Temporal averaging for analysis of four-dimensional whole-heart computed tomography perfusion of the myocardium: proof-of-concept study

Feger, Sarah; Shaban, Ahmed; Lukas, Steffen; Kendziorra, Carsten; Rief, Matthias; Zimmermann, Elke; Dewey, Marc

doi:10.1007/s10554-016-1011-0

Cited by 9 publications

(12 citation statements)

References 43 publications

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“…For myocardial CT perfusion imaging, static imaging either with or without a vasodilator stressor (such as adenosine) is used, whereas dynamic (4D) imaging allows the quantification of MBF but requires multiple scans over time. Dynamic CT perfusion imaging might provide the greatest clinical value but challenges with this modality include increased radiation dose, motion artefacts and image quality limitations 140 . A meta-analysis showed higher sensitivity (0.85 versus 0.72) but lower specificity (0.81 versus 0.90) for dynamic compared with static CT perfusion imaging 141 .…”

Section: Key Points For Echocardiographymentioning

confidence: 99%

Clinical quantitative cardiac imaging for the assessment of myocardial ischaemia

et al. 2020

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International guidelines advocate noninvasive testing for patients with suspected ischaemia before proceeding with revascularization decision-making 1-4. Noninvasive clinical cardiac imaging continues to undergo rapid evolution, focusing on quantitative perfusion technologies for the assessment of myocardial ischaemia and coronary flow. At present, imaging of myocardial ischaemia stands at a crossroads. During a European meeting on quantitative cardiac imaging, a bench-to-bedside-to-bench perspective was used to summarize the current status and future potential of myocardial ischaemia imaging from the viewpoint of basic scientists and clinical researchers. This approach created discussions, which led to this Consensus Statement on the main advantages and disadvantages of each imaging modality, a clinical consensus on the appropriateness for specific indications and a summary of the latest developments, which together provide a framework for future quantitative imaging of myocardial ischaemia. Pathophysiology considerations The coronary circulation comprises the epicardial conductance vessels (diameter 1-6 mm) feeding an extensive network of small vessels (diameter <300-400 μm) that penetrates the cardiac muscle tissue and is the site of regulation of myocardial blood flow (MBF; Fig. 1a,b). High-resolution 3D fluorescence cryomicrotome imaging 5 has also revealed the existence of abundant small

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Section: Key Points For Echocardiographymentioning

confidence: 99%

Clinical quantitative cardiac imaging for the assessment of myocardial ischaemia

et al. 2020

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“…A study conducted in 32 Asian patients [ 17 ] shows a good correlation of the myocardial blood flow and the coronary flow reserve determined by 4D CTP compared with the findings of positron emission tomography. We investigated additional objective (noise, SNR and CNR) and subjective image quality parameters [ 18 ], which have already been published in the main manuscript of our study. For 4D dynamic CTP, we chose a protocol aimed at acquiring 20 heart beats, which was not always possible in patients with low or high heart rate.…”

Section: Discussionmentioning

confidence: 99%

“…This is the contour sharpness sub-study of the prospective 4D CT perfusion pilot study [ 18 ]. A detailed description of in- and exclusion criteria, patient preparation and CT protocol has already been published with the main study.…”

Section: Methodsmentioning

confidence: 99%

“…Temporal averaging of multiple datasets and iterative reconstruction techniques as means of noise reduction reduce beam hardening artefacts but may lead to poorer image sharpness from blurred edges. Two feasibility studies of temporal averaging have been published so far [ 17 , 18 ] and this is one of the largest whole-heart CT myocardial perfusion dataset studies to date.…”

Section: Introductionmentioning

confidence: 99%

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Effect of iterative reconstruction and temporal averaging on contour sharpness in dynamic myocardial CT perfusion: Sub-analysis of the prospective 4D CT perfusion pilot study

et al. 2018

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PurposeMyocardial computed tomography perfusion (CTP) allows the assessment of the functional relevance of coronary artery stenosis. This study investigates to what extent the contour sharpness of sequences acquired by dynamic myocardial CTP is influenced by the following noise reduction methods: temporal averaging and adaptive iterative dose reduction 3D (AIDR 3D).Materials and methodsDynamic myocardial CT perfusion was conducted in 29 patients at a dose level of 9.5±2.0 mSv and was reconstructed with both filtered back projection (FBP) and strong levels of AIDR 3D. Temporal averaging to reduce noise was performed as a post-processing step by combining two, three, four, six and eight original consecutive 3D datasets. We evaluated the contour sharpness at four distinct edges of the left-ventricular myocardium based on two different approaches: the distance between 25% and 75% of the maximal grey value (d) and the slope in the contour (m).ResultsIterative reconstruction reduced contour sharpness: both measures of contour sharpness performed better for FBP than for AIDR 3D (d = 1.7±0.4 mm versus 2.0±0.5 mm, p>0.059 at all edges; m = 255.9±123.9 HU/mm versus 160.6±123.5 HU/mm; p<0.023 for all edges). Increasing levels of temporal averaging degraded contour sharpness. When FBP reconstruction was applied, contour sharpness was best without temporal averaging (d = 1.7±0.4 mm, m = 255.9±123.9 HU/mm) and poorest for the strongest levels of temporal averaging (d = 2.1±0.3 mm, m = 142.2±104.9 HU/mm; comparison between lowest and highest temporal averaging level: for d p>0.052 at all edges and for m p<0.001 at all edges).ConclusionThe use of both temporal averaging and iterative reconstruction degrades objective contour sharpness parameters of dynamic myocardial CTP. Thus, further advances in image processing are needed to optimise contour sharpness of 4D myocardial CTP.

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“…Feger et al evaluated the feasibility of four-dimensional (4D) whole-heart computed tomography perfusion (CTP) of the myocardium and the added value of temporal averaging of consecutive 3D datasets from different heartbeats for analysis [84]. Out of 30 patients with suspected or known CAD who underwent 320-row coronary CT angiography (CTA) and myocardial CTP, 15 patients underwent magnetic resonance myocardial perfusion imaging (MR MPI).…”

Section: Computed Tomographymentioning

confidence: 99%

Cardiovascular imaging 2017 in the International Journal of Cardiovascular Imaging

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et al. 2018

Int J Cardiovasc Imaging

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Temporal averaging for analysis of four-dimensional whole-heart computed tomography perfusion of the myocardium: proof-of-concept study

Cited by 9 publications

References 43 publications

Clinical quantitative cardiac imaging for the assessment of myocardial ischaemia

Clinical quantitative cardiac imaging for the assessment of myocardial ischaemia

Effect of iterative reconstruction and temporal averaging on contour sharpness in dynamic myocardial CT perfusion: Sub-analysis of the prospective 4D CT perfusion pilot study

Cardiovascular imaging 2017 in the International Journal of Cardiovascular Imaging

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