Diagnostic accuracy of a modified subtraction coronary CT angiography method with short breath-holding time: a feasibility study

Yoshioka, Kunihiro; Tanaka, Ryoichi; Takagi, Hidenobu; Nagata, Kyouhei; Chiba, Takuya; Takeda, Kota; Ueda, Takanori; Sugawara, Tsuyoshi; Sasaki, Akinobu; Ueyama, Yuta; Kikuchi, Kei; Sasaki, Tadashi

doi:10.1259/bjr.20160489

Cited by 10 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Afterward, these two groups of images with their corresponding non-contrast images were sent to a dedicated post-processing software to obtain subtraction CCTA ( SURE Subtraction Canon Medical Systems, Otawara, Japan). The subtraction algorithm was based on the combination of global non-rigid registration and local rigid refinement, and the registered non-contrast data set was subtracted from the contrast data set to finally remove calcification ( 12 ).…”

Section: Methodsmentioning

confidence: 99%

“…Deep learning-based image reconstruction (DLR) has been demonstrated as potentially further valuable for improving image quality and reducing dose for CCTA images (8,9). In addition, subtraction CCTA approaches have been investigated previously and put forward in decreasing the impacts of the calcification artifacts, improving the image quality (10) and diagnostic accuracy (6,(11)(12)(13)(14)(15). Both Guo et al (10) and Xu et al (15) reported that, in comparison with conventional CCTA, subtraction CCTA based on standard kernel iterative reconstruction would allow stenosis regarding and improve the diagnostic accuracy in coronary segments with severe calcification.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Improvements of Deep Learning–Based Image Reconstruction for Assessing Calcification-Related Obstructive Coronary Artery Disease

Xu³

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Objectives: The objective of this study was to explore the diagnostic value of deep learning-based image reconstruction (DLR) and hybrid iterative reconstruction (HIR) for calcification-related obstructive coronary artery disease (CAD) evaluation by using coronary CT angiography (CCTA) images and subtraction CCTA images.Methods: Forty-two consecutive patients with known or suspected coronary artery disease who underwent coronary CTA on a 320-row CT scanner and subsequent invasive coronary angiography (ICA), which was used as the reference standard, were enrolled. The DLR and HIR images were reconstructed as CTADLR and CTAHIR, and, based on which, the corresponding subtraction CCTA images were established as CTAsDLR and CTAsHIR, respectively. Qualitative images quality comparison was performed by using a Likert 4 stage score, and quantitative images quality parameters, including image noise, signal-to-noise ratio, and contrast-to-noise ratio were calculated. Diagnostic performance on the lesion level was assessed and compared among the four CCTA approaches (CTADLR, CTAHIR, CTAsDLR, and CTAsHIR).Results: There were 166 lesions of 86 vessels in 42 patients (32 men and 10 women; 62.9 ± 9.3 years) finally enrolled for analysis. The qualitative and quantitative image qualities of CTAsDLR and CTADLR were superior to those of CTAsHIR and CTAHIR, respectively. The diagnostic accuracies of CTAsDLR, CTADLR, CTAsHIR, and CTAHIR to identify calcification-related obstructive diameter stenosis were 83.73%, 69.28%, 75.30%, and 65.66%, respectively. The false-positive rates of CTAsDLR, CTADLR, CTAsHIR, and CTAHIR for luminal diameter stenosis ≥50% were 15%, 31%, 24%, and 34%, respectively. The sensitivity and the specificity to identify ≥50% luminal diameter stenosis was 90.91% and 83.23% for CTAsDLR.Conclusion: Our study showed that deep learning–based image reconstruction could improve the image quality of CCTA images and diagnostic performance for calcification-related obstructive CAD, especially when combined with subtraction technique.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic Improvements of Deep Learning–Based Image Reconstruction for Assessing Calcification-Related Obstructive Coronary Artery Disease

Xu³

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…In subtraction CCTA, one- and two-breathhold acquisition protocols have been used to obtain the mask image data. A one-breathhold approach requires a long breath-holding time, and even a modified one-breathhold scan protocol tested by Yoshioka et al (13) required approximately 15 seconds of breath-holding time to provide diagnostic images. Many elderly patients with a high coronary artery calcium score and obstructive lung disease may not be able to hold their breath for such a long time.…”

Section: Discussionmentioning

confidence: 99%

“…In subtraction CCTA, plaque calcifications in the coronary arteries were eliminated by subtracting precontrast CT image data from postcontrast CCTA image data. Promising results have been reported by applying subtraction CCTA in patients with severe coronary calcifications or stents (89101112131415).…”

Section: Introductionmentioning

confidence: 99%

“…In subtraction CCTA, one-breathhold and two-breathhold scanning techniques have been used. In previous studies, researchers mainly focused on a long-lasting one-breathhold scan protocol in subtraction CCTA (910111213). The one-breathhold approach requires a relatively longer breathhold for the acquisition of precontrast and postcontrast image data.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Modified Subtraction Coronary CT Angiography with a Two-Breathhold Technique: Image Quality and Diagnostic Accuracy in Patients with Coronary Calcifications

et al. 2019

View full text Add to dashboard Cite

Objective To evaluate a modified subtraction coronary computed tomography angiography (CCTA) technique with a two-breathhold approach in terms of image quality and stenosis grading of calcified coronary segments and in the detection of significant coronary stenosis in segments with severe calcification. Materials and Methods The institutional board approved this study, and all subjects provided written consent. A total of 128 patients were recruited into this trial, of which 32 underwent subtraction CCTA scans and invasive coronary angiography (ICA). The average Agatston score was 356 ± 145. In severely calcified coronary segments, the presence of significant (> 50%) stenosis was assessed on both conventional CCTA and subtraction CCTA images, and the results were finally compared with ICA findings as the gold standard. Results For severely calcified segments, the image quality in conventional CCTA significantly improved from 2.51 ± 0.98 to 3.12 ± 0.94 in subtraction CCTA ( p < 0.001). In target segments, specificity (70% vs. 87%; p = 0.005) and positive predictive value (61% vs. 79%, p < 0.01) were improved using subtraction CCTA in comparison with conventional CCTA, with no loss in the negative predictive value. The segment-based diagnostic accuracy for detecting significant stenosis was significantly better in subtraction CCTA than in conventional CCTA (area under the receiver operating characteristic curve, 0.94 vs. 0.85; p = 0.03). Conclusion This modified subtraction CCTA method showed lower misregistration and better image quality in patients with limited breathhold capability. In comparison with conventional CCTA, modified subtraction CCTA would allow stenosis regrading and improve the diagnostic accuracy in coronary segments with severe calcification.

show abstract

Subtraction CT angiography improves evaluation of significant coronary artery disease in patients with severe calcifications or stents—the C-Sub 320 multicenter trial

et al. 2018

View full text Add to dashboard Cite

show abstract

Diagnostic accuracy of a modified subtraction coronary CT angiography method with short breath-holding time: a feasibility study

Abstract: Modified subtraction CCTA can improve the diagnostic accuracy in patients with a high calcium score and patients who are unable to perform long breath-holds.

Cited by 10 publications

References 15 publications

Diagnostic Improvements of Deep Learning–Based Image Reconstruction for Assessing Calcification-Related Obstructive Coronary Artery Disease

Diagnostic Improvements of Deep Learning–Based Image Reconstruction for Assessing Calcification-Related Obstructive Coronary Artery Disease

Modified Subtraction Coronary CT Angiography with a Two-Breathhold Technique: Image Quality and Diagnostic Accuracy in Patients with Coronary Calcifications

Subtraction CT angiography improves evaluation of significant coronary artery disease in patients with severe calcifications or stents—the C-Sub 320 multicenter trial

Contact Info

Product

Resources

About