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Coronary artery visibility in free-breathing young children on non-gated chest CT: impact of temporal resolution

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Abstract

Background

Dual-source CT allows scanning of the chest with high pitch and high temporal resolution, which can improve the detection of proximal coronary arteries in infants and young children when scanned without general anesthesia, sedation or beta-blockade.

Objective

To compare coronary artery visibility between higher and standard temporal resolution.

Materials and methods

We analyzed CT images in 93 children who underwent a standard chest CT angiographic examination with reconstruction of images with a temporal resolution of 75 ms (group 1) and 140 ms (group 2).

Results

The percentage of detected coronary segments was higher in group 1 than in group 2 when considering all segments (group 1: 27%; group 2: 24%; P = 0.0004) and proximal segments (group 1: 37%; group 2: 32%; P = 0.0006). In both groups, the highest rates of detection were observed for the left main coronary artery (S1) (group 1: 65%; group 2: 58%) and proximal left anterior descending coronary artery (S2) (group 1: 43%; group 2: 42%). Higher rates of detection were seen in group 1 for the left main coronary artery (P = 0.03), proximal right coronary artery (P = 0.01), proximal segments of the left coronary artery (P = 0.02) and proximal segments of the left and right coronary arteries (P = 0.0006).

Conclusion

Higher temporal resolution improved the visibility of proximal coronary arteries in pediatric chest CT.

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Conflicts of interest

Dr. Flohr is a Siemens employee who provided the research prototype enabling reconstruction of images with different temporal resolutions. His professional position had no influence on the results of this investigation, which was independently conducted by the radiologic and statistical departments of our university center.

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Authors and Affiliations

  1. Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Université de Lille, Boulevard Jules Leclerq, 59037 Lille Cedex, France

    Alexandre Bridoux, Antoine Hutt, Jean-Baptiste Faivre, Julien Pagniez, Jacques Remy & Martine Remy-Jardin

  2. Department of Research & Development in CT, Siemens Healthcare, Forchheim, Germany

    Thomas Flohr

  3. Department of Biostatistics, Université de Lille, Lille, France

    Alain Duhamel

Authors
  1. Alexandre Bridoux
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  2. Antoine Hutt
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  3. Jean-Baptiste Faivre
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  4. Thomas Flohr
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  5. Alain Duhamel
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  6. Julien Pagniez
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  7. Jacques Remy
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  8. Martine Remy-Jardin
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Corresponding author

Correspondence to Martine Remy-Jardin.

Appendix

Appendix

We reconstructed two sets of CT images from the same CT raw data, one with the standard reconstruction implemented on the dual-source CT scanner, the other with an off-line reconstruction using optimized temporal resolution, running on a separate PC.

For image reconstruction of the dual-source CT data acquired at pitch 2, an angular range of 180° of CT raw data per measurement system (in parallel geometry) are available for each image close to the isocenter of the CT scanner [33]. In the standard filtered back-projection reconstruction as well as when using the iterative reconstruction SAFIRE, all scan data available per image contribute to the final image, i.e. the full angular range of 180°. This type of image reconstruction, which we used to generate the first set of CT images, is beneficial for complete utilization of the applied radiation dose, but it is suboptimal with regard to temporal resolution. A scan data range of 180° corresponds to a temporal resolution of 140 ms at 0.28-s gantry rotation time. We obtained the second set of images with an alternative off-line reconstruction that uses only the minimum scan data range of 90° (in parallel geometry) per measurement system for each image. By doing so, only a sub-range of the available CT data contributes to each image. This approach is suboptimal with regard to dose utilization, but it provides images with the best possible temporal resolution of 75 ms. The method is fully equivalent to the image reconstruction that would have been used on the scanner if the scan data had been acquired at a higher pitch of 3.2. Reconstruction of both image datasets allows for an assessment of the effect of improved temporal resolution on the analyzability of coronary arteries.

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Bridoux, A., Hutt, A., Faivre, JB. et al. Coronary artery visibility in free-breathing young children on non-gated chest CT: impact of temporal resolution. Pediatr Radiol 45, 1761–1770 (2015). https://doi.org/10.1007/s00247-015-3401-1

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  • DOI: https://doi.org/10.1007/s00247-015-3401-1

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