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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Optimal cardiac phase for coronary artery calcium scoring on single-source 64-MDCT scanner: least interscan
Noriaki Matsuura1, Jun Horiguchi, Hideya Yamamoto
1Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Insights
For coronary artery calcium studies using 64-MDCT, mid-diastole reconstruction (70-75% cardiac phase) minimizes interscan variability and motion artifacts. This phase offers the most reliable coronary artery calcium scoring.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Physics
Background:
- Coronary artery calcium (CAC) scoring is crucial for cardiovascular risk assessment.
- Minimizing variability and artifacts in CAC studies improves diagnostic accuracy.
- Optimal cardiac phase selection is key for reliable 64-MDCT CAC imaging.
Purpose of the Study:
- To identify the optimal cardiac phase for 64-MDCT coronary artery calcium studies.
- To evaluate interscan variability and motion artifacts across different cardiac phases.
- To determine the best phase for minimizing errors in CAC scoring.
Main Methods:
- Ninety-one patients underwent dual 64-MDCT scans for CAC assessment.
- Images were reconstructed at nine cardiac phases (40-80%).
- Interscan variability and motion artifact scores were analyzed across phases and heart rates.
Main Results:
- Interscan variability differed significantly between cardiac cycles (p < 0.01).
- Least variability occurred at 70% (Agatston, volume) and 75% (mass).
- Lowest motion artifacts were observed at 75% across coronary arteries.
Conclusions:
- Middiastole reconstruction (70-75% cardiac phase) is recommended for 64-MDCT CAC studies.
- This phase provides the least interscan variability and motion artifacts.
- Optimal phase selection enhances the reliability of CAC scoring.
Objective:
The purpose of our study was to investigate the cardiac phase with the least interscan variability and motion artifacts on coronary artery calcium studies using a 64-MDCT scanner.
Subjects And Methods:
Ninety-one patients with suspected coronary artery disease were scanned twice on retrospective ECG-gated helical scans. Images with 2.5-mm thickness and 1.25-mm interval at nine cardiac phases (center of cardiac phase: 40-80% in 5% increments) were reconstructed. The interscan variability of coronary artery scores (Agatston, volume, and mass) per patient and motion artifact scores per branch, subjectively assigned by motion artifact grading (1, none; 2, minor; and 3, major), were compared between cardiac phases for all patients, low (< 65 beats per minute [bpm]) and high (>or= 65 bpm) heart rate patient groups.
Results:
For all patients, two-factor factorial analysis of variance revealed that the interscan variability was different between cardiac cycles (p < 0.01); however, this was not statistically significant between scoring algorithms (p = 0.46). The least variability was obtained at 70% on Agatston (8%) and volume (7%) and at 75% on mass (7%). Adjacent categories logit model analysis revealed that the motion artifact score was the least at 75% (left anterior descending coronary artery, 1.3; left circumflex coronary artery, 1.4; and right coronary artery, 1.9 in all patients) and that a smaller difference in calcium scores between the scans led to a smaller motion artifact score (p < 0.05).
Conclusion:
Middiastole reconstruction (center of cardiac phase: 70-75%), with the least interscan variability and the least motion artifacts, is recommended on 64-MDCT.
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