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Second-generation motion correction algorithm improves diagnostic accuracy of single-beat coronary CT angiography in patients with increased heart rate

  • Junfu Liang
  • Ying Sun
  • Ziqing Ye
  • Yanchun Sun
  • Lei Xu
  • Zhen Zhou
  • Brian Thomsen
  • Jianying Li
  • Zhonghua Sun
  • Zhanming Fan
Computed Tomography

Abstract

Objective

To assess the effect of a second-generation motion correction algorithm on the diagnostic accuracy of coronary computed tomography angiography (CCTA) using a 256-detector row CT in patients with increased heart rates.

Methods

Eighty-one consecutive symptomatic cardiac patients with increased heart rates ( 75 beats per min) were enrolled. All patients underwent CCTA and invasive coronary angiography (ICA). CCTA was performed with a 256-detector row CT using prospectively ECG-triggered single-beat protocol. Images were reconstructed using standard (STD) algorithm, first-generation intra-cycle motion correction (MC1) algorithm, and second-generation intra-cycle motion correction (MC2) algorithm. The image quality of coronary artery segments was assessed by two experienced radiologists using a 4-point scale (1: non-diagnostic and 4: excellent), according to the 18-segment model. Diagnostic performance for segments with significant lumen stenosis (≥ 50%) was compared between STD, MC1, and MC2 by using ICA as the reference standard.

Results

The mean effective dose of CCTA was 1.0 mSv. On per-segment level, the overall image quality score and interpretability were improved to 3.56 ± 0.63 and 99.2% due to the use of MC2, as compared to 2.81 ± 0.85 and 92.5% with STD and 3.21 ± 0.79 and 97.2% with MC1. On per-segment level, compared to STD and MC1, MC2 improved the sensitivity (92.2% vs. 79.2%, 80.7%), specificity (97.8% vs. 82.1%, 90.8%), positive predictive value (89.9% vs. 48.4%, 65.1%), negative predictive value (98.3% vs. 94.9%, 95.7%), and diagnostic accuracy (96.8% vs. 81.5%, 89.0%).

Conclusion

A second-generation intra-cycle motion correction algorithm for single-beat CCTA significantly improves image quality and diagnostic accuracy in patients with increased heart rate.

Key Points

A second-generation motion correction (MC2) algorithm can further improve the image quality of all coronary arteries than a first-generation motion correction (MC1).

MC2 algorithm can significantly reduce the number of false positive segments compared to standard and MC1 algorithm.

Keywords

Coronary vessels Tomography, X-ray computed Heart rate Motion Coronary angiography 

Abbreviations

AUC

Area under curve

bpm

Beats per minute

CAD

Coronary artery disease

CCTA

Coronary computed tomography angiography

HRV

Heart rate variability

ICA

Invasive coronary angiography

LAD

Left anterior descending artery

LCX

Left circumflex artery

MC1

First-generation motion correction

MC2

Second-generation motion correction

NPV

Negative predictive value

PPV

Positive predictive value

RCA

Right coronary artery

STD

Standard

Notes

Funding

This study has received funding by the National Key R&D Program of China (2016YFC1300300) and The National Natural Science Foundation of China (81641069).

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Lei Xu.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: GE Healthcare.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• diagnostic study

• performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Junfu Liang
    • 1
    • 2
  • Ying Sun
    • 2
  • Ziqing Ye
    • 2
  • Yanchun Sun
    • 2
  • Lei Xu
    • 1
  • Zhen Zhou
    • 1
  • Brian Thomsen
    • 3
  • Jianying Li
    • 4
  • Zhonghua Sun
    • 5
  • Zhanming Fan
    • 1
  1. 1.Department of Radiology, Beijing Anzhen HospitalCapital Medical UniversityBeijingChina
  2. 2.Department of RadiologyBeijing Huairou HospitalBeijingChina
  3. 3.GE HealthcareMilwaukeeUSA
  4. 4.CT LaboratoryGE Healthcare ChinaBeijingChina
  5. 5.Department of Medical Radiation SciencesCurtin UniversityPerthAustralia

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