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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/21880

Title: Coronary Computed Tomography Angiography: Patient-related factors determining image quality using a second-generation 320-slice CT scanner
Authors: Ghekiere, Olivier
Nchimi, Alain
Djekic, Julien
El Hachemi, Mounia
Mancini, Isabelle
Hansen, Dominique
Vanhoenacker, Piet
de Roos, Albert
Dendale, Paul
Issue Date: 2016
Abstract: Purpose: To investigate the diagnostic confidence of Coronary Computed Tomography Angiography (CCTA) and the effect of patient-related factors on CCTA image quality using a second-generation 320-slice scanner. Methods and results: 200 consecutive patients (mean age 60 ± 12 years; 109 men) prospectively underwent CCTA. The mean body mass index (BMI) was 27.1 ± 4.9 kg/m2; the median heart rate (HR) was 60.0 (interquartile range (IQR), 53.9–66.1) beats per minute (bpm). The median segment's diameter was 2.8 (IQR, 2.2–3.4) mm. For each coronary segment ≥1.5 mm in diameter, two readers scored: diameter narrowing as b or ≥50%, overall diagnostic confidence and motion-related image quality, with interobserver agreement kappa-values of 0.89, 0.91 and 0.61 respectively. Seventy-nine of the 2505 evaluated segments (3.2%) had non-diagnostic image quality because of coronary calcifications (66/79; 83.5%), stent- (6/79; 7.5%), pacemaker- (2/79; 2.5%) or motionrelated artifacts (5/79; 6.5%). The effect of patient-related factors on motion-related image quality was investigated by multinomial logistic regression in 181 patients with calcium score (IQR, 0–446.5). Increasing coronary diameter was the most improving image quality factor (odds ratio (OR), 1.8637; p b 0.001), marginally followed by lower HR (OR, 0.9547; p b 0.001) and calcium score (OR, 0.9997; p = 0.04). Gender (p = 0.70), age (p = 0.24) and BMI (p = 0.45) did not affect image quality. Conclusion: Using a second-generation 320-slice scanner, CCTA diagnostic confidence is predominantly affected by coronary calcifications, whereas motion-related image quality is non-diagnostic only in exceptional cases and mainly influenced by the coronary diameter. For future developments, our study findings therefore suggest greater requirements concerning spatial resolution and calcium-related artifact removal than concerning temporal resolution, especially to improve diagnostic confidence in patient groups with smaller coronary diameters.
Notes: Ghekiere, O (reprint author), CHC, Dept Radiol, Rue Hesbaye 75, B-4000 Liege, Belgium. olivierghekiere@gmail.com
URI: http://hdl.handle.net/1942/21880
DOI: 10.1016/j.ijcard.2016.07.141
ISI #: 000384692600183
ISSN: 0167-5273
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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