Can Radiation Dose Burden of CT Angiography be Reduced While Still Accurately Diagnosing Etiology of Acute Chest Pain?

Sharara, Sherine Mohamed; Monnin, Scott R.; Rubio, M. J.; Khouzam, Rami N.; Ragheb, Samar Ramzy

doi:10.1016/j.cpcardiol.2020.100766

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…The traditional computed tomography (CT) angiography (CTA) is to inject a contrast agent into the blood vessel and uses the characteristic of X-ray to penetrate the contrast agent to diagnose vascular disease through the image displayed by the contrast agent under X-ray [ 11 , 12 ]. It requires a higher radiation dose than traditional X-ray examinations, which may have side effects on the human body [ 13 ], and it is impossible to dynamically observe blood flow, so the diagnosis of vascular disease is not the most accurate, and it is more suitable for early investigation [ 14 ]. With the continuous development of modern medical technology, the advent of digital subtraction angiography (DSA) has made a breakthrough in clinical vascular examination.…”

Section: Introductionmentioning

confidence: 99%

Digital Subtraction Angiography Image Features under the Deep Learning Algorithm in Cardiovascular Interventional Treatment and Nursing for Vascular Restenosis

Zhao

Zeng

et al. 2022

Computational and Mathematical Methods in Medicine

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The objective of this study was to explore the application value of digital subtraction angiography (DSA) images optimized by deep learning algorithms in vascular restenosis patients undergoing cardiovascular intervention and their nursing efficacy. In this study, a network model for removing artifacts was constructed based on a deep algorithm. 60 patients with coronary artery restenosis were selected as the research objects, and they were randomly divided into the CTA group guided by CT angiography (CTA) and digital subtraction angiography (DSA) group, with 30 cases in each group. The antiartifact network model constructed based on the depth algorithm was applied to the images of CTA and DSA for experiments. After cardiovascular intervention and clinical pathway nursing intervention, it was found that the diameter stenosis rate in the DSA group decreased from 65.82 ± 12.9 % to 4.7 ± 1.3 % , and the area stenosis rate decreased from 88.4 ± 14.3 % to 5.4 ± 1.7 % . During the follow-up period of 3-24 months, 3 out of 46 lesions in the DSA group showed restenosis, so the restenosis rate was 6.5%, which was significantly lower than the 18.4% in the CTA group ( P < 0.05 ). In the DSA group, there was 1 case of bleeding, 0 case of hematoma, 2 cases of urinary retention, and 0 case of hypotension, so the total incidence of adverse reactions was 10%, which was significantly lower than the 30% of the CTA group ( P < 0.05 ). The high-sensitivity C-reactive protein (hs-CRP) levels of the two groups of patients were 3.58 ± 2.02 mg / L and 4.36 ± 3.11 mg / L before surgery and 3.49 ± 2.18 mg / L and 4.57 ± 3.4 mg / L after the surgery. The postoperative hs-CRP level in the CTA group was slightly lower than that before the surgery and the postoperative hs-CRP level in the DSA group was slightly higher than that before the surgery, but they were not statistically significant ( P > 0.05 ). The hs-CRP level of the DSA group before and after the surgery was slightly higher than that of the CTA group, but there was no significant difference ( P > 0.05 ). In summary, the network model based on the deep learning algorithm can remove the artifacts in DSA images and present high-quality clear images, and convolutional neural network (CNN) algorithms had a strong ability to automatically learn features in the field of medical image processing and were worthy of being widely used and popularized. In addition, the DSA-guided intervention can reduce the rate of vascular stenosis in patients, showing low probability of postoperative restenosis and adverse reactions and a good clinical effect.

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Section: Introductionmentioning

confidence: 99%

Digital Subtraction Angiography Image Features under the Deep Learning Algorithm in Cardiovascular Interventional Treatment and Nursing for Vascular Restenosis

Zhao

Zeng

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Over the past years, CTA has been widely applied for analyzing the source, territory, and variations of lower limb arteries for preparation of ALTPF surgery (11). However, the large scale of the scanning area raises concerns regarding exposure to high levels of ionizing radiation, which re-mains an important issue in clinical imaging (12). Major efforts have been made to reduce the radiation dose while maintaining the image quality for diagnostic purposes.…”

Section: Discussionmentioning

confidence: 99%

Clinical Feasibility of a Low-dose Computed Tomography Angiography Protocol with an Iterative Reconstruction Algorithm in Preoperative Examinations for Anterolateral Thigh Perforator Flap Surgery

Tang¹,

Cao²,

Chen³

et al. 2023

Iran J Radiol

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Background: In the past several years, emerging imaging techniques, such as computed tomography angiography (CTA), Doppler ultrasound, and magnetic resonance imaging (MRI), have been used for investigating the anatomy and perfusion of perforator complexes. Preoperative CTA can provide explicit information on perforator flaps, which not only helps surgeons to evaluate the optimal design of flaps with respect to the lateral circumflex femoral artery (LCFA) territory and the concomitant venous drainage pattern, but also reduces postoperative complications and secondary operation rates. Objectives: This study aimed to evaluate the clinical feasibility of a low-dose CTA protocol with adaptive statistical iterative reconstruction (ASIR) for patients scheduled for anterolateral thigh perforator flap (ALTPF) surgery. Patients and Methods: This prospective randomized controlled trial was conducted in a single institution from August 2016 to July 2017. A total of 60 inpatients scheduled for the ALTPF surgery were randomly allocated into three groups (n = 20 per group): Group A, filtered back projection (FBP) reconstruction with a tube voltage of 120 kVp; group B, ASIR with a tube voltage of 100 kVp; and group C, ASIR with a tube voltage of 80 kVp. The vessel attenuation value, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) were compared between the three groups. Additionally, a four-point Likert scale was used to evaluate the subjective quality of images. The scan length, dose-length product (DLP), CT dose index (CTDI), and effective dose (ED) were also recorded and compared. Results: The age, sex, and body mass index (BMI) were not significantly different between the three groups (P > 0.05 for all). The FOM of images in the three segments was significantly higher in group C compared to the other two groups (P < 0.001 for all). The results of subjective evaluation revealed no poor-quality images, and the Likert score did not significantly differ between the groups. Compared to group A and group B, significant reductions were observed in CTDI, DLP, and ED in group C. Conclusion: The 80-kVp protocol with ASIR not only reduced the radiation dose, but also exhibited lower performance compared to the 120-kVp protocol with FBP and the 80-kVp protocol with ASIR; it also yielded relatively satisfactory image quality.

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Can Radiation Dose Burden of CT Angiography be Reduced While Still Accurately Diagnosing Etiology of Acute Chest Pain?

Cited by 2 publications

References 13 publications

Digital Subtraction Angiography Image Features under the Deep Learning Algorithm in Cardiovascular Interventional Treatment and Nursing for Vascular Restenosis

Digital Subtraction Angiography Image Features under the Deep Learning Algorithm in Cardiovascular Interventional Treatment and Nursing for Vascular Restenosis

Clinical Feasibility of a Low-dose Computed Tomography Angiography Protocol with an Iterative Reconstruction Algorithm in Preoperative Examinations for Anterolateral Thigh Perforator Flap Surgery

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