Abstract
Background
Advances in image reconstruction are necessary to decrease radiation exposure from
coronary CT angiography (CCTA) further, but iterative reconstruction has been shown
to degrade image quality at high levels. Deep-learning image reconstruction (DLIR)
offers unique opportunities to overcome these limitations. The present study compared
the impact of DLIR and adaptive statistical iterative reconstruction-Veo (ASiR-V)
on quantitative and qualitative image parameters and the diagnostic accuracy of CCTA
using invasive coronary angiography (ICA) as the standard of reference.
Methods
This retrospective study includes 43 patients who underwent clinically indicated CCTA
and ICA. Datasets were reconstructed with ASiR-V 70% (using standard [SD] and high-definition
[HD] kernels) and with DLIR at different levels (i.e., medium [M] and high [H]). Image
noise, image quality, and coronary luminal narrowing were evaluated by three blinded
readers. Diagnostic accuracy was compared against ICA.
Results
Noise did not significantly differ between ASiR-V SD and DLIR-M (37 vs. 37 HU, p = 1.000),
but was significantly lower in DLIR-H (30 HU, p < 0.001) and higher in ASiR-V HD (53
HU, p < 0.001). Image quality was higher for DLIR-M and DLIR-H (3.4–3.8 and 4.2–4.6)
compared to ASiR-V SD and HD (2.1–2.7 and 1.8–2.2; p < 0.001), with DLIR-H yielding
the highest image quality. Consistently across readers, no significant differences
in sensitivity (88% vs. 92%; p = 0.453), specificity (73% vs. 73%; p = 0.583) and
diagnostic accuracy (80% vs. 82%; p = 0.366) were found between ASiR-V HD and DLIR-H.
Conclusion
DLIR significantly reduces noise in CCTA compared to ASiR-V, while yielding superior
image quality at equal diagnostic accuracy.
Keywords
Abbreviations:
CCTA (Coronary Computed Tomography Angiography), ASiR-V (Adaptive Statistical Iterative Reconstruction-Veo), ASiR-V SD (ASiR-V With Standard Definition Kernel), ASiR-V HD (ASiR-V With High Definition Kernel), DLIR (Deep-Learning Image Reconstruction), DLIR-M (DLIR at Medium Level), DLIR-H (DLIR at High Level), ICA (Invasive Coronary Angiography)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 13, 2020
Accepted:
January 8,
2020
Received in revised form:
October 29,
2019
Received:
August 23,
2019
Identification
Copyright
© 2020 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
