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Erschienen in: European Radiology 10/2011

01.10.2011 | Cardiac

Coronary CT angiography: image quality, diagnostic accuracy, and potential for radiation dose reduction using a novel iterative image reconstruction technique—comparison with traditional filtered back projection

verfasst von: Antonio Moscariello, Richard A. P. Takx, U. Joseph Schoepf, Matthias Renker, Peter L. Zwerner, Terrence X. O’Brien, Thomas Allmendinger, Sebastian Vogt, Bernhard Schmidt, Giancarlo Savino, Christian Fink, Lorenzo Bonomo, Thomas Henzler

Erschienen in: European Radiology | Ausgabe 10/2011

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Abstract

Objectives

To compare image noise, image quality and diagnostic accuracy of coronary CT angiography (cCTA) using a novel iterative reconstruction algorithm versus traditional filtered back projection (FBP) and to estimate the potential for radiation dose savings.

Methods

Sixty five consecutive patients (48 men; 59.3 ± 7.7 years) prospectively underwent cCTA and coronary catheter angiography (CCA). Full radiation dose data, using all projections, were reconstructed with FBP. To simulate image acquisition at half the radiation dose, 50% of the projections were discarded from the raw data. The resulting half-dose data were reconstructed with sinogram-affirmed iterative reconstruction (SAFIRE). Full-dose FBP and half-dose iterative reconstructions were compared with regard to image noise and image quality, and their respective accuracy for stenosis detection was compared against CCA.

Results

Compared with full-dose FBP, half-dose iterative reconstructions showed significantly (p = 0.001 – p = 0.025) lower image noise and slightly higher image quality. Iterative reconstruction improved the accuracy of stenosis detection compared with FBP (per-patient: accuracy 96.9% vs. 93.8%, sensitivity 100% vs. 100%, specificity 94.6% vs. 89.2%, NPV 100% vs. 100%, PPV 93.3% vs. 87.5%).

Conclusions

Iterative reconstruction significantly reduces image noise without loss of diagnostic information and holds the potential for substantial radiation dose reduction from cCTA.
Literatur
1.
Zurück zum Zitat Abdulla J, Abildstrom SZ, Gotzsche O, Christensen E, Kober L, Torp-Pedersen C (2007) 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis. Eur Heart J 28:3042–3050PubMedCrossRef Abdulla J, Abildstrom SZ, Gotzsche O, Christensen E, Kober L, Torp-Pedersen C (2007) 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis. Eur Heart J 28:3042–3050PubMedCrossRef
2.
Zurück zum Zitat Bastarrika G, Lee YS, Huda W, Ruzsics B, Costello P, Schoepf UJ (2009) CT of coronary artery disease. Radiology 253:317–338PubMedCrossRef Bastarrika G, Lee YS, Huda W, Ruzsics B, Costello P, Schoepf UJ (2009) CT of coronary artery disease. Radiology 253:317–338PubMedCrossRef
3.
Zurück zum Zitat Budoff MJ, Dowe D, Jollis JG, Gitter M, Sutherland J, Halamert E, Scherer M, Bellinger R, Martin A, Benton R, Delago A, Min JK (2008) Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol 52:1724–1732PubMedCrossRef Budoff MJ, Dowe D, Jollis JG, Gitter M, Sutherland J, Halamert E, Scherer M, Bellinger R, Martin A, Benton R, Delago A, Min JK (2008) Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol 52:1724–1732PubMedCrossRef
4.
Zurück zum Zitat Johnson TR, Nikolaou K, Busch S, Leber AW, Becker A, Wintersperger BJ, Rist C, Knez A, Reiser MF, Becker CR (2007) Diagnostic accuracy of dual-source computed tomography in the diagnosis of coronary artery disease. Investig Radiol 42:684–691CrossRef Johnson TR, Nikolaou K, Busch S, Leber AW, Becker A, Wintersperger BJ, Rist C, Knez A, Reiser MF, Becker CR (2007) Diagnostic accuracy of dual-source computed tomography in the diagnosis of coronary artery disease. Investig Radiol 42:684–691CrossRef
5.
Zurück zum Zitat Einstein AJ, Henzlova MJ, Rajagopalan S (2007) Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 298:317–323PubMedCrossRef Einstein AJ, Henzlova MJ, Rajagopalan S (2007) Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 298:317–323PubMedCrossRef
6.
Zurück zum Zitat Hausleiter J, Meyer T, Hermann F, Hadamitzky M, Krebs M, Gerber TC, McCollough C, Martinoff S, Kastrati A, Schomig A, Achenbach S (2009) Estimated radiation dose associated with cardiac CT angiography. JAMA 301:500–507PubMedCrossRef Hausleiter J, Meyer T, Hermann F, Hadamitzky M, Krebs M, Gerber TC, McCollough C, Martinoff S, Kastrati A, Schomig A, Achenbach S (2009) Estimated radiation dose associated with cardiac CT angiography. JAMA 301:500–507PubMedCrossRef
7.
Zurück zum Zitat Ziegler A, Kohler T, Proksa R (2007) Noise and resolution in images reconstructed with FBP and OSC algorithms for CT. Med Phys 34:585–598PubMedCrossRef Ziegler A, Kohler T, Proksa R (2007) Noise and resolution in images reconstructed with FBP and OSC algorithms for CT. Med Phys 34:585–598PubMedCrossRef
8.
Zurück zum Zitat Brooks RA, Di Chiro G (1975) Theory of image reconstruction in computed tomography. Radiology 117:561–572PubMed Brooks RA, Di Chiro G (1975) Theory of image reconstruction in computed tomography. Radiology 117:561–572PubMed
9.
Zurück zum Zitat Flicek KT, Hara AK, Silva AC, Wu Q, Peter MB, Johnson CD (2010) Reducing the radiation dose for CT colonography using adaptive statistical iterative reconstruction: a pilot study. AJR Am J Roentgenol 195:126–131PubMedCrossRef Flicek KT, Hara AK, Silva AC, Wu Q, Peter MB, Johnson CD (2010) Reducing the radiation dose for CT colonography using adaptive statistical iterative reconstruction: a pilot study. AJR Am J Roentgenol 195:126–131PubMedCrossRef
10.
Zurück zum Zitat Gosling O, Loader R, Venables P, Roobottom C, Rowles N, Bellenger N, Morgan-Hughes G (2010) A comparison of radiation doses between state-of-the-art multislice CT coronary angiography with iterative reconstruction, multislice CT coronary angiography with standard filtered back-projection and invasive diagnostic coronary angiography. Heart 96:922–926PubMedCrossRef Gosling O, Loader R, Venables P, Roobottom C, Rowles N, Bellenger N, Morgan-Hughes G (2010) A comparison of radiation doses between state-of-the-art multislice CT coronary angiography with iterative reconstruction, multislice CT coronary angiography with standard filtered back-projection and invasive diagnostic coronary angiography. Heart 96:922–926PubMedCrossRef
11.
Zurück zum Zitat Hara AK, Paden RG, Silva AC, Kujak JL, Lawder HJ, Pavlicek W (2009) Iterative reconstruction technique for reducing body radiation dose at CT: feasibility study. AJR Am J Roentgenol 193:764–771PubMedCrossRef Hara AK, Paden RG, Silva AC, Kujak JL, Lawder HJ, Pavlicek W (2009) Iterative reconstruction technique for reducing body radiation dose at CT: feasibility study. AJR Am J Roentgenol 193:764–771PubMedCrossRef
12.
Zurück zum Zitat Leipsic J, Labounty TM, Heilbron B, Min JK, Mancini GB, Lin FY, Taylor C, Dunning A, Earls JP (2010) Estimated radiation dose reduction using adaptive statistical iterative reconstruction in coronary CT angiography: the ERASIR study. AJR Am J Roentgenol 195:655–660PubMedCrossRef Leipsic J, Labounty TM, Heilbron B, Min JK, Mancini GB, Lin FY, Taylor C, Dunning A, Earls JP (2010) Estimated radiation dose reduction using adaptive statistical iterative reconstruction in coronary CT angiography: the ERASIR study. AJR Am J Roentgenol 195:655–660PubMedCrossRef
13.
Zurück zum Zitat Pontana F, Duhamel A, Pagniez J, Flohr T, Faivre JB, Hachulla AL, Remy J, Remy-Jardin M (2010) Chest computed tomography using iterative reconstruction vs filtered back projection (Part 2): image quality of low-dose CT examinations in 80 patients. Eur Radiol 21:636–643PubMedCrossRef Pontana F, Duhamel A, Pagniez J, Flohr T, Faivre JB, Hachulla AL, Remy J, Remy-Jardin M (2010) Chest computed tomography using iterative reconstruction vs filtered back projection (Part 2): image quality of low-dose CT examinations in 80 patients. Eur Radiol 21:636–643PubMedCrossRef
14.
Zurück zum Zitat Pontana F, Pagniez J, Flohr T, Faivre JB, Duhamel A, Remy J, Remy-Jardin M (2010) Chest computed tomography using iterative reconstruction vs filtered back projection (Part 1): evaluation of image noise reduction in 32 patients. Eur Radiol 21:627–635PubMedCrossRef Pontana F, Pagniez J, Flohr T, Faivre JB, Duhamel A, Remy J, Remy-Jardin M (2010) Chest computed tomography using iterative reconstruction vs filtered back projection (Part 1): evaluation of image noise reduction in 32 patients. Eur Radiol 21:627–635PubMedCrossRef
15.
Zurück zum Zitat Prakash P, Kalra MK, Ackman JB, Digumarthy SR, Hsieh J, Do S, Shepard JA, Gilman MD (2010) Diffuse lung disease: CT of the chest with adaptive statistical iterative reconstruction technique. Radiology 256:261–269PubMedCrossRef Prakash P, Kalra MK, Ackman JB, Digumarthy SR, Hsieh J, Do S, Shepard JA, Gilman MD (2010) Diffuse lung disease: CT of the chest with adaptive statistical iterative reconstruction technique. Radiology 256:261–269PubMedCrossRef
16.
Zurück zum Zitat Prakash P, Kalra MK, Kambadakone AK, Pien H, Hsieh J, Blake MA, Sahani DV (2010) Reducing abdominal CT radiation dose with adaptive statistical iterative reconstruction technique. Investig Radiol 45:202–210CrossRef Prakash P, Kalra MK, Kambadakone AK, Pien H, Hsieh J, Blake MA, Sahani DV (2010) Reducing abdominal CT radiation dose with adaptive statistical iterative reconstruction technique. Investig Radiol 45:202–210CrossRef
17.
Zurück zum Zitat Flohr TG, McCollough CH, Bruder H, Petersilka M, Gruber K, Suss C, Grasruck M, Stierstorfer K, Krauss B, Raupach R, Primak AN, Kuttner A, Achenbach S, Becker C, Kopp A, Ohnesorge BM (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16:256–268PubMedCrossRef Flohr TG, McCollough CH, Bruder H, Petersilka M, Gruber K, Suss C, Grasruck M, Stierstorfer K, Krauss B, Raupach R, Primak AN, Kuttner A, Achenbach S, Becker C, Kopp A, Ohnesorge BM (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16:256–268PubMedCrossRef
18.
Zurück zum Zitat McCollough CH, Primak AN, Saba O, Bruder H, Stierstorfer K, Raupach R, Suess C, Schmidt B, Ohnesorge BM, Flohr TG (2007) Dose performance of a 64-channel dual-source CT scanner. Radiology 243:775–784PubMedCrossRef McCollough CH, Primak AN, Saba O, Bruder H, Stierstorfer K, Raupach R, Suess C, Schmidt B, Ohnesorge BM, Flohr TG (2007) Dose performance of a 64-channel dual-source CT scanner. Radiology 243:775–784PubMedCrossRef
19.
Zurück zum Zitat McCollough CH, Schmidt B, Yu L, Primak A, Ulzheimer S, Bruder H, Flohr TG (2008) Measurement of temporal resolution in dual source CT. Med Phys 35:764–768PubMedCrossRef McCollough CH, Schmidt B, Yu L, Primak A, Ulzheimer S, Bruder H, Flohr TG (2008) Measurement of temporal resolution in dual source CT. Med Phys 35:764–768PubMedCrossRef
20.
Zurück zum Zitat Leschka S, Stinn B, Schmid F, Schultes B, Thurnheer M, Baumueller S, Stolzmann P, Scheffel H, Flohr TG, Wildermuth S, Alkadhi H (2009) Dual source CT coronary angiography in severely obese patients: trading off temporal resolution and image noise. Investig Radiol 44:720–727CrossRef Leschka S, Stinn B, Schmid F, Schultes B, Thurnheer M, Baumueller S, Stolzmann P, Scheffel H, Flohr TG, Wildermuth S, Alkadhi H (2009) Dual source CT coronary angiography in severely obese patients: trading off temporal resolution and image noise. Investig Radiol 44:720–727CrossRef
21.
Zurück zum Zitat Barrett HH, Swindell W (eds) (1996) Radiological imaging—the theory of image formation, detection and processing, 1st edn. Academic Press, Harcourt Brace & Company, Orlando. Barrett HH, Swindell W (eds) (1996) Radiological imaging—the theory of image formation, detection and processing, 1st edn. Academic Press, Harcourt Brace & Company, Orlando.
22.
Zurück zum Zitat Kijewski MF, Judy PF (1987) The noise power spectrum of CT images. Phys Med Biol 32:565–575PubMedCrossRef Kijewski MF, Judy PF (1987) The noise power spectrum of CT images. Phys Med Biol 32:565–575PubMedCrossRef
23.
Zurück zum Zitat Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS, McGoon DC, Murphy ML, Roe BB (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51:5–40PubMed Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS, McGoon DC, Murphy ML, Roe BB (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51:5–40PubMed
25.
Zurück zum Zitat Hamon M, Biondi-Zoccai GG, Malagutti P, Agostoni P, Morello R, Valgimigli M (2006) Diagnostic performance of multislice spiral computed tomography of coronary arteries as compared with conventional invasive coronary angiography: a meta-analysis. J Am Coll Cardiol 48:1896–1910PubMedCrossRef Hamon M, Biondi-Zoccai GG, Malagutti P, Agostoni P, Morello R, Valgimigli M (2006) Diagnostic performance of multislice spiral computed tomography of coronary arteries as compared with conventional invasive coronary angiography: a meta-analysis. J Am Coll Cardiol 48:1896–1910PubMedCrossRef
26.
Zurück zum Zitat Rist C, Johnson TR, Muller-Starck J, Arnoldi E, Saam T, Becker A, Leber AW, Wintersperger BJ, Becker CR, Reiser MF, Nikolaou K (2009) Noninvasive coronary angiography using dual-source computed tomography in patients with atrial fibrillation. Investig Radiol 44:159–167CrossRef Rist C, Johnson TR, Muller-Starck J, Arnoldi E, Saam T, Becker A, Leber AW, Wintersperger BJ, Becker CR, Reiser MF, Nikolaou K (2009) Noninvasive coronary angiography using dual-source computed tomography in patients with atrial fibrillation. Investig Radiol 44:159–167CrossRef
27.
Zurück zum Zitat Henzler T, Hanley M, Arnoldi E, Bastarrika G, Schoepf UJ, Becker HC (2010) Practical strategies for low radiation dose cardiac computed tomography. J Thorac Imaging 25:213–220PubMedCrossRef Henzler T, Hanley M, Arnoldi E, Bastarrika G, Schoepf UJ, Becker HC (2010) Practical strategies for low radiation dose cardiac computed tomography. J Thorac Imaging 25:213–220PubMedCrossRef
28.
Zurück zum Zitat Hausleiter J, Meyer T, Hadamitzky M, Huber E, Zankl M, Martinoff S, Kastrati A, Schomig A (2006) Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation 113:1305–1310PubMedCrossRef Hausleiter J, Meyer T, Hadamitzky M, Huber E, Zankl M, Martinoff S, Kastrati A, Schomig A (2006) Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation 113:1305–1310PubMedCrossRef
29.
Zurück zum Zitat Leschka S, Stolzmann P, Schmid FT, Scheffel H, Stinn B, Marincek B, Alkadhi H, Wildermuth S (2008) Low kilovoltage cardiac dual-source CT: attenuation, noise, and radiation dose. Eur Radiol 18:1809–1817PubMedCrossRef Leschka S, Stolzmann P, Schmid FT, Scheffel H, Stinn B, Marincek B, Alkadhi H, Wildermuth S (2008) Low kilovoltage cardiac dual-source CT: attenuation, noise, and radiation dose. Eur Radiol 18:1809–1817PubMedCrossRef
30.
Zurück zum Zitat D’Agostino AG, Remy-Jardin M, Khalil C, Delannoy-Deken V, Flohr T, Duhamel A, Remy J (2006) Low-dose ECG-gated 64-slices helical CT angiography of the chest: evaluation of image quality in 105 patients. Eur Radiol 16:2137–2146PubMedCrossRef D’Agostino AG, Remy-Jardin M, Khalil C, Delannoy-Deken V, Flohr T, Duhamel A, Remy J (2006) Low-dose ECG-gated 64-slices helical CT angiography of the chest: evaluation of image quality in 105 patients. Eur Radiol 16:2137–2146PubMedCrossRef
31.
Zurück zum Zitat Earls JP, Berman EL, Urban BA, Curry CA, Lane JL, Jennings RS, McCulloch CC, Hsieh J, Londt JH (2008) Prospectively gated transverse coronary CT angiography versus retrospectively gated helical technique: improved image quality and reduced radiation dose. Radiology 246:742–753PubMedCrossRef Earls JP, Berman EL, Urban BA, Curry CA, Lane JL, Jennings RS, McCulloch CC, Hsieh J, Londt JH (2008) Prospectively gated transverse coronary CT angiography versus retrospectively gated helical technique: improved image quality and reduced radiation dose. Radiology 246:742–753PubMedCrossRef
32.
Zurück zum Zitat Achenbach S, Marwan M, Ropers D, Schepis T, Pflederer T, Anders K, Kuettner A, Daniel WG, Uder M, Lell MM (2010) Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J 31:340–346PubMedCrossRef Achenbach S, Marwan M, Ropers D, Schepis T, Pflederer T, Anders K, Kuettner A, Daniel WG, Uder M, Lell MM (2010) Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J 31:340–346PubMedCrossRef
33.
Zurück zum Zitat Kalender W (2000) Computed tomography: fundamentals, system technology, image quality, applications, 1st edn. Wiley-VCH, Weinheim Kalender W (2000) Computed tomography: fundamentals, system technology, image quality, applications, 1st edn. Wiley-VCH, Weinheim
34.
Zurück zum Zitat Raff GL, Gallagher MJ, O’Neill WW, Goldstein JA (2005) Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 46:552–557PubMedCrossRef Raff GL, Gallagher MJ, O’Neill WW, Goldstein JA (2005) Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 46:552–557PubMedCrossRef
35.
Zurück zum Zitat Kubo T, Lin PJ, Stiller W, Takahashi M, Kauczor HU, Ohno Y, Hatabu H (2008) Radiation dose reduction in chest CT: a review. AJR Am J Roentgenol 190:335–343PubMedCrossRef Kubo T, Lin PJ, Stiller W, Takahashi M, Kauczor HU, Ohno Y, Hatabu H (2008) Radiation dose reduction in chest CT: a review. AJR Am J Roentgenol 190:335–343PubMedCrossRef
36.
Metadaten
Titel
Coronary CT angiography: image quality, diagnostic accuracy, and potential for radiation dose reduction using a novel iterative image reconstruction technique—comparison with traditional filtered back projection
verfasst von
Antonio Moscariello
Richard A. P. Takx
U. Joseph Schoepf
Matthias Renker
Peter L. Zwerner
Terrence X. O’Brien
Thomas Allmendinger
Sebastian Vogt
Bernhard Schmidt
Giancarlo Savino
Christian Fink
Lorenzo Bonomo
Thomas Henzler
Publikationsdatum
01.10.2011
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 10/2011
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2164-9

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