Image Quality, Overall Evaluability, and Effective Radiation Dose of Coronary Computed Tomography Angiography with Prospective Electrocardiographic Triggering Plus Intracycle Motion Correction Algorithm in Patients with a Heart Rate over 65 Beats per Minute

Gianluca Pontone, Giuseppe Muscogiuri, Andrea Baggiano, Daniele Andreini, Andrea I. Guaricci, Marco Guglielmo, Fabio Fazzari, Saima Mushtaq, Edoardo Conte, Andrea Annoni, Alberto Formenti, Elisabetta Mancini, Massimo Verdecchia, Laura Fusini, Lorenzo Bonfanti, Elisa Consiglio, Mark G. Rabbat, Antonio L. Bartorelli, Mauro Pepi

Research output: Contribution to journalArticle

Abstract

Purpose: Recently, a new intracycle motion correction algorithm (MCA) was introduced to reduce motion artifacts from heart rate (HR) in coronary computed tomography angiography (cCTA). The aim of the study was to evaluate the image quality, overall evaluability, and effective radiation dose (ED) of cCTA with prospective electrocardiographic (ECG) triggering plus MCA as compared with standard protocol with retrospective ECG triggering in patients with HR≥65 bpm. Materials and Methods: One hundred consecutive patients (67±10 y) scheduled for cCTA with 65<HR<80 bpm were retrospectively analyzed. The patients were assigned to 2 groups undergoing prospective (group 1) or retrospective (group 2) triggered cCTA. The study protocol was approved by the Institutional Ethics Committee and a written informed consent was obtained from all patients. Image noise, signal to noise ratio, contrast to noise ratio, Likert image quality score (score 1, nondiagnostic; score 2, adequate; score 3, good; score 4, excellent), overall image evaluability, and ED were measured and compared between the 2 groups. Both vessel-based and patient-based analyses were evaluated. Student test or Wilcoxon test were used to evaluate differences of continuous variables, whereas the χ 2 test was used to study differences with regard to categorical data. A P-value <0.05 was considered statistically significant. Results: cCTA was successfully performed in all patients. In a segment-based model, group 1 compared with group 2 showed a lower rate of overall artifacts (67% vs. 83%; P<0.001) and motion artifacts (49% vs. 66%; P<0.001), resulting in a better Likert image quality score (2.83±1.03 vs. 2.37±1.02; P<0.01) and overall evaluability (85% vs. 75%; P<0.01). Group 1 showed a lower ED as compared with group 2 (3.1±1.9 vs. 11.9±3.3 mSv; P<0.01). Conclusion: MCA and cCTA with prospective ECG-triggering acquisition in patients with high HR improves image quality and overall evaluability compared with cCTA with standard retrospective ECG triggering.

Original languageEnglish
Pages (from-to)225-231
Number of pages7
JournalJournal of Thoracic Imaging
Volume33
Issue number4
DOIs
Publication statusPublished - Jul 1 2018

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Heart Rate
Radiation
Artifacts
Ethics Committees
Signal-To-Noise Ratio
Computed Tomography Angiography
Informed Consent
Noise
Students

Keywords

  • effective radiation dose
  • heart rate
  • intracycle motion correction algorithm
  • prospective triggering
  • retrospective triggering

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pulmonary and Respiratory Medicine

Cite this

@article{7b90248cb40e4c6290b7dde1afb38cc1,
title = "Image Quality, Overall Evaluability, and Effective Radiation Dose of Coronary Computed Tomography Angiography with Prospective Electrocardiographic Triggering Plus Intracycle Motion Correction Algorithm in Patients with a Heart Rate over 65 Beats per Minute",
abstract = "Purpose: Recently, a new intracycle motion correction algorithm (MCA) was introduced to reduce motion artifacts from heart rate (HR) in coronary computed tomography angiography (cCTA). The aim of the study was to evaluate the image quality, overall evaluability, and effective radiation dose (ED) of cCTA with prospective electrocardiographic (ECG) triggering plus MCA as compared with standard protocol with retrospective ECG triggering in patients with HR≥65 bpm. Materials and Methods: One hundred consecutive patients (67±10 y) scheduled for cCTA with 65<HR<80 bpm were retrospectively analyzed. The patients were assigned to 2 groups undergoing prospective (group 1) or retrospective (group 2) triggered cCTA. The study protocol was approved by the Institutional Ethics Committee and a written informed consent was obtained from all patients. Image noise, signal to noise ratio, contrast to noise ratio, Likert image quality score (score 1, nondiagnostic; score 2, adequate; score 3, good; score 4, excellent), overall image evaluability, and ED were measured and compared between the 2 groups. Both vessel-based and patient-based analyses were evaluated. Student test or Wilcoxon test were used to evaluate differences of continuous variables, whereas the χ 2 test was used to study differences with regard to categorical data. A P-value <0.05 was considered statistically significant. Results: cCTA was successfully performed in all patients. In a segment-based model, group 1 compared with group 2 showed a lower rate of overall artifacts (67{\%} vs. 83{\%}; P<0.001) and motion artifacts (49{\%} vs. 66{\%}; P<0.001), resulting in a better Likert image quality score (2.83±1.03 vs. 2.37±1.02; P<0.01) and overall evaluability (85{\%} vs. 75{\%}; P<0.01). Group 1 showed a lower ED as compared with group 2 (3.1±1.9 vs. 11.9±3.3 mSv; P<0.01). Conclusion: MCA and cCTA with prospective ECG-triggering acquisition in patients with high HR improves image quality and overall evaluability compared with cCTA with standard retrospective ECG triggering.",
keywords = "effective radiation dose, heart rate, intracycle motion correction algorithm, prospective triggering, retrospective triggering",
author = "Gianluca Pontone and Giuseppe Muscogiuri and Andrea Baggiano and Daniele Andreini and Guaricci, {Andrea I.} and Marco Guglielmo and Fabio Fazzari and Saima Mushtaq and Edoardo Conte and Andrea Annoni and Alberto Formenti and Elisabetta Mancini and Massimo Verdecchia and Laura Fusini and Lorenzo Bonfanti and Elisa Consiglio and Rabbat, {Mark G.} and Bartorelli, {Antonio L.} and Mauro Pepi",
year = "2018",
month = "7",
day = "1",
doi = "10.1097/RTI.0000000000000320",
language = "English",
volume = "33",
pages = "225--231",
journal = "Journal of Thoracic Imaging",
issn = "0883-5993",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Image Quality, Overall Evaluability, and Effective Radiation Dose of Coronary Computed Tomography Angiography with Prospective Electrocardiographic Triggering Plus Intracycle Motion Correction Algorithm in Patients with a Heart Rate over 65 Beats per Minute

AU - Pontone, Gianluca

AU - Muscogiuri, Giuseppe

AU - Baggiano, Andrea

AU - Andreini, Daniele

AU - Guaricci, Andrea I.

AU - Guglielmo, Marco

AU - Fazzari, Fabio

AU - Mushtaq, Saima

AU - Conte, Edoardo

AU - Annoni, Andrea

AU - Formenti, Alberto

AU - Mancini, Elisabetta

AU - Verdecchia, Massimo

AU - Fusini, Laura

AU - Bonfanti, Lorenzo

AU - Consiglio, Elisa

AU - Rabbat, Mark G.

AU - Bartorelli, Antonio L.

AU - Pepi, Mauro

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Purpose: Recently, a new intracycle motion correction algorithm (MCA) was introduced to reduce motion artifacts from heart rate (HR) in coronary computed tomography angiography (cCTA). The aim of the study was to evaluate the image quality, overall evaluability, and effective radiation dose (ED) of cCTA with prospective electrocardiographic (ECG) triggering plus MCA as compared with standard protocol with retrospective ECG triggering in patients with HR≥65 bpm. Materials and Methods: One hundred consecutive patients (67±10 y) scheduled for cCTA with 65<HR<80 bpm were retrospectively analyzed. The patients were assigned to 2 groups undergoing prospective (group 1) or retrospective (group 2) triggered cCTA. The study protocol was approved by the Institutional Ethics Committee and a written informed consent was obtained from all patients. Image noise, signal to noise ratio, contrast to noise ratio, Likert image quality score (score 1, nondiagnostic; score 2, adequate; score 3, good; score 4, excellent), overall image evaluability, and ED were measured and compared between the 2 groups. Both vessel-based and patient-based analyses were evaluated. Student test or Wilcoxon test were used to evaluate differences of continuous variables, whereas the χ 2 test was used to study differences with regard to categorical data. A P-value <0.05 was considered statistically significant. Results: cCTA was successfully performed in all patients. In a segment-based model, group 1 compared with group 2 showed a lower rate of overall artifacts (67% vs. 83%; P<0.001) and motion artifacts (49% vs. 66%; P<0.001), resulting in a better Likert image quality score (2.83±1.03 vs. 2.37±1.02; P<0.01) and overall evaluability (85% vs. 75%; P<0.01). Group 1 showed a lower ED as compared with group 2 (3.1±1.9 vs. 11.9±3.3 mSv; P<0.01). Conclusion: MCA and cCTA with prospective ECG-triggering acquisition in patients with high HR improves image quality and overall evaluability compared with cCTA with standard retrospective ECG triggering.

AB - Purpose: Recently, a new intracycle motion correction algorithm (MCA) was introduced to reduce motion artifacts from heart rate (HR) in coronary computed tomography angiography (cCTA). The aim of the study was to evaluate the image quality, overall evaluability, and effective radiation dose (ED) of cCTA with prospective electrocardiographic (ECG) triggering plus MCA as compared with standard protocol with retrospective ECG triggering in patients with HR≥65 bpm. Materials and Methods: One hundred consecutive patients (67±10 y) scheduled for cCTA with 65<HR<80 bpm were retrospectively analyzed. The patients were assigned to 2 groups undergoing prospective (group 1) or retrospective (group 2) triggered cCTA. The study protocol was approved by the Institutional Ethics Committee and a written informed consent was obtained from all patients. Image noise, signal to noise ratio, contrast to noise ratio, Likert image quality score (score 1, nondiagnostic; score 2, adequate; score 3, good; score 4, excellent), overall image evaluability, and ED were measured and compared between the 2 groups. Both vessel-based and patient-based analyses were evaluated. Student test or Wilcoxon test were used to evaluate differences of continuous variables, whereas the χ 2 test was used to study differences with regard to categorical data. A P-value <0.05 was considered statistically significant. Results: cCTA was successfully performed in all patients. In a segment-based model, group 1 compared with group 2 showed a lower rate of overall artifacts (67% vs. 83%; P<0.001) and motion artifacts (49% vs. 66%; P<0.001), resulting in a better Likert image quality score (2.83±1.03 vs. 2.37±1.02; P<0.01) and overall evaluability (85% vs. 75%; P<0.01). Group 1 showed a lower ED as compared with group 2 (3.1±1.9 vs. 11.9±3.3 mSv; P<0.01). Conclusion: MCA and cCTA with prospective ECG-triggering acquisition in patients with high HR improves image quality and overall evaluability compared with cCTA with standard retrospective ECG triggering.

KW - effective radiation dose

KW - heart rate

KW - intracycle motion correction algorithm

KW - prospective triggering

KW - retrospective triggering

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U2 - 10.1097/RTI.0000000000000320

DO - 10.1097/RTI.0000000000000320

M3 - Article

C2 - 29346192

AN - SCOPUS:85041557089

VL - 33

SP - 225

EP - 231

JO - Journal of Thoracic Imaging

JF - Journal of Thoracic Imaging

SN - 0883-5993

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