European journal of radiology · 2023
New Whole-Heart motion correction algorithm enables diagnostic CT of aortic valve and coronary arteries in systolic phase for transcatheter aortic valve implantation candidates.
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Zhang Yu, Liu Zixuan, Cheng Yong, Li Zhenlin, Wang Ziwei, Peng Liqing, Li Jianying, Shuai Tao
Аннотация
OBJECTIVES: To investigate the ability of new generation snapshot freeze (NGSSF) algorithm in improving diagnostic image quality of both aortic valve and coronary arteries for transcatheter aortic valve implantation (TAVI) candidates in TAVI planning CT.
METHODS: Sixty-four TAVI candidates underwent TAVI planning CT were enrolled. Scans from coronary CT angiography were reconstructed at 20%, 30%, 40%, and 75% R-R cardiac phases with NGSSF and standard (STD) algorithm. In each phase, following parameters were compared: aortic valve measurements and their reproducibility; image quality of aortic valve and coronary arteries. The diagnostic accuracies of TAVI planning CT for coronary artery stenosis in 30% R-R phase with NGSSF and STD algorithms were calculated in 47out of 64 patients with invasive coronary angiography as reference standard.
RESULTS: For subjective image quality evaluation, the excellent rate for aortic valve improved from 25.0% to 93.8% and the interpretable rate for coronary arteries increased from 20.3% to 95.3% in the 30% phase images with NGSSF compared with images with STD. For the detection of > 50% coronary artery stenosis, the 30% phase images with NGSSF provided a sensitivity of 90%, specificity of 81.48%, negative predictive value of 91.7%, and positive predictive value of 78.3% on a per-patient basis; While images with STD, had a corresponding results of 95.0%, 33.33%, 90.0%, and 51.4%, respectively.
CONCLUSIONS: NGSSF significantly improves image quality for both aortic valve and coronary arteries compared with STD for TAVI patients of all heart rates. NGSSF enables the accurate measurement for aortic valve and satisfactory diagnostic performance for coronary arteries stenosis in the same systolic phase for TAVI planning.
METHODS: Sixty-four TAVI candidates underwent TAVI planning CT were enrolled. Scans from coronary CT angiography were reconstructed at 20%, 30%, 40%, and 75% R-R cardiac phases with NGSSF and standard (STD) algorithm. In each phase, following parameters were compared: aortic valve measurements and their reproducibility; image quality of aortic valve and coronary arteries. The diagnostic accuracies of TAVI planning CT for coronary artery stenosis in 30% R-R phase with NGSSF and STD algorithms were calculated in 47out of 64 patients with invasive coronary angiography as reference standard.
RESULTS: For subjective image quality evaluation, the excellent rate for aortic valve improved from 25.0% to 93.8% and the interpretable rate for coronary arteries increased from 20.3% to 95.3% in the 30% phase images with NGSSF compared with images with STD. For the detection of > 50% coronary artery stenosis, the 30% phase images with NGSSF provided a sensitivity of 90%, specificity of 81.48%, negative predictive value of 91.7%, and positive predictive value of 78.3% on a per-patient basis; While images with STD, had a corresponding results of 95.0%, 33.33%, 90.0%, and 51.4%, respectively.
CONCLUSIONS: NGSSF significantly improves image quality for both aortic valve and coronary arteries compared with STD for TAVI patients of all heart rates. NGSSF enables the accurate measurement for aortic valve and satisfactory diagnostic performance for coronary arteries stenosis in the same systolic phase for TAVI planning.