Reduced radiation dose with model based iterative reconstruction coronary artery calcium scoring

Choi, Andrew D.; Leifer, Eric; Yu, Jeannie; Datta, Tapan K; Bronson, Kathie; Rollison, S.; Schuzer, John L.; Steveson, Chloe; Shanbhag, Sujata M.; Chen, Marcus Y

doi:10.1016/j.ejrad.2018.12.010

Cited by 19 publications

(12 citation statements)

References 35 publications

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“…Nevertheless, the Agatston score of medium and high density calcification did not differ from baseline, when radiation dose was reduced by 50%. Similar findings were presented by Choi et al who applied 75% dose reduction with comparable image quality [ 8 ].…”

Section: Discussionsupporting

confidence: 89%

“…When considering patients with a zero Agatston score as defined by the reference method, MBIR classified one patient as a nonzero Agatston score, thereby increasing the risk classification. However, similar results were presented before, with 17% of cases reclassified into higher risk group, including 8% of patient misclassified as non-zero Agatston scores [ 8 ]. One explanation for this behaviour might be the impact of the edge enhancement algorithm, whereby more pronounced CAC edges increase overall Agatston scores.…”

Section: Discussionsupporting

confidence: 80%

“…These reconstruction algorithms reduce image noise, and therefore allow for a decrease in radiation dose while maintaining image quality equal to traditional filtered back projection (FBP) [ 6 , 7 ]. Previous studies have shown a good agreement in Agatston scores between FBP and HIR and MBIR [ 8 – 10 ]. However, it was also shown that HIR resulted in decreased Agatston scores for small and/or low density lesions [ 9 ].…”

Section: Introductionmentioning

confidence: 86%

“…However, it was also shown that HIR resulted in decreased Agatston scores for small and/or low density lesions [ 9 ]. Similarly, MBIR resulted in decreased detection of small calcifications [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Systematic assessment of coronary calcium detectability and quantification on four generations of CT reconstruction techniques: a patient and phantom study

Dobrolińska

Praagh

Oostveen

et al. 2022

Int J Cardiovasc Imaging

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In computed tomography, coronary artery calcium (CAC) scores are influenced by image reconstruction. The effect of a newly introduced deep learning-based reconstruction (DLR) on CAC scoring in relation to other algorithms is unknown. The aim of this study was to evaluate the effect of four generations of image reconstruction techniques (filtered back projection (FBP), hybrid iterative reconstruction (HIR), model-based iterative reconstruction (MBIR), and DLR) on CAC detectability, quantification, and risk classification. First, CAC detectability was assessed with a dedicated static phantom containing 100 small calcifications varying in size and density. Second, CAC quantification was assessed with a dynamic coronary phantom with velocities equivalent to heart rates of 60–75 bpm. Both phantoms were scanned and reconstructed with four techniques. Last, scans of fifty patients were included and the Agatston calcium score was calculated for all four reconstruction techniques. FBP was used as a reference. In the phantom studies, all reconstruction techniques resulted in less detected small calcifications, up to 22%. No clinically relevant quantification changes occurred with different reconstruction techniques (less than 10%). In the patient study, the cardiovascular risk classification resulted, for all reconstruction techniques, in excellent agreement with the reference (κ = 0.96–0.97). However, MBIR resulted in significantly higher Agatston scores (61 (5.5–435.0) vs. 81.5 (9.25–435.0); p < 0.001) and 6% reclassification rate. In conclusion, HIR and DLR reconstructed scans resulted in similar Agatston scores with excellent agreement and low-risk reclassification rate compared with routine reconstructed scans (FBP). However, caution should be taken with low Agatston scores, as based on phantom study, detectability of small calcifications varies with the used reconstruction algorithm, especially with MBIR and DLR.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Systematic assessment of coronary calcium detectability and quantification on four generations of CT reconstruction techniques: a patient and phantom study

Dobrolińska

Praagh

Oostveen

et al. 2022

Int J Cardiovasc Imaging

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“…In recent years, some studies paid attention to the influence of IR, such as SAFIRE [ 16 – 18 ], adaptive statistical IR (ASIR) [ 19 – 21 ], advanced modeled IR (ADMIRE) [ 22 ], hybrid IR (HIR) [ 23 ], model-based IR [ 24 ], and adaptive iterative dose reduction (AIDR) [ 25 ], on accurate measurement of the coronary calcium score. Kurata et al [ 16 ] reported that SAFIRE techniques significantly affected the calcium score measurement, which potentially alters subsequent cardiovascular risk in current medicine practice.…”

Section: Introductionmentioning

confidence: 99%

Sinogram-Affirmed Iterative Reconstruction Negatively Impacts the Risk Category Based on Agatston Score: A Study Combining Coronary Calcium Score Measurement and Coronary CT Angiography

Wang

Zhao

et al. 2020

BioMed Research International

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Purpose. To assess the impact of sinogram-affirmed iterative reconstruction (SAFIRE) on risk category for coronary artery disease by combining coronary calcium score measurement and coronary CT angiography (CCTA). Materials and Methods. Eighty-nine patients (64.0% male) older than 18 years (64.4±10.3 years) underwent coronary artery calcium scanning and prospectively ECG-triggered sequential CCTA examination. All raw data acquired in coronary artery calcium scanning were reconstructed by both filtered back projection (FBP) and SAFIRE algorithms with 5 different levels. Objective image quality and calcium quantification were evaluated and compared between FBP and all SAFIRE levels by the Sphericity Assumed test or Greenhouse-Geisser ε correction coefficient. Coronary artery stenosis was assessed in CCTA. Risk categories of all patients and of the patients with coronary artery stenosis in CCTA were compared between FBP and all SAFIRE levels by the Friedman test. Results. The reconstruction protocol from traditional FBP to SAFIRE 5 was associated with a gradual reduction in CT value and image noise (P<0.001) but associated with a gradual improvement in the signal-to-noise ratio (P<0.001). There was a gradual reduction in coronary calcification quantification (Agatston score: from 73.5 in FBP to 38.1 in SAFIRE 5, P<0.001) from traditional FBP to SAFIRE 5. There was a significant difference for the risk category between FBP and all levels of SAFIRE in all patients (from 3.5 in FBP to 3.2 in SAFIRE 5, P<0.001) and in the patients with coronary artery stenosis in CCTA (from 4.0 in FBP to 3.6 in SAFIRE 5, P<0.001). Conclusions. SAFIRE significantly reduces coronary calcification quantification compared to FBP, resulting in the reduction of risk categories based on the Agatston score. The risk categories of the patients with coronary artery stenosis in CCTA may also decline. Thus, SAFIRE may lead risk categories to underestimate the existence of significant coronary artery stenosis.

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Individualized coronary calcium scoring at any tube voltage using a kV-independent reconstruction algorithm

et al. 2020

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Reduced radiation dose with model based iterative reconstruction coronary artery calcium scoring

Cited by 19 publications

References 35 publications

Systematic assessment of coronary calcium detectability and quantification on four generations of CT reconstruction techniques: a patient and phantom study

Systematic assessment of coronary calcium detectability and quantification on four generations of CT reconstruction techniques: a patient and phantom study

Sinogram-Affirmed Iterative Reconstruction Negatively Impacts the Risk Category Based on Agatston Score: A Study Combining Coronary Calcium Score Measurement and Coronary CT Angiography

Individualized coronary calcium scoring at any tube voltage using a kV-independent reconstruction algorithm

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