Abstract
BACKGROUND: Although coronary CT angiography (CTA) shows high diagnostic performance for detection and exclusion of obstructive coronary artery disease, limited temporal resolution of current-generation CT scanners may allow for motion artifacts, which may result in nonevaluable coronary segments.
OBJECTIVE: We assessed a novel vendor-specific motion-correction algorithm for its effect on image quality and diagnostic accuracy.
METHODS: Thirty-six consecutive patients with severe aortic stenosis undergoing coronary CTA without rate control and invasive coronary angiography as part of an evaluation for transcatheter aortic valve replacement. We compared image quality and diagnostic accuracy between standard (STD) and motion-corrected (MC) reconstructions. Coronary CTAs were interpreted in an intent-to-diagnose fashion by 2 experienced readers; a third reader provided consensus for interpretability and obstructive coronary stenosis (>= 50% stenosis). All studies were interpreted with and without motion correction using both 45% and 75% of the R-R interval for reconstructions. Quantitative coronary angiography was performed by a core laboratory.
RESULTS: Mean age was 83.0 +/- 6.4 years; 47% were men. Overall image quality (graded 1-4) was higher with the use of MC versus STD reconstructions (2.9 +/- 0.9 vs 2.4 +/- 1.0; P < 0.001). MC reconstructions showed higher interpretability on a per-segment [97% (392/406) vs 88% (357/406); P < 0.001] and per-artery [96% (128/134) vs 84% (112/134); P = 0.002] basis, with no difference on a per-patient level [92% (33/36) vs 89% (32/36); P = 1.0]. Diagnostic accuracy by MC reconstruction was higher than STD reconstruction on a per-segment [91% (370/406) vs 78% (317/406); P < 0.001] and per-artery level [86% (1151134) vs 72% (96/134); P = 0.007] basis, with no significant difference on a per-patient level [86% (31/36) vs 69% (25/36); P = 0.16].
CONCLUSIONS: The use of a novel MC algorithm improves image quality, interpretability, and diagnostic accuracy in persons undergoing coronary CTA without rate-control medications. (C) 2012 Published by Elsevier Inc. on behalf of Society of Cardiovascular Computed Tomography.