Submillisievert CT angiography for carotid arteries using wide array CT scanner and latest iterative reconstruction algorithm in comparison with previous generations technologies: Feasibility and diagnostic accuracy

Annoni, Andrea; Montorsi, Piero; Andreini, Daniele; Mancini, Maria Elisabetta; Muscogiuri, Giuseppe; Formenti, Alberto; Mushtaq, Saima; Trabattoni, Piero; Dainese, Luca; Pepi, Mauro

doi:10.1016/j.jcct.2019.01.009

Cited by 9 publications

(11 citation statements)

References 18 publications

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“…The obtained data sets of each CTA were transferred to a dedicated imageprocessing workstation (Advantage Workstation Version 4.6, GE Healthcare, Milwaukee, WI). CTA images were evaluated by two experienced readers, blinded to the scan protocol, in terms of image quality and presence of artifacts (17). Plaque type was classified according to density measurements based on previously reported criteria (18).…”

Section: Ct Angiography Evaluationmentioning

confidence: 99%

Aortic Valve Sclerosis as an Important Predictor of Long-Term Mortality in Patients With Carotid Atheromatous Plaque Requiring Carotid Endarterectomy

Myasoedova

Saccu

Chiesa

et al. 2021

Front. Cardiovasc. Med.

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Background: A strong association between aortic valve sclerosis (AVSc), the earliest manifestation of calcific aortic valve disease, and atherosclerosis exists. The aim of the study was to evaluate the predictive capabilities of AVSc on long-term all-cause mortality, in patients requiring carotid endarterectomy (CEA).Methods and Results: 806 consecutive CEA patients were enrolled. Preoperative echocardiography was used to assess AVSc. Computed tomography angiography was applied for plaque characterization. Kaplan-Meier curves, Cox linear regression, and area under the receiving operator characteristic (AUC) curve analyses were used to evaluate the predictive capability of AVSc. Overall, 348 of 541 patients had AVSc (64%). Age, diabetes, and estimated glomerular filtration rate (eGFR) were associated with AVSc. In the 5-year follow-up, AVSc group had a mortality rate of 16.7% while in no-AVSc group was 7.8%. Independent predictors of all-cause mortality were age, sex, eGFR, left ventricular ejection fraction, and AVSc. After adjustments, AVSc was associated with a significant increase in all-cause mortality risk (hazard ratio, HR = 1.9; 95%CI: 1.04–3.54; p = 0.038). We stratify our cohort based on carotid atheromatous plaque-type: soft, calcified, and mixed-fibrotic. In patients with mixed-fibrotic plaques, the mortality rate of AVSc patients was 15.5% compared to 2.4% in no-AVSc patients. In this group, AVSc was associated with an increased long-term all-cause mortality risk with an adjusted HR of 12.8 (95%CI: 1.71–96.35; p = 0.013), and the AUC, combing eGFR and AVSc was 0.77 (p < 0.001).Conclusions: Our findings indicate that AVSc together with eGFR may be used to improve long-term risk stratification of patients undergoing CEA surgery.

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Section: Ct Angiography Evaluationmentioning

confidence: 99%

Aortic Valve Sclerosis as an Important Predictor of Long-Term Mortality in Patients With Carotid Atheromatous Plaque Requiring Carotid Endarterectomy

Myasoedova

Saccu

Chiesa

et al. 2021

Front. Cardiovasc. Med.

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“…The use of lower kV values would, on one hand, improve the attenuation of the opacified lumen but conversely slightly reduce the visualization of periluminal tissues on the other hand. Nevertheless, when no plaque component measurements are required (e.g., follow-up examinations), and depending on the clinical context, lower kV settings and application of modern noise reduction mechanisms (e.g., iterative reconstruction techniques) can be successfully applied, delivering good diagnostic performance at lower radiation exposure levels [129][130][131].…”

Section: Technical Parametersmentioning

confidence: 99%

State-of-the-art CT and MR imaging and assessment of atherosclerotic carotid artery disease: standardization of scanning protocols and measurements—a consensus document by the European Society of Cardiovascular Radiology (ESCR)

et al. 2022

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The European Society of Cardiovascular Radiology (ESCR) is the European specialist society of cardiac and vascular imaging. This society’s highest priority is the continuous improvement, development, and standardization of education, training, and best medical practice, based on experience and evidence. The present intra-society consensus is based on the existing scientific evidence and on the individual experience of the members of the ESCR writing group on carotid diseases, the members of the ESCR guidelines committee, and the members of the executive committee of the ESCR. The recommendations published herein reflect the evidence-based society opinion of ESCR. We have produced a twin-papers consensus, indicated through the documents as respectively “Part I” and “Part II.” The first document (Part I) begins with a discussion of features, role, indications, and evidence for CT and MR imaging-based diagnosis of carotid artery disease for risk stratification and prediction of stroke (Section I). It then provides an extensive overview and insight into imaging-derived biomarkers and their potential use in risk stratification (Section II). Finally, detailed recommendations about optimized imaging technique and imaging strategies are summarized (Section III). The second part of this consensus paper (Part II) is focused on structured reporting of carotid imaging studies with CT/MR. Key Points • CT and MR imaging-based evaluation of carotid artery disease provides essential information for risk stratification and prediction of stroke. • Imaging-derived biomarkers and their potential use in risk stratification are evolving; their correct interpretation and use in clinical practice must be well-understood. • A correct imaging strategy and scan protocol will produce the best possible results for disease evaluation.

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“…reconstruction algorithm make it possible to achieve a marked patient dose reduction. In particular, Annoni et al demonstrated the combined use of 80 KVp, 160 mm detector coverage and iterative reconstruction algorithm in CTA of carotid artery lead to an overall mean effective dose reduction up to 86 % compared to the previous generation 64-slice CT scanner using standard 100 kVp tube voltage and first-generation adaptive statistical iterative reconstruction algorithm [14]…”

Section: Role Of Cta Scansmentioning

confidence: 99%

“…There is tremendous interest today in the application of artificial intelligence (AI) in diagnostic imaging and in the entire discipline of medicine [13]. AI is potentially able to support radiologists and clinicians in their days to days routine in different tasks, including optimization of image reconstruction [14] and reduction in time analysis [15,16].…”

Section: Introductionmentioning

confidence: 99%

Artificial intelligence in computed tomography plaque characterization: A review

Cau

Flanders

Mannelli

et al. 2021

European Journal of Radiology

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Cardiovascular disease (CVD) is associated with high mortality around the world. Prevention and early diagnosis are key targets in reducing the socio-economic burden of CVD.Artificial intelligence (AI) has experienced a steady growth due to technological innovations that have to lead to constant development. Several AI algorithms have been applied to various aspects of CVD in order to improve the quality of image acquisition and reconstruction and, at the same time adding information derived from the images to create strong predictive models. In computed tomography angiography (CTA), AI can offer solutions for several parts of plaque analysis, including an automatic assessment of the degree of stenosis and characterization of plaque morphology. A growing body of evidence demonstrates a correlation between some type of plaques, so-called high-risk plaque or vulnerable plaque, and cardiovascular events, independent of the degree of stenosis. The radiologist must apprehend and participate actively in developing and implementing AI in current clinical practice.In this current overview on the existing AI literature, we describe the strengths, limitations, recent applications, and promising developments of employing AI to plaque characterization with CT.

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Submillisievert CT angiography for carotid arteries using wide array CT scanner and latest iterative reconstruction algorithm in comparison with previous generations technologies: Feasibility and diagnostic accuracy

Cited by 9 publications

References 18 publications

Aortic Valve Sclerosis as an Important Predictor of Long-Term Mortality in Patients With Carotid Atheromatous Plaque Requiring Carotid Endarterectomy

Aortic Valve Sclerosis as an Important Predictor of Long-Term Mortality in Patients With Carotid Atheromatous Plaque Requiring Carotid Endarterectomy

State-of-the-art CT and MR imaging and assessment of atherosclerotic carotid artery disease: standardization of scanning protocols and measurements—a consensus document by the European Society of Cardiovascular Radiology (ESCR)

Artificial intelligence in computed tomography plaque characterization: A review

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