Assessment of Image Quality for Selective Intracoronary Contrast-Injected CT Angiography in a Hybrid Angio-CT System: A Feasibility Study in Swine
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: To compare image quality in selective intracoronary contrast-injected computed tomography angiography (SelectiveCTA) with that in conventional intravenous contrast-injected CTA (IV-CTA). Materials and Methods: Six pigs (35 to 40 kg) underwent both IV-CTA using an intravenous injection (60 mL) and Selective-CTA using an intracoronary injection (20 mL) through a guide-wire during/after percutaneous coronary intervention. Images of the common coronary artery were acquired. Scans were performed using a combined machine comprising an invasive coronary angiography suite and a 320-channel multi-slice CT scanner. Quantitative image quality parameters of CT attenuation, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), mean lumen diameter (MLD), and mean lumen area (MLA) were measured and compared. Qualitative analysis was performed using intraclass correlation coefficient (ICC), which was calculated for analysis of interobserver agreement. Results: Quantitative image quality, determined by assessing the uniformity of CT attenuation (399.06 vs. 330.21, p<0.001), image noise (24.93 vs. 18.43, p<0.001), SNR (16.43 vs. 18.52, p=0.005), and CNR (11.56 vs. 13.46, p=0.002), differed significantly between IV-CTA and Selective-CTA. MLD and MLA showed no significant difference overall (2.38 vs. 2.44, p=0.068, 4.72 vs. 4.95, p=0.078). The density of contrast agent was significantly lower for selective-CTA (13.13 mg/mL) than for IV-CTA (400 mg/mL). Agreement between observers was acceptable (ICC=0.79±0.08). Conclusion: Our feasibility study in swine showed that compared to IV-CTA, Selective-CTA provides better image quality and requires less iodine contrast medium
Abstract
Purpose: To compare image quality in selective intracoronary contrast-injected computed tomography angiography (SelectiveCTA) with that in conventional intravenous contrast-injected CTA (IV-CTA). Materials and Methods: Six pigs (35 to 40 kg) underwent both IV-CTA using an intravenous injection (60 mL) and Selective-CTA using an intracoronary injection (20 mL) through a guide-wire during/after percutaneous coronary intervention. Images of the common coronary artery were acquired. Scans were performed using a combined machine comprising an invasive coronary angiography suite and a 320-channel multi-slice CT scanner. Quantitative image quality parameters of CT attenuation, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), mean lumen diameter (MLD), and mean lumen area (MLA) were measured and compared. Qualitative analysis was performed using intraclass correlation coefficient (ICC), which was calculated for analysis of interobserver agreement. Results: Quantitative image quality, determined by assessing the uniformity of CT attenuation (399.06 vs. 330.21, p<0.001), image noise (24.93 vs. 18.43, p<0.001), SNR (16.43 vs. 18.52, p=0.005), and CNR (11.56 vs. 13.46, p=0.002), differed significantly between IV-CTA and Selective-CTA. MLD and MLA showed no significant difference overall (2.38 vs. 2.44, p=0.068, 4.72 vs. 4.95, p=0.078). The density of contrast agent was significantly lower for selective-CTA (13.13 mg/mL) than for IV-CTA (400 mg/mL). Agreement between observers was acceptable (ICC=0.79±0.08). Conclusion: Our feasibility study in swine showed that compared to IV-CTA, Selective-CTA provides better image quality and requires less iodine contrast medium
참고문헌 (35)
- Jang IK, "Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography : comparison with intravascular ultrasound", J Am Coll Cardiol, 39, pp.604~609 (2002)
- Voros S, "Coronary atherosclerosis imaging by coronary CT angiography : current status, correlation with intravascular interrogation and meta-analysis", JACC Cardiovasc Imaging, 4, pp.537~548 (2011)
- Nissen SE, "Intravascular ultrasound assessment of lumen size and wall morphology in normal subjects and patients with coronary artery disease", Circulation, 84, pp.1087~1099 (1991)
- Bezerra HG, "Intracoronary optical coherence tomography : a comprehensive review : clinical and research applications", JACC Cardiovasc Interv, 2, pp.1035~1046 (2009)
- Hong SJ, "Effect of intravascular ultrasound-guided vs angiography-guided everolimus-eluting stent implantation : the IVUS-XPL randomized clinical trial", JAMA, 314, pp.2155~2163 (2015)
- Feynman RP, "The theory of a general quantum system interacting with a linear dissipative system", Annals of Physics, 281, pp.547~607 (2000)
- Alfonso F, "Acute coronary closure complicating intravascular ul-trasound examination", Eur Heart J, 15, pp.710~712 (1994)
- Hausmann D, "The safety of intracoronary ultrasound. A multicenter survey of 2207 examinations", Circulation, 91, pp.623~630 (1995)
- Sgura FA, "New methods of coronary imaging II. Intracoronary ultrasonography in clinical practice", Ital Heart J Suppl, 2, pp.579~592 (2001)
- Mueller C, "Cost-effectiveness of intracoronary ultrasound for percutaneous coronary interventions", Am J Cardiol, 91, pp.143~147 (2003)
- Motoyama S, "Multislice computed tomographic characteristics of coronary lesions in acute coronary syndromes", J Am Coll Cardiol, 50, pp.319~326 (2007)
- Motoyama S, "Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome", J Am Coll Cardiol, 54, pp.49~57 (2009)
- Maurovich-Horvat P, "The napkin-ring sign indicates advanced atherosclerotic lesions in coronary CT angiography", JACC Cardiovasc Imaging, 5, pp.1243~1252 (2012)
- Otsuka K, "Napkin-ring sign on coronary CT angiography for the prediction of acute coronary syndrome", JACC Cardiovasc Imaging, 6, pp.448~457 (2013)
- van der Giessen AG, "Reproducibility, accuracy, and predictors of accuracy for the detection of coronary atherosclerotic plaque composition by computed tomography : an ex vivo comparison to intravascular ultrasound", Invest Radiol, 45, pp.693~701 (2010)
- Ko BS, "Computed tomography stress myocardial perfusion imaging in patients considered for revascularization : a comparison with fractional flow reserve", Eur Heart J, 33, pp.67~77 (2012)
- George RT, "Computed tomography myocardial perfusion imaging with 320-row detector computed tomography accurately detects myocardial ischemia in patients with obstructive coronary artery disease", Circ Cardiovasc Imaging, 5, pp.333~340 (2012)
- Cury RC, "A randomized, multicenter, multivendor study of myocardial perfusion imaging with regadenoson CT perfusion vs single photon emission CT", J Cardiovasc Comput Tomogr, 9, pp.103~112 (2015)
- Koo BK, "Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms : results from the prospective multicenter DISCOVER-FLOW(Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve)study", J Am Coll Cardiol, 58, pp.1989~1997 (2011)
- Min JK, "Diagnostic accuracy of fractional flow reserve from anatomic CT angiography", JAMA, 308, pp.1237~1245 (2012)
- Taylor CA, "Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve : scientific basis", J Am Coll Cardiol, 61, pp.2233~2241 (2013)
- Min JK, "Noninvasive fractional flow reserve derived from coronary CT angiography : clinical data and scientific principles", JACC Cardiovasc Imaging, 8, pp.1209~1222 (2015)
- Eshtehardi P, "Association of coronary wall shear stress with atherosclerotic plaque burden, composition, and distribution in patients with coronary artery disease", J Am Heart Assoc, 1, pp.e002543~ (2012)
- Hong Y, "Feasibility of selective catheter-directed coronary computed tomography angiography using ultralow-dose intracoronary contrast injection in a swine model", Invest radiol, 50, pp.449~455 (2015)
- Raff GL, "SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography", J Cardiovasc Comput Tomogr, 3, pp.122~136 (2009)
- Pflederer T, "Image quality in a low radiation exposure protocol for retrospectively ECG-gated coronary CT angiography", AJR Am J Roentgenol, 192, pp.1045~1050 (2009)
- Choi JH, "Intracoronary transluminal attenuation gradient in coronary CT angiography for determining coronary artery stenosis", JACC Cardiovasc Imaging, 4, pp.1149~1157 (2011)
- Johnson KR, "Three-dimensional, time-resolved motion of the coronary arteries", J Cardiovasc Magn Reson, 6, pp.663~673 (2004)
- Shetty AN, "Contrast volume reduction with superior vena cava catheter-directed coronary CT angiography : comparison with peripheral iv contrast enhancement in a swine model", AJR Am J Roentgenol, 190, pp.W247~54 (2008)
- Kumar A, "Aortic root catheter-directed coronary CT angiography in swine : coronary enhancement with minimum volume of iodinated contrast material", AJR Am J Roentgenol, 188, pp.W415~22 (2007)
- Stone GW, "A prospective natural-history study of coronary atherosclerosis", N Engl J Med, 364, pp.226~235 (2011)
- Park HB, "Atherosclerotic plaque characteristics by CT angiography identify coronary lesions that cause ischemia : a direct comparison to fractional flow reserve", JACC Cardiovasc Imaging, 8, pp.1~10 (2015)
- Park HB, "Clinical feasibility of 3D automated coronary atherosclerotic plaque quantification algorithm on coronary computed tomography angiography : comparison with intravascular ultrasound", Eur Radiol, 25, pp.3073~3083 (2015)
- Deseive S, "Image quality and radiation dose of a prospectively electrocardiography-triggered high-pitch data acquisition strategy for coronary CT angiography : the multicenter, randomized PROTECTION IV study", J Cardiovasc Comput Tomogr, 9, pp.278~285 (2015)
- Taylor AJ, "ACCF", SCCT, AHA, pp.ASE, ASNC[DOI]