at the heart—novel imaging techniques

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