Impact of advanced modeled iterative reconstruction on interreader agreement in coronary artery measurements |
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| Institution: | 1. Department of Burns, Plastic & Maxillofacial Surgery, VM Medical College & Safdarjung Hospital, Delhi, India;2. Department of Pathology, VM Medical College & Safdarjung Hospital, Delhi, India;1. Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Loma Linda University School of Medicine, 11234 Anderson Street, Room 2586A, Loma Linda, CA 92354, USA;2. Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA;1. Associate Professor, Dept of Surgery, Armed Forces Medical College, Pune 411040, India;2. Senior Advisor (Surgery & Reconstructive Surgery), Command Hospital (Air Force), Bengaluru, India;3. DMS (E&S), Air HQ, RK Puram (Med Directorate), New Delhi, India;1. Department of Plastic Surgery, The Ohio State University, 915 Olentangy River Road, Suite 2100, Columbus, OH 43212, USA;2. Private Practice, Columbus Institute of Plastic Surgery, 6499 East Broad Street, Suite 130, Columbus, OH 43213, USA |
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| Abstract: | ObjectivesTo evaluate the influence of advanced modeled iterative reconstruction (ADMIRE) on coronary artery computed tomography angiography (cCTA) measurements in comparison to filtered back projection (FBP).Material and methodsPhantom scans and coronary CTA studies of 27 patients were acquired with a third generation dual-source CT scanner. Images were reconstructed using FBP and ADMIRE. Phantom measurements were used as reference standard. In patient studies, representative axial slices of each coronary artery segment without (n = 308) and with coronary plaques (n = 40) were assessed in identical positions for comparison of FBP and ADMIRE reconstructions. Image analyses included quality assessment, phantom and coronary artery measurements, plaque analysis, and interreader agreement of two independent and blinded readers.ResultsMean image noise was lower on ADMIRE reconstructions with 31.3 ± 9.9 HU compared to 55.9 ± 15.7 HU on FBP reconstructions (p < 0.001). Measurement precision and interreader agreement of both observers were assessed satisfactorily on phantom images in comparison to the full width half maximum method. In patients, correlation of lumen diameters of both observers improved using ADMIRE with a Pearson’s r = 0.987 (95% confidence interval CI], 0.983–0.989; p < 0.001) compared to FBP images with r = 0.939 (95% CI, 0.924–0.951; p < 0.001). Applying ADMIRE, agreement of both observers for lumen diameter measurements significantly increased (p < 0.001). This was also observed for the degree of stenosis (p < 0.001) with r = 0.560 using FBP (95% CI, 0.301–0.742) and with r = 0.818 using ADMIRE (95% CI, 0.680–0.900). Plaque density measurements correlated closely with a Pearson’s r of 0.951 in FBP (95% CI, 0.909–0.974) and 0.967 in ADMIRE (95% CI, 0.939–0.983).ConclusionsAdvanced modeled iterative reconstruction significantly improves coronary artery assessment in coronary CTA in comparison to FBP by improved image quality due to image noise removal. This renders improved interobserver agreement for coronary lumen diameter and degree of stenosis measurements without influencing mean plaque attenuation. |
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| Keywords: | CT Coronary CT angiography Iterative reconstruction Coronary plaque |
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