New transluminal attenuation gradient derived from dynamic coronary CT angiography: diagnostic ability of ischemia detected by 13N-ammonia PET

Kojima, Tohru; Nagao, Michinobu; Yabuuchi, Hidetake; Yamasaki, Yoshio; Shirasaka, Takashi; Kawakubo, Masateru; Fukui, Kenji; Kato, Tomoko S.; Yamamoto, Atsushi; Nakao, Risako; Sakai, Akiko; Watanabe, Eri; Sakai, Shuji

doi:10.1007/s00380-020-01712-y

Cited by 5 publications

(10 citation statements)

References 37 publications

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“…The fully automatic method generally refers to the process of extracting the centerline without any human intervention, and the algorithm automatically extracts the centerline of the coronary artery based on the input data information; the more classical methods include the method proposed by Freiman to further extract the centerline based on the extraction of the coronary vascular tree by fitting the cylindrical model; the semi-automatic method refers to the process of vessel extraction [ 15 ]. The semi-automatic method refers to the method in which one or several seed points need to be artificially specified as reference points for centerline extraction, and the algorithm extracts the centerline in the image data based on the artificially provided reference points, such as the method proposed by Kojima et al to extract the centerline of coronary arteries after segmenting the aorta and coronary arteries and performing 3D reconstruction by using the local gray values of the vessels and the orientation of the vessels to select the starting point of the iteration [ 16 ]. The various automatic or semi-automatic methods for extracting the centerline can be classified into the following six types according to the extraction ideas they use: topology refinement-based methods, distance transformation-based methods, tracing-based methods, fast marching algorithm-based methods, deep learning-based methods, and other methods [ 17 ].…”

Section: Current Status Of Researchmentioning

confidence: 99%

Detection of 3D Arterial Centerline Extraction in Spiral CT Coronary Angiography

Cai

Wang

et al. 2021

Journal of Healthcare Engineering

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This paper presents an in-depth study and analysis of the 3D arterial centerline in spiral CT coronary angiography, and constructs its detection and extraction technique. The first time, the distance transform is used to complete the boundary search of the original figure; the second time, the distance transform is used to calculate the value of the distance transform of all voxels, and according to the value of the distance transform, unnecessary voxels are deleted, to complete the initial contraction of the vascular region and reduce the computational consumption in the next process; then, the nonwitnessed voxels are used to construct the maximum inner joint sphere model and find the skeletal voxels that can reflect the shape of the original figure. Finally, the skeletal lines were optimized on these initially extracted skeletal voxels using a dichotomous-like principle to obtain the final coronary artery centerline. Through the evaluation of the experimental results, the algorithm can extract the coronary centerline more accurately. In this paper, the segmentation method is evaluated on the test set data by two kinds of indexes: one is the index of segmentation result evaluation, including dice coefficient, accuracy, specificity, and sensitivity; the other is the index of clinical diagnosis result evaluation, which is to refine the segmentation result for vessel diameter detection. The results obtained in this paper were compared with the physicians’ labeling results. In terms of network performance, the Dice coefficient obtained in this paper was 0.89, the accuracy was 98.36%, the sensitivity was 93.36%, and the specificity was 98.76%, which reflected certain advantages in comparison with the advanced methods proposed by previous authors. In terms of clinical evaluation indexes, by performing skeleton line extraction and diameter calculation on the results obtained by the segmentation method proposed in this paper, the absolute error obtained after comparing with the diameter of the labeled image was 0.382 and the relative error was 0.112, which indicates that the segmentation method in this paper can recover the vessel contour more accurately. Then, the results of coronary artery centerline extraction with and without fine branch elimination were evaluated, which proved that the coronary artery centerline has higher accuracy after fine branch elimination. The algorithm is also used to extract the centerline of the complete coronary artery tree, and the results prove that the algorithm has better results for the centerline extraction of the complete coronary vascular tree.

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Section: Current Status Of Researchmentioning

confidence: 99%

Detection of 3D Arterial Centerline Extraction in Spiral CT Coronary Angiography

Cai

Wang

et al. 2021

Journal of Healthcare Engineering

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“…This DLP was higher than that for the current method (mean DLP: 434 mGy × cm). Recently, Kojima et al reported a DLP of approximately 330 mGy × cm, estimated based on the standard chest k‐factor of 0.026 mSv ×mGy −1 cm −1 in a similar protocol 14 …”

Section: Discussionmentioning

confidence: 99%

“…This dynamic scan protocol was developed based on previous studies 14,15 . Intravenous or oral metoprolol (20 mg) was administered to patients with a heart rate of ≥65 beats/min.…”

Section: Methodsmentioning

confidence: 99%

“…Functional coronary stenosis, rather than anatomic coronary stenosis, is key in determining whether to perform coronary interventions such as revascularization therapy 13 . Recently, Kojima et al proposed a new method for quantifying resting coronary flow estimated by 320‐row dynamic CCTA combined with a low radiation dose and boost scan 14,15 …”

Section: Introductionmentioning

confidence: 99%

“… 13 Recently, Kojima et al proposed a new method for quantifying resting coronary flow estimated by 320‐row dynamic CCTA combined with a low radiation dose and boost scan. 14 , 15 While this may be a new noninvasive method for detecting functional coronary stenosis, it risks increasing radiation exposure. Therefore, we aim to verify and compare the dose of radiation exposure for 320‐row dynamic CCTA with that for standard CCTA and the latest CCTA diagnostic reference levels (DRLs) for Japan and Western countries.…”

Section: Introductionmentioning

confidence: 99%

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Radiation dose for 320‐row dose‐modulated dynamic coronary CT angiography

Izoe

Nagao

Tokai

et al. 2021

J Applied Clin Med Phys

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Objectives The area detector 320‐row CT scanner, which can cover the whole heart in one rotation, can aid in reducing radiation exposure during electrocardiography (ECG)‐gated coronary CT angiography (CCTA). Recently, researchers have proposed dose‐modulated dynamic CCTA with a 320‐row scanner for the detection of functional myocardial ischemia. In the present study, we compared and validated the radiation dose of this method with that of the standard CCTA method and the latest diagnostic reference levels (DRLs). Materials and Methods The study included a total of 164 consecutive patients with suspected or known coronary artery disease (CAD) who underwent CCTA with a 320‐row scanner. The patients were randomly divided into dynamic and standard CCTA groups, and the CT dose index (CTDIvol) and dose length product (DLP) calculated by the CT system were compared between the two protocols and with the latest DRL. Results Standard and dynamic CCTA scans were performed in 77 and 87 patients, respectively. CTDIvol was significantly higher for standard CCTA than for dynamic CCTA (41 ± 35 mGy vs. 22 ± 7 mGy, p = 0.0014). DLP was also significantly higher for standard CCTA than for dynamic CCTA (864 ± 702 mGy × cm vs. 434 ± 106 mGy × cm, p < .0001). For standard scans, CTDIvol and DLP exceeded the 2020 DRL in Japan in 16% (12/77) and 17% (13/77) of cases, respectively. In contrast, rates for the dynamic scan were only 1% (1/87) for CTDIvol and 0% (0/87) for DLP. Conclusion The dose of radiation exposure during dynamic CCTA with a 320‐row scanner does not exceed that of standard CCTA and is sufficient to meet the latest DRL. Thus, our results suggest that the method is safe from the perspective of radiation exposure.

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Software-based analysis for computed tomography coronary angiography: current status and future aspects

Fukui¹,

Nagao²

2023

Cardiovascular and Coronary Artery Imaging

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New transluminal attenuation gradient derived from dynamic coronary CT angiography: diagnostic ability of ischemia detected by 13N-ammonia PET

Cited by 5 publications

References 37 publications

Detection of 3D Arterial Centerline Extraction in Spiral CT Coronary Angiography

Detection of 3D Arterial Centerline Extraction in Spiral CT Coronary Angiography

Radiation dose for 320‐row dose‐modulated dynamic coronary CT angiography

Software-based analysis for computed tomography coronary angiography: current status and future aspects

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