Facilitating coronary artery evaluation in MDCT using a 3D automatic vessel segmentation tool

Abstract

The purpose of this study was to investigate a 3D coronary artery segmentation algorithm using 16-row MDCT data sets. Fifty patients underwent cardiac CT (Sensation 16, Siemens) and coronary angiography. Automatic and manual detection of coronary artery stenosis was performed. A 3D coronary artery segmentation algorithm (Fraunhofer Institute for Computer Graphics, Darmstadt) was used for automatic evaluation. All significant stenoses (>50%) in vessels >1.5 mm in diameter were protocoled. Each detection tool was used by one reader who was blinded to the results of the other detection method and the results of coronary angiography. Sensitivity and specificity were determined for automatic and manual detection as well as was the time for both CT-based evaluation methods. The overall sensitivity and specificity of the automatic and manual approach were 93.1 vs. 95.83% and 86.1 vs. 81.9%. The time required for automatic evaluation was significantly shorter than with the manual approach, i.e., 246.04+/-43.17 s for the automatic approach and 526.88+/-45.71 s for the manual approach (P<0.0001). In 94% of the coronary artery branches, automatic detection required less time than the manual approach. Automatic coronary vessel evaluation is feasible. It reduces the time required for cardiac CT evaluation with similar sensitivity and specificity as well as facilitates the evaluation of MDCT coronary angiography in a standardized fashion.

Quantification of Coronary Arterial Stenoses by Multidetector CT Angiography in Comparison With Conventional Angiography

“…4). While these contour detection algorithms have not been adequately validated, initial data are encouraging, as similar accuracies for automated and manual assessments are being reported (19,20). Of note, semiautomatically generated lumen assessment by MDCT resulted in better positive predictive values for diagnosing CAD than visual assessment in comparison to (21,22).…”

Evaluation of right ventricular function with multidetector computed tomography: comparison with magnetic resonance imaging and analysis of inter- and intraobserver variability

“…MRI, as the currently accepted reference standard for volume measurements of the cardiac chambers, is in some cases contraindicated (e.g., pacemakers) and has a long duration as well as high costs. In recent studies it became clear that MDCT has a high negative predictive value concerning the presence of significant coronary artery stenoses [3][4][5][6][7][8][9][10] and has the potential to assess right ventricular function [11]. It would be a clinical advantage if the same coronary MDCT examination could be used to noninvasively measure global right ventricular function, since the right ventricle is important in a wide range of cardiac diseases [12][13][14][15].…”

Multislice computed tomography: angiographic emulation versus standard assessment for detection of coronary stenoses

“…As the software we used was easy to handle, it is conceivable that angiographic emulation can be performed by a technologist and only coronary artery assessment needs to be done by an experienced reader in a second step. Several software developments facilitating the assessment of the coronary arteries [8,13] and cardiac function [14,15] using MSCT have been developed in the past years. The present software appears to improve both the assessment of image data and the opportunities for presentation to referring physicians.…”