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Published on: May 24, 2021
Cardiac Structural and Functional Evaluation Using a Heart Motion Correction Algorithm for Coronary Computed
Xiaorong Chen1, Yanping Dong1, Aiyun Sun2
1Department of Medical Imaging, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, 321000 Jinhua, Zhejiang, China.
Insights
The second-generation snapshot freeze (SSF2) protocol enhances cardiac computed tomography angiography (CCTA) image quality and cardiac function assessment in patients with high heart rates. This advanced heart motion correction improves strain evaluation compared to standard methods.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
- Radiology
Background:
- Current multi-slice computed tomography (CT) heart motion correction is adequate for coronary artery imaging in high heart rate patients.
- The impact of these algorithms on whole-cardiac-cycle reconstruction image quality remains insufficiently understood.
- This study evaluates a novel heart motion correction algorithm for coronary CT angiography (CCTA) in rapid heart rate scenarios.
Purpose of the Study:
- To investigate the image quality of whole-cardiac-cycle reconstructions using a new heart motion correction algorithm.
- To assess the segmentation performance and accuracy of cardiac structure and function evaluation.
- To compare the novel algorithm against standard reconstruction protocols in patients with high heart rates.
Main Methods:
- Retrospective analysis of 58 patients with heart rates ≥80 beats/min.
- CT images reconstructed using standard (STD) and second-generation snapshot freeze (SSF2) protocols across the cardiac cycle (0-100% in 5% increments).
- Comparison of image quality metrics, automatic segmentation accuracy (vs. manual contouring), and cardiac function parameters, including strain, with cardiac magnetic resonance (CMR) where available.
Main Results:
- The SSF2 protocol demonstrated significantly higher image quality scores, steeper edge rise slopes, and lower entropy compared to STD (p < 0.01).
- Excellent agreement was found between SSF2 automatic segmentation and manual contouring for left ventricular end-diastolic volume (ICC=0.96, CV=7.84%).
- While SSF2 showed good correlation with CMR for global circumferential and longitudinal strain (ICC=0.90 and 0.85), statistically significant differences were noted.
Conclusions:
- The SSF2 protocol significantly enhances image quality, cardiac structure, and function assessment in whole-cardiac-cycle CCTA reconstructions for high heart rate patients.
- SSF2 provides superior performance over the STD protocol for evaluating myocardial strain.
- This advanced algorithm facilitates more accurate cardiac assessment in challenging patient populations.
Background:
The heart motion correction algorithm used in current multi-slice computed tomography (CT) is sufficient for coronary artery imaging in patients with high heart rates. However, the effect of this algorithm on the image quality in whole-cardiac-cycle reconstructions remains unclear. Therefore, this study aimed to investigate image quality, segmentation performance, and cardiac structure and function assessment using a heart motion correction algorithm for coronary CT angiography in patients with rapid heart rates.
Methods:
This study retrospectively collected data from 58 consecutive patients with high heart rates (≥80 beats/min), of whom 36 also underwent cardiac magnetic resonance (CMR) imaging. CT images were reconstructed from 0% to 100% in 5% increments using the standard reconstruction (STD) and second-generation snapshot freeze (SSF2) protocols, and then processed by an automatic heart segmentation algorithm. Image quality, segmentation performance, cardiac volumes, and functional parameters were compared between protocols.
Results:
Compared with the STD protocol, the SSF2 protocol yielded a higher image quality score (3.91 ± 0.29 vs. 3.84 ± 0.37; p < 0.01), a steeper edge rise slope (41.71 ± 19.03 vs. 25.59 ± 13.16; p < 0.01), and lower entropy (4.12 ± 0.48 vs. 4.40 ± 0.28; p < 0.01). For left ventricular end-diastolic volume, the intraclass correlation coefficient (ICC) between automatic segmentation and manual contouring for the SSF2 protocol was 0.96, and the coefficient of variation was 7.84%. In contrast, the coefficients of variation for left ventricular end-systolic volume were poor (48.24% for STD and 48.18% for SSF2). Differences in global circumferential strain (-13.30 ± 3.42 vs. -15.01 ± 4.44; p < 0.01) and global longitudinal strain (-11.80 ± 4.83 vs. -13.01 ± 4.36; p < 0.01) between SSF2 and CMR were statistically significant, although correlations (ICC = 0.90 and 0.85, respectively) were good.
Conclusions:
SSF2 significantly improves image quality, structure, and function, and enables strain assessment in whole-cardiac-cycle reconstructions in patients with high heart rates. SSF2 also demonstrates superior performance over the STD protocol for evaluating myocardial strain.
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