TY - JOUR
T1 - Evaluation of heavily calcified vessels with coronary CT angiography
T2 - Comparison of iterative and filtered back projection image reconstruction
AU - Renker, Matthias
AU - Nance, John
AU - Schoepf, U. Joseph
AU - O'Brien, Terrence X.
AU - Zwerner, Peter L.
AU - Meyer, Mathias
AU - Kerl, J. Matthias
AU - Bauer, Ralf W.
AU - Fink, Christian
AU - Vogl, Thomas J.
AU - Henzler, Thomas
PY - 2011/8
Y1 - 2011/8
N2 - Purpose: To prospectively compare traditional filtered back projection (FBP) and iterative image reconstruction for the evaluation of heavily calcified arteries with coronary computed tomography (CT) angiography. Materials and Methods: The study had institutional review board approval and was HIPAA compliant. Written informed consent was obtained from all patients. Fifty-five consecutive patients (35 men, 20 women; mean age, 58 years ± 12 [standard deviation]) with Agatston scores of at least 400 underwent coronary CT angiography and cardiac catheterization. Image data were reconstructed with both FBP and iterative reconstruction techniques with corresponding cardiac algorithms. Image noise and subjective image quality were compared. To objectively assess the effect of FBP and iterative reconstruction on blooming artifacts, volumes of circumscribed calcifications were measured with dedicated volume analysis software. FBP and iterative reconstruction series were independently evaluated for coronary artery stenosis greater than 50%, and their diagnostic accuracy was compared, with cardiac catheterization as the reference standard. Statistical analyses included paired t tests, Kruskal-Wallis analysis of variance, and a modified McNemar test. Results: Image noise measured significantly lower (P =.011-.035) with iterative reconstruction instead of FBP. Image quality was rated significantly higher (P =.031 and .042) with iterative reconstruction series than with FBP. Calcification volumes measured significantly lower (P =.019 and .026) with iterative reconstruction (44.3 mm3 ± 64.7 and 46.2 mm3 ± 68.8) than with FBP (54.5 mm3 ± 69.5 and 56.3 mm3 ± 72.5). Iterative reconstruction significantly improved some measures of per-segment diagnostic accuracy of coronary CT angiography for the detection of significant stenosis compared with FBP (accuracy: 95.9% vs 91.8%, P =.0001; specificity: 95.8% vs 91.2%, P =.0001; positive predictive value: 76.9% vs 61.1%, P =.0001). Conclusion: Iterative reconstruction reduces image noise and blooming artifacts from calcifications, leading to improved diagnostic accuracy of coronary CT angiography in patients with heavily calcified coronary arteries.
AB - Purpose: To prospectively compare traditional filtered back projection (FBP) and iterative image reconstruction for the evaluation of heavily calcified arteries with coronary computed tomography (CT) angiography. Materials and Methods: The study had institutional review board approval and was HIPAA compliant. Written informed consent was obtained from all patients. Fifty-five consecutive patients (35 men, 20 women; mean age, 58 years ± 12 [standard deviation]) with Agatston scores of at least 400 underwent coronary CT angiography and cardiac catheterization. Image data were reconstructed with both FBP and iterative reconstruction techniques with corresponding cardiac algorithms. Image noise and subjective image quality were compared. To objectively assess the effect of FBP and iterative reconstruction on blooming artifacts, volumes of circumscribed calcifications were measured with dedicated volume analysis software. FBP and iterative reconstruction series were independently evaluated for coronary artery stenosis greater than 50%, and their diagnostic accuracy was compared, with cardiac catheterization as the reference standard. Statistical analyses included paired t tests, Kruskal-Wallis analysis of variance, and a modified McNemar test. Results: Image noise measured significantly lower (P =.011-.035) with iterative reconstruction instead of FBP. Image quality was rated significantly higher (P =.031 and .042) with iterative reconstruction series than with FBP. Calcification volumes measured significantly lower (P =.019 and .026) with iterative reconstruction (44.3 mm3 ± 64.7 and 46.2 mm3 ± 68.8) than with FBP (54.5 mm3 ± 69.5 and 56.3 mm3 ± 72.5). Iterative reconstruction significantly improved some measures of per-segment diagnostic accuracy of coronary CT angiography for the detection of significant stenosis compared with FBP (accuracy: 95.9% vs 91.8%, P =.0001; specificity: 95.8% vs 91.2%, P =.0001; positive predictive value: 76.9% vs 61.1%, P =.0001). Conclusion: Iterative reconstruction reduces image noise and blooming artifacts from calcifications, leading to improved diagnostic accuracy of coronary CT angiography in patients with heavily calcified coronary arteries.
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U2 - 10.1148/radiol.11103574
DO - 10.1148/radiol.11103574
M3 - Article
C2 - 21693660
AN - SCOPUS:79960799961
SN - 0033-8419
VL - 260
SP - 390
EP - 399
JO - Radiology
JF - Radiology
IS - 2
ER -