Aims and objectives
Since the years 2000 and the use of 64-slice multidetector computed tomography,
cardiac computed tomographic angiography (CCTA) has been widely utilized as a noninvasive diagnostic modality for visualizing the coronary arteries to detect coronary artery disease (CAD).
Although the diagnostic accuracy of CCTA for detection of obstructive CAD has been validated by numerous retrospective and prospective trials,
most of the available study samples consisted of selecting patients with low heart rate (HR) in order to be optimal for CCTA with a high sensitivity and an...
Methods and materials
Motion phantom model and CCTA scanning protocol
We used a cardiac motion phantom (20) coupled to a three-dimensional (3D) motion simulator (QRM-Sim4D-Cardio; Quality Assurance in Radiology and Medicine,
Moehrendorf,
Germany).
The motion simulator permits a range of motion of 80×40×80 mm (x-,
y- and z-axis) and a maximum frequency of 3 Hz,
thereby creating motion sequences simulating 3D heart motion with corresponding simulated ECG,
which can be fed out to the CT machine’s ECG control panel (figure 1).
This allows for an ECG-synchronised CT image...
Results
Image quality was significantly improved (table 1),
whereas blooming and motion artifacts were significantly reduced with MCA compared to conventional algorithm (table 2 and figure 6).
The difference was more important for high HR and arrhythmia (figure 7)or when image quality was initially poor (table 3).
Diagnostic accuracy was not significantly improved with MCA (table 1).Considering the size of vessels,
we found a difference of error measurement more important for small vessel (<1.2mm) than for the others (figure 8).
Conclusion
The MCA improves image quality,
particularly for high HR or arrhythmia.
The benefit is more important when image quality is initially poor.
The MCA does not significantly improve diagnostic accuracy.
References
1.
Budoff MJ,
Dowe D,
Jollis JG,
Gitter M,
Sutherland J,
Halamert E,
et al.
Diagnostic Performance of 64-Multidetector Row Coronary Computed Tomographic Angiography for Evaluation of Coronary Artery Stenosis in Individuals Without Known Coronary Artery Disease: Results From the Prospective Multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) Trial.
J Am Coll Cardiol.
2008 Nov 18;52(21):1724–32.
2.
Gueret P,
Deux J-F,
Bonello L,
Sarran A,
Tron C,
Christiaens L,
et al.
Diagnostic Performance of Computed Tomography Coronary Angiography...