Image quality and artifacts in coronary CT angiography with dual-source CT: Initial clinical experience

Dey, Damini; Lee, Cynthia J.; Ohba, Muneo; Gutstein, Ariel; Slomka, Piotr J.; Cheng, Victor; Suzuki, Yasuyuki; Suzuki, Shoji; Wolak, Arik; Le Meunier, Ludovic; Thomson, Louise E.J.; Cohen, Ishac; Friedman, John D.; Germano, Guido; Berman, Daniel S.

doi:10.1016/j.jcct.2007.12.017

« Previous Next »Journal of Cardiovascular Computed Tomography
Volume 2, Issue 2 , Pages 105-114, March 2008

Image quality and artifacts in coronary CT angiography with dual-source CT: Initial clinical experience

Damini Dey, PhD
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
- David-Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
Cynthia J. Lee, DO
- Capitol Hearts Associates, P.C., Washington, D.C., USA
Muneo Ohba, MD
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
Ariel Gutstein, MD
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
Piotr J. Slomka, PhD, FCCPM
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
- David-Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
Victor Cheng, MD
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
Yasuyuki Suzuki, MD
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
Shoji Suzuki, MD
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
Arik Wolak, MD
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
Ludovic Le Meunier, PhD
- Siemens Medical Solutions (PET Division), Knoxville, TN, USA
Louise E.J. Thomson, MD, MBChB FRACP
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
- David-Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
Ishac Cohen, PhD
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
John D. Friedman, MD, FACC
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
- David-Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
Guido Germano, PhD, FACC
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
- David-Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
Daniel S. Berman, MD, FACC
- Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Taper Building, A1258, Los Angeles, CA 90048, USA
- David-Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
- Corresponding author.

Received 25 August 2007; accepted 21 December 2007. published online 16 January 2008.

Abstract

Introduction

We aimed to characterize artifacts observed in a routine clinical coronary CT angiography (CCTA) performed by a dual-source CT (DSCT) scanner (Definition; Siemens Medical Solutions).

Methods

Studies of 167 consecutive patients referred for CCTA, performed after β-blockade (if not contraindicated), were prospectively analyzed for artifacts with a predefined visual approach. American Heart Association coronary segments (n = 2589) were assessed in 40%–80% R-R interval phases by 2 experts for stenosis, plaque presence or composition, and presence or type of artifacts. Each segment was considered evaluable when image quality was diagnostic in at least one cardiac phase. Artifacts included motion (cardiac, respiratory, patient), phase misregistration because of varying heart beats, calcified plaque blooming or beam hardening, metal beam hardening, large patient size, and contrast timing error.

Results

Maximum HR (HR) during CCTA ranged from 45 to 120 beats/min (66.4 ± 14.8 beats/min). Artifacts of some type were observed in 69 (41.3%) of 167 studies. Calcified plaque was the most common source of artifacts (14.4%), followed by misregistration (13.8%). Only 25 (1%) of 2589 coronary segments, in 6 (4%) of 167 patients were unevaluable, primarily because of calcified plaque blooming (coronary calcium score [CCS], 1112 ± 1255]. Artifacts were associated with CCS (P = 0.002), change in HR (P = 0.01), age (P = 0.03), and body mass index (P = 0.048). The optimal phase for evaluation of all coronary arteries was 70% (mid-diastole), with a shift toward the systolic phases for HR > 70 beats/min.

Conclusion

CCTA artifacts with DSCT were related primarily to calcified plaque and cardiac phase misregistration. When correctly recognized, the artifacts did not have a serious effect on the final interpretation.

Keywords: Artifacts, Calcified plaque, Coronary CTA, computed tomography angiography, Dual-source CT

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Conflict of interest: Dr. Le Meunier is an employee of Siemens Medical Systems, PET Division. The other authors report no conflicts of interest.This study was supported by in part by grant 6318 from the Glazer Foundation, Los Angeles, CA, and in part by The Lincy Foundation, Los Angeles, CA.

PII: S1934-5925(08)00046-4

doi:10.1016/j.jcct.2007.12.017

« Previous Next »Journal of Cardiovascular Computed Tomography
Volume 2, Issue 2 , Pages 105-114, March 2008

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