High Calcium Scores in Coronary CT Angiography: Effects of Image Post-Processing on Visualization and Measurement of Coronary Lumen Diameter

International Journal of Cardiology

Fan

2016

Self Cite

Section: Introductionmentioning

confidence: 99%

Coronary CT angiography in calcified coronary plaques: Comparison of diagnostic accuracy between bifurcation angle measurement and coronary lumen assessment for diagnosing significant coronary stenosis

International Journal of Cardiology

Fan

2016

Self Cite

“…[11][12][13][14][15] This limitation has been addressed to some extent with use of image processing methods as reported in some studies. [16][17][18] Another approach to improve diagnostic value of CCTA in the diagnosis of calcified plaques is to use left coronary bifurcation angle as opposed to the conventional method of measuring coronary lumen stenosis. Recent studies have shown that diagnostic accuracy of CCTA has been significantly augmented with use of bifurcation angle as a criterion to determine coronary stenosis when compared to assessment of the degree of lumen stenosis.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Coronary CT Angiography With Use of Left Coronary Bifurcation Angle in Coronary Artery Disease

Lee²

2016

Heart Res Open J

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Background: Atherosclerosis generally occurs in the blood vessels with angulation or curvature, however, association between coronary bifurcation angle and coronary artery disease needs to be further clarified when compared to normal patients. Objectives: The aim of this study is to determine the relationship between left coronary bifurcation angle and development of coronary artery disease when compared to patients with normal coronary arteries. Methods: Fifty patients (40 men, mean age, 55.2 years) who underwent coronary computed tomography (CT) angiography for clinical diagnosis of coronary artery disease were included in the study. Of these patients, coronary plaques were present at one or more coronary arteries in 25 patients, while in the remaining 25 cases, no plaque was detected at the coronary arteries, thus serving as the control group. Left coronary bifurcation angle between left anterior descending and left circumflex was measured on 3D volume rendering images by two assessors with >80º as the cut-off value to determine significant stenosis. Results: The mean bifurcation angle was 72.9º±19.4º (range, 36º, 112º) among 50 patients. The mean bifurcation angle was significantly wider in patients with coronary plaques than that measured in patients with normal coronary artery (p<0.001), with corresponding values being 83.9º±17.5º (range, 45º,112º) and 62.5º±15.4º (range, 36º, 89º). Of 25 patients with coronary plaques, 18 (72%) had a bifurcation angle >80º, while only 12% of the patients had a bifurcation angle >80º in the control group. Conclusion: This study further confirms the direct relationship between left coronary bifurcation angle and development of coronary artery disease with diseased coronary arteries associated with wider angulation.

“… 6 This limitation has been addressed by 2 approaches: use of iterative reconstruction (IR) techniques in the CT raw data for reduction of image noise while improving assessment of calcification in the coronary arteries; and application of image postprocessing algorithms for suppression of the effect of heavy calcification on the coronary lumen visualization. 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

“…We have recently reported our experience of using different image postprocessing algorithms in the assessment of CCTA images with high calcium scores, and showed the improved visualization of coronary artery lumen with use of image postprocessing “sharpen” algorithm. 8 Due to limited information on the effects of image processing methods on the calcified coronary plaques, 8 , 20 the purpose of this study is to apply the appropriate image postprocessing reconstruction derived from our preliminary findings to a group of patients with heavily calcified coronary plaques. We hypothesized that diagnostic value of CCTA, in particular, the specificity and positive predictive value (PPV) might be improved in the evaluation of heavily calcified plaques with use of the appropriate image processing method.…”

Section: Introductionmentioning

confidence: 99%

Coronary CT Angiography in Heavily Calcified Coronary Arteries

et al. 2015

Medicine

Self Cite

To compare the diagnostic value of coronary CT angiography (CCTA) with use of 2 image postprocessing methods (CCTA_S) and (CCTA_OS) and original data (CCTA_O) for the assessment of heavily calcified plaques.Fifty patients (41 men, 9 women; mean age 61.9 years ± 9.1) with suspected coronary artery disease who underwent CCTA and invasive coronary angiography (ICA) examinations were included in the study. Image data were postprocessed with “sharpen” and smooth reconstruction algorithms in comparison with the original data without undergoing any image postprocessing to determine the effects on suppressing blooming artifacts due to heavy calcification in the coronary arteries. Minimal lumen diameter and degree of stenosis were measured and compared between CCTA_S, CCTA_OS, and CCTA_O with ICA as the reference method. The area under the curve (AUC) by receiver-operating characteristic curve analysis (ROC) was also compared among these 3 CCTA techniques.On a per-vessel assessment, the sensitivity, specificity, positive predictive value and negative predictive value, and 95% confidence interval (CI) were 100% (95% CI: 89%, 100%), 33% (95% CI: 22%, 45%), 41% (95% CI: 30%, 53%), 100% (95% CI: 85%, 100%) for CCTA_O, 94% (95% CI: 79%, 99%), 66% (95% CI: 54%, 77%), 57% (95% CI: 43%, 70%), and 95% (95% CI: 85%, 99%) for CCTA_S, 94% (95% CI: 79%, 99%), 44% (95% CI: 32%, 57%), 44% (95% CI: 32%, 57%), and 97% (95% CI: 79%, 99%) for CCTA_OS, respectively. The AUC by ROC curve analysis for CCTA_S showed significant improvement for detection of >50% coronary stenosis in left anterior descending coronary artery compared to that of CCTA_OS and CCTA_O methods (P < 0.05), with no significance differences for detection of coronary stenosis in the left circumflex and right coronary arteries (P > 0.05).CCTA with “sharpen” reconstruction reduces blooming artifacts from heavy calcification, thus, leading to significant improvement of specificity and positive predictive value of CCTA in patients with heavily calcified plaques. However, specificity is still moderate and additional functional imaging may be needed.