Technical development in cardiac CT: current standards and future improvements—a narrative review

Toia, Patrizia; Grutta, Ludovico La; Sollami, Giulia; Clemente, Alberto; Gagliardo, Cesare; Galia, Massimo; Maffei, Erica; Midiri, Massimo; Cademartiri, Filippo

doi:10.21037/cdt-20-527

Cited by 18 publications

(9 citation statements)

References 69 publications

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“…For such reasons, its application in clinical practice has been a source of debate in scientific literature, as IR changes the texture of the image with the generation of "unfamiliar" altered images that have been defined as having a "blotchy", "plastic-looking" and "smooth" appearance. 14,15 Moreover, there are still challenging clinical scenarios, like imaging of obese patients, heavily calcified vessels or coronary stents, in which dose reduction strategies have proven to be relatively ineffective, because of intrinsic reduction of the signal to noise ratio (SNR) associated with low-dose protocols, inducing a poor delineation of small moving vessels like coronary arteries with a parallel limited visualization of soft tissue plaques. 14 To overcome these limitations, CT manufactures have implemented new image reconstruction algorithms based on artificial intelligence tools to denoise low-dose images keeping a balanced depiction of texture features.…”

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confidence: 99%

Deep Learning Image Reconstruction Algorithm for CCTA: Image Quality Assessment and Clinical Application

Catapano,

Lisi,

Savini

et al. 2023

J Comput Assist Tomogr

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Objective The increasing number of coronary computed tomography angiography (CCTA) requests raised concerns about dose exposure. New dose reduction strategies based on artificial intelligence have been proposed to overcome limitations of iterative reconstruction (IR) algorithms. Our prospective study sought to explore the added value of deep-learning image reconstruction (DLIR) in comparison with a hybrid IR algorithm (adaptive statistical iterative reconstruction-veo [ASiR-V]) in CCTA, even in clinical challenging scenarios, as obesity, heavily calcified vessels and coronary stents. Methods We prospectively included 103 consecutive patients who underwent CCTA. Data sets were reconstructed with ASiR-V and DLIR. For each reconstruction signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) was calculated, and qualitative assessment was made with a four-point Likert scale by two independent and blinded radiologists with different expertise. Results Both SNR and CNR were significantly higher in DLIR (SNR-DLIR median value [interquartile range] of 13.89 [11.06–16.35] and SNR-ASiR-V 25.42 [22.46–32.22], P < 0.001; CNR-DLIR 16.84 [9.83–27.08] vs CNR-ASiR-V 10.09 [5.69–13.5], P < 0.001). Median qualitative score was 4 for DLIR images versus 3 for ASiR-V (P < 0.001), with a good interreader reliability [intraclass correlation coefficient(2,1)e intraclass correlation coefficient(3,1) 0.60 for DLIR and 0.62 and 0.73 for ASiR-V]. In the obese and in the “calcifications and stents” groups, DLIR showed significantly higher values of SNR (24.23 vs 11.11, P < 0.001 and 24.55 vs 14.09, P < 0.001, respectively) and CNR (16.08 vs 8.04, P = 0.008 and 17.31 vs 10.14, P = 0.003) and image quality. Conclusions Deep-learning image reconstruction in CCTA allows better SNR, CNR, and qualitative assessment than ASiR-V, with an added value in the most challenging clinical scenarios.

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confidence: 99%

Deep Learning Image Reconstruction Algorithm for CCTA: Image Quality Assessment and Clinical Application

Catapano,

Lisi,

Savini

et al. 2023

J Comput Assist Tomogr

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“…The presented images were obtained using one of the most advanced computed tomography scanners currently available-384 (2 × 192) slices Siemens Somatom Force (Erlangen, Germany). Such a computed tomography scanner enables the acquisition of images in layers of 0.6 mm thickness, with a time resolution of <0.3 s, with a low dose of ionizing radiation <1 mSv and a low volume of contrast agent <60 mL [9]. CCT in the case of CCMA is a highly accurate method of differentiating from proliferative and inflammatory changes in the heart valves.…”

Section: Discussionmentioning

confidence: 99%

The Importance of Cardiac Computed Tomography in the Diagnosis of Caseous Calcification of the Mitral Annulus—Case Reports

Gać

Cheładze²,

Poręba

2022

Diagnostics

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Mitral annular calcification (MAC) is a common pathology of the mitral valve. In rare cases, calcifications occur in the mitral annulus degenerate serous; the caseous calcification of the mitral annulus (CCMA) then develops. Detection of CCMA is often random and requires differentiation from heart tumors or an abscess. The paper presents two cases of patients with ambiguous focal lesions of the mitral valve in echocardiography. In the first case, the cardiac computed tomography (CCT) showed a spherical, slightly irregular structure measuring approximately 33 × 22 mm, which was in contact with the posterior mitral valve leaflet from the lumen of the left ventricle. The lesion was heterogeneously intense, with an average density of about 500 HU and up to 975 HU on the periphery; it was not enhanced after the administration of a contrast agent. In the second case, the CCT revealed a heterogeneous, highly calcified structure in the peripheral zone and intermediate density in the central zone in the topography of the posterior mitral valve leaf, with dimensions up to about 41 × 31 mm in the plane of the valve leaflet, passing into the lumen of the left ventricle along its inferolateral wall to a depth of about 3.5 cm. In both cases, CCT enabled the diagnosis of CCMA. In conclusion, cardiac computed tomography may be decisive in the case of suspected caseous calcification of the mitral annulus where there is ambiguous echocardiography.

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“…The development of multilayer spiral CT significantly reduces the patient's breath-holding time. At the same time, the improvement in temporal resolution reduces cardiac motion artifacts ( 50 ). After long-term clinical application, MSCT is a non-invasive, highly safe, operationally simple technique that can analyze coronary artery calcification and accurately assess the severity of coronary artery stenosis and plaque composition ( 21 ).…”

Section: Current Clinically Available Ct Techniquesmentioning

confidence: 99%

Advances in CT Techniques in Vascular Calcification

Zhang

Feng

et al. 2021

Front. Cardiovasc. Med.

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Vascular calcification, a common pathological phenomenon in atherosclerosis, diabetes, hypertension, and other diseases, increases the incidence and mortality of cardiovascular diseases. Therefore, the prevention and detection of vascular calcification play an important role. At present, various techniques have been applied to the analysis of vascular calcification, but clinical examination mainly depends on non-invasive and invasive imaging methods to detect and quantify. Computed tomography (CT), as a commonly used clinical examination method, can analyze vascular calcification. In recent years, with the development of technology, in addition to traditional CT, some emerging types of CT, such as dual-energy CT and micro CT, have emerged for vascular imaging and providing anatomical information for calcification. This review focuses on the latest application of various CT techniques in vascular calcification.

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Technical development in cardiac CT: current standards and future improvements—a narrative review

Cited by 18 publications

References 69 publications

Deep Learning Image Reconstruction Algorithm for CCTA: Image Quality Assessment and Clinical Application

Deep Learning Image Reconstruction Algorithm for CCTA: Image Quality Assessment and Clinical Application

The Importance of Cardiac Computed Tomography in the Diagnosis of Caseous Calcification of the Mitral Annulus—Case Reports

Advances in CT Techniques in Vascular Calcification

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